Anti-Inflammatory/Anti-Aging Strategies
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An article in a recent trade publication opened with the following: “Charles couldn’t believe the intensity of the pain – and he had been shot during a tour in Iraq with the Marines. “I was lying in my sleeper and my big toe just went on fire. It was like nothing I had ever experienced. I thought I was going to pass out from the pain,” Charles explained. “My big toe was red, swollen and when I touched it, even a little, it hurt like hell”. Charles’ problem is that he suffers from gout.

 Gout is a type of arthritis that seems to run in families and results from the presence of crystals that form in the body. For example, during digestion and metabolism, the body produces uric acid which is eliminated via urine. Any uric acid that the body cannot excrete accumulates in the blood. For reasons not understood, about 30% of people with high levels of uric acid in their blood form needle-like, sharp urate crystals that end up in their joints and/or other parts of the body.

 Herbert Baraf, MD, Chevy Chase, MD, has a great analogy: “Imagine pouring packets of sugar into a glass of tea; can only hold so much in solution. And sooner or later, the sugar is going to start accumulating on the bottom of the glass.

 People with gout may go weeks or months without an attack, but when it flares up it can be excruciating and last for days. Over time, repeated attacks can eat into bone and cartilage, causing permanent damage to affected joints.

Inflammation

The presence of crystals triggers an intense inflammatory response and painful swelling the result of the body’s attempt to break down the crystals. Typically the crystals end up in joint cartilage, and for unknown reasons, especially the big toe.

gouty toe

In others, crystals settle in kidneys or the urinary tract, impairing their function or forming stones. White blood cells migrate into the joint spaces and fluids and the lubricating membranes that line the joints, the synovial membranes trying to eliminate the crystals. The immune cells attracted to the area release biological factors, cytokines and chemokines, into the surrounding area. This attracts more inflammatory cells with a result of redness, swelling and debilitating pain.

Certain immune factors are typically only in small amount in normal uninflamed joint fluids, but in individuals undergoing a gout attack (flare) the levels of the factors are significantly increased.

 Since inflammation is associated with many diseases, such as cancer, diabetes, obesity and cardiovascular health, it is not surprising to find that patients with gout are at higher risk of these diseases when compared to the general population.

 Summary:

Gout is caused by an overactive immune system using inflammation unsuccessfully to get rid of the crystals that are causing the discomfort.

Returning the immune system to balance, immune homeostasis, can result in a higher level of quality of life (QOL) for people with gout.

For years I have helped people promote  joint, digestive, energy and overall health.   Feel free to contact me DrHellen@DrHellenGreenblatt.info, use the form, or give me a call at 302.265.3870 (ET) and let us talk. Let me help you help yourself, it is  time!

www.nature.com/icb/journal/v88/n1/full/icb200999a.html
fleetowner.com/driver-management-resource-center/truck-drivers-crosshairs-gout
www.nytimes.com/2013/04/27/booming/why-do-i-have-gout.html
rheumatology.oxfordjournals.org/content/44/9/1090.short
www.hopkinsarthritis.org/ask-the-expert/heredity-and-gout/
www.uptodate.com/contents/gout-beyond-the-basics
www.internationaljournalofcardiology.com/article/S0167-5273(15)30342-9/abstract?cc=y=
www.ncbi.nlm.nih.gov/pubmed/28093417
www.ncbi.nlm.nih.gov/pubmed/25332119
www.hindawi.com/journals/mi/2015/680853/

 

One of the major complaints that people have is that “they are always tired”. “They just do not care anymore, they are just too tired.” [Kindly view a post that is relevant to this subject: Depression, Anhedonia and Run-Away Inflammation.]

In the past, scientists thought that there was a blood-brain barrier that “isolated” the brain from the actions of the immune system. They labeled the brain “immune privileged”; because studies suggested that a healthy brain had few, if any inflammatory cells in it. Only when there was a brain infection did scientists think that immune cells migrated into the brain.

Researchers failed to take into account that chronic inflammatory diseases are associated the brain. For example conditions such as inflammatory bowel disease, psoriasis, liver disease, and rheumatoid arthritis may result in a lack of social interest, feelings of being unwell and unremitting fatigue—all which are governed by brain function.

Inflammation is activated when the body encounters pathogens and cancerous cells. The inflammatory response is a primary means by which the body will destroy these threats. Inflammation is basically a controlled “burn”.  Firefighters will often have a “controlled burn” in a forest to get rid of dead trees and limbs.  They strive to keep the fire limited to a specific area.  Sometimes however firefighters are unable to control the fire and acres of forest are burned in error.

Similarly, once immune cells have taken care of a threat to the body, for example cancer cells, pathogens, etc., it is essential that the immune system “turn” down the inflammatory “flame”. Chronic, unnecessary inflammation leads to many autoimmune diseases that destroy their own organs, such as diabetes, Crohn’s bowel disease, multiple sclerosis, and lupus

Inflammation is all about location, location, location. If one has inflammation in the insulin-producing cells that control blood sugar, the person may get diabetes. If their intestines are inflamed they may suffer from Crohn’s.  If there is too much destruction and inflammation of nerve cells, they may suffer from multiple sclerosis.

Let us hypothesize that an individual has two trillion immune white blood cells and that half of these cells are out of control and producing too strong an inflammatory response. This inflammation is destroying previously healthy tissues and organs.  Since the body is always striving to balance inflammation, the other half a trillion of cells are working towards lowering the amount of inflammation and destruction that is going on in the body

Each of these cells is expending a trivial amount of energy trying to accomplish its task, but a tiny amount of energy multiplied by two trillion cells is a great deal of “wasted energy”. Is it any wonder why these people complain of being tired?

Individuals who have been diagnosed with autoimmune conditions have higher levels of inflammatory cytokines, immune messages, than people without disease. In heart failure patients, significant fatigue is associated with poor recovery and a higher risk of death. Patients with high levels of anti-inflammatory cytokines, molecules that decrease inflammation, recover more fully and rapidly than patients with high amounts of inflammatory cytokines. When patients are treated for their heart problems, their cytokine levels begin to resemble the cytokine ratios of healthy individuals, and their energy returns.

In mice with liver inflammation, immune cells from the liver travel to the brain and trigger other specialized immune cells called microglia releasing a biochemical that attracts more inflammatory cells into the brain, which in turn produces more inflammation.

In individuals with multiple sclerosis, a nervous system disease with a major inflammatory component, patients had less fatigue when they took anti-inflammatory medications.

The association of appropriate levels of inflammation with a healthy brain and high energy reserves is clear; the key is being in immunological balance. Once individuals balance inflammatory and anti-inflammatory cells they typically regain their energy and focus.

Aren’t you tired of being tired all the time? Don’t wait any longer. Contact Dr. Hellen to talk bout enhancing your quality of life.  There is no fee for consulting with her for the first 30 minutes.  She may be contacted by using this form or at: 302.265.3870 (ET, USA).

http://www.ncbi.nlm.nih.gov/pubmed/25905315
http://www.ncbi.nlm.nih.gov/pubmed/25905315
www.ncbi.nlm.nih.gov/pubmed/26589194
http://www.the-scientist.com/?articles.view/articleNo/43120/title/Brain-Drain/
http://www.ncbi.nlm.nih.gov/pubmed/26705751
http://www.ncbi.nlm.nih.gov/pubmed/25682012

 

For over two decades I have noticed that individuals in immune homeostasis, immune balance, are on fewer medications or no medications than their cohorts, and the majority of them look and feel 10 years younger than other people their age. Comparing photos of how these individuals look now with photos as how they looked 10-20 years ago, it is amazing how great they look! Their youthfulness is especially apparent when I compare these photos to those of individuals that have not made the effort to control inflammation.

Too many older individuals suffer from chronic inflammatory diseases such as arthritis, diabetes, cognition deficits, Parkinson’s disease, lung, kidney, and bladder problems. Over the years there have been numerous studies associating chronic (long-term) inflammation with the development of mutating cells and cancers. However because of the time it takes to do longevity studies it is difficult to prove that limiting inflammation makes a difference in how well people age.

Just this month, a team of scientists from Keio University School of Medicine, Tokyo, Japan and the Newcastle University’s Institute for Ageing in the UK published a study of the immune status of over 1500 individuals ranging in age from 100-115 years.

The study group was divided into two: centenarians, 100-104 years of age, and semi-supercentenarians aged 105 and above. The result was that these long-lived individuals had lower levels of inflammation as compared to the general public.  

Dr. von Zglinicki, one of the investigators, said, “Centenarians and supercentenarians are different – put simply, they age slower. They can ward off diseases for much longer than the general population… it’s only recently we could mechanistically prove that inflammation actually causes accelerated ageing in mice…This study, showing for the first time that inflammation levels predict successful ageing even in the extreme old….”

Dr. Yasumichi Arai, the first author on the study said, “Our results suggest that suppression of chronic inflammation might help people to age more slowly…However, presently available potent anti-inflammatories [medications] are not suited for long-term treatment of chronic inflammation because of their strong side-effects. Safer alternatives could make a large difference for the quality of life of older people.

As I have pointed out for decades, controlling the delicate balance of inflammatory responses, i.e., achieving immune homeostasis, makes all the difference in one’s youthfulness and quality of life.

P.S.  My post of May 20, 2013 also discusses the role of inflammation in longevity.

Please contact me directly if you would like to learn simple approaches to making a difference in your health.
http://www.ncl.ac.uk/press.office/press.release/item/scientists-crack-the-secret-of-the-centenarians
http://www.ebiomedicine.com/article/S2352-3964(15)30081-5/fulltext
www.ncbi.nlm.nih.gov/pubmed/26265203
www.ncbi.nlm.nih.gov/pubmed/26263854

 

Borrelia burgdorferi, is a bacterial infection that results from an infected tick, originally from mammals or birds, biting and injecting the microorganism into a human host. Individuals treated early in infection are likely to recover completely; however, delaying treatment may result in long recovery times, or result in disease that will last for years, or for life.

Infection Affects Multiple Organ Systems
Lyme disease can affect any organ or multiple systems including, skin, joints, nervous system, muscles, and skin. Early symptoms are a red, expanding rash, erythema migrans, that often appears at the tick bite site, and flu-like symptoms such as body aches, fever, chills, headache, and fatigue.

Left untreated, unfocused severe pain may, irregular heart beat and other heart problems, chronic inflammation of the joints (especially the knees, i.e., Lyme arthritis), liver inflammation (hepatitis) and eye problems. Unremitting fatigue, memory problems, and brain “fog” may also accompany the disease.

Incomplete recovery from Lyme disease may result in significant neurological problems, including Bell’s palsy (paralysis of one side of the face), weakness or numbness of limbs, impaired muscle movement, and meningitis (inflammation of brain membranes).

Twenty to fifty percent of patients with neurological issues may continue to experience difficulties for years.

Immune Responses to Lyme Infection
The extent of recovery from Lyme disease depends on factors such as the numbers of bacteria initially injected and the types of immune responses triggered by the infection.

As with healing from most infections, recovery from Lyme disease is a highly complex process requiring the correct interplay of inflammatory and anti-inflammatory cytokines, immune regulating molecules. Successful recovery requires a homeostatic, a balanced immune attack with enough inflammation to kill the organism without damaging by-stander cells and organs.

For example, the cytokine interleukin-6 (IL-6) stimulates inflammation but is also, depending on what the body needs, able to decrease inflammatory responses. (IL-6 is also triggers pain receptors and helps nerve cells regenerate.) Transforming growth factor-β (TGF-β) is another cytokine that helps the body control the amount of inflammation produced in response to infection.

Another cytokine, tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that stimulates certain immune cells to find, engulf, and digest invading organisms. Mice susceptible to Lyme disease are unable to manufacture enough of this factor which may account for their susceptibility.

In humans as well, patients that were recovering well had significantly higher levels of tumor necrosis factor-α compared to those with on-going disease. Once again, these responses likely reflect the powerful inflammatory response that helps the body eliminate the disease.

Additionally, recovering infected individuals had higher levels of transforming growth factor than individuals with severe symptoms. These findings suggest that transforming growth factor was successfully limiting the amount of inflammation being produced in response to infection.

Similarly, in mice with Lyme arthritis, animals that did best were those in which high TNF-α cytokine levels helped kill the bacteria, followed by an aggressive IL-6 response that dampened the inflammatory response.

In further support of these findings, patients with rashes (early infection) had high levels of the anti-inflammatory cytokine, transforming growth factor, as compared to those who had more severe neurological involvement.

Conclusion:
The body uses inflammatory responses to protect itself from infection and heal itself. Inflammation helps the body destroy organisms, almost as if the body was “burning” the infection out. However, just like a forest fire, if inflammation is not well controlled the person with Lyme disease may suffer symptoms for years or for life. This is why it is essential for the body to produce a balanced, immune inflammatory response to infection.

 

Contact Dr. Hellen at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.


www.mayoclinic.org/diseases-conditions/lyme-disease/basics/definition/con-20019701
www.ncbi.nlm.nih.gov/pmc/articles/PMC1782772/
www.ncbi.nlm.nih.gov/pubmed/23945160
www.youtube.com/watch?v=xuTlC_0KzGU VIDEO
www.ncbi.nlm.nih.gov/pmc/articles/PMC2991005/

During the 1970′s and 80′s, the saga of the “boy in the bubble” was followed with great interest. David Vetter, a young Texas boy had severe combined immunodeficiency (SCID), a disease caused by life-threatening defects in his immune system. His immune system was unable to protect him from infection, resulting in the necessity of having to live in a germ-free, isolation containment center designed by NASA engineers. He lived in this plastic bubble from the time of this birth until he died at the age of 12 following a failed bone marrow transplant.

The containment center was supposed to keep David separated from any pathogens that might harm him. Unfortunately, it was likely that it was a virus-contaminated bone marrow transplant that resulted in lymphoma, an immune system cancer, which ended David’s life.

Living in a sea of pathogens, a functional immune system is essential for our survival. Inflammation is among the first steps the body takes to heal after injury or disease and it uses immune inflammatory responses to protect us from cancer cells and pathogens. But too much inflammation is as serious a problem as too little inflammation. The body constantly struggles to limit the amount of inflammation that it produces, with uncontrollable amounts of inflammation acting like as if it was an out-of-control forest fire, destroying healthy cells in its path.

The four letters “itis” indicate an inflammatory condition. Typically, the name of the disease depends on the location in which the inflammation occurs. For example, arthritis (inflammation of the joints), colitis (inflammation of the intestinal tract, the colon), dermatitis (inflammation of the skin), nephritis (inflammation of the kidney), pancreatitis (inflammation of the pancreas), and uveitis (inflammation of a part of the eye).

Most immune cells do not have specialized names, however some organs have specialized inflammatory immune cells that detect infection and help resolve infection or injury to the body. Kupffer cells are most often associated with the liver. Microglia are associated with the brain and are involved in repairing damaged brain tissue and protecting the brain against disease. Dust cells, also known as alveolar macrophages, carry out similar functions in the lungs.

Inflammation is like real estate: location, location, location. The process of inflammation is substantially the same no matter where in the body the inflammation occurs. The intensity of the inflammatory response is determined by a balance between pro-inflammatory (molecules that cause inflammation) and anti-inflammatory (molecules that dampen inflammation) cytokines, immune messages that are released by immune cells.

The key to healthy immune responses is to be in immune homeostasis, immune balance. We must maintain the balance of enough inflammation to defend ourselves from pathogens, stimulate repair, and healing against the need to limit the amount of inflammation that too often leads to inflammatory diseases.

Contact Dr. Hellen for guidance in utilizing natural means to help the body return to immune homeostasis. She may be reached at:  DrHellen@DrHellenGreenblatt.info or or at 302.265.3870.

www.ncbi.nlm.nih.gov/books/NBK22254/
www.ncbi.nlm.nih.gov/pubmed/23720329
www.thedoctorwillseeyounow.com/content/mind/art3792.html?getPage=2
www.hindawi.com/journals/cherp/2012/490804/

 

Nearly every day people tell me that their joints are swollen and stiff, they hurt all over, and that they look and feel older than their chronological age. Most of these individuals have been diagnosed with rheumatoid arthritis.

Arthritis is a sign of a “boosted” immune system with excessive inflammation leading to joint damage. People report pain in areas such as their backs, fingers, hands, wrists, knees, and shoulders.

Rheumatoid arthritis typically affects the joints of the body. However sometimes even before joint symptoms appear, rheumatoid arthritis can involve other parts of the body including the lungs or eyes. Long-term inflammation of the lungs leads to scarring and shortness of breath, fatigue, weakness, and an on-going, chronic dry cough. If the pleura, the tissues around the lungs, become inflamed, fluid buildup may result in fever, pain when taking a breath, and difficulty in breathing.

Inflammation Is Essential for Our Survival:
Clinicians, and most lay people, focus on the harmful aspects of inflammation and try to stop the inflammatory response at all costs. Instead, all that is needed is to control the this immune response. The process of inflammation is normal, protective, and absolutely essential for our survival. Inflammation is the first step to healing after an injury or when the body is gathering its forces to stop an infection. Immune inflammation also helps the body destroy cancer cells before they grow and multiply.

When the body recognizes it has been injured or infected, the immune system releases antibodies and cytokines, smaller proteins that attract different types of immune cells into an area, to help eliminate and destroy threats to the body.

Once healing has started, the amount of inflammation that the body produces must be controlled. The genes that control inflammation have to be “turned off”, down-regulated, so that inflammatory responses are limited.

Arthritis is an Autoimmune Disorder:
Arthritis is one of many autoimmune disorders in which the body mistakenly produces autoantibodies, antibodies against its own tissues that attach to joint linings, and cartilage which acts as a shock absorber. The presence of autoantibodies may trigger immune cells to release inflammatory molecules that cause damage to the joints and other organ systems.

The Effect of Stress and Weight on Arthritis:
There are many factors that contribute to the discomfort experienced by individuals with joint issues. Two of these most recently investigated are: stress and weight.

Stress:
The body increases the amount of inflammation it produces when it is exposes to constant stress and the stress of pain. It becomes part of a vicious cycle. Stress causes inflammation, and inflammation leads to more stress. There is crosstalk between the nervous, hormonal, and immune systems. Changes in one system effects the other system.

Stressed individuals suffering from rheumatoid arthritis produce much higher levels of most cytokines than people without arthritis. Immunologically they respond differently to stress.

Weight Issues:
Overweight and obese patients with rheumatoid arthritis have more pain and respond less well to medication, as compared to normal weight patients. Obesity is an inflammatory disease during which fat cells, especially those concentrated around the inner organs, pump out large numbers of inflammatory molecules. Certain inflammatory proteins are found in high number in the abdominal fat tissue of overweight and obese individuals.

Importance of Immune Balance/Immune Homeostasis:
Immune inflammation is tightly regulated by the body. It consists of a) triggering and maintaining inflammatory responses, and b) producing immune messages that decrease and/or entirely stop the inflammation. Imbalances between the two phases of inflammation results in unchecked inflammation, loss of immune homeostasis, and may result in cell and tissues damage like that experienced in rheumatoid arthritis.

The key is to incorporate lifestyle changes to help the body maintain immune balance.

 Help your body return to immune balance.  Dr. Hellen may be contacted at: 302.265.3870 ET USA, or use the contact form. Thank you.

www.mayoclinic.org/diseases-conditions/arthritis/basics/definition/con-20034095
www.hopkinsmedicine.org/Press_releases/2003/10_17_03.html
www.ncbi.nlm.nih.gov/pubmed/24846478
www.ncbi.nlm.nih.gov/pubmed/24738934
 www.ncbi.nlm.nih.gov/pubmed/24850878
ard.bmj.com/content/early/2014/05/12/annrheumdis-2013-205094
www.fasebj.org/content/27/12/4757

A previous posting (1) discussed the relationship between obstructive sleep apnea and inflammation. Evidence was presented, that levels and types of inflammatory cytokines, as well as other blood markers, are different for individuals suffering with sleep apnea as compared to controls.

Steven Park,MD, a renowned sleep apnea expert in NYC, has discussed the contribution of inflammation to sleep apnea and vice versa (2).

Arthritis, Sleep Apnea, and Inflammation
Recently Dr. Park discussed a Mayo Clinic study in which 50% of rheumatoid arthritis patients were diagnosed with sleep apnea, compared to 31% of the rest of the population. Rheumatoid arthritis is a disease of runaway inflammation affecting the joints. (Older individuals are also at greater risk of sleep apnea, and they trend towards higher levels of inflammation.)

Cancer, Sleep Apnea, and Inflammation
Dr. Park has also mentioned a study concluding that sleep issues are associated with a heightened risk of cancer. Moreover, it is known that there is substantial “cross-talk” between cancerous cells and inflammatory immune cells. Cancer patients experiencing high levels of inflammation, have reduced survival rates. Clinicians have suggested that decreasing levels of inflammation in cancer patients may improve their prognoses.

Obesity, Sleep Apnea, Asthma, and Inflammation
As Dr. Park and others have pointed out, there is a strong association between obstructive sleep apnea and obesity. Fat cells, adipocytes, not only serve as fat depots, but also produce cytokines, immune messages, that up regulate or increase, inflammatory responses.

Obesity is also associated with a higher rate and severity of asthma. Overweight individuals with asthma have increased levels of TNF-apha, an “inflammatory” cytokine than healthy controls.

Obstructive Sleep Apnea Symptoms May be Reduced by Physical Activity
One of the most important steps one can take to lower inflammation, besides controlling weight, and eating a healthy diet, is consistent exercise.

This concept is supported by a recent study from Brazil suggesting that physical exercise affects the cytokine makeup of obstructive sleep apnea patients and may reduce inflammation and symptoms of their disease.

Immune Homeostasis, Immune Balance
The key to excellent health, and healthy aging, is to achieve immune homeostasis, immune balance. The immune system needs to produce enough inflammation to meet healing and infectious disease challenges, but it must be a “controlled” burn, so as not to damage innocent, by-stander cells and tissues.

Lifestyle changes are some of the simplest ways to correct immune imbalances and should be considered as part of anyone’s “preventive and treatment” protocol.

www.jrheum.org/content/36/9/1869.short
www.ncbi.nlm.nih.gov/pubmed/22758643
www.ncbi.nlm.nih.gov/pubmed/22377793
www.ncbi.nlm.nih.gov/pubmed/22610391
www.ncbi.nlm.nih.gov/pubmed/21339327
www.ncbi.nlm.nih.gov/pubmed/22720220
www.ncbi.nlm.nih.gov/pubmed/22751736
www.ncbi.nlm.nih.gov/pubmed/22773729
http://drhellengreenblatt.info/2012/02/inflammation-cancer-chemotherapy-and-brain-fog/

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