Understanding the Causes and Health Consequences of Chronic Inflammation

by Dr. Susan Tanner, MD

Inflammation is a term we hear applied to almost every body part when function, performance, or overall wellbeing is impacted in a non-positive way. It has almost become a buzzword these days for the cause of all sickness and medical problems. We hear about inflammation-induced obesity, or inflammation causing autoimmune diseases such as rheumatoid arthritis, lupus, and diabetes. And, while it is true, inflammation is at the core of much of what ails us, it can be a difficult concept to navigate. Interestingly, inflammation used to be thought of as much more cut-and-dry in the medical world. For example, in medical school, we were taught the basic signs of inflammation–visible redness, swelling, heat and/or pain. Any or all of these symptoms were said to be signs of inflammation or indicators of possible infection. These were signs that shouldn’t be ignored and were what we always told patients to look for when evaluating an injury or ailment. You cannot always see inflammation externally, though. Internal inflammation creates body-system or organ-related symptoms that we don’t always associate with an immune system reaction. To understand that, we need to get a bit more granular and detailed.

External vs. Internal Inflammation

Things can get a bit more complicated when you begin considering external vs. internal inflammation. When the inflammation is external, such as joint or limb swelling, skin irritation, bloodshot eyes, swollen and clogged nasal passages, etc., the signs are obvious to the sufferer and to the doctor, but inflammation that is occurring internally and affecting organ systems is less obvious. This type of inflammation manifests with symptoms like headaches, gastrointestinal distress or bloating, brain fog, anxiety, or cardiac issues, like irregular heartbeat, just to name a few. Internal inflammation may also cause organ system pain, but the nature of the discomfort (more widespread and less pronounced) often makes it harder to recognize. Even less obvious is inflammation that affects the body at the cellular level, meaning the small blood vessels (or capillaries), and the nerves of the body. These areas may indeed have pain or even swelling, but can also impact or impair function to the point that other symptoms may become primary. This can lead to the cycle of treating the obvious symptoms while ignoring the underlying inflammation or cause of the symptoms, which then leads to ongoing inflammation and more symptoms. Furthermore, not all inflammation is bad, for example, inflammation induced by exercise. This type of inflammation puts a stress on the body to induce adaptation and change which is, on the whole positive, as long as it is mitigated by a well-functioning repair system of the body.

Confused? Don’t be. I am going to break it down more for you.

Causes of Inflammation

The symptoms come from a malfunction in the immune system and are actually a manifestation of the body trying to protect itself from the impact of the cause or trigger for the inflammation. The list of potential causes can be vast, but may be broken down into specific groups:

  1. Physical trauma;
  2. Infection(s);
  3. Genetic tendency toward immune dysfunction;
  4. Exposure to toxins or irritants;
  5. Chronic stress/abuse/Psychological trauma;
  6. Poor diet;
  7. Gastrointestinal malfunction causing malabsorption.

The Impact of Inflammation on the Body

Besides causing pain or malfunction in the various targeted organs or body parts, what else does inflammation do? The answer to that is “A LOT”. Inflammation is likely the cause of all disease in one way or another. To understand this concept, it is important to know what happens when inflammation occurs, regardless of cause or target.

When trauma occurs, a cascade of events happens. First, there is recognition by the cells that something has happened. There are signals that are sent to all parts of the immune system like a fire alarm. When the alarm is sounded, then the first responders come running. These first responders are substances that the body produces naturally to protect it from damage. An example of one of these substances is histamine, which on the good side of things, allows more mucous production, more lymph production, and more blood flow. All of these bodily fluids are intended to surround the damaged area and provide protection. That is all well and good in the short term but long term, well not so much.

Long-term or Chronic Inflammation

When inflammation stays in place for long periods of time, then reinforcements from the immune system enter in to continue the work the first responders can’t prolong or have failed to heal. These reinforcements are in the form of fairly complicated compounds called cytokines. There are quite a few cytokines that transition into other forms and compounds the longer they stay around and the more stimulation they receive from toxins, stress, emotional trauma, etc.   The effect is exponential, the more stressors you have, the more intense the immune response to produce these cytokines.

The end result of all of this is ultimately tissue damage from the over-exuberant repair mechanisms that are stimulated by the body. This is what results in arterial plaque causing heart disease, deformed joints in arthritis, progressive loss of many functions in the neurological system such as Alzheimer’s disease and Parkinson’s disease, and in cancer. Basically, any chronic disease can be linked to long-term inflammation.

Treating Inflammation

What about anti-inflammatories, why don’t they help? In some situations, anti-inflammatories DO help, at least in the short term. These are medications that reduce the production of certain cytokines, such as prostaglandins, that can cause joint pain among other things. But the problem is that certainly, not all types of inflammation respond to OTC and prescription anti-inflammatories. There are many other substances that the body produces that these medications do not address or help.

There is now a huge market for a group of medications called “biologics”. Biologics basically prevent the body from forming an immune response to inflammation and attacking itself. I am sure you have seen the ads for these on TV, targeted at certain types of arthritis, psoriasis, Crohn’s disease, and the like. Never am I against using something to help patients quickly and to get them out of pain or prevent irreversible damage. However, these drugs are not without risk, as the entire immune system is suppressed during their use. They are also very expensive with no signs of price reduction any time soon. Obviously, every patient’s case must be considered individually, but I think a combination of both traditional medicine and integrative approaches must be employed for best overall outcome. How do we do this?

An Integrative Approach

Starting with a detailed patient history, detecting where inflammation may be present is the first order of business. From here, doctor and patient can also work together to pinpoint where the inflammation may have arisen. Depending on this history, a planned schedule of testing and treatment can be derived.

I always come around to the “clean air, clean water, clean food model,” for the best way to approach inflammation, as each of these must be in place to have any long-term treatment success. If mold or chemicals are found to be in the air that a patient is routinely breathing, these must be removed. If a patient’s diet is lacking in nutrition or includes highly inflammatory foods or ingredients, it must be improved. If there is ongoing infection in the body, it must be treated appropriately (and finding this can be difficult!). Each patient is unique, so there is no blanket approach, but starting with the basics of air, water, and food usually gets us moving forward and pinpointing the major things that are causing the inflammation and standing in the way of wellness.

In our next article, we will address in greater detail some of the testing and procedures for digging deeper into the causes of inflammation and what we can do to address them.

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