An integrative approach to explaining systemic, or chronic, inflammation and its significance to your health.
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by Marcelle Pick, OB/GYN NP
Think of the balance of the seasons. What fuels the regenerative cycle? The power of the sun. Without the heat of the sun, we would have eternal winter — nothing could grow or live. Now imagine the opposite: a world on fire where the heat scorches everything in its path. In the same way, that the Earth requires balance, our bodies rely on just enough inflammation — but not too much — to fuel the natural regeneration of cells and ward off infection and disease.
The inflammatory response is a basic mechanism of our immune system. But there is danger in having too much of a good thing: while a healthy immune response includes sporadic bouts of acute inflammation, it’s not okay to stay perpetually inflamed. When you get to the point where the built-in checks and balances of your immune system can’t contain your inner fire, inflammation is considered chronic and systemic. And we’re seeing it in more and more of our patients.
Chronic inflammation gradually destroys an otherwise beautiful machine. It upsets the delicate balance among all of our major systems: endocrine, central-nervous, digestive, and cardiovascular/respiratory, creating health issues with one or several or all. In a healthy body, these systems communicate with and respond to one another. With chronic inflammation, that cross-talk no longer works.
Chronic inflammation in conventional medicine
Although Chinese medicine has dealt with inflammation for centuries, conventional medicine is just starting to get a handle on it. The medical community is discovering the importance of inflammation in the way it approaches all underlying causes of symptoms — by digging deeply into individual conditions — and so it presently can't see the forest for the trees.
Progressive doctors will now discuss inflammation as a root cause when you present with diseases like asthma, allergies, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or rheumatoid arthritis. Heart disease is on the verge of joining this notorious group, but there are still some unanswered questions about the link to inflammation. Obesity and Alzheimer’s may soon follow.
Despite this progress, there are problems with conventional medicine’s approach. First is the issue of specialization. Traditionally, a specialist looks at your symptoms as they relate to particularly affected organs — a cardiologist for your heart, a pulmonologist for your lung, and so on. Treatment is symptom-specific and relate only to the relevant system of your body. In other words, from the outside in — the opposite of the holistic medicine we practice at Women to Women.
A second problem is the drug-based approach of conventional medicine. Legions of pharmaceutical drugs have been developed to interrupt the inflammatory cascade. Over-the–counter NSAID’s (non-steroid anti-inflammatory drugs) like Motrin and Advil disrupt the production of prostaglandins. Corticosteroids like Prednisone, Cox-II inhibitors like Vioxx and Celebrex, and antihistamines and ACE inhibitors have followed suit, each targeted at shutting down a different inflammatory mechanism.
A third problem is that medical science doesn’t know how drugs interact with each other. For example, a patient might simultaneously be put on Lipitor to lower cholesterol, Prednisone for respiratory relief and Motrin for pain. The odds that these drugs interact are nearly 100%, but there are no long-term studies of multiple drug interactions.
I can say for certain that the new patients who come to me having been on multiple drugs over long periods of time have generally seen their health deteriorate. That’s because the pharmaceutical drugs do nothing to heal the underlying issues that created the inflammation in the first place — when they stop taking the drugs, the symptoms come back.
(We don’t advocate stopping your prescriptions. Many drugs are essential, especially as the first stage in healing. We do advocate finding natural solutions to the underlying cause of your problems, which in many cases will allow you, with the help of your healthcare practitioner, to reduce the number or dosages of prescriptions you are taking.)
Still, we are happy to see medical science map out the links between inflammation and almost every disease related to poor quality of life and aging — from obesity to Alzheimer’s to cancer. We are lifelong advocates for combining Chinese and Western medicine, so this looks like progress to us!
The Eastern perspective on inflammation
The Chinese describe fire as one of the five elements in the body that foster life. Just as summer gives way to fall, fire represents the height of activity before a decline and rest. It is a necessary part of a balanced system. But if the balance is upset and fire takes over, your life energy is blocked and you are stuck in the hot zone.
In the Eastern paradigm, too much fire in the body stems from internal and external sources of heat. Initially the imbalance manifests as an aversion to heat, skin eruptions and bowel disturbances. Often the patient’s skin looks red and flushed. Over time, too much fire affects the heart (the major, or yang organ associated with fire) or the small intestine (the minor, or yin organ). Fire is also associated with joy — a powerful emotion that can go awry. Too little and you feel depressed and lethargic, too much and you feel anxious, even manic.
Our view —the integrative approach to inflammation
At Women to Women we have always combined the best of Western and Eastern medicine, with an emphasis on preventive health and natural solutions. As a result, we see the development of inflammatory disease as an outcome of what began as an imbalance of some kind — often one that had its subtle beginnings in a digestive disorder.
Just yesterday I saw Nancy, a patient who has been with me for years. When she first came in, her triglycerides were very high (in the 400’s!), her cholesterol was elevated, and she was overweight, unhappy and stressed. Her face was red and chapped, her lips were dry, and she seemed fluttery and agitated. On the surface she looked like a heart disease candidate, but when I probed deeper I saw a woman on fire from the inside out.
Currently there is no direct test for inflammation — the best that conventional medicine can do is measure C-reactive protein (a pro-inflammatory marker in the blood) and the irritating blood acid called homocysteine. I use the ultra-sensitive CRP test now available at most labs. Anything above 1 mg/dL with this test is too high in my book. With the older tests a reading of between 2-5 mg/dL was considered normal. If you’ve been tested, be sure to ask your doctor for the results.
When I first ran Nancy’s tests, I was surprised to see that her CRP levels were normal (although this was before the new ultra-sensitive tests were widely available as they are today). This was good news for her heart, since elevated CRP and cholesterol increase your risk of heart disease threefold. But her homocysteine levels were high and all of her other symptoms pointed to inflammation. I prescribed an anti-inflammation diet, essential fatty acids, other anti-inflammatory supplements, and a daily exercise regime. When she next came in, her tryglycerides were down by 200 points, her skin was clear, and her mood was much better. Later tests revealed her cholesterol had gone down, too.
A year went by and Nancy went through a stressful period in her life; she began snacking again on unhealthy food and went days without exercise. Her cholesterol began to creep back up and she began having problems with her bowels. After a brief pep talk, she got back on track and today she’s feeling great. When I saw her yesterday she looked like a different person. Her blood tests looked good and her inflammation is back under control. Nancy’s fires are well-tended and I feel confident she knows what to do if they start flaring up again.
I think that like Nancy, almost all of us have some degree of inflammation present at all times. I think it's safe to say that most of us in this country are walking around on “simmer” — which means setting ourselves up for problems as we age. Our ballooning rates of allergies, obesity, IBS and chronic pain don’t lie. I’m seeing such a spike in the number of patients with symptoms of inflammation that it’s becoming the norm, not the exception. The good news is, once we understand this and see how quickly our actions either fuel or cool the flames, we can begin to make better choices that will help prevent symptoms and conditions of chronic inflammation.
Lifestyle choices to reduce inflammation
When I talk about lifestyle, I think of three dominating factors: diet, exercise and habits. When we’re looking at inflammation all three are very important.
Nutrition: It’s almost impossible for the average American to get the right quantity of necessary nutrients on a daily basis without a supplement. Adding the right supplements to your diet and eating foods rich in anti-inflammatory compounds like flavanoids provide a valuable countermeasure to chronic inflammation.
Physical activity: Exercise, including sexual activity, is potent medicine. It releases compounds such as endorphins into the blood that act as a natural anti-inflammatory. Almost everyone with an inflammation-related condition finds more control and relief when they exercise. Exercise lowers CRP, regulates insulin levels and creates muscle, which helps the body regulate weight. Mindful exercise done in concert with deep breathing, like yoga, walking, tai chi, and Pilates has the double benefit of reducing psychological stress.
Habits: Smoking, recreational drug use and excessive alcohol and caffeine grate on our systems and incite free radicals. Smoking raises levels of CRP. Chronic cocaine and marijuana use have been shown to accelerate atherosclerosis. As a rule of thumb, it’s good to remember that our body reacts to foreign substances as intruders to be wiped out — sending the immune system into overdrive.
Weight loss: Let me add a special note for women who are dieting and already suffer from an inflammatory condition. Because toxins are stored in fat cells, burning that fat releases those toxins. Such women may feel awful while losing weight. Those feelings are temporary, especially if you understand how to support your body's natural detoxification. But those stored toxins make it all the more important to reduce inflammation every way you can.
Kay’s Note: The SCDiet is an all natural, anti-inflammatory, healing diet that will keep the immune system stronger to fight for, rather than against us.