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Managing Inflammation: The Body's Potent Jekyll & Hyde

  [ 284 votes ]   [ 5 Comments ]
By Dr. Sarah Myhill, MD* • www.ProHealth.com • July 14, 2010


Dr. Myhill is a UK-based ME/CFS & fibromyalgia specialist with a special interest in nutrition and preventive medicine.*

Inflammation is an essential part of our survival package. From an evolutionary perspective, the biggest killer of Homo sapiens has been infection, with cholera claiming a third of all deaths, ever.

The body has to be alert to the possibility of any infection, to which it responds with inflammation. However, inflammation is metabolically expensive and inherently destructive. It has to be, in order to kill infections by bacteria, viruses, parasites or whatever. For example, part of the immune defense involves a "scorched earth" policy - tissue immediately around an area of infection is destroyed so there is nothing for the invader to parasitize.

• The mechanism by which the immune system kills these infections is by firing free radicals at it. [Free radicals are very unstable molecules missing an electron that attack & destabilize other molecules to ‘steal’ an electron.]

• However, if the immune system fires too many free radicals, then this "friendly fire" will damage self.

Therefore, for inflammation to be effective it must be switched on, targeted, localized and then switched off. This entails extremely complex immune responses, so no wonder there is great potential for things to go wrong.

Inflammation is also involved in the healing process. Where there is damage by trauma, there will be dead cells. Inflammation is necessary to clear away these dead cells and lay down new tissues.

Inflammation is characterized by heat and redness (heat alone is antiseptic), combined with swelling, pain, and loss of function, which immobilizes the area being attacked by the immune system. This is necessary because physical movement will tend to massage the infection to other sites.

If one looks at life from the point of view of the immune system, it has a very difficult balancing act to make.

• Too little reaction and we die from infection;

• Too much reaction is metabolically expensive and damaging.

Indeed, inappropriately switched on, the immune system has the power to kill us within seconds - one example of this, of course, is anaphylaxis [a severe potentially life-threatening allergic reaction, e.g., to bee venom].

What Causes Inflammation

• Infection - any acute or chronic infection will result in inflammation

• Tissue damage – for example, trauma, burn, fracture, overuse of muscles, ligaments and joints

• Auto-immunity [for example, rheumatoid arthritis, type 1 diabetes]

• Allergy

• Chemicals and toxic insult

• Radiation – for example too much sun bathing will give us red skin from ultraviolet light!

What Controls Inflammation

Vitamin D is Anti-Inflammatory
The reason is because sunshine with all its radiations causes inflammation in the skin, so locally produced vitamin D stops this local inflammation. It then diffuses to the rest of the body, causing a generalized anti-inflammatory effect.

The further away from the Equator one lives the greater one's risk of autoimmunity, cancer, allergy and arterial disease.

Adrenal Function
The adrenal gland produces cortisol, DHEA, adrenaline and noradrenaline, all of which have profound effects on the level of immunity. Adrenaline, for example, can switch off anaphylaxis within a few second. Adrenal function can be determined by doing an adrenal stress profile. As we age the adrenal function declines and we are more prone to inflammatory disorders. See “CFS and Adrenal Gland Problems – Why they Occur.”

Antioxidant Status
The immune system uses free radicals to kill bugs. If these are not quickly mopped up by the antioxidant system, then they go on to damage normal tissues. [Antioxidants neutralize free radicals because they’re able to donate one of their own electrons but still remain stable.] See “Antioxidants and Free Radicals - What They Are and What They Do.”

Poor anti-oxidant status is a disease amplifying state because then immune activity cannot be switched off. This can be corrected by taking antioxidants.

Cell Damage
If there is damage of any sort the immune system will be switched on in order to digest away the damaged cells before they get infected. The level of cell damage can be measured by doing a Cell-Free DNA test [profile of circulating DNA].

There are lots of possible causes of cell damage, but it is also caused by inflammation, which then causes further cell damage - a typical vicious cycle of Chronic Fatigue Syndrome.

Essential Fatty Acids
Having good levels of Omega 3 and 6 essential fatty acids (EFAs) feeds into prostaglandins and prostacyclins and leukotrienes - which are essential messengers within the immune system.

A low fat diet so beloved of the "cholesterol can be reduced by diet" school of thought will result in a pro-inflammatory tendency. High dose essential fatty acids can be most helpful.

Sugar
Is directly pro-inflammatory because it raises insulin levels and generates free radicals.

Toxic Load
Because this causes cell damage and produces free radicals. Examples are cigarette smoking, heavy metals, pesticides, volatile organic compounds, surgical implants such as silicones.

If I do fat biopsies, almost invariably I find a range of chemicals. These can be got rid of by detoxification. See “Detoxification – An Overview.”

Nitric Oxide
Nitric oxide (NO), a cell to cell communicator, is directly pro-inflammatory and drives the NO/ONOO- cycle as described by Martin Pall [who believes this inflammatory cycle drives CFS, fibromyalgia, and other syndromes, which he terms "10th Paradigm" disorders].

Essentially, NO combines with superoxide (a major free radical which is very damaging and mopped up by superoxide dismutase) to form peroxynitirite. This may explain why B-12 is so helpful, because it scavenges peroxynitrite directly. These effects result in an up-regulation of the NMDA receptor - this is down regulated by magnesium. See  “B-12 - Rationale for Using Vitamin B-12 in CFS”  and “CFS - The Methylation Cycle.”

Inflammation is a central part of the ageing process - the more inflammation, the more cell damage and the faster we age.

What Switches Inflammation On?

The major cause historically, of course, is infections.
Broadly speaking viruses produce a lymphocyte reaction, bacteria a neutrophil reaction, and parasites an eosinophil reaction. Physical causes include any sort of trauma which could be a fracture, a burn, a wound or ischemia from poor blood supply - all these issues can result in tissue death.

Modern lifestyles.
Modern Western man has got ahead (for the time-being!) of death by infection. However Western lifestyles are now the major cause of inflammation. See “The general approach to maintaining and restoring good health.” 

Evolution intended humans to spend their lives living in one place, eating the same local foods throughout their lives, not travelling and meeting unfamiliar bacteria in other countries, nor being invaded by people from abroad. Nowadays the immune system is brought face to face with new foods it had not experienced whilst it was being programmed in early life and is assailed by a multiplicity of new bacteria and viruses.

Furthermore, modern Western lifestyles bring us into contact with new chemicals including heavy metals, pesticides and volatile organic compounds, all of which upset the normal processes of immune recognition. These are called adjuvants.

One example of this was revealed by a study in Japan which showed how people living in the cities had a higher rate of hay fever than people in the countryside despite pollen counts being very much higher in the countryside. The answer came from diesel particulates, which stick on to grass pollen to make it more antigenic.

Vaccinations are an example of how adjuvants work.
Vaccinations are intended to program the immune system to recognize pathogenic bacteria and viruses. The body is presented not with the real live bug, but with either a dead form or an attenuated form. In order to wake up the immune system so that it recognizes these as a threat (which of course it isn't in reality), adjuvants are added. Many adjuvants are either mercury or aluminum. Again this is an illustration of how heavy metals may switch on the immune system.

Nowadays children are receiving so many vaccinations that the toxic load of metals may be causing a toxic problem in addition to the problem of immune activation.

The hygiene hypothesis has much to commend it.
Modern life is too clean. The immune system needs constant training from soil bacteria, gut flora and gut parasites. If it doesn't get this training, it starts to react inappropriately to, for example, foods.

A vital part of the education of the immune system occurs within the first hour of life. The baby is born with a sterile gut which accepts, immunologically speaking, bacteria which are passed through mother's gut. The baby's gut should be inoculated at birth, and that gut flora should persist for life.

Nowadays with Caesarean sections, sterilization of bottle and teats, lack of breast feeding, use of antibiotics, etc., the baby's immune system may not get this essential programming. See “Probiotics – We should be taking these all the time, and double the dose following antibiotics and gastroenteritis.”

Good digestion is essential to protect against inflammation.
Anything which causes a leaky gut will mean large antigenically interesting [antibody-stimulating] molecules can get from the gut into the blood stream to possibly switch on allergies. Alcohol, drugs, gastroenteritis, poor digestion of foods, poisoning and so on can all cause leaky guts.

See “Digestive enzymes are necessary to digest food” and “Fermentation in the gut and CFS.”

Any foreign materials implanted in the body may also switch on the immune system.
The best example is silicone implants, but surgical implants, especially those containing nickel, can potentially do this. Jewelry and piercing is a common cause of metal allergies, often to nickel, but it can be to any metal. Dental amalgam passes freely into the body and can switch on sensitivity to mercury, nickel and silver.

Toxins turn on inflammation.
We then come to the problem of pesticides and volatile organic compounds, all of which are very good at switching on inflammation. These are ever present in food, water and polluted air.

The Problems of Switching on the Immune System

If the immune system is switched on then it may become activated against substances entirely inappropriately. This is the basis of allergy, in which reactions to foods, pollens, animal furs, chemicals (Multiple Chemical Sensitivities) are switched on as well as autoimmunity, which can switch on reactions to whole organs in the body (such as autoimmune thyroiditis) or to cell organelles such as anti-DNA antibodies (found in several autoimmune diseases but notably systemic lupus erythematosis).

Indeed it is often impossible to tell the difference between infection, allergy and auto-immune reactions. The same inflammation is at work - it is just either appropriate or inappropriate.

Herbal Treatments Which Help Switch off Inflammation

• Devil's Claw

• Curcumin (turmeric)

• Flavonoids, carotenoids

• Probably many others that I do not know of!

Nutritional Supplements Which Help Switch off Inflammation

• Vitamin D

• Vitamin B12

• Essential fatty acids

• Anti-oxidant effect: vitamins A, C, E, magnesium, zinc, copper, manganese, selenium, glutathione
___

* This article is excerpted with kind permission from Dr. Myhill's newly redesigned patient-education website (DrMyhill.co.uk). ®Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198. For ME/CFS patients, a special feature of Dr. Myhill's site is her free, constantly updated online book - Diagnosing and Treating Chronic Fatigue Syndrome.

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.




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Article Comments Post a Comment

Anti-inflammatories
Posted by: liztom
Jul 14, 2010
There is little that is new in this article and the recommendations just repeat all the well-rehearsed arguments extolling the virtues of these anti-inflammatory herbals and supplements. With the exception of devil's claw I've been taking all these for 4 years. But my ME has become considerably worse over this time. I must have spent thousands of pounds with nothing to show for it. Perhaps these supplements are only effective at certain doses, and perhaps certain brands are sub-standard. What is needed are evidence-based recommendations as to the precise amounts of these supplements that are beneficial, and for which sub-groups of ME patients. Reading the research into some of these on Pubmed it seems that huge amounts are often given in animal studies, nothing like the dosages recommended on the containers.
Reply Reply

 
jekyll & hyde
Posted by: harboreen
Jul 14, 2010
Thank you for honest opinion and comment. I for one appreciate this immensley. I'm constantly researching supplements for fibromyalgia, trying different ones when my pocket book allows. I too am feeling worse as years pass me by and I routinely take my vitamins each day hoping for improvement. Thinking that if I dont take them at al I'll feel even worse. thanks, Reen

 


Concurrence on Lack of Improvement
Posted by: RatsWife
Jul 14, 2010
I have to concur on lack of improvement after many months (even a year and more) of use of the listed supplements and others. The costs have become too prohibitive to continue use until and unless solid evidence in human studies gives credence. The anxiety that is generated in fruitless and energy-eroding experimentation and expenditures is not substainable for me, and others it would seem, and is in and of itself inflammatory to my Fibromyalgia. I cannot describe how much I wish this were not the case. The research must go on despite negative results as good results may present eventually, and the efforts are worthwhile. Peace.
Reply Reply

reply to comment managing inflammation
Posted by: harboreen
Jul 14, 2010
Thank you both so much for taking the time to comment on this article. It's great to hear feedback.I appreciate it because I ofetn wonder if I'll feel better if I try this that or another supplement and I take many as is. Currently I'm trying the Fibro Freedon supplements (along with others). After a few weeks I feel nothing different- we'll see! thanks again!
Reply Reply

junk science
Posted by: FMoldtimer
Aug 1, 2010
Not only does this article merely rehash a lot of older stuff, it pushes quackery & makes false statements. Among other points, I have to call out the author on his reference to adjuvants in vaccines: "...Many adjuvants are either mercury or aluminum. Again this is an illustration of how heavy metals may switch on the immune system. Nowadays children are receiving so many vaccinations that the toxic load of metals may be causing a toxic problem in addition to the problem of immune activation." There is no mercury in childhood vaccines. There has been no mercury in childhood vaccines for over a decade. Even when there was, in the form of thimerosal, it was 1) a preservative, not an adjuvant, and 2) insufficient to cause any of the problems that have been blamed on it. It is questionable as to whether any aluminum is present in vaccines. These arguments, including the related "too many, too soon" arguments, are favored by the anti-vaccine crowd. I suppose they'd rather see children (and adults) die of measles, mumps, rubella, chicken pox, and whooping cough. Any article that includes anti-vax arguments is not scientific, not accurate, and not to be trusted in any of its other statements. On top of all that, I find myself extremely sceptical of Dr. Pall's protocol. I don't doubt that he's done the basic science, because the publication history is readily available. However, one thing I've learned is never to trust a doctor who is busy pushing a proprietary blend or set of supplements. If s/he is making money from those sales, there's every reason to believe that the value & findings of the research are overstated. Leaky gut is a specific condition, caused by the action of zonulin in the small intestine. It's not a generic term for any kind of gut ailment, as the author implies. For more information, look into the work of Dr. Alessio Fasano. I could go on, point by point, but I've probably said enough to get this post removed from the site for being too negative. For anyone interested in reading real science, I recommend the sites www.scienceblogs.com and www.sciencebasedmedicine.org.
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