Low-Grade Inflammation Wreaks Havoc
Depression should be categorized with other inflammatory disorders including heart disease, arthritis, multiple sclerosis, diabetes, cancer, and dementia.
—Kelly Brogan, A Mind of Your Own
Inflammation has been on mind. Why? Because recently, I've been working with A LOT of people who are struggling with chronic pain and depression. No surprises that those two who up hand-in-hand. But the truth is. They're not alone. Nearly all of these people are also struggling with diabetes and heart disease. All of these chronic conditions lifestyle factors that increase the risk and seem to be associated with systemic inflammation. These include psychosocial stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability, and sleep deficiency.
For instance, diabetes and heart disease are both considered "lifestyle" diseases. And believe it or not, chronic pain is often linked to both of these "lifestyle" diseases. For example, the Australia Institute of Health and Welfare published a report that showed that 64.5% of people with chronic back problems also report another chronic condition. The most common chronic conditions stated were cardiovascular disease, diabetes, and chronic obstructive pulmonary disease.
While there are several links and risk factors for chronic disease and persistent pain, we're going to focus on inflammation. In this post, we’ll start by defining inflammation and how it can impact your health. In the next post, I'll give you some tips on how to tap into some of your lifestyle habits to shift your inflammation for the better. I used all of the strategies listed there plus intermittent fasting to reduce my inflammation while on the road.
NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.
What Is Inflammation?
Inflammation gets a lot of bad press, but it's not always a bad thing. As in most areas of health, it's the balance that's important.
Inflammation is a natural process that our body uses to protect against infections, irritants, and damage. Inflammation helps our bodies eliminate damaged cells and tissues and helps them to repair. It also helps to reduce the cause of the damage, for example, by fighting the infection.
The word inflammation comes from the Latin word "inflammo," meaning "I set alight, I ignite."
Inflammation is a natural process to protect and heal our bodies. However, it can become self-perpetuating and stick around way longer than necessary. This long-term (chronic) inflammation is often associated with several health conditions and persistent pain.
Acute vs. Chronic Inflammation
When inflammation happens in a big way, for a short time, this is known as "acute" inflammation. Signs of acute inflammation include redness, heat, swelling, pain, and loss of function.
These short durations of active inflammation can help the body to heal injuries and infections.
When the injury heals or the infection goes away, inflammation typically goes away too. However, sometimes, your immune system gets turned on and stays on after the "crisis" has passed.
Over time, this can damage healthy cells and organs and cause constant pain in muscles, tissues, and joints. It's this type of inflammation linked to conditions like diabetes, heart disease, and persistent pain. It's also linked with many other concerns related to the body, brain, and even mental health concerns.
“Chronic low grade inflammation is increasingly seen as a part of other orthopaedic conditions such as osteoarthritis — once considered a ‘cold’ wear and tear problem (as opposed to the far more overt and ‘hot’ inflammation of rheumatoid arthritis).”
Testing For Inflammation
Inflammation stems from the immune system’s response and also involves our blood vessels (arteries and veins) and other molecules.
One of these molecules is the infamous “free radical.” These highly reactive molecules (oxidants) help to fight infectious agents and also help cells to communicate. But, when they are in overdrive, and they aren’t counteracted with many antioxidants, they can tip the balance and cause damage to healthy cells.
There are several other inflammatory molecules, one of which can be measured with a blood test known as C-reactive protein (CRP). CRP is considered one of the “markers” of inflammation. This “inflammatory marker,” when found in a blood test at high levels, indicates that there is inflammation in the body.
High blood levels of inflammatory markers like CRP are associated with increased risk of diabetes and heart disease. Some researchers believe that levels of inflammatory markers in the blood can predict whether someone is going to develop diabetes or heart disease eventually.
As I mentioned, there are several inflammatory molecules. And a lot of inflammation is not easy to detect. Some of the molecules (markers) stay localized to specific tissues and systems. Unfortunately, the more localized inflammatory markers are only detectable with complicated, expensive, invasive testing. But even then, biology is messy, and the tests are not always super reliable. So it’s important to note that even people with severe inflammatory diseases do not always get an accurate result.
5 Tell-Tell Signs That You Have Chronic Inflammation:
Body pain, especially in the joints
Constantly feeling tired & fatigue, despite sufficient sleep
Skin rashes, such as eczema or psoriasis
Excessive mucus production (i.e., always needing to clear your throat or blow your nose)
Ongoing digestive issues: including bloating, abdominal pain, constipation, and loose stool
Inflammation & Chronic Pain
Chronic or persistent pain is complicated and very dynamic. When it comes to inflammation, keep in mind that multiple cells are involved in the release of inflammatory mediators. The release of these mediators is part of the cell-to-cell communication that can generate pain.
Let’s take a quick look at one way chronic inflammation can contribute to persistent pain.
Specialized nerve cells play an essential role in the inflammatory process and tissue homeostasis — think muscles, tendons, ligaments, and fascia. Pain researchers describe one group of specialized neurons, the IV afferent neurons, as having the ability to “taste” the local tissue chemistry. When they taste inflammation, they are activated. When the flavor is anti-inflammatory, these neurons are inhibited or modulated.
What’s fascinating is that cells can release both pro-inflammatory and anti-inflammatory mediators and, in doing so, determine the “flavor” of the tissue chemistry that is “tasted” by these specialized neurons. And nutrition can be a determining factor that generates the tissue “flavor” of inflammation.
Joint pain is where my systemic inflammation flares. Most often, it begins in my ankles and then my knees. For me, this happens when my lifestyle has been compromised for too long — lack of sleep, lack of movement, poor food choices, excess stress. You get the picture. I know that when my lifestyle is in check, my inflammation returns to a healthy state of elevating when biologically necessary and subsiding when it isn’t.
“A lot of chronic pain is the result of chronic inflammation, and the evidence is quite strong that your diet can contribute to increased systemic inflammation.”
Chronic Inflammation & Depression
Depression is a complex disorder that isn't just in your head. It involves a variety of bodily systems, including the immune system. According to the World Health Organization, depression is the leading cause of disability that impacts more than 120 million people worldwide.
A growing body of research suggests that depression is associated with a low-grade, chronic inflammatory response. Much of this research revolves around the "Immune Cytokine Model of Depression." This theory views depression as a "multifaceted sign of chronic immune system activation" rather than a disease in and of itself.
In a 2013 paper by Berk et al., the authors offered a review of the research exploring the connection between depression and inflammation. What piqued my interest in this paper was the focus on lifestyle factors that correlate with elevated inflammation. Changing your lifestyle might not be the only answer, but it's a vital part of the overall solution.
If you suffer from depression and haven’t read Kelly Brogan’s book, A Mind Of Your Own, I recommend checking it out. It just might inspire you to implement a healthy lifestyle as part of your treatment plan.
“Depression should be categorized with other inflammatory disorders including heart disease, arthritis, multiple sclerosis, diabetes, cancer, and dementia.”
Chronic Inflammation & Diabetes
Diabetes is a complex condition of metabolism where our bodies don’t manage blood sugar levels very well.
Blood sugar levels naturally go up and down throughout the day. It goes up after we eat, and drops when we’re hungry. In a person with optimal blood sugar control, when blood sugar levels get high, insulin is released.
But when the control of the blood sugar levels isn’t as good, for example, when it stays too high for too long (i.e., because of insulin issues), this can lead to diabetes. And having diabetes can have many long-term health consequences like amputation, blindness, and kidney disease.
About 95% of diabetes is type 2 diabetes (T2DM), formerly known as “adult-onset” diabetes. This is because there are a whole host of nutrition and lifestyle habits, when done for years and decades, contribute to this diagnosis.
These nutrition and lifestyle habits can promote excess body fat and inflammation, and lead to an imbalance between insulin need and insulin production. Some researchers argue that virtually all of the factors that promote diabetes are linked with inflammation.
Here’s the rub. If you have chronic pain, then chances are pretty good that you experience brain fog from time-to-time. Unfortunately, dis-regulated blood sugar levels also cause brain fog. If you add the two together, life can start to feel like a haze of foggy confusion and forgetfulness.
“...nearly every modern disease — everything from autoimmune diseases, heart disease, and cancer to obesity, diabetes, and dementia — is caused by inflammation!”
Chronic Inflammation & Heart Disease
Heart disease is a major cause of death in countries such as Australia, the US, Canada, and the European Union.
The link between inflammation and heart disease was discovered back in 2006. The first stage of heart disease is called “atherosclerosis.” Complications of heart disease include things like heart attacks. Inflammation is a key issue linked with both atherosclerosis and heart attacks.
Atherosclerosis (hardening of the arteries) starts when there are too many “free radicals” inside the blood vessels. This can be from high blood sugar, high levels of oxidized fats in the blood (from too many free radicals), low levels of homocysteine (an anti-inflammatory molecule), etc.. These lead to damage of the inside surfaces of the blood vessels allowing buildup of plaque (including immune system cells) which increases chronic inflammation. This plaque narrows the inside of the blood vessels and can lead to complications like heart attacks. And after a heart attack, inflammation rises to even higher levels.
Research is underway specifically targeting inflammation to try to reduce heart and blood vessel injury, reduce the worsening of heart disease, and to promote healing.
“Inflammation is both the cause and the result of diabesity.”
Inflammation & Body Fat
There are different types of fat in the body, and various places fat tends to occur. Two types of fat are in the body, brown fat and white fat. The brown fat is highly vascularized, is found in the neck and shoulder regions in adults, and tends to burn energy as well as help in body temperature regulation. There is also an indication that this type of fat helps control the body’s triglycerides and cholesterol, and may reduce atherosclerosis. The most common fat in the body is the white fat, this is the stuff in the belly and is the majority of the “flab” we have.
Excess body fat, especially the white fat in the abdomen and around the internal organs, is linked with both diabetes and heart disease. Excess body fat also increases the body’s need for insulin, and negatively affects insulin-producing cells.
But that’s not all.
Body fat itself can promote the activation of immune cells. The fat tissue can even produce its own inflammatory markers. This is particularly true for internal fat around the belly, liver, and heart. Plus, excess body fat can change the biomechanical loading of a joint, which may accelerate degenerative joint diseases such as osteoarthritis.
But it’s the inflammation aspect of increased body fat that might explain why high levels of body fat are associated with osteoarthritis in non-weight bearing joints such as hands, where biomechanical loading isn’t weight-related as it is in the knee.
Losing weight (i.e., excess body fat) reduces inflammation in belly fat as well as the rest of the body, and can help you to change the way that you move.
Remember, inflammation can be healthy if it is fighting an infection or healing a wound. We need it to survive. But chronic inflammation is associated with many serious conditions. The good news is that your lifestyle can go a long way towards pushing the inflammation dial towards a healthy state.
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