Chronic Inflammation

Chronic Inflammation: Overview

Inflammation is the body's response to injury.  This is true regardless of whether the injury results from a cut, burn, bruise, infection, or even an autoimmune disease such as rheumatoid arthritis.  The inflammatory response includes redness, swelling and an increased local supply of white blood cells.  These changes are an attempt to ward off infections and to help repair damaged tissue.

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Even after trauma, however, the inflammatory response may be excessive and result in unnecessary pain.  In some conditions, as with rheumatoid arthritis, the inflammation serves no useful purpose and is actually a component of the disease rather than part of the healing process.

Causes and Development

If tissue health is not restored, or if it continues to cause irritation, inflammation can become chronic.

Signs, symptoms & indicators of Chronic Inflammation:

Lab Values - Cells

Lab Values - Chemistries

Elevated ferritin levels

Less common causes of elevated ferritin levels include the presence of chronic inflammatory disorders, acute hepatitis and Gaucher's disease.

Symptoms - General

Conditions that suggest Chronic Inflammation:

Aging

Alzheimer's Disease

Research published in the Journal of Neuroinflammation in July, 2012 has shown that chronic inflammation can leave the brain vulnerable to developing Alzheimer's.

Premature/Signs of Aging

Research shows that chronic inflammation is a major cause of premature aging: The cumulative damage caused by chronic inflammation often occurs without any apparent signs or symptoms, but gradually causes severe skin deterioration and accelerated skin aging.

Inflammation

Lab Values

Respiratory

Asthma

Asthma is simply a chronic inflammatory condition of the airways rather than some other part of the body, such as the joints.  People with asthma have inflamed, hyperreactive airways that produce excessive bronchial mucus.

Tumors, Benign

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Risk factors for Chronic Inflammation:

Glandular

Low Adrenal Function / Adrenal Insufficiency

The adrenal glands produce hydrocortisol, the major natural anti-inflammatory steroid in the body.  Without enough circulating cortisol there may be a tendency to become easily inflamed.

Nutrients

EFA (Essential Fatty Acid) Requirement

In order to maintain proper balance of the antispasmodic and anti-inflammatory prostaglandins (PGE1 and PGE3) with the pro-spasmodic and pro-inflammatory prostaglandins (PGE2), it is critical to have the proper balance of essential fatty acids.  Without adequate amounts of both Omega-3 and Omega-6 oils in the diet, prostaglandin production will be reduced and problems may result.

Symptoms - Immune System

Symptoms - Skeletal

Recommendations for Chronic Inflammation:

Botanical / Herbal

Turmeric Extract, Curcumin

Curcumin comes from the spice turmeric.  The rhizome of this plant has been traditionally used as an antiinflammatory agent in Ayurvedic medicine.  Curcumin appears to reduce proinflammatory leukotriene synthesis and also promotes the breakdown of fibrin.  In a double-blinded trial, patients receiving 1,200mg of curcumin per day experienced reductions in stiffness and joint swelling comparable to the effects of phenylbutazone, a potent antiinflammatory drug.  Curcumin has also reduced inflammation in surgical patients.

Diet

Therapeutic Fasting

Fasting promotes the resolution of inflammatory processes, as seen, for example, in rheumatoid arthritis.

Digestive Aids

Bromelain

Bromelain's most common application is in the treatment of inflammation and soft tissue injuries.  Bromelain's anti-inflammatory activity appears to be due to a variety of physiological actions.  It has been shown to speed healing from bruises and hematomas.  Treatment with bromelain following blunt injuries to the musculoskeletal system results in a clear reduction in swelling, pain at rest and during movement, and tenderness.  Administration of bromelain pre-surgically can reduce the average number of days for complete disappearance of pain and inflammation. [Fortschr Med 1995;113: pp.303-306]

Drug

Aspirin

Drugs that reduce inflammation are effective, but even the relatively "safe" ones such as aspirin can cause gastritis or even an ulcer.

NSAIDs

Although they are sometimes necessary, long-term use of the more dangerous antiinflammatory drugs, such as prednisone, can cause diabetes, osteoporosis, or even death.

Supplements

Essential Fatty Acids

A tendency towards chronic repeated inflammations may be resolved through prostaglandin balancing.  The levels of pro-inflammatory and anti-inflammatory prostaglandins are primarily determined by the intake of essential fatty acids.  A dietary deficiency of Omega-3 type fatty acids has been associated with a tendency toward chronic inflammation, which regular consumption of these oils can reduce.

Omega-3 fatty acids such as flax oil or fish oil and the digestive aid bromelain make a useful anti-inflammatory combination.  Their use can be considered together in trying to resolve any chronic inflammatory condition.  While oils should be taken with food because they may cause irritation or indigestion by themselves, bromelain is best taken separately from food.  If a person can not tolerate these oils on an empty stomach, then these two products should be rotated; oils with a meal, bromelain between meals.  Typical doses are 1T flax oil per day or 3,000-5,000mg fish oil per day along with 125-500mg tid bromelain (3,000 mcu or 2,000 GDU/gm potency).

Vitamins

Bioflavonoids

Clinical trials have not yet examined the effects of the bioflavonoid quercetin in the treatment of inflammation.  However, several inflammation-promoting pathways are known to be inhibited by quercetin.

  • Histamine is one of the body's triggers for promoting inflammation.  Quercetin is known to reduce histamine release from some inflammatory white blood cells
  • Quercetin has been likened to the anti-inflammatory drug cromolyn sodium, which acts in a similar fashion
  • Quercetin has also been shown to prevent release of leukotrienes – prostaglandin-like substances that also cause inflammation.
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