What Everyone Should Know About Inflammation: A Cardiologist Explains
Regular readers of MindBodyGreen are aware that a process in our bodies called inflammation is involved in many aspects of human health and disease. For example, you may have read that a breakfast of Egg McMuffins, sleep apnea, obesity and ultra-exercise are inflammatory, while turmeric, meditation and the Mediterranean diet are anti-inflammatory, and so on. Lost in the search for vitality and longevity is an understanding of what inflammation is and what can be done to tame it. In many ways, inflammation is a Goldilocks process – you don't want too much or too little, but just the right amount.
When I explain inflammation to patients, I point out that the middle of the word is "flame," and that it comes from the Latin "I ignite." Inflammation is a complex process of cells and chemicals in our bodies standing ready to fight infections and other threats, and is a life saver when it's a controlled reaction to a threat. For example, you may experience inflammation when you're working on your deck and get a wood splinter. Maybe a mosquito lands on your back and enjoys some of your blood (hopefully full of fresh green juice!). Maybe you sprained your ankle when your perfect yoga hand stand came crashing down.
Over 2,000 years ago, the signs of acute inflammation were described as including pain, warmth, redness and swelling. This "first responder" wave of healing occurs because cells in the area are surveying their environment all the time with detectors on their surface that act much like radar watching for invaders. These detectors are called pattern recognition receptors (PRR). If a PRR detects something that has a "foreign" structure – a pathogen-associated molecular pattern, or PAMP – it will ring the fire alarm internally in the cell and surrounding blood vessels.
Chemicals begin to pour out that cause blood vessels to dilate (redness, warmth and swelling); others increase the sensitivity to pain, and the next thing you know, your ankle or finger is a hot, red, sore mess. These chemicals attract white blood cells that begin to clean up the area by engulfing foreign proteins. Enough white blood cells clumped together is called pus. After a period of increased blood flow, helping to dilute the irritant and bringing fighters to the scene, other factors that promote clotting are released and work to balance and decrease the blood flow. This is what happens when you scrape your knee and it weeps for a while but then scabs over.
Some of the star chemicals involved in this process deserve a shout-out. Histamine is waiting to be released when an injury occurs, and causes arteries to expand and leak fluid (think of an antihistamine pill drying up your nose). Interleukins, such as IL-8, come from macrophages ("big eaters" in Greek, ready to swallow substances sensed as foreign) and bring their best friends: white blood cells. The white cells arrive to fight for your recovery because chemical attractants – sort of a white blood cell perfume – are released. Tumor necrosis factor alpha (TNF-alpha) also is released from macrophage cells, and may produce fever and loss of appetite. Nitric oxide is a gas released by the inner lining of blood cells and can be dumped out to increase blood flow when an injury occurs.
While inflammation is a protector of our health when it's an acute response, chronic inflammation is a different story. A diverse group of medical illness are believed to be caused in part by chronic activation of the same chemical and cellular processes described above. These include asthma, acne, celiac disease, rheumatoid arthritis, and even atherosclerosis of heart arteries. In fact, in 1856 Rudolf Virchow proposed that arterial disease was an inflammation of blood vessels and now, over 150 years later, people who fear heart disease are routinely checked for this process.
So how does a natural, acute response become a chronic condition? Some of the reasons include injury to the gut (leaky gut syndrome) from processed foods, trans fats, sugars, alcohol, gluten and dairy allergies, toxins, ultra-exercise, obesity, inadequate sleep, and excessive stress and anger.
What can you do to keep your balance of pro- and anti-inflammatory reactions in the "Goldilocks" position? There are foods that you can add daily to your meals that cool down inflammation, such as ginger, turmeric, basil and rosemary. Vegetables, fruits, nuts, seeds and small amounts of olive oil, can do the same. Avoiding processed foods, dairy, wheat and sugar are also good strategies. Nutritional supplements, such as vitamin D3, omega-3 fish oil, probiotics, turmeric capsules, and boswellia can be helpful. Avoiding toxins such as pesticides and GMO foods by selecting organic products, taking care to choose skin and personal use products that do not contain irritant chemicals, and drinking purified water are solid recommendations. Getting adequate sleep, controlling your weight, and getting regular doses of moderate exercise will help keep you in balance.
Remember, you can use these relatively simple lifestyle choices to keep the flame of inflammation at a low level and not get burned.