INFLAMMATION: THE GOOD, THE BAD AND THE UGLY
If you have had a broken bone, a cut or abrasion, a sore throat, a rash, a tooth ache, infection or most any other kind of hurt, you have experienced inflammation. Inflammation is part of a complex biological response to cellular damage caused by injury or some sort of irritant. Inflammation is an attempt by the body to remove the injurious stimuli and initiate the healing process. Because inflammation is part of the body’s response to injury or infection, it is considered a mechanism of the immune system. Without inflammation, wounds and infections would never heal. Progressive destruction of tissue would occur and threaten survival of the organism. Therefore, inflammation is a good and necessary dynamic in maintaining health of the body.
However, there is inflammation that is bad for the body and it can become downright ugly. It can lead to a host of health problems such as asthma, osteo and rheumatoid arthritis, hay fever and even heart disease and cancer. Research continues to show that inflammation is not only present in obvious cases of injury or infection but is a serious contributor to degenerative disease of all types. It is this “silent” inflammation going on in the body that can lead to cellular damage of the cardiovascular system and be a causative factor in the development of cancer and other degenerative diseases. While the body has a variety of mechanisms designed to closely regulated inflammation, these mechanisms are often overwhelmed by chronic inflammation.
ACUTE AND CHRONIC INFLAMMATION:
Inflammation is classified as either acute or chronic. Acute inflammation is the initial response of the body to harmful stimuli and is achieved by the increased movement of blood plasma and immune cells into the injured tissues. This is what causes the swelling, discoloration, heat and pain associated with injured tissue. Redness and heat is due to increased blood flow to the injured tissue. Swelling is caused by accumulation of fluid. Pain is due to release of chemicals that stimulate nerve endings. These signs appear when acute inflammation occurs on the body's surface, whereas acute inflammation of internal organs may not result in this full set of symptoms. Pain only happens where the appropriate sensory nerve endings exist relative to the inflamed area. For example, acute inflammation of the lung, as in pneumonia, does not cause pain unless the inflammation involves the parietal pleura, which does have pain sensitive nerve endings.
While acute inflammation is usually a temporary response to injury, chronic inflammation is prolonged inflammation which leads to a progressive shift in the type of cells present at the site of inflammation and is characterized by simultaneous destruction and healing of the tissue involved. Chronic inflammation can occur unnoticed in the internal organs of the body until it creates enough damage to cause noticeable symptoms of disease. While acute inflammation is usually caused by injury, infection, radiation, toxins and allergies, chronic inflammation can result from poor diet, alcohol abuse, smoking, excessive exercise and other life style dynamics. For example, poor diet will deprive bodily tissues of the nutrients they require for optimal function. This can lead to the perpetual presence of inflammation and the eventual malfunction of the tissues involved.
INFLAMMATION AND PAIN:
Since pain often accompanies inflammation, it is normal to want that pain relieved. The quest for pain relief has resulted in the proliferation of what are called non-steroidal anti-inflammatory drugs, often referred to as NSAIDs. Regular use of NSAIDs such as aspirin, acetaminophen (Tylenol), naproxen (Aleve) and ibuprofen (Advil and Motrin) can lead to a variety of health problems which includes bleeding of the intestinal lining, degradation of joint tissue and kidney and liver damage. An estimated 17 million Americans take an NSAID daily. Acetaminophen sends an estimated 56,000 people to the emergency room each year. NSAIDs are blamed for sending more than 200,000 Americans to the hospital every year and are linked to an estimated 16,000 deaths annually.
Common NSAIDs such as aspirin, and ibuprofen, as well as, Cox-2 inhibitors such as Vioxx and Celebrex, all work to reduce inflammation by reducing prostaglandin synthesis in the body. Prostaglandins are hormone like substances that are created by the activity of certain fatty acids. For example: The enzyme cyclooxygenase-2 (Cox-2) converts a fat called arachidonic acid to prostaglandin E2. This prostaglandin is a pro-inflammatory and can lead to inflammation resulting in pain.
When you take an NSAID like aspirin, you inhibit the Cox-2 enzyme that leads to pro-inflammatory prostaglandins which results in reduced inflammation and its associated pain. Unfortunately, NSAIDs, such as aspirin, also inhibit cox-1 enzymes which are responsible for maintaining the membranes of stomach lining, calcium metabolism, blood sugar control and regulation of arachidonic acid release which in turn regulates Cox 2 activity. NSAIDS tend to cause irritation of the mucosal lining of the intestinal tract resulting in ulcer formation. Other side effects of using NSAIDS include the creation of allergies, tinnitus (ringing in the ears), fluid retention, easy bruising and potential toxicity to the liver and kidneys.
In an effort to deal with the negative impact of NSAIDs on Cox-1 activity, Cox-2 inhibitors like Vioxx were developed which target only cox-2 enzymes and leave Cox-1 enzymes alone. Unfortunately, it has been determined that these Cox-2 NSAIDs can create higher risk for heart attack and stroke.
Many people use NSAIDs to reduce the pain of arthritis. While NSAIDs will lessen the pain of arthritis and provide symptomatic relief, they have also been shown to speed up the degeneration of joint tissue and thus create more series problems with continued usage. NSAIDS have been shown to inhibit the repair of cartilage by preventing the synthesis of the collagen matrix essential to cartilage repair.
Corticosteroids such as prednisone are sometimes used in addition to NSAIDS. These types of drugs are great at reducing inflammation but the side effects make them downright dangerous. These drugs are known to depress immunity, create high blood pressure, thin the bones and damage the liver. Depression and other mental disturbances, diabetes, peptic ulcers, insomnia and general weakness are also associated with corticosteroids.
Opioids:
Prescription opioid painkillers such as fentanyl, codeine, oxycodone (OxyContin), morphine and hydrocodone (vicodin) are being widely used to treat pain. Opioid drugs work by binding to opioid receptors in the brain, spinal cord, and other areas of the body and in so doing reduce or eliminate the sending of pain messages to the brain which effectively blocks the feelings of pain. These drugs diminish in effectiveness after a while requiring a higher potency of the drug which often leads to addiction. The most common side effects associated with opioid usage is constipation and nausea. They can also cause slowed breathing leading to death in cases of overdose.
Health care providers in the US wrote nearly a quarter of a billion opioid prescriptions in 2013. In 2014, more than 28,000 people died from an opioid overdose, and more than half of those deaths involved a prescription opioid. Deaths from overdosing on opioids has been steadily increasing. Users of these drugs report going through withdrawal much as a heroin addict does. Heroin is an opioid. Opioids are rough on the liver and kidneys which are the two organs responsible for clearing them from the body. If possible, it is best to reserve the use of opioids to relieve pain associated with cancer and other degenerative disease in end of life situations.
INFLAMMATION AND HEART DISEASE:
In animal studies involving induced atherosclerosis (intentional facilitation of fat accumulation in the arteries), signs of inflammation occur hand-in-hand with fat accumulation on the artery wall. For example, white blood cells called leukocytes, which present themselves in cases of acute inflammation, are seen to bind to the endothelium lining of the blood vessels in the earliest stages of atherosclerosis. This same phenomenon has been seen in human studies. Since healthy endothelium does not in general support binding of white blood cells, their appearance in the arteries after initiation of an atherogenic diet indicates the presence of inflammation. If such inflammation continues over a prolonged period of time, it results in destruction of the endothelium and subsequent breakdown of the arteries responsible for blood flow to the heart.
It has been demonstrated that it is not so much the accumulation of fats in the arteries but the oxidation of such fats that causes lesions in the walls of the arteries. The body sees the creation of lesions in the arterial wall as an injury to the body and mobilizes an inflammatory response to deal with the injury. If this process continues unabated, destruction of the arterial wall will occur which can lead to insufficient blood flow to the heart.
MEASURING LEVELS OF INFLAMMATION:
One way to measure the level of inflammation in the body is to determine the level of C-reactive protein (CRP). CRP is a special type of protein produced by the liver that is only present when inflammation is present somewhere in the body. The most important role of CRP is its interaction with the “complement system” which is one of the body's immunologic defense mechanisms. Studies have shown that CRP may be an important marker of risk for heart attack. Readings above 3.00 mg/dl are believed to indicate high risk. Testing for CRP is recommended as a method for determining inflammation levels in the body. Test results can be used to make the necessary dietary and life style changes to reduce levels of inflammation if the CRP test shows C-reactive protein levels to be high. At Milk ‘N Honey we make available blood testing for CRP.
REDUCING INFLAMMATION THROUGH DIET:
Because of the side effects associated with NSAIDs and other pain relieving drugs, our efforts to control inflammation should be directed toward working with the body and not against it. How do we do this? First and foremost we must insure that we provide our bodies with the necessary balance of nutrients to support balanced activity between pro and anti-inflammatory prostaglandins.
The inflammatory process can be slowed down and even reversed by eating a very high quality diet that is abundant in antioxidants and natural anti-inflammatories while avoiding foods that create inflammation. For example, omega-6 fatty acids, while important to our health, convert in the body to pro-inflammatory arachidonic acid which leads to the production in the body of predominantly pro-inflammatory prostaglandins. The American diet is very high in omega-6 fatty acids which are found in refined polyunsaturated vegetable oils such as safflower, sunflower, corn, peanut and soy. These oils are pervasive in the processed and refined foods most people eat.
Conversely, the American diet is low in omega-3 fatty acids which lead to the making of anti-inflammatory prostaglandins which regulate the activity of the pro-inflammatory prostaglandins. Reducing the consumption of omega 6 fatty acids and increasing the intake of omega 3 fatty acids will help reduce inflammation. Good sources for Omega-3 fatty acids are dark green leafy vegetables, flex seeds, walnuts, and salmon. Taking a high quality fish oil such as Wholemega from New Chapter or the product Vectomega from EuroPharma will provide a an ample supply of Omega-3 fatty acids.
Avoiding foods high in refined carbohydrates will reduce inflammation in the body. Such foods quickly raise insulin levels. High insulin levels trigger the release of short-lived hormones inside our cells called eicosanoids. Eicosanoids act as both pro-and anti-inflammatory compounds depending on their type. Eicosanoids become skewed toward being pro-inflammatory when insulin levels are high. High insulin levels also activate enzymes that raise levels of arachidonic acid in our blood which lead to the production of pro-inflammatory prostaglandins. Avoiding refined carbohydrates is another way to reduce inflammatory responses in the body.
The protein gluten found in wheat and other grains can quickly spark the inflammatory cascade. Anyone suffering from celiac disease knows how inflammatory gluten can be. If you are experiencing pain you may want to eliminate gluten from the diet and see if this results in the reduction or elimination of your pain. To do this you will have to stop eating all food products containing wheat and other gluten containing grains.
Avoid hydrogenated and partially hydrogenated fats. These fats are often used in the making of processed and refined foods. Hydrogenated fats are produced by adding hydrogen to liquid oils that have been heated to high temperatures. This results in the liquid oil becoming more solid (more saturated). The Hydrogenation process creates what are called trans-fatty acids. Trans- fats are stickier than normal “cis” fats like found in butter. They encourage fatty deposits in the arteries, liver, and other body organs. These fats also make your blood clotting platelets more sticky and therefore increase the risk of stroke and heart attack. Trans-fats have been shown to raise blood levels of both cholesterol and triglycerides and in general create free radicals that damage healthy cells and trigger inflammation. Free radicals are created when atoms lose an electron and become destabilized. Such atoms try to stabilize themselves by taking an electron from another atom which destabilizes that atom. This continuing process creates a chain reaction of free radical activity which is very damaging to body tissues. Avoiding foods containing hydrogenated oils will cut down on free radical activity and thus reduce inflammation.
USING HERBS TO REDUCE INFLAMMATION:
While a diet low in processed and refined foods and rich in nutrient dense foods is the most important consideration in reducing inflammation, adding certain herbs to the diet will help this process. A number of herbs have been identified as helpful in this regard. Herbs such as green tea, ginger, holy basil, rosemary, oregano and boswellia have all been found to be effective in reducing inflammation without unwanted side effects.
The king of anti-inflammatory herbs is turmeric. The herb turmeric contains compounds called curcuminoids which are phenolic compounds known to facilitate anti-inflammatory effects. They appear to block inflammatory processes by inhibiting the production of pro-inflammatory prostaglandins, downregulating the COX-2 enzyme and suppressing pro-inflammatory genes. Turmeric’s most active and dominant curcuminoid is curcumin. Research has shown that curcumin is an effective antioxidant and anti-inflammatory. Curcumin has been shown to be effective in the treatment of a variety of health problems including heart disease, cancer, diabetes and arthritis.
Curcumin and Cancer:
In a 2004 study, lung cancer cells treated with curcumin showed curcumin to have an inhibitory effect on the growth of these cells and to facilitate the death of existing cancer cells. A 2005 study reported in Biochemical Pharmacology found that curcumin can help slow the spread of breast cancer cells to the lungs in mice. This report explained that curcumin acts to shut down genes that are involved in the growth of cancer cells. Research at Emory School of Medicine has shown that curcumin attacks vascular endothelial growth factors which reduces the ability of tumors to generate their own blood supply lines. This is a critical dynamic in preventing tumors from growing.
In recent years, a number of products have become available where manufactures have extracted curcumin from turmeric. Such products are often advertized as natural anti-inflammatories. However, research done with curcumin reveals it is poorly absorbed in the gastrointestinal tract. The intake of large amounts of curcumin is needed in order for it to show up in the blood. The challenge has been to get adequate levels of curcumin into the blood stream to allow for its therapeutic effect.
In an effort to solve this problem of poor absorption, the company New Chapter manufactures a curcumin product called Turmeric Force which provides not only the curcumin but also the other curcuminoids found in turmeric along with other constituents present in this herb. It is New Chapter’s belief that all the components of turmeric need to be present in order for this herb to be adequately absorbed and utilized by the body.
In 2009, research was conducted at Miami Children’s Hospital where Turmeric Force (TF) was used to treat certain forms of pancreatic cancer. It was found that TF was more effective in killing cancer cells than curcumin used by itself. This result appears to be supported by the fact that the incidence of pancreatic cancer in India is very low compared to the United States and Europe. The people of India use a great deal of turmeric in their daily diet. Turmeric Force is available at Milk ‘N Honey. Another product from New Chapter called Zyflamend is also available at Milk ‘N Honey and contains an ample amount of curcumin plus other anti-inflammatory nutrients.
Another curcumin product that has shown excellent results is Curamin from the company EuroPharma. This product contains a very absorbable form of curcumin called BCM-95. BCM-95 is a blend of curcuminoids and the essential oil of turmeric. According to an article found on www.TerryTalksNutrition.com, fifteen healthy volunteers (men and women ages 24-45 years old) were assigned either to a group using a standard curcumin extract or to a group using the specialized curcumin, BCM-95. Blood samples were drawn before the volunteers were given the curcumin and then at regular intervals after they ingested the curcumin. This study indicates that the bioavailability of the specialized curcumin (BCM-95) extract was 7 times higher than that of the standard curcumin extract. Moreover, the results show that the specialized curcumin stayed in the blood stream longer and at higher levels than the standard curcumin extract. We carry Curamin at Milk ‘N Honey.
There have been thousands of studies published on the beneficial effects of the curcuminoids found in turmeric. All indications are that these compounds will help reduce inflammation and oxidation in the body. Because of the poor absorption of curcumin into the blood stream, it is best to use a high concentration of the whole herb turmeric as seen in the New Chapter product or to use a specialized extract of curcumin as found in BCM-95. While you will get some curcumin into your diet by using turmeric as a spice and eating turmeric based products such as curry, the amount of curcumin ingested will be very minimal. However, regular eating of turmeric based products, as seen in India, does appear to provide some level of benefit.
Inflammation has been shown to be a root cause of many health problems. We should be doing all we can to minimize the effects of inflammation in the body. Avoiding processed and refined foods is essential. Supplementing with a high quality Omega-3 product is very important. Using an effective turmeric product will help keep inflammation at bay and reduce the potential for everything from cancer to heart disease.
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