What This Functional MD Wants You To Know About Inflammation & Energy
The three Ls of chronic inflammation:
1. Leaky gut
The first of the three Ls refers to leaky gut. We'll discuss this condition in more detail shortly, but the basic concept is this: Thanks to a steady stream of processed foods, certain plant foods, pesticides and other chemicals, and overprescribed pharmaceuticals, the protective lining of our intestinal tract—aka our "gut wall"—has to weather quite a storm.
All of these agents combine to degrade the integrity of the gut wall, causing microscopic holes to form that then allow bacteria and other harmful molecules to leak out of the intestines and into the bloodstream and surrounding tissues. Because 70 to 80% of your immune system lives in the layers of tissue making up the gut wall and in the fat that surrounds your intestines, wherever there is leaky gut, there is also inflammation.
If you had asked me 15 years ago when I was writing my first book about my thoughts on leaky gut, I would have told you quite honestly that it was pseudoscience. But thanks to sophisticated tests now available and the work of numerous other researchers, like Alessio Fasano, M.D., at Harvard Medical School, I can say with virtual certainty that leaky gut is an epidemic of its own, and can be found in the majority of the population today. Indeed, 100% of my fatigued patients have tested positive for some degree of leaky gut.
The second L stands for lectins, which are proteins found in certain plants that serve as their defense system to protect them and their babies (seeds) from being eaten by predators—including humans.
Gluten is one well-known lectin—perhaps one you already avoid. Yet there are many others in legumes and grains—they're mainly found in the hulls of whole grains—as well as in some vegetables, like the nightshades, and in the peels and seeds of some fruits we call vegetables (like cucumbers and squashes), as well as fruits picked out of season. Conventional milk and dairy products are yet another source of lectins.
Quite frankly, our modern diet is practically built on these pesky proteins (and, sorry, most gluten-free foods are full of them). Unless you are following one of my Paradox food programs, they're pretty hard to avoid.
As part of their attack strategy, lectins create holes in the gut walls of predators—so imagine the field day they have when they come into contact with an already weakened or leaky gut. Not only do lectins irritate the gut and cause inflammation there, but they're also able to sneak through the gut wall and into the bloodstream, where our immune system recognizes them as foreign proteins and triggers an even wider inflammatory response.
I go into much greater detail about lectins and their relationship to autoimmune diseases in my previous books, but the key takeaway here is that lectins are also equally at play in the lower-grade epidemic of inflammatory exhaustion.
3. Lipopolysaccharides (LPSs)
And that brings us to L number three, LPS's, short for lipopolysaccharides. These are fragments or pieces of bacterial cell walls that make it across the gut wall and trigger inflammation, even without a leaky gut. I sometimes call LPSs "little pieces of sh*t" because, well, that's what they are.
When contained within the gut, held amid the ecology of your microbiome, these tiny bits of bacterial cell walls are no big deal. But when they pass through the gut wall and into your bloodstream, they provoke a localized or even systemic defense attack by your immune system.
Most of the time, the resulting inflammation takes place in your liver, which is bad enough for your energy production, but LPS's also can start cruising around in your blood and lymph, where they activate immune cells all over the body, including in your brain. Voilà: a state of inflammation—and exhaustion—that never stops.
Unfortunately, there's another insidious way LPS's sneak into circulation. Research shows that LPS's and even living bacteria can piggyback onto saturated fat transport molecules called chylomicrons and ride "through" the gut lining into the lymph system on the other side, circulating to lymph nodes (hot spots of white blood cells that catch pathogens to be destroyed) and to the liver—one of the most important sites of your energy ATP production.
The ability of LPS's to make their way into circulation has led to a new understanding of why the standard Western diet—high in saturated fat—is so inflammatory.
Far from being something to muscle through or dismiss, fatigue is a warning from your body that it is burning with the fire of inflammation. It is a signal that it is trying valiantly to follow its innate programming and protect you from harm—but in many cases, you are the one unwittingly causing the harm. Instead of reaching for another double espresso, it's time to stop and listen.