Understanding Inflammation

June 1, 2024
Dr. Mary Knudsen ND

What is inflammation? Inflammation occurs when the body’s immune cells (think white blood cells) respond to a threat in the body. Acute inflammation is a protective mechanism and is an important part of healing. Chronic inflammation on the other hand, can lead to illness.

Acute Inflammation

Think of bumping your knee, it swells, turns red and is painful! Acute inflammation is characterized by redness (rubor), heat (calor), swelling (tumor), pain (dolor) and loss of function. All these factors bring more blood flow to the area, which carries healing cells and nutrients to help the body repair and the pain and immobility mean you will rest your injury! Acute inflammation is helpful.

Chronic Inflammation

Chronic inflammation occurs when the inflammatory response persists over a longer period, which can last for months or even years. Essentially, the immune system starts to get cranky! The white blood cells might start to secrete excess proteins, called cytokines, inflammatory prostaglandins, and histamine, that can propagate an inflammatory cascade.

Signs of Chronic Inflammation

Blood tests may show elevated levels of proteins such as highly sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), which are markers of inflammation. Chronic Inflammation can lead to many symptoms, including “mystery” symptoms such as:

Fatigue and Brain Fog
Unexplained Pain in Muscles and/or Joints
Worsening Allergies and Chronic Hives
Skin problems such as Acne and Eczema
Autoimmune Disease
Digestive Distress
Swelling, Water Retention and Unexplained Weight Gain

Causes of Chronic Inflammation

Chronic Infection

Chronic infection with a virus like Epstein-Barr Virus, bacteria such as Lyme, yeast such as Candida or a chronic fungal overgrowth such as Aspergillus, can cause a chronic low-grade immune response in the body, setting off inflammation.

High Body Burden of Toxins

The first sign of toxicity in the body is often immunotoxicity, toxins irritating and causing dysfunction in the immune system. An increased toxic burden in the body occurs when more toxins are entering the body than leaving, or the body is unable to eliminate toxins effectively and they get trapped in the tissues, causing damage.

Some examples of toxins include:

Heavy Metals: Such as mercury, lead , cadmium, and aluminium. These can be tested with a 6-hour provoked urine collection.

Mycotoxins: Toxins that are absorbed into the body because of mold exposure, tested through a first morning urine sample.

Chemicals: Solvents (think of anything with a smell, cleaners, gasoline, paints etc.), pesticides on produce and herbicides like glyphosate (roundup) in the environment, phthalates from plastics, and parabens from cosmetics. All these toxins can also be tested in urine.

Leaky Gut

Leaky gut, also known as increased intestinal permeability, is a condition where the lining of the intestines becomes more permeable than normal, allowing substances such as toxins, bacteria, and undigested food particles to pass through the intestinal wall and enter the bloodstream.

Normally, the cells of the small intestine, called enterocytes, are bound tightly together by tight junctions which hold the cells together, forming a barrier between the contents of the intestines and the blood stream. What enters the blood stream must pass THROUGH the cells, which is strictly regulated by these enterocytes.

When the tight junctions are damaged, they release a substance called Zonulin, which is our most sensitive test for the presence of leaky gut and can be tested in comprehensive stool tests. Weakening of the tight junctions creates space between the cells and then allows for substances to leak BETWEEN the cells.

Effects of Leaky Gut on the Immune System

Leaky gut makes our immune system cranky, triggering inflammation.

Our immune system is constantly patrolling for foreign proteins. In the presence of leaky gut, longer protein chains of food particles (longer than 12 amino acids, to be specific) and micro-organisms such as bacteria and viruses trigger an immune response. Our immune system starts to become upregulated or cranky, as I like to say, and may start confusing the body’s own proteins as foreign.

This is autoimmune disease. The body’s own immune system is attacking tissues in the body. This could be joints, thyroid, skin, stomach, intestines, nerves, and connective tissues leading to autoimmune conditions.

Causes of Leaky Gut

Leaky gut is caused by inflammation and damage to the gut. Markers of gut inflammation include Calprotectin and Secretory IgA (the gut’s immune system). These are tested through a comprehensive stool test. Causes of leaky gut can include:

Food Sensitivities that can trigger inflammation. Coincidentally, leaky gut will cause more food sensitivities as the immune system reacts to larger particles of food that “leak through”. This is the cause of adult-onset food sensitivities.
Poor diet high in processed foods, sugar and alcohol
Certain medications such as antibiotics and NSAIDS (Ibuprofen)
Dysbiosis or an imbalance of gut bacteria
Chronic Stress we know that elevated stress hormones disrupt the microbiome. Yet another example of how stress is bad for us.

Metabolic Dysfunction

Insulin-resistance and obesity can contribute to inflammation. Adipose cells secrete molecules called pro-inflammatory adipokines, that add to the body’s inflammation burden. More about metabolic dysfunction ahead.

Long-Term Effects of Inflammation.

Chronic inflammation in the long term can reduce health-span, the length of time in our lives that we have health and vitality. Diseases that can result from chronic inflammation include cardiovascular disease, neurodegenerative diseases, cancer and metabolic disease like diabetes.

Treatment of Inflammation

The first step in treating inflammation is removing the root cause. Your naturopathic doctor will look for causes of inflammation and may recommend testing based on your personal health history. Treatment plans may include antimicrobials, foods and nutrients to support detoxification, food sensitivity testing and elimination diet, a plan to restore the microbiome balance, and nutrients to support gut healing.

Reducing inflammation is foundational for optimal health!