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/

 

(My initial post on endometriosis can be found at: http://drhellengreenblatt.info/archives/1448)

Endometriosis is a painful, chronic (long-lasting) condition from which over 5 million girls and women suffer. This is a condition in which the lining of the uterus, called the endometrium, overgrows itself, and actually starts to spread and grow outside of the uterus. These endometrial growths or lesions can end up in the abdomen, in other organs, or as part of abdominal scars after surgery.

Follows a Menstrual Cycle/Infertility
Oddly enough, the misplaced tissue continues to follow a menstrual cycle. As these cells are under the influence of female hormones, each month the cell cluster gets larger and sheds blood and tissue and then shrinks again. The shed blood and tissues trigger inflammation resulting in pain, scar tissue, and adhesions, tissues that stick to one another and neighboring organs. Thirty-40% of women who have endometriosis are unable to have children. (This rate is 2-3 times the rate of infertility of the general population.)

Inflammatory Environment
Excruciating pain, sometimes far from the source, is a major issue for women suffering with endometriosis. Endometriosis appears to create an inflammatory environment that stimulates nerve fibers close to the endometrial lesions and other parts of the nervous system.

Genetics
Genetically, there is a seven-fold increased risk of disease in patients with a family history of the disease and the cells in the endometrial growths have damaged chromosomes.

Toxic Chemicals Implicated
The causes of endometriosis have been under study for decades, but one factor may be toxic chemicals. For example, dioxins are a group of highly toxic environmental chemicals that accumulate in the water and the food chain. They are absorbed by fat tissues and stay in the body for decades. Dioxins appear to cause developmental problems for children, interfere with hormone production, and negatively affect the immune system.

In the test tube, dioxin-like chemicals affect the production of inflammatory cytokines, immune cell factors. In one case, 79% of monkeys exposed to dioxin developed endometriosis, and the greater their exposure, the more severe their disease. Further study suggested that these monkeys had similar immune issues as did women with endometriosis.

Immune Homeostasis: A Balanced Immune System
The immune system strives to maintain a fine balance between protecting the body from the damaging consequences of toxic chemicals and “over-reacting” by causing too much of an inflammatory response.

Endometriosis is an inflammatory condition. Women with endometriosis may experience significant quality of life changes when they approach immune homeostasis.

 

On a personal note, (modified from the previous post http://drhellengreenblatt.info/archives/1448):
Over a decade ago, a young female researcher from West Virginia reported that a large number of women in her West Virginia community had been diagnosed with endometriosis. She was researching this problem, and unfortunately, she herself had endometriosis. She reported that her quality of life improved dramatically when she began to return to immune inflammatory homeostasis. [Unfortunately, she lost contact with the scientist.]


Dr. Hellen is available to work with individuals who wish to enhance their quality of life. She can be contacted at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.

www.ncbi.nlm.nih.gov/pubmed/25528731
www.endometriosisassn.org/endo.html
www.cwhn.ca/en/node/39753
genomemedicine.com/content/2/10/75
www.ncbi.nlm.nih.gov/pubmed/25465987
www.ncbi.nlm.nih.gov/pubmed/25433332
www.ncbi.nlm.nih.gov/pubmed/15731321
researchpub.org/journal/bmbn/number/vol1-no2/vol1-no2-2.pdf
www.ncbi.nlm.nih.gov/pubmed/16101534

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

Blood disorders are diseases that affect blood components: 1) red blood cells, 2) white blood cells, and/or 3) platelets.

 Red blood cells are disc-shaped cells that carry oxygen from the lungs to all the cells in the body White blood cells are immune cells that help the body heal, and protect itself from infections and cancerous cells that might grow into tumors or cancers of the blood.  Platelets are blood elements that stick to the lining of blood vessels and help the blood to clot when  bleeding from a wound.

 Some common blood disorders are  anemia, thalassemia, sickle cell anemia,  idiopathic thrombocytopenic purpura (ITP),pernicious anemia,  hemolytic anemia, and aplastic anemia.

 All of these disorders have a single commonality, mainly that individuals with these types of conditions have low numbers of red cells, white blood cells, and/or platelets.

 Inflammation is necessary for our survival. Invasion by pathogens initiates inflammatory processes that attack these organisms. However, too often the “forest fire” gets out of control, and healthy cells, tissues, and organs are damaged.  When the body attacks its own cells, the condition is called an autoimmune, against -oneself, response.

 Thalassemia is an inherited disease in which people have abnormally low numbers of red blood cells and low hemoglobin. The hemoglobulin molecule is faulty and unable to carry its typical complement of oxygen.  [Hemoglobin is a protein that  helps  transport oxygen throughout the body.  Red blood cells also carry waste gases like carbon dioxide  to the lungs where it is released and then exhaled.]

 Individuals with thalassemia often suffer from inflamed blood vessels and slower blood flow in their blood vessels.  Both problems put individuals at greater risk of suffering from thromboembolism.  In this condition, a blood clot, an embolus, partially or totally blocks blood vessels deep in the body (deep vein thrombosis) or a clot is released that suddenly interferes with blood flow within a lung artery (pulmonary embolism), which can be fatal.

As blood clots form, an inflammatory response is triggerred to break up the clots.  More inflammation results in the production of more cytokines, immune messages that affect blood clotting.  Individuals with thalassemia, as with other blood disorders, typically have higher levels of inflammatory cytokines than individuals without such conditions.

It never ceases to amaze me how many health practitioners ignore the contribution of inflammatory process to diseases such as thalassemia.  In blood disorders, as with most other diseases, achieving and maintaining immune inflammatory homeostasis, balance, is essential.

 Being in homeostasis means that there are enough immune factors, pro-inflammatory cytokines to initiate a proper inflammatory response, and corresponding anti-inflammatory factors to limit inflammation and the damage it may cause.  A delicate balance of these messages are essential.

 What does one lose by moderating excessive inflammatory responses?  Control inappropriate levels of inflammation, and improve the quality of life of those with blood disorders, and most other diseases.

 [Please look for future posts on other blood disorders such as sickle cell anemia, pernicious anemia, and idiopathic thrombocytopenic purpura (ITP)].

 There is no cost to readers of these posts to speak with Dr. Hellen.  She can be reached at 1.302-265.3870 [USA] or contacted at:  drhellen@drhellengreenblatt.info .

 

www.nhlbi.nih.gov/health/public/blood/
www.nhlbi.nih.gov/health/health-topics/topics/pe/
www.sciencedirect.com/science/article/pii/S1079979609001387
bloodjournal.hematologylibrary.org/content/87/12/5051.full.pdf

 

 

Through the years, I have spoken with many individuals, usually, women, who have now been diagnosed with fibromyalgia.  Fibromyalgia is a condition in which individuals suffer from chronic pain, and have tenderness in about a dozen different spots in the body, and have “brain fog”.   They suffer from unremitting fatigue, bowel problems, difficulty in sleeping through the night, and waking up unrefreshed.  As would be expected, they are depressed and anxious as well.

 There are some physicians, even now, that think fibromyalgia “is all in the minds” of their patients.  Some studies have shown, that compared to the general population, individuals with fibromyalgia have significantly higher levels of depression and anxiety.  [Now why someone who is in pain and tired much of the time, would be depressed is beyond me.]

 I once spoke to a male physician who said that he always thought that fibromyalgia was “just” a psychological problem, having nothing to do with biology.  I asked him why he used the past tense, and he said to me, “because I got it!”. 

 Now that the pharmaceutical industry has come out with at least three FDA-approved medications for fibromyalgia, it evidently means that fibromyalgia can now be classified as a disease, and many clinicians treat it as such.  

Many patients have differing success when using these prescription medications.  The three pharmaceuticals reduced pain symptoms by only 30%.  Some of the medications made a difference in fatigue, but not in sleep patterns.  Many of these medications result in side effects ranging from insomnia (which they were trying to combat in the beginning!), nausea, and diarrhea.  Unfortunately for individuals suffering with fibromyalgia, many patients find that if the medication does work for them, too often it is for only a short-period of time, for as little as six months total.

Most clinicians state that the cause of fibromyalgia is unknown, but that “painful tissues” are not associated with inflammation. 

I respectfully suggest that inflammatory responses are major contributors to the pain and discomfort those individuals with fibromyalgia experience.  Indeed, I cannot imagine that a person can feel pain, in the absence of inflammation.

Increasingly, the literature suggests that fibromyalgia, and other neuromuscular conditions are characterized by low-grade inflammation.  Inflammatory cytokines such as tumor necrosis factor-alpha and IL-1, and other immunological factors, have been found to be at higher levels than “normals” and may be resulting in the fatigue and flu-like illness experienced by individuals with fibromyalgia.

Controlling run-away inflammation by returning to immune homeostasis, immune balance, has, in my experience, resulted in dramatic differences in the quality of life of individuals suffering with fibromyalgia.  These individuals have tried other approaches with only limited success, so why not support balanced immune responses?

Medscape Family Medicine 2012 WebMD, LLC
www.actabiomedica.it/data/2007/2_2007/fietta.pdf
www.medicinenet.com/fibromyalgia/article.htm
www.ncbi.nlm.nih.gov/pubmed/21975140
www.ncbi.nlm.nih.gov/pubmed/19957871

 

Exercise is essential for workers such as firefighters and paramedics that have physically-and emotionally-demanding jobs, and is mandated by most departments.

According to a study by the University of Arizona, Tucson, AZ and the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 30% of the strains and sprains that firefighters and paramedics experienced, happened as they were working out. Seventeen percent of injuries, and almost half of time off work for injuries, were caused by strains and sprains resulting from workers carrying individuals.

Pain and inflammation “feed one another”. Pain triggers more inflammation and inflammation  leads to more pain. It is not clear how the body senses pain, nor biochemically, the exact events that lead to the sensation of pain. We know however, that pain signals from our back or limbs travel along nerve cells to the spinal cord and up to the brain, and that inflammation in the spinal cord and brain is either the direct cause of pain, or a major contributor to pain sensations that we experience.

When muscles and tissues are injured, immune cells respond by entering the area and releasing cellular factors (e.g., cytokines) that will up-regulate inflammation as a way to help the body heal.

However, it is as important for the body to decrease its inflammatory responses after a challenge is met, as it is to increase the response in the first place. Decreases in inflammatory responses, down-regulation, result from the production of different amounts of anti-inflammatory cytokines and their ratio to pro-inflammatory cytokines that cause inflammation. It all about the appropriate balance of immune responses, immune homeostasis.

(Please watch for the next posting discussing natural methods of helping the body achieve immune homeostasis, and recover, and heal faster.)

injuryprevention.bmj.com/content/early/2011/11/03/injuryprev-2011
www.nature.com/nrneurol/journal/v7/n3/full/nrneurol.2011.4.html
www.ncbi.nlm.nih.gov/pubmed/19096368
www.ncbi.nlm.nih.gov/pubmed/22119349
www.gluegrant.org/inflammation101.htm
http://www.ncbi.nlm.nih.gov/pubmed?term=Curr%20Drug%20Targets%20Immune%20Endocr%20Metabol%20Disord%202005%205%3A413

>Gina Kolata of the NY Times reports that many athletes, both professional and amateur, often have difficulties in finding the right approach when they injure themselves. They spend thousands of dollars visiting physicians who are confident that they can help, but too often, the procedures are not very helpful.

Research clinicians are questioning the benefits of certain procedures recommended by physicians. Their concern is that there is little “credible evidence” to back up many of the methods that their colleagues use (1).

Most physicians would probably agree that the pain their patients experience is due to excessive levels of inflammation. Inflammation is essential for good healing, but it is just as important that inflammation be a controlled event.

“Inflammation is the immune system’s response to injury and infection, and quick decisions must be made when one or both are present. If the immune system detects an infection, it also looks for signs of injury (broken cell parts, spilled cell constituents). The reverse holds as well — after sensing an injury, the immune system searches for telltale signs of the presence of microbes launching an infection. In many cases, both an infection and an injury set off an inflammatory response. After massive tissue damage caused by trauma …, a systemic inflammatory reaction can set in (2).”

Tissue injury is associated with “an inflammatory soup bathing small nerve fibers”. The immune factors, cytokines, that make up this “soup” are initially pro-inflammatory (2).  They trigger inflammation, resulting in pain sensation that occur throughout the body, including in the brain.

When athletes are injured, the key is for the body to heal the injury, and then down-regulate, “calm-down”,  the inflammatory response and return to immune homeostasis.

(1) www.nytimes.com/2011/09/05/health/05treatment.html?ref=health
(2) www.gluegrant.org/inflammation101.htm
(3) www.ncbi.nlm.nih.gov/books/NBK57275/

 

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