Dr. Hellen Greenblatt

The Role of Inflammation in the Blood Disorder Thalassemia

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

and aplastic anemia., anemia, anti-inflammatory, autoimmune, balance, blood clots, blood disorders, cancer, chronic disease, cytokines, deep vein thrombosis, hemoglobulin, hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), immune homeostasis, immune system, inflammation, inflammatory responses, injuries, pain, pernicious anemia, platelets, pulmonary embolism, red blood cells, sickle cell anemia, thalassemia, thromboembolism

Ventilators Can Result in Excessive Inflammation of Already-Damaged Lungs

People with serious lung problems who are unable to breathe for themselves, for example, patients in intensive care units recovering from injuries, or who have viral, or bacterial infections, like pneumonia, may be placed on mechanical ventilation.

Although these patients may require a ventilator, too often these devices make their lung conditions worse. Patients with lung injuries that require mechanical ventilation lead to more deaths annually than do breast cancer and prostate cancer combined.

For years, scientists have known that when lungs are exposed to rhythmic pressure of ventilation, the production of cytokines, immune messengers, are stimulated. This excessive production of cytokines results in “boosted” levels of inflammation in the lungs that may damage the lungs, even after ventilation has been stopped. Excessive inflammation can lead to the destruction of formerly healthy organ systems.

It is as if the immune system sees “pressure” as a “foreign agent” an event against which the body much be protected. The pressure appears to trigger an immune inflammatory response in the body.

This phenomenon can be seen even at the cellular level. Exposing cells in a test tube to as few as four hours of rhythmic pressures results in increased levels of inflammatory cytokines that recruit more inflammatory immune cells into the area. Twelve (12) hours of ventilation-type treatment results in a 5-7 times increase in the levels of inflammatory cytokines.

During winter months, respiratory infections are the most frequent cause of intensive care unit hospitalizations for infants. For some infections, Infants that are on mechanical ventilators have significantly higher levels of lung inflammation than infants not being ventilated. However, even in healthy children, mechanical ventilation triggers an inflammatory response within hours.

For over a decade I have tried to educate the public about the need for the body to maintain immune inflammatory homeostasis, immune balance; having enough inflammation to do the job, but not so much that it causes damage.

Inflammation is necessary for our survival to protect us from infections, and it is the first step the body takes when it heals itself, for example, after an injury.

But the amount of inflammation produced by the body must be tightly limited, because too much inflammation is like an uncontrollable forest fire.

One of my greatest frustrations has been trying to help medical practitioners understand that inappropriate inflammation is the foundation of most of their patients’ problems, but too often, “they just couldn’t get it”. Now, every journal, every magazine touts the fact that “inflammation is the root cause of disease”. They admit that it has a role in cardiovascular disease, gastrointestinal, emotional problems etc. and that inflammatory responses play a major role in cancer.

It has been my experience that when individuals have major health issues, “following the levels of inflammation” will help explain what is happening to the patient. In cases of mechanical ventilation, other procedures and conditions, what would be the harm in taking steps to limit uncontrolled levels of inflammation, and help return the body to immune homeostasis?

Dr. Greenblatt looks forward to assisting you in returning to immune balance: She can be contacted at: http://drhellengreenblatt.info/contact-dr-hellen or 1.302-265.3870 [USA, ET]. Thank you.

www.ncbi.nlm.nih.gov/pubmed/24349427
www.ncbi.nlm.nih.gov/pmc/articles/PMC3859624/
www.ncbi.nlm.nih.gov/pubmed/?term=Ghadiali+ventilators
researchnews.osu.edu/archive/lungvent.htm
www.fasebj.org/search?fulltext=Samir+Ghadiali&submit=yes&x=13&y=12
www.medicine.uiowa.edu/Newsarticle.aspx?id=22193
www.ncbi.nlm.nih.gov/books/NBK6868/

anti-inflammatory, balance, chronic disease, cytokines, healing, immune homeostasis, immune system, inflammation, injuries, lungs, pro-inflammatory, Ventilators

Microbes, Gluten, Celiac Disease, Diabetes, and Inflammation

We humans exist in sea of microorganisms. According to the American Society for Microbiology, there are 10 fold the number of bacteria living in and on our bodies as cells that make up our bodies. Wherever our bodies are exposed to the outside world, for example our digestive tracts, skin, mouth, vagina, etc. we find specific varieties of bacteria and other organisms.

The totality of all the bacteria and other microorganisms that populate our bodies is called the microbiome. The microbiome is highly individualized, with the spectrum of bacteria differing from one person to another; much like an individual’s fingerprints. All people display wide variations in the kinds of bacteria that inhabit them. The types and numbers of bacteria in and on our bodies differ depending on our genetic makeup, our diet, and environmental factors.

Immune cells are found throughout the body where they are always on alert defending the body against infection. Inflammation is the primary way that the immune system controls infections and healing, but overactive immune responses can lead to debilitating inflammatory diseases such as atherosclerosis, diabetes, and bowel disorders.

There is considerable “cross-talk” between the microbiome and the immune cells. Microorganisms influence the responses of the immune system, and the immune system in turn affects the populations of the organisms that inhabit us. For example, evidence suggests that certain bacteria in the gut can decrease inflammation in the gut and decrease chronic disease. [Whether the organisms themselves are producing these molecules, or whether they are triggering immune cells to release anti-inflammatory compounds is not clear.]

Celiac Disease and Diabetes:
Individuals with celiac disease are highly sensitive to foods containing gluten, a protein found in barley, rye, and wheat. People with celiac disease have significant quality of life issues such as bloating, diarrhea, and/or constipation.

When the immune cells of celiacs see gluten, they mount an inflammatory response to try to eliminate the gluten from the intestines. The immune cells produce antibodies that attach to the inner surface of the gut and through inflammatory responses cause direct damage of the gut lining. Inflammatory responses against the body’s own tissues lead to autoimmune (against oneself) disease.

Diabetes is also the result of an autoimmune condition. Inflammatory immune cells destroy specialized cells in the pancreas that produce insulin, a hormone needed to control blood sugar.

Individuals with celiac disease have more than digestive issues, since they have almost 2.5 times a greater chance of developing diabetes than those without intestinal problems. Such conditions are associated with antibodies directed against the insulin-producing cells. When Individuals with celiac disease go on a strict gluten-free diet, they produce fewer anti-insulin-antibodies, suggesting that they are producing less of an inflammatory response.

Gluten intake changes the kinds of bacteria found in the gut. Diabetic-prone mice that eat regular mouse chow containing gluten are more likely to get diabetes than diabetic-prone mice on gluten-free chow. In addition, when the gut bacteria are analyzed, the diabetic-prone mice on gluten have the type of bacteria more often associated with inflammation, than the mice not on gluten. Thus, diet affects the responses of the immune cells and the microbiome.

As followers of this blog are aware, in the face of constantly changing external and internal challenges, the immune system of a healthy person makes adjustments to maintain immune balance, immune homeostasis.

One would expect that if inflammatory and autoimmune responses were better controlled by the body, that individuals with celiac disease and diabetes would experience a far better quality of life.

www.ncbi.nlm.nih.gov/pubmed/22699609
www.ncbi.nlm.nih.gov/books/NBK27169
www.ncbi.nlm.nih.gov/pmc/articles/PMC3256734
www.ncbi.nlm.nih.gov/pmc/articles/PMC2575488
www.ncbi.nlm.nih.gov/pubmed/22913724
www.ncbi.nlm.nih.gov/pubmed/24164337
www.ncbi.nlm.nih.gov/pubmed/24041379 www.sciencedaily.com/releases/2013/11/131113182423.htm
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078687

anti-inflammatory, autoimmune, balance, C-reactive protein, celiac, chronic disease, Crohn's, cytokines, diabetes, gluten, gut, immune, immune homeostasis, immune system, immunoglobulins, infection, inflammation, Inflammatory Bowel Disease, inflammatory responses, insulin, microbes, microbiome, pro-inflammatory

Alcohol Abuse, Immune Balance, and Inflammation

Alcoholism is a condition in which individuals drink alcohol in excess despite the fact that their habit causes physical and mental health problems, and social, family, and/or job-related issues. Heavy alcohol consumption results in damage to many parts of the body including the brain, liver, digestive system, and joints. Alcoholics also suffer with dementia, memory loss, depression, emotional instability, and are at increased risk of cancer of the colon, liver, and esophagus.

Immune System Effects

Prolonged, heavy alcohol consumption negatively affects immune cells and their production of cytokines, immune messages. Alcoholics have significantly higher rates of bacterial and viral infections and when hospitalized remain hospitalized longer than those that do not abuse alcohol. Alcohol not only kills key immune cells, but excess amounts of alcohol results in an increased risk of autoimmune responses in which the body’s immune cells mistakenly attack the body’s own healthy cells as foreign.

The body constantly strives to maintain immune inflammatory homeostasis; to balance the amount of inflammation it produces to protect the body from infection. Imbalances of inflammatory responses, loss of immune homeostasis, result from excessive alcohol consumption. For example, white cells, immune cells, search out and destroy and remove pathogens from the lungs. After alcohol consumption, fewer immune cells respond to the call for “help”. Those cells that do enter the lungs are unable to kill microbes as effectively as cells from non-alcoholic animals.

The inefficient immune responses of alcoholics lead them to be more vulnerable to viral infections such as hepatitis C, influenza, and HIV and bacterial infections including tuberculosis and pneumonia. Especially after experiencing trauma, e.g., surgery, alcoholics are more likely than non-alcoholics to get pneumonia.

A mouse study is one of many that demonstrates the decreased ability of alcohol-imbibing animals to fend off infection. Sixty percent of mice that were exposed to the flu after imbibing alcohol for two months died of the flu as compared to a 15% mortality rate of mice that had not been drinking alcohol prior to exposure.

Hormone Effects:

Cortisol, the “stress-response hormone” affects nervous, immune, circulatory, and metabolic systems of the body. After surgery, chronic alcoholics have higher cortisol levels compared to non-alcoholic patients. The increased inflammation that accompanies stress also leads to higher levels of depression, other addictions, and mood disorders.

Other hormones effected by alcohol consumption are those a)that may interfere with the a women’s menstrual cycle, b) the ability for men and women to enjoy sex, or c) control blood sugar.

Nervous System Complications:

Alcohol is neuro-toxic to brain cells interfering with the development, repair, and communication of nerve cells. Consumption of large amounts of alcohol leads to shrinkage of white matter in the brain, adding to depression, confusion, short-term memory loss, “fuzzy” thinking, and a greater risk of getting dementia. Alcohol also directly affects the nervous system in other ways, causing numbness, tingling, and pain in hands and feet.

Additionally, too great a consumption of alcohol, especially over a long period of time, results in problems with absorption of nutrients, the lack of which can become so severe that certain forms of dementia are triggered.

Bone Loss

Alcohol damages osteoblasts, the cells needed to grow and maintain bone. Destruction of osteoblasts results in decreased bone mass and susceptibility to fractures and other orthopedic problems. When a bone fracture occurs, immune cells rush in to start the healing process. They release immune signals, cytokines that start the inflammatory process that recruits more cells into the area. However, when there is too much inflammation, healing, and bone growth is delayed with the result that bones become brittle, thin, or misshapen.

Vitamin B12, vitamin D, phosphate, and magnesium are needed to grow bone. Excessive intake of alcohol is associated with low or subnormal levels of these elements, further inhibiting the growth of and repair of bones.

Skin and Injuries

The cells in the skin help defend the body from pathogens, and keep the skin healthy, youthful, and supple. The immune cells in the skin interact with the microbes that live on the surface. Although the numbers of bacteria on healthy skin stays constant, the types of bacteria that exist change depending on environmental and immune interactions

Heavy use of alcohol significantly slows the movement of immune cells, upsetting the balance, the homeostasis of the skin. Alcoholics experience a greater number of severe skin infections than individuals that drink responsibly.

Almost half of all patients coming into an emergency room with an injury, trauma cases, have high levels of alcohol in their blood. Drunken patients have more severe symptoms, and take longer to recover. They also have higher rates of death as compared to non-intoxicated patients.

Because these patients have imbalances of inflammatory response, it takes them longer to heal, and wounds may become more severe, more quickly. Alcohol damage to the skin continues even after they stop drinking. Alcoholics experience longer hospital stays, especially if they are patients in an intensive care unit.

In a study of two groups of animals with burns, 50% of the animals that had not consumed alcohol survived, compared to 20% of the alcohol-consuming animals.

Summary:

Although not discussed in this post, moderate intake of alcohol has a beneficial effect on inflammatory markers. However, heavy drinking results in uncontrolled amounts of inflammation leading to a myriad of health consequences. Controlling the amount of inflammation the body produces will make a major difference in the quality of life of an individual.

Some steps abusers of alcohol can take to help their body modulate inflammation are:

Limit the number of drinks consumed*
Exercise 30 minutes/day for 5 days a week (150 minute minimum/week)
Have smaller food portion sizes.
Consume more fruits and vegetables.

*It is recommended that women limit their alcohol intake to one drink** per day, and men to two drinks/day. [Women absorb and metabolize alcohol differently from men and are more susceptible to alcohol-related organ damage and trauma than men.]

**One drink is defined as 1.5 fluid ounces of 80-proof distilled spirits, 12 ounces of beer, or 5 ounces of wine (a pinot noir wine glass about 1/4 full).

Dr. Greenblatt looks forward to assisting you in reaching your goals: http://drhellengreenblatt.info/contact-dr-hellen or 1.302-265.3870 [USA, ET].

www.nlm.nih.gov/medlineplus/ency/article/000944.htm
eurheartj.oxfordjournals.org/content/25/23/2075.full
www.ncbi.nlm.nih.gov/pubmed/21193024
www.ncbi.nlm.nih.gov/pmc/articles/PMC2377009/
www.ncbi.nlm.nih.gov/pubmed/23895590
www.ncbi.nlm.nih.gov/pmc/articles/PMC2906126/
www.ncbi.nlm.nih.gov/pubmed/24138635
www.ncbi.nlm.nih.gov/pmc/articles/PMC3005009/
www.ncbi.nlm.nih.gov/pubmed/23240627
pubs.niaaa.nih.gov/publications/10report/chap04b.pdf
www.ncbi.nlm.nih.gov/pubmed/23981442

alcoholism, anti-inflammatory, autoimmune, balance, cancer, chronic disease, cytokines, depression, exercise, gut, healing, immune homeostasis, immune system, infection, inflammation, inflammatory responses, injuries, joint pain, microbes, pro-inflammatory

THE MIND-BODY CONNECTION: INFLAMMATION AND DEPRESSION

Exposure to chronic constant emotional or physical stress triggers a vicious cycle of inflammation. The stress increases the amount of inflammation that the body generates, and the additional inflammation “feeds” more stress.

Depressed individuals report that they experience high levels of tension and anxiety, fatigue, muscle discomfort, and/or gastrointestinal problems. Often they have a feeling that “something is very wrong”, but they cannot pinpoint what is bothering them.

Individuals suffering from depression often start by visiting physicians that specialize in specific organ systems of the body. For example a neurologist (specialty in the nerves), a gastroenterologist (digestive system), or a psychiatrist (medical doctor) or a psychologist, practitioners specializing in mental disorders. Unfortunately, most of these experts tend to focus on a single part of the body.

Since the human body is a single organism, and all the organ systems are integrated, it might be useful to realize that there is substantial and constant cross talk between all the organ systems of the body. Affect one part of the body and it has a ripple effect on all the other parts of the body.

As an example, when individuals are depressed, their immune cells produce large amounts of inflammatory molecules, pro-inflammatory cytokines, which circulate throughout the body. Since cytokines act in a hormone-like fashion, they affect all parts of the body and the brain.

Treatment Resistant Depression
Over seven million individuals with depression find little or no relief that prescribed antidepressant medications. A significant number of these patients have high levels of inflammatory cytokines, immune messages that result in inflammation. These inflammatory cytokines can interfere with the actions of medications.
Lifestyle Changes.

Too many individuals are convinced that only prescription medications can make a difference in their depression and anxiety. However, there are certain life style changes that may help them, with their clinician’s approval, decrease their medication.*

(*Note: The following lifestyle changes should only be incorporated after consultation with a qualified health practitioner. If you are on prescription medications, especially for depression or anxiety, DO NOT REDUCE OR STOP ANY MEDICATIONS without consulting with the prescribing health practitioner.)

Some naturally oriented steps that one can take are:

EXERCISE:
Researchers at Duke University Medical Center, Durham, NC, found that a brisk 30-minute walk or jog three times a week may be just as effective in relieving major depression as are antidepressant prescription medications. Patients were assigned to three groups: antidepressant medications only, exercise only, or a combination of both medication and exercise. The scientists found that the exercise by itself was just as effective as medication and “was equally effective in reducing depression…” as were antidepressants.

One reason exercise may be so effective in reducing the inflammatory-depression cycle is that every time a muscle contracts, it releases anti-inflammatory immune cytokines that reduce inflammation and a help to decrease anxiety, and improve mood.
SUNSHINE AND FRESH AIR:
The amount of time subjects are exposed to sunlight is directly related to the amount of a specific inflammatory cytokine they produce, and depressed individuals show differing levels of the cytokine when exposed to light for varying amounts of time.
Moderate exposure to sunshine and fresh air may contribute greatly to feeling less depressed. This may “simply” be because when one is exposed to sunlight, vitamin D is produced by the body.

Vitamin D is more like a “hormone” than a purely nutritional element, since it affects hundreds of genes and is a powerful immune system regulator. Although still not definitively proven, individuals living in temperate areas may find that taking vitamin D3 supplements may prove helpful.

EAT SMARTER:
Increase the amount of fresh and colorful fruits and vegetables, beans, fish, and chicken. Limit non-nutritious “foods”, especially fried foods, sweets, sodas (diet or regular!), white rice, and pasta. Eating in a nutritional manner may help the body regulate its daily inflammatory responses.

CONTROL YOUR WEIGHT:
Fat cells, adipose cells, especially those around abdomen produce a wide range of inflammatory cytokines. As the size of the cells decrease, the amount of inflammation that the body produces decreases. Lowering inflammation helps an individual to return to their natural immune homeostasis, their natural immune balance.

OMEGA-3 FATTY ACIDS FROM FISH OILS:
Studies suggest that daily consumption of omega-3 fatty acids from fish makes a difference in depression. In a recent randomized double-blind placebo-controlled study of shift workers, supplementation with omega-3 was associated with a reduction in high sensitivity C-reactive protein (an inflammatory marker) and depression. In another study of women, the highest intake of omega-3 was associated with a 49% decrease in symptoms of depression. In the latter study, investigators suggested that omega-3 was triggering the production of anti-inflammatory compounds.

RETURN THE BODY TO IMMUNE BALANCE, IMMUNE HOMEOSTASIS:
Inflammation in the body is a normal and desired process that is part of the healing cycle and it is the primary method by which the body defends itself from pathogens. The key to good health is to help the body achieve the right level of inflammation, immune homeostasis. We want the body to produce enough of an inflammatory response to defend itself from pathogens and cancerous cells, but not so much inflammation that healthy tissues are damaged.

Hyperimmune egg has been shown to help the body return to immune homeostasis, immune balance. In a university, double-blind placebo-controlled trial (the gold standard of human trials), subjects consuming hyperimmune egg reported lower levels of moodiness, anger, and hostility. [Med Sci Sports Exer 2009 5:228].

SUMMARY
Chronic inflammation, brought about by an over-expression or lack of control of the normal protective mechanisms of the body, has been linked to range of conditions including depression.
Individuals who control inflammatory responses will have a much higher emotional and physical quality of life.

anti-inflammatory, balance, C-reactive protein, chronic disease, cytokines, depression, exercise, fat cells, fatigue, gut, healing, hyperimmune egg, immune homeostasis, immune system, inflammation, inflammatory responses, pro-inflammatory

Endometriosis, Inflammation, and Immune Homeostasis (Balance)

Endometriosis* is a painful, hormonal and immune system disease in which tissues similar to the mucous membranes lining the uterus (endometrium), end up in “strange” locations, places that these sorts of tissues are not typically found. The pockets of tissue react to monthly surges of estrogen and progesterone just like the uterus. These cells can be found, for example, outside the uterus, around the ovaries, fallopian tubes, the abdominal cavity, bladder, cervix, or bowels, and can become irritated and inflamed during the reproductive cycle. Eventually the condition may result in scarring and adhesions, abnormal tissue that binds organs together like a spider web.

Autoimmune Contribution?
Some scientists suggest that in endometriosis the immune cells of the woman are unable to recognize the presence of these “displaced” tissues and that the cells are not destroyed as they normally would be. Women with endometriosis, besides having greater inflammatory responses, often produce autoantibodies (antibodies against healthy tissue) and immune factors that lead to inflammatory conditions.

Endometriosis is a complex disease in which many factors, including genetic, one’s anatomy, and one’s environment all contribute to the problem. Endometriosis is associated with a disrupted inflammatory and hormonal environment in which growth factors and immune factors, such as cytokines, exist at increased levels. Women with endometriosis may exhibit excessive growth of blood vessels and nerve cells in their pelvis, which may “feed” the pain.

Symptoms
Endometriosis may be accompanied by heavy bleeding at anytime during the menstrual cycle, with severe pain becoming especially acute during menstruation. Pain and cramping may begin before, and extend several days into a women’s menses, and she may experience lower back and abdominal pain, bloating, diarrhea, fatigue, and malaise. Pain may be present during or after sex, and with urination, or bowel movements.

The severity of the pain experienced is an unreliable indicator of the extent of the condition. For example, women with mild endometriosis may have extensive pain, while others with advanced endometriosis may experience little or no pain.
Endometriosis can develop in girls as young as eight, or years after the onset of menstruation. While many women find that symptoms of endometriosis temporarily stop during their pregnancy, and/or completely with menopause, this is not always the case.

The main complication of endometriosis, besides excruciating pain, is infertility. Thirty to fifty percent of women suffering with endometriosis have difficulty getting pregnant.

Inflammation
Endometriosis is associated with an inflammatory environment of the pelvis. Different types of cytokines, immune factors, and growth factors are elevated in these individuals. For example, IL-8 is an inflammatory cytokine associated with inflammatory responses. The amount of Il-8 present in the body is strongly correlated with the severity of the disease, and contributes to the formation of adhesions.

Lean vs. Obese Women
In a study of younger women, the risk of endometriosis later in life was 40% lower in morbidly obese women as compared to lean women. The latter group had a nearly 3-fold greater risk of developing endometriosis than the obese women. This finding is contrary to expectations, since typically, obese women are at greater risk of inflammatory-mediated diseases than leaner women, and therefore would be expected to be at greater risk of developing endometriosis.

[As an aside, heavy women that engage in regular, moderate to vigorous physical activity, lower their risk for endometrial cancer and other diseases. This result is expected, since every time muscle cells contract, they release potent anti-inflammatory molecules which balance the amount of inflammation generated by fat cells.]

Toxic Chemical Exposure
Dioxin is a toxic byproduct of industrial and consumer processes that involve chlorine or incineration of chlorine-containing substances, such as PVC, polyvinyl chloride, commonly known as “vinyl” plastics.

Exposure to dioxin and dioxin-like compounds have been shown to disrupt immune and hormonal balance and such chemicals have been implicated in the development of endometriosis and other diseases.

Non-Clinical Approaches
Physicians commonly recommend surgery and pharmaceutical approaches for endometriosis, but “alternative” approaches have been found to be helpful to others. For example acupuncture has been shown to be an effective pain treatment for some individuals. Additionally, eating a healthful diet, regular exercise, and certain amino acids may prove helpful.

Personal Note
I would be negligent if I did not mention that over a decade ago, a young researcher from West Virginia reported to me that a large number of women in a West Virginia community had been diagnosed with endometriosis. She was researching this problem, and unfortunately, she herself had endometriosis. I suggested a gradual introduction of a daily administration of 9-12 grams of polyvalent hyperimmune egg, a whole-egg protein from specially treated hens.

After a number of weeks the researcher reported back to me that her quality of life had improved dramatically. Unfortunately, I have lost contact with the investigator, so cannot report further on any changes she may have experienced.

Importance of Immune Homeostasis, Immune Balance
The key to endometriosis, as with most disease, is run-away inflammation. Therefore, achieving immune, inflammatory, homeostasis (balance) in individuals with endometriosis, may result in major differences in their quality of life.

Dr. Hellen can be contacted at: http://drhellengreenblatt.info/contact-dr-hellen/ or 1.302-265.3870 [USA, ET].

*Interested parties may contact support@endometriosisassn.org for a free information packet on endometriosis.

www.nmihi.com/e/endometriosis.htm
www.ncbi.nlm.nih.gov/pubmed/21054165
www.ncbi.nlm.nih.gov/pubmed/11949939
http://humrep.oxfordjournals.org/content/28/7/1783Share
www.endometriosisassn.org/environment.html
http://toxsci.oxfordjournals.org/content/70/2/161.full

anti-inflammatory, autoantibodies, autoimmune, balance, cancer, chronic disease, cytokines, dioxin, endometriosis, exercise, fat cells, fatigue, hyperimmune egg, immune homeostasis, infertility, inflammation, inflammatory responses, menstruation

Migraines, Inflammation, and Immune Homeostasis

| Posted by in Chronic Disease | Inflammation | Migraines - (0 Comments)

Migraine headaches are often characterized by excruciating throbbing pain on one side of the head, which may switch to a different side from episode to episode. Individuals may also experience severe pain in/or over one or both eyes, or in their sinuses. Nausea, vomiting, disturbed vision, and increased sensitivity to light and sound may also occur. Migraine headaches can last for hours or even days, and may reoccur, daily, weekly, or monthly.

Preventing the onset of a migraine, or decreasing its frequency or severity appears to be the best strategy because once a headache starts to occur on a daily basis, treatment options are few. This makes it important to take action before this point is reached.

Migraines are difficult to study, because in between episodes, the person is basically healthy and researchers have been unable to find a biomarker that is the hallmark of the condition. Unfortunately, many patients go from doctor to doctor trying to find migraine relief.

Some people can identify triggers for their migraines, while others find no association. However, even with those that have known triggers, avoiding triggers does not always prevent their migraines.

Some triggers that people report are: allergic responses, emotional or physical stress, certain odors or perfumes, loud noises, bright lights, sleep disturbances, exposure to smoke or smoking, alcohol, fasting, hormonal changes, and certain foods.

Besides medication, some methods used to reduce the frequency and severity of migraines are: massage of temples, neck, shoulders, and back, head and neck stretches, acupuncture, stress reduction, biofeedback training, Botox® injections, stimulator devices, staying hydrated, and eliminating specific foods. Unfortunately these techniques rely on a trial and error method.

Several studies have found that people who exercise have fewer, shorter, and less severe migraines than those who are not active, but other individuals report that physical activity merely acts as a trigger for their migraines.

In women of a reproductive age, and in children, obesity often increases the number of migraines they experience. Fat cells produce inflammatory immune molecules. These immune factors may result in increasing the severity, duration, and frequency of migraine attacks.

Inflammation protects the body from pathogens. But the amount of inflammation produced has to be carefully regulated by the body, otherwise innocent bystander organs and tissues are attacked. When the body produces the correct amount of inflammation, it is in immune homeostasis, immune balance.

Disruptive levels of inflammation in the body contribute to migraine pain. Therefore, taking steps which lower inflammation, such as exercise, nutritional intervention, and weight reduction, helps the body reduce unhealthy levels of inflammation and change the quality of life of individuals.

http://www.neurology.org/content/64/10_suppl_2/S9.extract
http://www.medicalnewstoday.com/articles/148373.php
http://www.ncbi.nlm.nih.gov/pubmed/23695047
http://www.nature.com/ng/journal/vaop/ncurrent/full/ng.2676.html
http://www.ncbi.nlm.nih.gov/pubmed/23524340
http://www.ncbi.nlm.nih.gov/pubmed/17515549
http://www.ncbi.nlm.nih.gov/pubmed/23390177
http://www.ncbi.nlm.nih.gov/pubmed/22894176

balance, exercise, fat cells, immune homeostasis, inflammation, inflammatory responses, migraines

Inflammatory Bowel Disease and Run-Away Inflammation

From 70-85% of the immune system and immune-like cells are found in the lining of the gut. This complex network of cells helps the body discriminate between helpful, commensal bacteria, and pathogenic bacteria that cause illness.

There is significant cross-talk between the immune cells and the organisms living in the intestines.
The immune system in the intestines is constantly balancing the kinds and numbers of bacteria and other organisms that live in the gut. And the bacteria are changing the population of immune cells. Both work to try to achieve balance, immune homeostasis.

Chronic inflammation of the digestive tract may be a reaction against specific bacteria found among the trillions of microorganisms living in the intestines. Inflammatory bowel diseases, IBDs, are characterized by unhealthy levels of inflammation occurring in different sections of the intestine. The bacterial strains found in the GI tracts of IBD patients differs from those seen in healthy controls and IBD patients have the most amount of inflammation in the areas of the GI tract with the highest concentration of bacteria.

Many of the cells in the gut directly recognize and attack infectious organisms. Upon exposure to pathogens, intestinal immune cells are stimulated to generate immune molecules such cytokines and natural antibiotics called defensins. Defensins kill microorganisms by punching holes in their membranes, or linking up small proteins into a “net” that stops pathogens from crossing the gastrointestinal barrier. These molecules also help the immune system control the types and numbers of beneficial microbes populating our intestines, and help in the recruitment of additional immune cells.

Individuals with IBD have imbalances of immune cells and intestinal microbes and without a sufficient immune response intestinal microbes invade the mucosa and an inflammatory response is triggered.

The intestines strive to achieve and maintain a delicate homeostatic balance. Complex interactions between the microorganism and immune components keep the beneficial bacteria “content” while simultaneously using inflammatory processes to keep infectious agents in check.

The key in recovery is to help the body limit unhealthy inflammation. Probiotic bacteria have been the first therapeutic agents for IBD shown to induce the production of defensins. Other agents such as worms, worm eggs, vitamin D, specific bacteria, and omega-3 appear to modulate inflammatory cytokines in test systems, yet these approaches have failed to correlate strongly with reducing IBD or its symptoms.

http://iai.asm.org/content/76/8/3360
http://www.sciencemag.org/content/337/6093/477.abstract
http://www.ncbi.nlm.nih.gov/pubmed/21423246
http://www.ncbi.nlm.nih.gov/pubmed/23398152
http://www.ncbi.nlm.nih.gov/pubmed/23176791
http://www.ncbi.nlm.nih.gov/pubmed/19800289
http://www.ncbi.nlm.nih.gov/pubmed/?term=morningstar+hyperimmune+egg

anti-inflammatory, autoimmune, balance, chronic disease, IBD, inflammation, inflammatory responses, pro-inflammatory, ulcerative colitis

Depression, Aging, Longevity, and Inflammation

Shirley Wang published an article in the WSJ titled “New View of Depression: An Ailment of the Entire Body”. Her lead-in stated: “Scientists are increasingly finding that depression and other psychological disorders can be as much diseases of the body as of the mind. People with long-term psychological stress, depression and post-traumatic stress disorder tend to develop earlier and more serious forms of physical illnesses that usually hit people in older age, such as stroke, dementia, heart disease and diabetes”.

Ms. Wang reported that Dr. Owen Wolkowitz at the University of California, San Francisco thinks of depression as “a systemic illness”, rather than a mental or brain disease. Dr. Wolkowitz found that
“[D]epression is associated with an unusually high rate of aging-related illnesses and early mortality”, or “accelerated aging”. He also points out that individuals who are aging more rapidly and/or are ill, have shorter telomeres than expected.

[Division is essential for most healthy cells. Telomeres are the protective tips of chromosomes that guide the chromosomes during cell division. Every time a cell divides, the telomeres shorten in length. Eventually there is little or no telomere resulting in an inability of the cell to divide efficiently. Eventually the cell dies. Some investigators are of the opinion that the length of telomeres is a predictor of longevity.]

There appears to be a strong association of inflammation with shorter telomeres. Senescent cells, which are unable to divide any longer and have almost non-existent telomeres, produce high concentrations of immune factors, cytokines, that regulate genes that result in inflammation.

Chronic inflammation is found in a myriad of diseases including cardiovascular disease, stroke, diabetes, cancer multiple sclerosis, dementia, as well as depression. Heightened levels of inflammation are found in smokers and the obese. Each pack of cigarettes smoked results in a 18% shortening of telomeres, and the telomeres of obese women are shorter than those of lean women. Using other biomarkers, both smokers and obese individuals have higher levels of inflammation in their bodies than the general population.

Depression results in inflammation and inflammation “feeds” depression. The same cytokines that cause inflammation, pro-inflammatory cytokines, under other circumstances may be anti-inflammatory.
Data from studies demonstrate that depressed individuals have an imbalance of pro- and anti-inflammatory factors.

Some practitioners suggest that depressed patients need to “boost” their immune responses. Instead, “boosting” the immune response, i.e., inflammation, may only exacerbate the disease.

Because of the complexity of immune responses, it is important to let the body find its own “set” point. This is why achieving immune homeostasis, immune balance, is essential for good health.

http://twinsuk.ac.uk/wp-content/uploads/2012/03/Valdes-.lancet.pdf
http://www.ncbi.nlm.nih.gov/pubmed/23136552
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868538/
http://www.ncbi.nlm.nih.gov/pubmed/17705097
http://www.sciencedirect.com/science/article/pii/S0022395609001241
http://drhellengreenblatt.info/2011/09/smoking-inflammation-immune-homeostasis-balance/

aging, anti-inflammatory, balance, cancer, cardiovascular disease, chronic disease, cytokines, demenia, depression, diabetes, immune homeostasis, immune system, inflammation, longevity, Obesity, pro-inflammatory, senescent, Smoking, stroke, telomeres

Immune Homeostasis with Limited Inflammation, Lowers Melanoma Risk?
| Posted by in Cancer | Chronic Disease | Immune Homeostasis (Immune Balance) | Inflammation - (0 Comments)

Studies conducted over the years have shown numerous benefits of using aspirin, a compound with potent
anti-inflammatory properties. If aspirin were discovered today, it would probably be available only through prescription, and cost us 10-40 fold more than we pay for it today.

Additionally, in the area of cancer, laboratory studies suggest that certain anti-inflammatory drugs may prevent certain types of cancers. However, human clinical trials on the efficacy of aspirin for reducing the risk of cancer, and its ability to make a difference in the course of cancer, are uncertain.

Dr. Jean Tang and her colleagues at Stanford University School of Medicine, CA. recently published a study examining how daily intake of aspirin effects the risk of getting melanoma, a deadly type of skin cancer. A study of 60,000 Caucasian women [lighter-skinned individuals are at greater risk of getting skin cancer] ran for an average of 12 years and involved women 50 years to 79 years of age.

Women who took aspirin twice weekly had on average, a 21 %reduction in their risk of getting melanoma compared to those who did not use aspirin regularly. Women who had taken aspirin twice weekly for at least 5 years had a 30% lower chance of getting melanoma. Other pain relievers such as acetaminophen (found in Tylenol) made no difference in melanoma rates.

Dr. Tang said, “There’s a lot of excitement about this because aspirin has already been shown to have protective effects on cardiovascular disease and colorectal cancer in women”… “This is one more piece of the prevention puzzle.” Dr. Tang feels that the ability of aspirin to limit inflammation may contribute to its association in reducing the risk of cancer. In future studies, Dr. Tang is planning to see whether a similar association is holds for men.

Inflammation is necessary for healing and recovery, but run-away inflammation may be the main contributor to disease. Cancer is a two-way street. Inflammation feeds cancer and cancer feeds inflammation. We need enough of an immune response to stop the growth of cancer cells, but not so much that it “feeds” the growth of mutant cells.

Immune homeostasis, immune balance, is the key to excellent health. Control inappropriately high inflammatory responses of the immune system, and change the course of disease both for the present and in the future.

http://www.ncbi.nlm.nih.gov/pubmed/23589729
http://www.ncbi.nlm.nih.gov/pubmed/18577752
http://onlinelibrary.wiley.com/doi/10.1002/cncr.27817/abstract
http://www.medicinenet.com/script/main/art.asp?articlekey=168421
http://med.stanford.edu/ism/2013/march/tang.html
http://consumer.healthday.com/Article.asp?AID=674264
http://jnci.oxfordjournals.org/content/current

anti-inflammatory, balance, cancer, healing, immune balance, immune homeostasis, inflammation, inflammatory responses, melanoma, recovery

Multiple Sclerosis, Neurological Disease, and Inflammation
| Posted by in Chronic Disease | Immune Homeostasis (Immune Balance) | Infections and Inflammatory Responses - (0 Comments)

People often ask how they ended up getting an autoimmune disease, a condition in which their own immune system turns on themselves and destroys healthy by-stander tissues and organs.

My response-the not-yet-proven-hypothesis that molecular mimicry results in autoimmune disease.

Molecular mimicry is a phenomenon in which tissues in the body share a “barcode”, antigenic receptors, with specific viruses or a bacteria. The immune system responds by mounting an inflammatory attack against the invading pathogen. This response targets not only the pathogen, but in addition, tissues that share the same antigenic makeup as the invading microorganism. In short, a terrible error occurs and the body starts destroying itself.

The inflammatory disease rheumatic fever is an excellent example of the possible outcome of molecular mimicry. Damage of heart valves may occur after infection with the bacteria Streptococcus. This development accounts for the panic that many parents experience when their kids come down with “strep throat”.

Antibodies, large unique proteins, are produced by the immune system when the body is exposed to pathogens. These specialized proteins attach to the invaders, “flagging” them for destruction by circulating immune cells. In the case of rheumatic fever, since bacteria and heart valve tissue look alike to the body, antibodies are produced that attach to both surfaces, triggering inflammatory immune responses ultimately resulting in damage to heart valves, as well as death of the bacteria.

The data, controversial, but compelling, is that molecular mimicry, due to viral and bacterial infections, may also be a trigger for neurological disease.

This concept is reinforced by the fact that multiple sclerosis is a condition in which nerve cells are damaged by uncontrolled levels of inflammation. Immune cell products mistakenly attack myelin proteins, which make up the protective sheath that “insulates” nerves. Damage to this covering results in nerve signals becoming intermittent, slowing down, or stopping entirely. Such nerve damage affects vision, mobility, coordination, balance, bladder, or bowel control.

A large body of data suggests that infection with herpes virus 6 and/or Epstein-Barr virus triggers inflammation that leads to nerve cell destruction. Different viruses and bacteria have been implicated as initiating inflammatory responses in other neurodegenerative diseases as well.

To understand the role of excessive inflammation in your own condition, enter the condition in combination with the word “inflammation”. The results you receive will help you understand the importance of achieving immune homeostasis, immune balance of our inflammatory responses.

Let me help you improve your quality of life, naturally. Please contact me at 302.265.3870 (USA ET) or email: DrHellen@DrHellenGreenblatt.info

http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au
http://www.ncbi.nlm.nih.gov/pubmed/22617826
http://www.ncbi.nlm.nih.gov/pubmed/18193392
http://www.ncbi.nlm.nih.gov/pubmed/9761770
http://www.ncbi.nlm.nih.gov/pubmed/22201827
http://www.ncbi.nlm.nih.gov/pubmed/12557285
http://www.ncbi.nlm.nih.gov/pubmed/21859892

antibodies, antigens, autoimmune, balance, chronic disease, immune homeostasis, immune system, infection, inflammation, inflammatory responses, multiple sclerosis, pathogens, receptors, strep throat, Streptococcus

Crohn’s Disease, Worms, and Inflammation
| Posted by in Chronic Disease | Inflammation - (0 Comments)

People will go to almost any length to get rid of their illnesses. Last month, a TV news program reported that a financial analyst from New York swallowed 2500 pig whipworm eggs, every two weeks for three months. He was driven to this “solution” because he had been suffering with Crohn’s since being a teenager, had had much of his bowels surgically removed, but still had severe symptoms. He found that drinking the solution of worm eggs made a major difference in his disease.

Crohn’s disease is an inflammatory disease of the digestive system, typically designated as an autoimmune condition. In such illnesses, the body’s own immune system mistakenly destroys various portions of its own bowels.

Symptoms can develop gradually or come on all at once. One may experience only mild amounts of inflammation, or the inflammatory response can be severe enough to cause scarring. Individuals may go long periods without experiencing any discomfort at all.

When the disease is causing problems, the inflammation can result in intestinal pain and ulcers on the surface of the bowel, diarrhea, bloody stools, and involuntary weight loss and reduce appetite.

Dr. Joel Weinstock, of Tufts Medical Center in Boston, MA is a world authority on inflammatory conditions of the intestine with a clinical specialty in inflammatory bowel diseases such as Crohn’s disease. He and his colleagues are in the midst of clinical trials to obtain evidence that the ingestion of parasites, such as whipworms will “dampen” inflammatory responses of individuals with Crohn’s.

Exposure to gastrointestinal parasites affects the production of cytokines, immune factors that either trigger, or inhibit, inflammation. Whipworms can inhibit the production of inflammatory cytokines that contribute to Crohn’s symptoms; they support anti-inflammatory responses in some cases..

Omega-3 fatty acids from fish oil and vitamin D3 are reported to have anti-inflammatory properties and therefore might help those with Crohn’s and other autoimmune diseases. However a recent review of the literature does not support the use of omega-3 to help alleviate symptoms in Crohn’s patients.

Studies of Vitamin D, a substance that regulates inflammatory and other immune responses, suggest that individuals with higher levels of vitamin D in their blood are at less risk of getting Crohn’s disease.

Additionally, hyperimmune egg has been reported to support bowel health, and with many reporting rapid changes in digestive function.

Instead of drinking a concoction of worms, consuming egg protein from specially-selected hens, hyperimmune egg, makes more sense for digestive support than ingesting worms!

Dr. Hellen looks forward to personally answering your questions. Send a note to DrHellen@DrHellenGreenblatt.info or click on: http://drhellengreenblatt.info/contact-dr-hellen/. She can also be reached at: 1.302-265.3870 [USA, Eastern Time].

http://www.mayoclinic.com/health/crohns-disease/DS00104/DSECTION=symptoms
http://www.ncbi.nlm.nih.gov/pubmed/22239614
http://www.ncbi.nlm.nih.gov/pubmed/22841731
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646983/
http://www.google.com/patents/US5772999?printsec=abstract#v=onepage&q&f=false

autoimmune, chronic disease, Crohn's, cytokines, digestive support, inflammation, inflammatory responses, omega 3, vitamin D, worms

Inflammation, Infections, and Statins
| Posted by in Cancer | Chronic Disease | Exercise | Immune Homeostasis (Immune Balance) | Infections | Infections and Inflammatory Responses | Inflammation | Nutrition - (0 Comments)

Healthcare-associated infections (HAI), nosocomial infections, are caused by a wide variety of bacteria, fungi, and viruses. One bacterium that commonly causes illness is Clostridium difficile, or C. difficile. Hospitalized children and elderly people are at special risk of acquiring these bacteria, infections that result in severe diarrhea. Individuals infected with C. difficile are more likely to be admitted to short and long-term care facilities, have longer hospital stays, are more likely to require colon surgery, and are at higher risk of death.

Nosocomial infections are on the increase, probably due to the heightened use of antibiotics used in hospitalized patients. The antibiotics kill off beneficial bacteria that might offer protection against getting infections such as C. difficile.

Intriguingly, in a recent study, patients admitted to the hospital who were on statins, medications used to lower low-density lipoprotein (LDL) cholesterol levels, had a 45% lower risk of getting Clostridium difficile infections compared to individuals that were not on these sorts of medications.

Other studies suggest that statins affect immune responses by down-regulating, inhibiting inflammation. For example, statins prevent and reverse chronic and relapsing disease in an animal model similar to multiple sclerosis, reduce lung inflammation in animals that exposed to airborne particles, and have been shown to lower the risk of death of individuals suffering from 13 different types of cancers.

In atherosclerosis, primarily caused by an inflammatory response directed against the wall inside blood vessels, statin therapy reduces blood vessel inflammation and significantly reduces markers of inflammation such as hsCRP, high sensitivity C – reactive protein.

Health warnings have been issued by the FDA for statins. These risks include: memory loss and confusion, liver damage, heightened diabetes, and for certain statins, muscle weakness. I am certainly NOT advocating that people use statins to limit inflammation. Instead, I want the reader to focus on the fact that the effects of statins appear to be due, in the long run, to their ability to modulate acute (short-term) and chronic (long-term) inflammation.

As I try to emphasize in all my posts, the key to good health is to achieve immune homeostasis, the appropriate balance of inflammatory and anti-inflammatory responses

Immune homeostasis is most easily achieved through a) consistent physical activity, b) controlling fat deposits around the abdominal area, c) increasing consumption of vegetables and fruits, d) moderate exposure to sunlight (or vitamin D3 supplementation when the sun is not sufficient), e) ingestion of omega-3 fatty acids from a fish source, and f) and daily consumption of hyperimmune egg.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

http://www.cdc.gov/hai/organisms/cdiff/cdiff_infect.html
http://www.medpagetoday.com/MeetingCoverage/ACG/35590?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=
http://www.mdjunction.com/forums/lyme-disease-support-forums/medicine-treatments/1722560-pubmed-report-c-diff-death-from-lyme-disease/limitstart/40
http://content.onlinejacc.org/article.aspx?articleid=1389315
http://www.medpagetoday.com/HematologyOncology/BreastCancer/35856?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-11-10&eun=g409635d0r&userid=409635&email=spider1222%40hotmail.com&mu_id=5510283
http://www.nejm.org/doi/full/10.1056/NEJMoa1201735
http://content.onlinejacc.org/article.aspx?articleid=1389317
http://www.ncbi.nlm.nih.gov/pubmed/20421792
http://circ.ahajournals.org/content/106/16/2041.full
http://www.ncbi.nlm.nih.gov/pubmed/22910717
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1986656/
http://www.nejm.org/doi/full/10.1056/NEJMoa1201735

atherosclerosis, balance, C-reactive protein, C. difficile, cancer, chronic disease, exercise, fat cells, healthcare-associated, hyperimmune egg, immune homeostasis, infection, inflammation, inflammatory responses, lungs, multiple sclerosis, nosocomial, pro-inflammatory, statins

Inflammation and Coffee: Its Ability to Down Regulate Inflammatory Responses
| Posted by in Cancer | Chronic Disease | Diabetes | Immune Homeostasis (Immune Balance) | Inflammation - (0 Comments)

When I ask people for their typical dietary intake, many people “shamefully” tell me that they drink coffee. It surprises them when I ask “what is wrong with that”? Coffee is a healthy addition to one’s diet because it can help the body regulate its immune inflammatory responses.

Studies have shown that coffee consumption reduces the risk of conditions such as diabetes, neurological diseases, cardiovascular disease, certain cancers, depression,and back and neck pain to mention a few.

Diabetes
Phytonutrients, plant compounds, other than caffeine, found in coffee, are reported to reduce blood sugar levels, and decrease the way the body stores carbohydrates and fats. Data from over 450,000 people found that every additional cup per day of caffeinated or decaffeinated coffee lowers the risk of diabetes by 5 to 10%. Heavy consumers of coffee, 12 cups/day, have a 67% lower risk of getting diabetes. The effect is not due to the caffeine found in coffee, but to other compounds in coffee.

Parkinson’s Disease
In Parkinson’s disease, caffeinated coffee may protect nerve cells from destruction, decrease the incidence of Parkinson’s, and the improve mobility of individuals with Parkinson’s disease. In the case of Parkinson’s, the caffeine in coffee is the “magic ingredient”, since decaffeinated coffee does not have the same affect. Women with Parkinson’s Disease, that were on hormonal replacement therapy, showed less benefit from coffee.

Alzheimer’s and Dementia
As mentioned above, caffeine may help the body protect nerve cells. Consuming caffeinated coffee over a long period appears to decrease the risk of dementia or Alzheimer’s.

Heart Disease
In other studies, although coffee may raise blood pressure for a brief time, after two months of daily coffee consumption, blood pressure is reduced. It also lowers the risk of heart disease and reduces stroke incidents.

Cancer
Drinking one cup of coffee a day has been associated with a 42% lower risk of liver cancer. Women that drank two or more cups of coffee per day had a delayed onset of a hard-to-treat cancer. Individuals drinking three cups of coffee a day had a 40% lower risk of developing pharyngeal, esophageal, and oral cancers. Men who drank over six cups of caffeinated or non-caffeinated coffee a da,y had an 18% lower risk of prostate cancer, and a 40% lower risk of aggressive prostate cancer. Individuals that were heavy coffee drinkers had a 30% lower risk of colorectal cancer.

Depression
A study of over 50,000 women, found that 4 cups of coffee daily lowered their risk of depression by 20%.

Coffee and Pain Responses
Subjects who consume coffee while working at the computer, report less pain in their back and necks than those that abstain from drinking coffee

Inflammatory Responses and Coffee:
Regular coffee consumption affects the production of cytokines, such as IL-1 and IL-10 that regulate immune inflammatory responses. The data suggests that the benefits of coffee consumption are due to the phytonutrients, plant nutrients, and caffeine found in coffee. The adage that “coffee is not good for you”, should be re-examined.

Reach out to Dr. Hellen Greenblatt for simple steps to help the body balance inflammatory responses.

http://www.lef.org/magazine/mag2012/jan2012_Discovering-Coffees-Unique-Health-Benefits_02.htm
http://www.ncbi.nlm.nih.gov/pubmed/22955949
http://www.biomedcentral.com/1756-0500/5/480/abstract
http://www.ncbi.nlm.nih.gov/pubmed/21858104
http://www.ncbi.nlm.nih.gov/pubmed/22070680
http://www.ncbi.nlm.nih.gov/pubmed/21779565
http://www.ncbi.nlm.nih.gov/pubmed/20839413
http://newsroom.ucla.edu/portal/ucla/why-coffee-protects-against-diabetes-190743.aspx
http://www.ncbi.nlm.nih.gov/pubmed/21030499
http://jama.jamanetwork.com/article.aspx?articleid=192731
http://www.ncbi.nlm.nih.gov/pubmed/22927157
http://www.ncbi.nlm.nih.gov/pubmed/22149008

Alzheimer's, balance, caffeine, cancer, cardiovascular, coffee, cytokines, dementia, depression, diabetes, heart, immune homeostasis, inflammation, inflammatory responses, joint pain, nerve cells, neurological, Parkinson's, phytonutrients

Inflammation, Celiac Disease, and Immune Balance/Homeostasis
| Posted by in Boosting Immune Responses (Pro-Inflammatory) | Cancer | Chronic Disease | Fatigue | Immune Homeostasis (Immune Balance) | Infections | Inflammation | Nutrition - (0 Comments)

Gut-associated lymphoid tissues are found in the walls of the intestine and contain billions of immune cells. The white blood cells control the levels and types of bacteria that naturally populate the intestines. The bacteria help to digest food that provides energy to the body, and are part of the immune/bacterial ecosystem of the intestine.

Interestingly, both immune cells and bacteria, protect the intestines from attack by pathogenic microorganisms, and cancer cells, and help heal the intestines when they are damaged. Cross talk between the bacteria, and immune cells help the intestines maintain homeostasis, balance. Each keeps the other in check.

CELIAC DISEASE
Celiac disease is an intestinal, inflammatory, autoimmune (against oneself) disorder. Individuals with celiac disease suffer from a wide-range of symptoms including diarrhea, fatigue, weight loss, inability to focus, skin and neurological issues, constipation, a feeling of being “bloated”, gas, anemia, headaches, osteoporosis (loss of bone density), and depression.

Ingesting grains, such as wheat, rye, and barley, which contain a component of protein called gluten, reportedly stimulate celiac disease.

The presence of gluten stimulates sensitive immune cells to produce proinflammatory cytokines. These immune messages drive inflammation, resulting in the destruction of the intestinal wall and symptoms.   Genetic, environmental, dietary, neuroendocrine, and immunological factors all contribute to disease progression.

Currently, the primary guidance that celiacs get, is to go on a “gluten-free” diet. Although it may be effective for some people, such diets are restrictive, expensive, and do not work well for everyone. In one study, every patient, 100% of those surveyed, in a cohort of 300 individuals, hoped for another option.

OTHER APPROACHES
I often hear from people with autoimmune challenges such as celiac disease, “it’s genetic”. Fine, so your genes are partially to blame. Meanwhile, what will you do? Continue to be uncomfortable? So I ask those with inflammatory issues, why not consider short-term approaches until researchers discover longer-term solutions? In three words: limit excessive inflammation.

I like to describe inflammation as a way that the body “burns” out pathogenic microorganisms and cancer cells. The body must produce enough inflammation to protect itself from disease, and help the healing process, but not so much that healthy tissue, for example the intestinal lining, is damaged.

Nutritional Approaches
Vitamin C and omega-3 fatty acids, from fish oil, inhibit the production of proinflammatory cytokines. (There is however, evidence that vitamin A increases inflammatory processes.).

Medical Approaches
Antibodies against specific inflammatory cytokines reduce intestinal injury in celiac disease, and the administration of corticosteroids, along with a gluten-free diet, was reported, in a small clinical trial, to provide benefit to celiac patients.

Immunological Homeostasis/Balance
Hyperimmune egg, an ingredient that helps the body return to immunological balance, helps to support gastrointestinal health. Many individuals with digestive issues report daily consumption of hyperimmune egg leads to major differences in their quality of life.

LIMIT INFLAMMATION FOR BETTER HEALTH
The key to a higher level of quality of life in celiac and other autoimmune and autoinflammatory conditions, is to help the body limit its excessive inflammatory responses. Removing gluten from one’s diet, using vitamin C, omega-3, corticosteroids, and hyperimmune egg, may contribute to helping the body regulate run-away inflammation.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

www.cell.com/cell-host-microbe/retrieve/pii/S1931312812000662
www.medscape.com
www.nature.com/nature/journal/v471/n7337/full/nature09849.html
www.nature.com/nature/journal/v471/n7337/full/nature09849.html
www.nature.com/nature/journal/v474/n7351/full/nature10208.html
www.ncbi.nlm.nih.gov/pubmed/18667914
www.ncbi.nlm.nih.gov/pubmed/22024540
www.ncbi.nlm.nih.gov/pubmed/22109896
www.ncbi.nlm.nih.gov/pubmed/22606367
www.ncbi.nlm.nih.gov/pubmed?term=morningstar%20hyperimmune%20egg
www.sciencedaily.com/releases/2008/11/081114185942.htm
www.sciencedaily.com/releases/2012/04/120426105654.htm

antibodies, autoimmune, autoinflammatory, balance, cancer, celiac, chronic disease, corticosteroids, cross talk, cytokines, diarrhea, GALT, gluten, gut, gut associated lymphoid tissue, hyperimmune egg, immune homeostasis, immune system, infection, inflammation, inflammatory responses, intestines, pro-inflammatory

Inflammation, Alzheimer’s, and Immune Homeostasis
| Posted by in Aging | Boosting Immune Responses (Pro-Inflammatory) | Chronic Disease | Immune Homeostasis (Immune Balance) | Infections | Inflammation | Injury and Trauma - (0 Comments)

Alzheimer’s and IVIG Rx
Last week John Gever, Senior Editor, MedPage Today brought attention to the results of a small study presented at the 2012 Alzheimer’s Association International Conference held in Vancouver, British Columbia. In this study, patients with mild to moderate Alzheimer’s were given antibody preparations, immunoglobulin preparations, which were obtained by pooling plasma from numerous blood donors. This sterile, medical product, IVIG, intravenous immunoglobulin, consists mostly of immunoglobulins, antibodies, and is administered intravenously (IV).

After receiving IVIG twice a month for three years, patient’s ‘ ability to function or think, their mood, or memory did not worsen over the three years. [Untreated Alzheimer’s disease patients typically show measurable declines in 3 to 6 months.]

The FDA, The U.S. Food and Drug Administration, has approved the use of IVIG for only six conditions. However, it has been used “off-label”, to try and treat about 50 other conditions, including infectious diseases, a wide-range of autoimmune conditions, organ transplant and cancer patients, blood, and neurological conditions to mention a few.

When practitioners are asked how s/he thinks IVIG works, the response is typically, except for infectious diseases, “we are not sure”.

IVIG Contains Immunoglobulins and Smaller Immune Factors
IVIG contains antibodies to organisms such as streptococcus, hepatitis, measles, polio, etc., that can specifically neutralize infectious agents.  Other immunoglobulins may be directed against specific immunological factors.

However, viewing reported results in chronically ill populations, I have always been of the opinion that IVIG also contains cytokines, or cytokine-like immune molecules, with potent immune system-modulating properties, which help the body return to immune homeostasis, immune balance.

I suggest that the reason that Alzheimer’s patients receiving IVIG saw a stabilization of their symptoms, is that IVIG limited inflammatory responses and thus slowed the progression of disease.

Alzheimer’s and Inflammatory Cytokine Levels
This supposition is further supported by the fact that animal models suggest that excessive production of inflammatory cytokines, inflammatory messages, are implicated in Alzheimer’s disease. These animals have a condition similar to human Alzheimer’s, and also have higher levels of inflammatory cytokines in their blood. When a drug was administered that inhibited the cytokines, there was less damage to nerve cells and neurological outcomes in the animals improved.

The scientists suggest that blocking production of high amounts of inflammatory cytokines may be beneficial for any number of brain conditions, such as “Alzheimer’s and Parkinson’s disease, multiple sclerosis (MS), motor neurone disease, frontotemporal dementia, and complications from traumatic brain injury.” (1)

Immune Homeostasis, Immune Balance the Key to Health
Thus improvements, or at least delay in the onset of Alzheimer’s, or other brain –associated conditions, may be associated with the body achieving immune homeostasis. A body in inflammatory balance controls the immune system’s inappropriate inflammatory responses which otherwise may lead to damage of bystander tissues.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

www.medpagetoday.com/MeetingCoverage/AAIC/33780
http://emedicine.medscape.com/article/210367-overview#aw2aab6b3
www.alz.org/aaic/tues_1030amct_ivig_trial.asp
www.jneurosci.org/content/32/30/10201.abstract?sid=349221d1-e12f-411a-80a6-80285ed5db54
www.ncbi.nlm.nih.gov/pubmed/22806462

Alzheimer's, antibodies, autoimmune, balance, brain, cytokines, dementia, immune homeostasis, immune system, immunoglobulins, immunological, inflammation, inflammatory responses, intravenous, IVIG, multiple sclerosis, neurological, Parkinson's, pro-inflammatory, traumatic brain injury

Inflammation, the Inflammatory Response, and Macular Degeneration
| Posted by in Chronic Disease | Immune Homeostasis (Immune Balance) | Inflammation | Smoking - (0 Comments)

The retina is the “flat screen” at the back of the eye onto which light is projected when we look at an object. The center of the retina is called the macula. When it is damaged, a condition called macular degeneration, there is a “hole” at the center of one’s vision, making it difficult to recognize faces, read, or drive a car.

As people grow older, they are at greater risk of getting macular degeneration.    Risk factors for this condition are: being Caucasian, obese, female, and having a family history of macular degeneration. High blood pressure, high cholesterol, and eating few fruits and vegetables, also add to one’s risk.

However, the greatest known risk of damaging the retina comes from smoking tobacco. Current and former smokers have 6.6 times the chance of developing macular degeneration as compared to those who never smoked. [Unfortunately, if you smoked one or more packs a day, even having quit 15 years previously, still increases the risk that you will have damaged your retina in some way.]

Even after decades of study, we do not understand the underlying mechanisms of macular degeneration. Increasingly however, the literature suggests that inflammation is a major contributor to destruction of the retina.

Immune system inflammation is the body’s first line of defense against pathogens such as viruses, bacteria, fungi, and parasites. Inflammation is also important to control mutating, cancer cells.

However, excessive amounts of tissue-damaging inflammation can damage healthy neighboring tissue. High sensitivity C-reactive protein (hs-CRP) is a blood marker associated with inflammation, and an indication that too great an inflammatory response is being generated by the immune system.

A seven year study of hs-CRP levels of 4900 people was conducted in the Netherlands. Individuals with high levels of C-reactive protein had a significantly greater risk of acquiring macular degeneration compared to those with “normal” baselines of the inflammatory marker. Additionally, other studies suggest that 75% of patients with macular degeneration have “inflammatory” genes that release pro-inflammatory cytokines that are associated with the condition.

Some clinicians have recommmended using-steroidal anti-inflammatory medications to control macular degeneration, yet contradictory studies suggest that frequent aspirin use leads to macular degeneration.

We know that high aspirin consumption leads to excessive bleeding in digestive tracts and the eyes. Perhaps the association of high aspirin use and macular degeneration is due the bleeding aspect of excessive aspirin consumption.

Inflammation is important for our survival, but it must be the appropriate amount of inflammation; it must be a balanced response of just enough inflammation to defend and heal, but not so much that it damages tissues.

Controlling excessive inflammation, without the  side-effects of medications such as bleeding,  would likely help limit degeneration of the retina.

www.blindness.org/index.php?option=com_content&view=article&id=46&Itemid=56

www.ophsource.org/periodicals/ophtha/article/S0161-6420(00)00580-7/abstract

www.ncbi.nlm.nih.gov/pubmed/21920607

www.ncbi.nlm.nih.gov/pubmed/21183941

www.ncbi.nlm.nih.gov/pubmed/17923549

www.csmd.ucsb.edu/news/md_science_article.pdf

balance, C-reactive protein, chronic disease, immune homeostasis, immune system, inflammation, inflammatory responses, macular degeneration, retina

Fibromyalgia, Inflammation, and the Inflammatory Response
| Posted by in Chronic Disease | Fatigue | Immune Homeostasis (Immune Balance) | Inflammation - (0 Comments)

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

balance, chronic disease, cytokines, fibromyalgia, immune homeostasis, immune system, inflammation, Inflammatory Bowel Disease, inflammatory responses, pain

Balance, Inflammation, and Sleep Apnea
| Posted by in Chronic Disease | Immune Homeostasis (Immune Balance) | Inflammation | Obesity - (0 Comments)

Obstructive sleep apnea syndrome (OSAS) occurs when an individual repeatedly stops breathing, sometimes as many as 1-2 times a minute during their sleep. It is most frequently associated with heavy snoring, broad swings in heart rate, and, as one would expect, extreme daytime sleepiness. Those that suffer with sleep apnea are prone to accidents; they are twice as likely to be involved in car crashes as compared to individuals without the condition.

The relationship between inflammation and sleep apnea is complicated, with not only inflammation of the airways, but body-wide inflammation as well.

As with other inflammatory conditions, obstructive sleep apnea is associated with cardiovascular disease, diabetes, and obesity. Visceral fat, belly fat, is a major predictor of having obstructive sleep apnea syndrome, since fat cells produce large amounts of immune modulating molecules, that trigger inflammation.

People suffering with sleep apnea have complex imbalances of immune factors, cytokines. Their levels of immune modulating cytokines, such as tumor necrosis factor and interleukin (IL)-6, are markedly high, as are levels of other inflammatory proteins, including C-reactive protein (hsCRP). [CRP is a blood protein typically associated with the presence and amount of inflammation in the body.] Additionally, hormones that regulate insulin and hunger levels are higher than levels found in those without sleep apnea.

There is conflicting data about the affect of CPAPs, continuous positive airway pressure breathing devices, on inflammation. Some studies suggest that the devices help lower the number of inflammatory molecules circulating in the body, other studies suggest that using a CPAP increases inflammation.

Successfully battling disease, and healing , is determined by inflammatory immune cells and the types and ratios of cytokines they generate. Restoring balance, immune homeostasis, to the body, helps the body stay healthy, and recover rapidly when in ill health.

emedicine.medscape.com/article/295807-overview
www.sciencedaily.com/releases/2008/02/080218214401.htm
www.ncbi.nlm.nih.gov/pubmed/22515302
www.chestjournal.chestpubs.org/content/127/3/1074.full
www.chestjournal.chestpubs.org/content/126/1/1.long
www.mayoclinic.com/health/sleep-apnea/DS00148
www.ncbi.nlm.nih.gov/pubmed/22408197

balance, C-reactive protein, cardiovascular disease, chronic disease, CPAP, cytokines, diabetes, immune homeostasis, immune system, inflammation, Obesity, sleep apnea, visceral fat

Inflammation, Epigenetics, and Aging
| Posted by in Aging | Boosting Immune Responses (Pro-Inflammatory) | Cancer | Chronic Disease | Diabetes | Exercise | Immune Homeostasis (Immune Balance) | Inflammation | Obesity - (0 Comments)

The concept of epigenetics was first introduced in the 1940s, and its implications on how we modulate inflammation through its processes are intriguing and exciting.

For most of my scientific career, we were taught that biological processes of the body were pre-determined by genes. It was said that DNA’s message was set-in-stone, and except through mutations which might result in cancer, or mutations and recombinations of genetic material that were handed down from one generation to another, the message encoded by DNA was unchanging.

Accumulating evidence suggests that altering our diet, life style, and environment, significantly influences gene expression; the way that the body translates the DNA message. We can change the affect our genes have on our physiological and emotional well-being.

It never ceases to amaze me that the medical profession writes off conditions such as arthritis, heart disease, cancer, strokes, Alzheimer’s etc. as being the result of “aging”; basically, saying to their patient, “you have to live with it because you are getting old”.

Instead, health practitioners might better focus on the fact that imbalances of inflammatory and anti-inflammatory responses contribute to health issues. Directing the emphasis on life style changes would enable individuals to take steps towards breaking the inflammation cycle, literally affecting the DNA message, and the resulting quality of their lives.

There are simple approaches that help maintain immune balance, immune homeostasis. Two such changes are: limiting the size of fat cells, and exercise. Fat cells, especially around our abdominal area, produce large amounts of pro-inflammatory cytokines, that trigger inappropriate levels of inflammation.

Exercise is a way to neutralize these molecules since contracting our muscles releases potent anti-inflammatory cytokines.

Additionally, the daily consumption of two or more servings of hyperimmune egg can go a long way toward supporting the body’s natural immune-rebalancing attempts.

In the controversy of genes vs. nurture, we now know that it is a combination of both that makes the difference. We can help regulate what our genes “say” by how we choose to live our lives.

www.sciencemag.org/site/feature/plus/sfg/resources/res_epigenetics.xhtml

www.ncbi.nlm.nih.gov/pubmed/22004920.1

target=”_blank”>articles.mercola.com/sites/articles/archive/2012/04/11/epigenetic-vs-determinism.aspx

www.ncbi.nlm.nih.gov/pubmed/22428854

www.ncbi.nlm.nih.gov/pubmed/20388091

aging, balance, cancer, chronic disease, cytokines, diabetes, epigenetics, exercise, fat cells, heart disease, immune homeostasis, immune system, inflammation, inflammatory responses, Obesity, pro-inflammatory

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