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Exercise and Inflammation

| Posted by in Depression | Diabetes | Exercise | Immune Homeostasis (Immune Balance) | Inflammation | Joints - (0 Comments)

The function of hundreds of genes and numerous biological pathways are affected by being physically active.  Too many individuals, especially health practitioners, fail to appreciate the dominant role exercise plays in maintaining the body’s immune homeostasis, its balance. Being physically active decreases the risk of chronic inflammatory conditions such as diabetes, depression, atherosclerosis, and certain cancers.

CYTOKINE PRODUCTION

Fat cells (adipose tissue) produce pro-inflammatory cytokines, immune messages that increase the levels of inflammation in the body–inflammation which contributes to chronic disease. Upon contraction, muscles release anti-inflammatory cytokines that help the body counteract inflammation.  Muscle-generated anti-inflammatory cytokines help the body balance its levels of inflammation. Consistent physical activity also helps increase immune responses to pathogens such as viruses, bacteria and mold. Even modest amount of physical activity changes the ratios of cytokines to healthful numbers. 

In formerly sedentary people, 10 months of moderate walking resulted in a 16%-32% decrease in various inflammatory proteins. In another study, using resistance bands resulted in increases in the anti-inflammatory cytokine, IL-10, along with an increase in cognitive functioning.  Even light activity (2–4 hours of walking-type activity/week) has been associated with better inflammatory balance.

“BRAIN-IMMUNE-GUT” AXIS

There is a “brain-immune-gut” axis. It can be a vicious cycle during which stress increases inflammation and inflammation results in more stress. Being stressed affects not only one’s emotional well-being but also hormonal, nervous and digestive status. 

The microbiome, the community of organisms found on and in the body greatly influences our health. Significant crosstalk between the microbiome and the immune system results in each system affecting the other in both function and composition. Physical activity modifies the gut microbiome which in turn affects muscle, immune and brain function.
The release of anti-inflammatory immune factors not only decreases inflammation throughout the body, but it also promotes the release of brain and gut biochemicals such as dopamine, norepinephrine and serotonin, biochemicals that involved in mood and gut regulation. 

Unhealthy Older Individuals

Poor aging is the result of cumulative effects of imbalances of inflammation. These individuals exhibit high levels of inflammatory cytokines which contribute to problems such as muscle weakness, neurological problems including Alzheimer’s Disease. Elderly people that remain physically active, have reduced levels of inflammation and a better quality of life with fewer chronic conditions than individuals that are not active.

Summary:

Regular physical activity suppresses inflammation by increasing the production of anti-inflammatory cytokines and inhibiting inflammation. 

https://www.ncbi.nlm.nih.gov/pubmed/26978184 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467003/ https://www.hopkinsmedicine.org/health/conditions-and-diseases/risks-of-physical-inactivity http://eir-isei.de/2019/eir-2019-084-article.pdf https://www.amjmed.com/article/S0002-9343(06)00782-0/fulltext https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320801/ https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
https://journals.lww.com/acsm-essr/Fulltext/2019/04000/Exercise_and_the_Gut_Microbiome__A_Review_of_the.4.aspx
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803113/ https://drhellengreenblatt.info/archives/1571

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Out with Inflammation = Out with Gout

| Posted by in Boosting Immune Responses (Pro-Inflammatory) | Chronic Disease | Diabetes | Gout | Immune Homeostasis (Immune Balance) | Inflammation | Joints | Obesity - (0 Comments)

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!

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Inflammation Is the Root Cause of Arthritis

| Posted by in Boosting Immune Responses (Pro-Inflammatory) | Exercise | Immune Homeostasis (Immune Balance) | Infections and Inflammatory Responses | Joints | Obesity | Weight Management - (0 Comments)

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
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Obesity and the Inflammatory State

| Posted by in Boosting Immune Responses (Pro-Inflammatory) | Cancer | Chronic Disease | Diabetes | Exercise | Immune Homeostasis (Immune Balance) | Infections | Infections and Inflammatory Responses | Inflammation | Joints | Obesity | Weight Management - (0 Comments)

People who are heavy and are not physically active, are at greater risk for conditions such as: increased blood sugar, higher pressures on their artery walls (high blood pressure), increased rate and workload on the heart, stroke, joint problems, sleep disorders, difficulty breathing, and even certain types of  cancer.

There are other posts on this blog relevant to the issue of being overweight or obese, but there is little question that most individuals would feel a lot better if they were only 5 or 10 pounds lighter.

When compared to leaner people, adipose tissue, the fat deposits of obese individuals, have higher numbers of, and larger, fat cells.  These cells produce cytokines, immune factors, that are inflammatory in nature and trigger numerous inflammatory conditions including many mentioned above.

Adipose tissue has “immune-like” properties.  For example, macrophages, white blood cells which alert the body to the presence of invaders, are found in high numbers in fat cell clusters.  Additionally, obese individuals have been shown to have  increased levels of proteins in the blood stream that stimulate inflammation.  Overweight or obese people do not fight infections or heal as well as individuals at more appropriate weights.

 The following hypothesis may have validity.  The immune system may “see” components of adipose tissue as “foreign material” that must be eliminated from the body.  If this scenario is correct, when the body “battles” adipose tissue an autoimmune response is triggered, a response in which the immune system destroys its own tissues, resulting in high levels of inflammation. My hypothesis is supported by the fact that obese individuals produce high levels of autoantibody, antibodies against their own tissues. Rather than resulting from inflammation, these autoantibodies may be the trigger for inflammation.

Muscle cells, like fat cells, secrete cytokines, molecules which help the body regulate inflammatory responses. In response to exercise, many different types of cytokines are produced by muscles and other cells.  Cytokine measurements taken after a marathon demonstrated 100 fold increases of certain cytokines, whereas other cytokines were produced that typically dampen an inflammatory response.

The wide spectrum of immune factors that the body produces in response to physical activity helps the body maintain a steady state of inflammation, an immune balance that helps the body defend itself against infection and helps healing, but not so much that innocent by-stander tissues are damaged.  In fact, studies have shown that individuals that are overweight, nevertheless may be healthy, if they are maintain a level of physical fitness.

The bodies of overweight and obese individuals are consistently exposed to self-generated, inappropriate levels of inflammation.  Helping the body return to a healthy balance of immune responses, a state of homeostasis, will go a long ways towards changing their quality of life.

I would be pleased to hear from you if you are interested in changing your quality of life.  I can be contacted at: drhellen@drhellengreenblatt.info or at:  302.265.3870 USA ET.

 


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Alcohol Abuse, Immune Balance, and Inflammation

| Posted by in Alcohol | Boosting Immune Responses (Pro-Inflammatory) | Cancer | Chronic Disease | Depression | Exercise | Hormones | Immune Homeostasis (Immune Balance) | Inflammation | Injury and Trauma | Joints | Menopause | Nutrition - (0 Comments)

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].

 

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A PERSONAL MESSAGE FROM DR. HELLEN GREENBLATT

| Posted by in Fatigue | Inflammation | Joints | Materials Authored by Dr. Hellen - (0 Comments)

TheseI grew up in a poor neighborhood in Brooklyn, NY. During the summers I spent most of my days sitting on the stoop, the front steps, reading piles of books that I carried home weekly from my local library, and watched people go by.

It hurt me, even at a young age, to see how hard it was for some people to get around. It broke my heart watching them as they struggled to get across the street. It seemed that everyone was in a hurry, beeping their horns, and telling them to “come on already!”. No respect for people who had dedicated their lives to working and bringing up children.

My father was known as the “Mayor” of Hopkinson Avenue, because if anyone needed his help, he was there. He was kind to people and animals. So perhaps this is why watching the older folks, I promised myself that I would make a difference in the lives of others.  This goal, of being of service to others, has governed my life.

I was lucky that The College of the City of New York, CCNY, had low tuition rates. Working during school breaks for the money I needed, I became the first person in my family to graduate from College, and staying within public education systems, eventually went on to get a PhD in the sciences from SUNY Downstate Medical Center in Brooklyn, NY.

My reasoning in becoming a scientist, rather than a medical physician, was that as the former, I might only affect the life of a patient one at a time, but as a scientist, my findings might help hundreds or thousands with a single approach.  And my hopes panned out, since I have been fortunate to help thousands change their quality of life.

To see comments of some folks for whom I have made a difference, please see http://drhellengreenblatt.info/notes . Some that I am reminded of:

A physician in Manhattan, NY had such significant fatigue and joint discomfort that she was forced to stop her practice and ended up in a wheelchair. Visits to other physicians, physical therapists, massage therapists, and other allopathic and complementary health practitioners did not change her quality of life. After our discussions about a protocol she might follow, she’s back in practice.

There’s Shirley F. who owns a charming restaurant on a scenic part of the Bay. Shirley does most of the preparation and cooking for her guests, but was finding it increasingly difficult to work in the kitchen. Chopping and cutting vegetables, fish, and meats was especially becoming harder and harder. Her fingers had become misshapen as well. Standing and walking around the kitchen and restaurant wasn’t becoming any easier either. After following my suggestions, Shirley found that she no longer had thoughts of giving up on her restaurant .

There’s Candy A. who had suffered from extreme gastrointestinal discomfort for years; nothing she tried made a difference. Within10 days of following my suggestion, Candy found that she was a new person.

These are just a few people who I have helped. You too deserve to feel better. It doesn’t cost you anything to talk with me. My passion is helping people improve their quality of life, naturally, and I would be delighted to help you as well. Feel free to contact me via phone 302.265.3870 (ET) or email me @ DrHellen@DrHellenGreenblatt.info.

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