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.
It is estimated that over 33 million people in the United States are uncomfortable leaving their homes or meeting with friends because they have an overactive bladder that forces them to be close to a bathroom at all times.
People with an overactive bladder may urinate eight or more times in 24 hours and multiple times during the night. Sixty percent of elderly women and 30% of middle-aged men and women experience symptoms of an overactive bladder, urinary incontinence (leaking urine). Individuals often hesitate to share this problem with their physician.
An overactive bladder, sometimes called a “spastic bladder”, is the name given to a group of urinary symptoms. There are two types of urinary incontinence, although one can have both at once. They are urge and stress incontinence. Urge incontinence is the strong, sudden urge to urinate that cannot be ignored. When one does not get to the bathroom “in time” there may be an involuntary leakage of urine. Stress incontinence happens when people leak urine while sneezing, laughing or being physical.
When it is time to empty the bladder, a signal goes out to the brain which “tells” the muscles of the bladder to contract, pushing urine out and to empty the bladder. In people with overactive bladders, the muscles of the bladder start to contract involuntarily even when the volume of urine in the bladder is low. This involuntary contraction creates the urgent need to urinate.
Several conditions are associated with an overactive bladder. These include diabetes, certain medications, stroke, urinary tract infections, bladder stones, tumors and excessive consumption of alcohol or caffeine. In too many cases the cause is unknown; this is called an idiopathic overactive bladder condition.
Recent studies suggest that individuals with an overactive bladder have higher levels of inflammation. High levels of the inflammatory marker, C-reactive protein, and inflammatory cytokines are found in patients. When analyzing over 1800 men and 1800 women with overactive bladders, and adjusting for other conditions including smoking and alcohol consumption, the higher the C-reactive protein levels, the greater the odds of having urgent episodes and frequency. The clinicians concluded that there may be a role of inflammation in the development of this condition.
Summary.
An overactive bladder is a common condition affecting all ages and has a severe impact on quality of life. Keeping the body and bladder in homeostasis, in balance, may be an important key to reducing the sudden urge tourinate.
Contact Dr. Hellen, she is there for you. No fee is charged for the first 30 minutes of consultation. She may be contacted by using this form or calling: 302.265.3870 (ET-USA).
HIV, or the human immunodeficiency virus is a virus that left untreated may lead to acquired immunodeficiency syndrome or AIDS. Unlike some other viruses, even with treatment some people infected with HIV may never eliminate the virus.
In an animal model of HIV, within 24 hours of infection, the virus hitches a ride on immune cells and travels throughout the body. HIV has a special propensity for immune cells, especially T cells. T cells help the body fight infections by activating the production of antibodies (large molecules that neutralize pathogens) and triggers inflammation to kill pathogens or destroy cells containing microbes. Left untreated, HIV infection reduces the numbers of defensive immune cells in the body, leaving HIV infected people (HIV positive) highly vulnerable to infection with other foreign agents (opportunistic infections) and cancers.
DC (dendritic cell)- A type of immune cell that plays a primary role in infections with HIV. They are important regulators of immune system responses to infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033703/
From 80-90% of immune cells are found in the walls of the intestines and in the tissues surrounding the intestines. HIV tends to accumulate in these tissues and attack them. These inflammatory responses may weaken the gut barrier resulting in inflammatory digestive issues for HIV positive individuals.
“Inflammation and immune activation accelerate heart disease and stroke, and chronic HIV infection results in both,” says Robert T. Schooley, AIDS researcher and Professor of Medicine in the Infectious Diseases division at the University of California at San Francisco. In addition, this population is at increased risk for certain cancers, gastrointestinal, liver and kidney problems.
There are no cures for HIV, but with proper medical care, the numbers of virus infecting a person and their symptoms may be controlled. Proper medical treatment dramatically improves and prolongs lives. Anti-retroviral therapy (ART or ARV) is used to treat HIV infections.
When the “cocktail” of medications is taken as prescribed, viral loads (the number of viruses in the body) are decreased. These medications can reduce the numbers of HIV down to very low levels (called “undetectable”). However, in some individuals HIV can continue to infectimmune cells. [Note: The CDC states that individuals with undetectable virus loads have no risk of sexually transmitting the virus.]
The body must be in immune balance, in immune homeostasis to protect the body from infection or fight infections. The immune system must produce the right ratio of inflammatory cytokines (pro-inflammatory) to anti-inflammatory cytokines. It needs enough inflammation to destroy the pathogen, or in this case HIV, but not so much that healthy tissues are damaged.
A recent study of people that have been treated over many years for HIV reports that HIV positive individuals are at a higher risk of getting diseases common to older individuals. Individuals that were infected in the early years with HIV are now in their 50s and 60s and develop inflammatory-related conditions at a significantly higher rate and lower age than uninfected people of the same age.
Summary:
The key to staying healthy is to remain in immune homeostasis, immune balance—this is true especially for people with chronic infections such as HIV.
Please contact Dr. Hellen if you wish to enhance your quality of life-don’t you deserve to do that? The first 30 minutes of discussion are gratis. Dr. Hellen may be contacted by using this form or calling: 302.265.3870 (ET-USA).
According to the Centers for Disease Control (CDC), Lyme disease is the fastest growing vector-borne, infectious disease in the United States with a 25 fold increase in the number of cases since surveillance of the disease began in 1982. World-wide, there are over 300 strains of these bacteria, many of which tolerate antibiotics and are able to evade immune cells.
Tick Borne Infections:
Lyme disease is associated with infected ticks and may be contacted after engaging in outdoor activities. The infected ticks bite through the skin of a person or animal, getting a blood meal and introducing the bacteria into the body. (Typically the tick has to be attached for 36 or more hours before the bacteria is passed to the host.) Symptoms may include: skin rash and painful inflammation of joints (particularly the knees) and be accompanied by flu-like symptoms such as fever, headache, fatigue and chills.
Diagnostic Testing:
Diagnostic tests are only 29-40% accurate in the first three weeks after infection. Once the infection spreads to the nervous system and joints, accuracy increases. After treatment, even when test results are “negative”, live organisms may still be found in organs. Early treatment with antibiotics and anti-inflammatory medications are helpful, but if left untreated, joints, heart, brain, muscles and brain may become involved– sometimes months or years later.
Nervous System Involvement:
About 15 percent of patients with Lyme disease develop nervous system (spine, brain, etc.) inflammation. This event is accompanied by debilitating and painful muscle and joint symptoms and major neurologic changes such as facial nerve palsy, pain radiating along the back into the legs and feet, limb pain, sensory loss and/or muscle weakness.
Inflammation results in injuries to the brain and spinal cord and may result in severe headaches, fatigue, memory loss, learning disability, depression and cognitive problems.
Inflammatory immune factors are increased in the body, recruiting more inflammatory white blood cells into the brain and the spinal cord. The healthy immune cells that protect nerve cells are damaged or destroyed by the inflammation. No longer protected, nerve cells are damaged even more.
Lingering Symptoms:
A major issue with tick-borne infections is that even after treatment; up to 25% of individuals may have persistent painful joint inflammation and other symptoms lasting months or years.
There are two factors that may account for this:
a) Small numbers of bacteria remain which the immune system has not been able to successfully eliminate.
b)Once the infection is over, traces of long-lasting bacterial proteins are found within and around the joints. These proteins trigger inflammatory responses resulting in significant joint, muscle and nerve pain. It is the body’s immune response to these residual proteins, rather than a lingering infection that results in symptoms.
Summary:
As always, the key to an active quality of life is to help the body maintain immune balance– its homeostasis. Exercise (suggested: 2.5 hours a week), maintaining a healthy weight, eating smart, going outdoors for a few minutes a day, and taking an excellent immune support product will make all the difference in one’s health.
Achieving immune homeostasis will make a difference in your life. Contact me, DrHellen@DrHellenGreenblatt.info, use the form or give me a call at 302.265.3870 and let us talk.
According to the Centers for Disease Control and Prevention (CDC), this flu season is an unusually severe outbreak with wide-spread instances of disease in 49 States with many schools being closed. The season started earlier than usual, which is never a good sign. CDC Deputy Director Anne Schuchat has said “This year’s influenza season is proving particularly difficult”. Hospitals do not have enough beds and the prevalence of the flu has led to shortages of anti-viral medications that if prescribed in the first 48 hours may shorten symptoms by a day or so.
This season’s primary virus strain is H3N2, a deadly type of influenza A that tends to result in more severe illness and higher numbers of hospitalizations and deaths than other strains. H3N2 is especially dangerous for the frail elderly and children, although people between the ages of 50 and 64 are being hospitalized at alarming rates, second only to the elderly. As of this post, almost 100 children have already died from the flu.
Since vaccination may lessen the severity of the illness and there are few other options, the CDC recommends people be vaccinated with the current flu vaccine, even though it may only be 30% -40% effective. [Antibiotics are useless against viruses since they only kill bacteria.]
Although some people view the flu as “merely” annoying and inconvenient, those suffering from influenza along with COPD (chronic obstructive pulmonary disease), asthma, emphysema, diabetes and other pre-existing conditions are at a higher risk of hospitalization or death, especially if they contract a secondary bacterial infection.
The influenza virus is difficult for the body to protect itself from, because it is able to mutate rapidly and frequently. This forces the immune system to constantly change its tactics to combat the latest version of the flu.
Infection by influenza triggers an intense immune inflammatory response in the lungs in the body’s attempt to stop the virus from multiplying. The lungs’ immune cells release cytokines, small molecules that signal and recruit other cells into the lungs to increase or decrease their immune and inflammatory responses.
But such a response can be a double edged sword. Too much inflammation causes lung damage on top of the damage already caused by the virus and secondary bacterial infections such as pneumonia. Additionally, although rare, if the balance of cytokines is significantly upset, the normal level of inflammatory cytokines may become too high, resulting in a cytokine storm (or cytokine cascade) that can kill a previously healthy individual in hours.
A properly balanced immune system, one in homeostasis, is more fully prepared to defend us against invasion by foreign agents, and is ready to help us combat an infection if we get one.
Following the following steps will help keep your immune system functioning at optimum levels:
Eat healthful meals with an emphasis on whole grains and plenty of colorful vegetables and fruits.
Be physical active to help keep the immune system in balance; incorporate it into your daily life.
Get adequate amounts of rest and avoid fatigue.
Drink plenty of fluids to keep membranes moist and more resistant to invasion.
Wash your hands frequently and try to keep them away from your face.
Stop, or at least cut down, on your smoking—your lungs are struggling enough.
Consume a superior immune support supplement to help your immune system balance.
Dr. Hellen’s passion is helping people have a better quality of life. Contact her by using this form, drhellen@drhellengreenblatt.info, or calling at: 302.265.3870 (ET, USA).
From the time of the ancient Greeks, it has been clear that the mind-gut-body connection influences one’s health; however, only during the last century have we begun to understand why this is the case.
With new tools, scientists can show that there is cross-talk between the brain, the gut and the immune system. Immune molecules from white blood cells send messages to the brain and the gut and in turn, these organs signal back to the immune system, up-regulating (increase) or down-regulating (decrease) inflammation.
Chronic, long-term stress, affects immune cells by changing their gene activity. This prepares them to fight infection or trauma and increases inflammation. More immune cells are then enlisted for the fight, resulting in increased inflammation.
Inflammation is necessary for survival, but too much inflammation is linked to heart and autoimmune disease, diabetes, depression, and cancer. This is why it is essential to maintain the right balance of signals.
Stress responses are part of a vicious cycle in which stress triggers inflammation and inflammation triggers additional stress.
In stressed mice, there are four times the numbers of immune cells than found in non-stressed mice. Additionally in mice that are stressed 1100 genes are responsible for increasing (up-regulating) inflammation. These genes in non-stressed mice are not activated.
Similar outcomes are seen in humans under chronic stress. For weeks and months following natural disasters such as earthquakes and hurricanes, individuals, especially those who have suffered great personal loss, have imbalances of the immune system that affects them both physically and emotionally.
The immune system and its inflammatory responses are in exquisite balance (homeostasis). The body expands much of its energy maintaining its balance in a steady state. This may be the reason that people who are stressed out tend to be “tired a lot of the time”.
Let us say that your immune system consists of 30 billion cells and that 15 billion of these cells are in the attack mode with excessive inflammation (up-regulation). Let us propose that another 15 billion cells are trying to limit the inflammatory response (down-regulation).
A total of 30 billion cells expending a “trivial” amount of energy is a great deal of wasted energy. No wonder people become exhausted when they are not in homeostasis, balance.
CONCLUSION:
The key to reducing stress is to help the immune system return to homeostasis, to its natural balance.
To better manage stress: incorporate an immune support supplement into your daily diet, be physically active 2-2.5 hours/week, spend time outdoors, eat smart, stay within healthy weight limits and remember that you are only one person—be kind to yourself; give yourself a break.
Achieving immune homeostasis will make all the difference in the quality of your emotional and physical well-being.
Contact Dr. Hellen at: DrHellen@DrHellenGreenblatt.info, use the form or give her a call at 302.265.3870 (ET, USA) at no charge to you.
Repeatedly I am asked whether there is an association between inflammation and an enlarged prostrate.
Fifty percent of men by age 50, and 80% of men by age 80 have inflamed, enlarged prostrates, a condition medically known as benign prostatic hyperplasia (BPH). (The prostate is an organ that wraps around the urethra, the tube that carries urine to the outside. The primary function of the prostate is to produce sperm. Hyperplasia refers to the fact that the number of cells in the prostate increase, resulting in abnormal growth.)
As many men age, inflammation of the prostrate increases its size, enlarging it and putting pressure on the urethra. (Although the prostate is enlarged, it is not a cancerous or fatal condition.) Why this occurs is still under investigation, but it appears to be a result of a combination of genetics, hormones and immune reactions.
Men with prostate hyperplasia have lower urinary tract symptoms (LUTS) such as an urgent and frequent need to urinate (especially during the night), waiting longer than usual for the stream of urine to begin, straining to urinate, having a weak stream or dribble of urine, not being able to completely empty one’s bladder, or needing to urinate immediately and having an “accident”.
Obesity leads to greater over-all inflammation and puts overweight people at higher risk of having prostrate and urinary tract disorders. Obese men are 3.5 times more likely to have enlarged prostrates compared with men of healthier weights.
The more weight a man carries, the more inflamed he is, the higher the risk of cardiovascular disease and diabetes as well. The relationship of an enlarged prostrate to diabetes remains controversial. Diabetes has been associated with bladder problems and the ability to control urination.
Additionally, the higher the level of sugar in the blood, the more likelihood of urinary problems and enlarged prostrates, especially in men that do not take medications for their diabetes. However, since both diabetes and benign prostate hyperplasia are inflammatory in nature and are clinically similar it is not clear whether the two diseases are associated.
Inflammation is tightly controlled to keep it balanced, in homeostasis. We need enough inflammation for healing and for defending us from infections, but not so much inflammation that organs and tissues are damaged.
Being active, controlling one’s weight, going outdoors for a few minutes a day and using a proven immune balancing supplement will greatly affect the ability of the body to modulate inflammation.
For years I have helped people promote their overall quality of life. 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, you deserve it.
During a recent 5-day cancer conference in Washington, D.C. additional evidence was presented about the fact that inflammation produced by fat cells (adipose tissue) contributes to the growth and spread of tumors.
Dr. M.Kolonin of the University of Texas Health Science Center in Texas has been quoted as saying: “Obesity is the leading preventable cause of cancer in the U.S. Extra body fat not only increases one’s risk of developing cancer, it is also associated with poorer prognosis [outcomes]”… “Ten percent to fifteen percent of cancer deaths may be attributed to obesity”.
Exactly how body fat influences cancer development is still under investigation, but the key appears to be the inflammatory responses of the body to cancer cells and vice versa. Macrophages are one of the major classes of white blood cells responsible for starting the inflammatory response when the body is threatened by cancer cells, and reducing inflammation when the challenge is over.
Typically, the breast tissue of overweight and obese young women is more inflamed, and has more immune cells, such as macrophages compared to women of healthy weight. Also cancer in obese women is more difficult to treat than in women at healthier weight.
Metabolic syndrome is associated with a group of factors that puts one at greater risk of having heart disease,diabetes and stroke. If a person has three of the following factors, or are on medication for them, it is called having a metabolic syndrome. These factors are: excess stomach fat, high blood pressure and triglycerides. low levels of “good” cholesterol (HDL), and high blood sugar.
In one study of 100 women, half of the women with inflammation of their breasts and early-stage breast cancer also had metabolic syndrome.
Since obesity contributes to growth of tumors, investigators wondered whether weight loss might reverse the tendency to grow tumors. In mice, tumors grew more slowly in obese mice that had previously lost weight.
The body tightly regulates its inflammatory responses by balancing the amount of inflammatory and anti-inflammatory immune factors it produces. Fat cells naturally produce inflammatory molecules. High amounts of body fat encourages growth of cancer cells.`
Note:
Controlling one’s weight at healthy levels, being physically active for 2.5 hours/week, getting outside every day for a few minutes and using a superior immune-balancing supplement will go a long ways toward helping the body stay in immune balance, stay in immune homeostasis,
Dr.Hellen is available to help you enhance your quality of life to its maximum. She can be contacted by using this form, contacting her at: drhellen@drhellengreenblatt.info or feel free to call her at: 302.265.3870 (ET, USA).
What is the Role of Inflammation? When the body is injured or recognizes the presence of pathogens such as bacteria, viruses, molds, parasites or cancerous cells, its immune system is triggered to respond with inflammation to “burn” the threat out of the body.
Balance is Essential Once the challenge has been met, a person in immune balance, homeostasis, will reduce the amount of inflammation that they are producing to “normal” levels. Uncontrolled, run-away inflammation leads to autoimmune diseases (against oneself) in which its own tissues and organs are attacked.
Lupus Systemic lupus erythematosus (SLE), lupus, is a complicated autoimmune condition affecting virtually every organ in the human body. Because of the wide-range of symptoms experienced, the disease is often difficult to diagnose. Common symptoms are extreme fatigue, swollen and/or painful joints, muscle pain, low-grade fever, thinning or loss of hair, butter-fly shaped rash across the nose and cheeks, chest pain when taking a deep breath, kidney and heart problems.
“Butterfly Rash” often associated with SLE (emedicine.medscape.com)
Females make up 80-90% of people with lupus and despite treatment, many individuals will experience flares and remissions (symptoms come and go) their entire lives.
Lupus and Inflammation The hallmark of lupus is over-activity of the immune system and inflammation. Imbalances of inflammatory immune factors, cytokines, are significantly higher in lupus patients compared to people without lupus. These immune molecules promote inflammation and damage tissues. High levels of these inflammatory factors are associated with the severity of disease but decrease as individuals are successfully treated.
Anti-malaria medications originally used to prevent or treat malaria has been used to treat lupus.It was not understood why these medicines were somewhat effective against SLE, but a recent study suggests that these medications inhibit inflammation.
Physical Activity Every time a muscle contracts, it releases anti-inflammatory molecules that helps the body balance the amount of overall inflammation produced.
As would be predicted, weekly physical activity improves fatigue, depression and increases the quality of life of most individuals. Even moderate exercise, 3 days a week for 20 minutes, has been shown to make a major difference in the amount of energy and feelings of well-being experienced by lupus patients.
If You Have Lupus Frequent physical activity, eating in a healthful manner and daily consumption of an excellent immune balancing supplement helps the body control inflammation and achieve immune homeostasis (immune balance).
Dr.Hellen is passionate about helping people enjoy life at its fullest. She may be contacted by using this form, contacting her at: drhellen@drhellengreenblatt.info or feel free to call her at: 302.265.3870 (ET, USA).
The second leading cause of death for people under the age of 44 years is suicide. Overall, it is the the tenth leading cause of death in the United States, with veterans comprising 22.2% of this statistic. Women are three times more likely to attempt suicide, but for every woman who takes her own life, four men will die from their attempt.
Although older adults make up only 12% of the population in the States, they account for 18% of all suicides. These fatal events in the elderly are probably under-reported by 40% with “silent suicides”, dehydration, “accidents”, medication over doses, etc. ending in death. Additionally, double suicides involving spouses or partners occur most frequently in this population. Since the elderly are the fastest growing segment of the population, these later-life deaths are predicted to result in suicide becoming a major public health issue in the too-near future.
Inflammation and Suicide
C-reactive protein (CRP) is associated with high levels of inflammation found in people with inflammatory disorders, burn and trauma victims, in obese individuals, in people with infections or with cardiovascular disease. People with suicidal thoughts (known as suicidal ideation) or attempts, also exhibit high levels of C-reactive protein compared to people without such behaviors.
Inflammatory factors are triggered during stress and are associated with depression.
When compared to patients being treated for psychiatric disorders who are not suicidal, individuals who have contemplated or attempted suicide have increased levels of inflammatory cytokines, immune cell molecules in their blood and/or brain.
The ratio of inflammatory molecules to anti-inflammatory molecules in the body either promotes inflammation or limits it. A healthy immune system constantly strives to maintain these factors in a delicate balance, in immune homeostasis.
Importance of Balancing Immune Factors
Imbalances in immune regulators are harmful and lead to disease. Taking the following steps should make a major difference in helping the body and mind return to homeostasis, to its natural, healthy balance:
Engage in physical activity at least 30 minutes a day 5 days/week.
Add one or more daily servings of a superior immune support supplement to your diet.
Maintain a healthy weight.
Eat a wide variety of colorful fruits and vegetables.
Spend some time outdoors.
For decades I have helped people enhance their quality of life. I can be contacted at: DrHellen@DrHellenGreenblatt.info, use this form or give me a call at 302.265.3870 (ET USA) and let us talk. Your first 30 minutes are on me! You’ve tried everyone and everything else, let me help you feel good again, you deserve it!
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.
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!
Given all the current social, political and economic uncertainties, this year may be even more anxiety-producing and stressful than in the past. Past surveys have shown that 30-50% of people (and because of all of their responsibilities, especially women) experience heightened stresses.
STRESS AND INFLAMMATION
Stress alters immune responses affecting our ability to fight infection and heal after injury. Inflammation is a necessary part of the immune response and is stimulated when the body is injured or exposed to pathogens or mutated cancer cells.
Short term stress stimulates the immune system by preparing it for a “flight vs. fight” response, but over a longer period of time stress results in negative imbalances of the immune system and increased inflammation. This becomes even a larger problem for people who are already in poor health or struggling with disease.
Poorly regulated inflammation results in chronic diseases such as diabetes, arthritis, coronary heart disease, Alzheimer’s disease, dementia and even cancers, so it is important that the body carefully regulate the amount of inflammation produced.
Inflammation is a two-way street. Stress causes inflammation and inflammation causes stress. And when daily activities increase stress, the amount of inflammation produced by the body increases as well.
There are biological markers in the blood that track differences in immune responses. The longer and greater the stress, the more likely the body is to switch from a healthy, controlled inflammatory response to one that affects its ability to fight disease and healing processes.
CONTROLLING INFLAMMATION AND STRESS
The net effect of an inflammatory response is determined by the body balancing its inflammatory and its resulting anti-inflammatory responses.
The four best ways to help the body balance are:
Be physically active for at least of 2.5 hours total per week.
Incorporate a daily immune balancing supplement into your diet.
Eat a smart, healthful diet.
Keep your weight under control.
Remember: The better you take care of your immune system, the better it will take care of you.
Graphic adapted from: Johanna Bendell, MD, with thanks.
Last week I talked with a young local Asian-American business owner who shared with me that he was “a little fatigued and stressed out”. I suggested that if he took steps to getting his immune system in balance, that since our physical and emotional well-being is dependent on homeostasis, he would feel much better.
He basically replied that, “he spends half the year in Florida, has a lot of friends that are “into” nutrition, he exercises and that he didn’t need any more information, thank you”.
Nothing like a person with an open mind, but unfortunately too many people think in this narrow way. We all know individuals that eat nutritiously, exercise 5-7 days a week and watch their weight but they still do feel “off”. Their fingers, elbows or knees hurt, they can’t eat everything they would like, or they have other health issues despite their “great” life style.
Nutritional Recommendations:
The evidence is strong that due to the hundreds of phytonutrients, plant nutrients, in fruits, vegetables, nuts, beans, whole grains and olive oil, that plant-based foods are important for our health. A broad variety of these phytonutrients are suggested since they appear to affect a wide-spectrum of biological functions. The consumption of plant-based foods influences the health of cells, blood pressure, risk of certain cancers, immune, dental, urinary, liver and gut health.
An additional dietary recommendation is to consume fish or fish oil 2-3 times a week for their omega-3 fatty acids. This “good” fat has multiple uses in our body, but the body cannot produced these fats by itself; we need an outside source.
Studies involving hundreds of thousands of people suggest that omega-3s reduce the risk of fatal heart disease, improve the flexibility of blood vessels, lower blood pressure and reduce immune inflammation. [Note: It is controversial whether omega-3 supplements are as beneficial as eating fish; in fact, they may cause certain health issues.]
Role of the Immune System
When the body is threatened by pathogens or cancer cells, or has been injured, the body responds with short-term inflammatory responses, acute inflammation.
Immune cells flood the area to destroy invading foreign organisms or cancer cells, or to start the healing process after trauma. If the body cannot get rid itself of the infection, or if it over-responds with excessive levels of inflammation, the immune response may become chronic, or long-term.
Chronic inflammation is abnormal and damages previously healthy tissues and organs. This sort of unlimited inflammation results in autoimmune diseases, diseases in which the body’s immune system turns on the body. Conditions such as arthritis, diabetes, lupus, multiple sclerosis, Crohn’s disease, ulcerative colitis, celiac disease, hepatitis and asthma can result from such run-away inflammatory responses.
Knowledgeable individuals know that nutrition plays only an initial role in staying healthy. Good nutrition is the foundation upon which to build health, but it is NOT ENOUGH; it is the immune system that governs one’s health and must be optimized.
The Importance of a Balanced Immune System
Immune balance, immune homeostasis, is tightly regulated by the body. It allows the organism to respond to infection, cancer cells and injury with the right amount of inflammation. Any imbalances, either too much stimulation, or too little, results in immune disorders and health issues.
The key to good health and healthy aging is keeping the immune system in balance.
Dr.Hellen’s major passion is helping people to enjoy life at its fullest. She may be contacted by using this form, at: drhellen@drhellengreenblatt.info or feel free to call: 302.265.3870 (ET, USA).
As of this writing, the Centers for Disease Control (CDC) in Atlanta is strongly recommending that pregnant woman postpone travel to many countries across the world, including the popular Caribbean islands. The CDC is taking these steps due to the possibility that these women may become are infected with a mosquito borne virus called Zika. The World Health Organization (WHO) Director General Dr Margaret Chan, has said that Zika had gone “from a mild threat to one of alarming proportions” and expects the virus to spread through the Americas and affect between three million and four million people.
Eighty percent of individuals who are infected with Zika do not show symptoms. However, when symptoms do occur, they can last up to a week or so and include fever, rash, pink eye, and joint pain. Some clinicians suggest that Zika virus infection may result in the autoimmune [against oneself] condition, Guillain-Barre syndrome (GBS). This is rare disorder where too much inflammation damages the nerve cells, causing muscle weakness and may lead to paralysis.
The greatest concern however right now is that health agencies “strongly suspect” that when a pregnant women is bitten by a mosquito that is carring the virus, that even if she does not experience symptoms, that her offspring may develop brain malformations.
This latest outbreak adds to concerns that infectious diseases are one of the top threats challenging our world—a major topic on the agenda of last week’s World Economic Forum world leader attendees. Until vaccines or treatments are developed, viral infections such as Zika, Ebola, SARS (severe acute respiratory syndrome), and MERS (Middle East Respiratory Syndrome) remain a threat to the world’s population.
Currently, there are no commercially available vaccines or treatments for Zika. Until recently the cost to develop a successful vaccine was far greater than what the manufacturers would recoup in vaccine sales. However, development of a vaccine for Zika will likely now escalate since Zika has spread so widely, infecting over 1.5 million individuals and its being linked to neurological problems, especially in newborns.
In addition to a lack of vaccines and treatments for a multitude of viral diseases, another significant health-care crisis we are facing is treatment of infection by anti-microbial-resistant pathogens. As Dr. Keiji Fukudaof the World Health Organization has stated: “We really hope to pull the world back from the brink where antibiotics don’t work anymore”.
When bacteria are stressed, for example by a killer antibiotic, their genetic material may change, mutate, so that they can tolerate and become resistant to such compounds. The bacteria can then replicate easily and outgrow bacterial strains that were not resistant to the antibiotic.
Fifty percent of antibiotic prescriptions written by U.S. physicians are of no benefit to the patient, and when used to fatten livestock and poultry it gives bacteria even more opportunity to acquire antibiotic tolerance.
It is our immune systems that identify, destroy, and remove invading pathogens. When our body recognizes that it has been invaded by foreign agents, a strong inflammatory responses is triggered to meet the onslaught of the pathogens. White blood cells accumulate in the area to combat the invaders. These immune cells release cytokines and other immune messages recruiting more white blood cells in an attempt to “burn out” the infection. Without a powerful inflammatory response, we cannot limit or survive infections.
In the absence of drugs or treatments that prevent and control the growth of viruses and other microorganism the immune system must be optimized to protect the body against them.
In the past, scientists thought that there was a blood-brain barrier that “isolated” the brain from the actions of the immune system. They labeled the brain “immune privileged”; because studies suggested that a healthy brain had few, if any inflammatory cells in it. Only when there was a brain infection did scientists think that immune cells migrated into the brain.
Researchers failed to take into account that chronic inflammatory diseases are associated the brain. For example conditions such as inflammatory bowel disease, psoriasis, liver disease, and rheumatoid arthritis may result in a lack of social interest, feelings of being unwell and unremitting fatigue—all which are governed by brain function.
Inflammation is activated when the body encounters pathogens and cancerous cells. The inflammatory response is a primary means by which the body will destroy these threats. Inflammation is basically a controlled “burn”. Firefighters will often have a “controlled burn” in a forest to get rid of dead trees and limbs. They strive to keep the fire limited to a specific area. Sometimes however firefighters are unable to control the fire and acres of forest are burned in error.
Similarly, once immune cells have taken care of a threat to the body, for example cancer cells, pathogens, etc., it is essential that the immune system “turn” down the inflammatory “flame”. Chronic, unnecessary inflammation leads to many autoimmune diseases that destroy their own organs, such as diabetes, Crohn’s bowel disease, multiple sclerosis, and lupus
Inflammation is all about location, location, location. If one has inflammation in the insulin-producing cells that control blood sugar, the person may get diabetes. If their intestines are inflamed they may suffer from Crohn’s. If there is too much destruction and inflammation of nerve cells, they may suffer from multiple sclerosis.
Let us hypothesize that an individual has two trillion immune white blood cells and that half of these cells are out of control and producing too strong an inflammatory response. This inflammation is destroying previously healthy tissues and organs. Since the body is always striving to balance inflammation, the other half a trillion of cells are working towards lowering the amount of inflammation and destruction that is going on in the body
Each of these cells is expending a trivial amount of energy trying to accomplish its task, but a tiny amount of energy multiplied by two trillion cells is a great deal of “wasted energy”. Is it any wonder why these people complain of being tired?
Individuals who have been diagnosed with autoimmune conditions have higher levels of inflammatory cytokines, immune messages, than people without disease. In heart failure patients, significant fatigue is associated with poor recovery and a higher risk of death. Patients with high levels of anti-inflammatory cytokines, molecules that decrease inflammation, recover more fully and rapidly than patients with high amounts of inflammatory cytokines. When patients are treated for their heart problems, their cytokine levels begin to resemble the cytokine ratios of healthy individuals, and their energy returns.
In mice with liver inflammation, immune cells from the liver travel to the brain and trigger other specialized immune cells called microglia releasing a biochemical that attracts more inflammatory cells into the brain, which in turn produces more inflammation.
In individuals with multiple sclerosis, a nervous system disease with a major inflammatory component, patients had less fatigue when they took anti-inflammatory medications.
The association of appropriate levels of inflammation with a healthy brain and high energy reserves is clear; the key is being in immunological balance. Once individuals balance inflammatory and anti-inflammatory cells they typically regain their energy and focus.
Aren’t you tired of being tired all the time? Don’t wait any longer. Contact Dr. Hellen to talk bout enhancing your quality of life. There is no fee for consulting with her for the first 30 minutes. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
Asthma is an inflammatory condition which affects the lungs in negative ways. It is not a single disease, but a group of symptoms that arise from the abnormal immune responses to environmental triggers.
Asthmatics suffer from limited air flow, difficulties in breathing, heightened sensitivity to particles or toxins in the air, wheezing, coughing, and tightness of the throat and chest.
Asthma can be triggered by allergens, air-borne pollutants, upper respiratory infections (like a cold or the flu), exercise, and nonsteroidal anti-inflammatory drugs, such as acetaminophen.
The cells that line the airways, the epithelium, are the first point of contact when particles are inhaled. Until recently, scientists were unaware that these cells contribute to inflammatory responses within the lungs.
Scientists are busily trying to clarify the role of over 50 different cytokines that are involved in regulating the amount of lung inflammation that asthmatics experience. When challenged with antigens, lung cells produce great numbers of inflammatory cytokines, immune messages. These immune factors regulate the activity of genes that result in inflammation and the body’s efforts to control inflammation. Inflammatory cytokines increase the levels of inflammation to help the body remove the antigens, while other cytokines dampen excessive immune responses, trying to bring inflammatory responses back to balance.
Structural changes in the airways result from the actions of different classes of inflammatory cells and their immune proteins and biologically active molecules. Lung cells can also release molecules that cause the muscles and blood vessels in the airways to become stiff and narrow.
The lungs become overly sensitive to environmental stimuli triggering the production of excessive levels of mucus, perhaps to help dilute and wash antigens out. These fluids can clog the airways of the lungs making it even more difficult to breathe. The hypersensitivity of the lungs results in a vicious cycle of over-active immune reactions, inflammation, and more mucus production.
As always the key to healthy immune support is balance. The body needs to produce enough inflammation to help us heal and protect us from external and internal challenges, but the inflammatory response must be well balanced and controlled.
Dr. Hellen’s major passion in life is helping people get more energy, become more productive, and enjoy life at its fullest. She may be contacted by using this form, drhellen@drhellengreenblatt.info, or at: 302.265.3870 (ET, USA).
Delirium is an under-reported condition that may affect up to 56% of older individuals after surgery, patients that have been heavily sedated for a length of time, burn, cancer, and patients on ventilators for long periods. Patients experience vivid hallucinations that may be part of a vicious cycle if doctors attempt to control the delusions with larger amounts of sedatives; the medications may disorient and confuse the patient even more.
The delusions and accompanying cognitive issues can persist for months after patients leave the hospital and can lead to a misdiagnosis of dementia, rather than delirium. [Dementia develops gradually and gradually worsens, while delirium may be of sudden onset.]
Delirium is associated with excessive inflammation in the brain resulting from triggering specialized immune cells the microglia. If stimulated over a long time, the cells release inflammatory cytokines, molecules that damage nerve cells and contribute to damage and break down of the capillaries in the brain, the blood-brain barrier.
C-reactive protein, CRP, is one measure of inflammation. CRP levels were measured in elderly surgical patients who had ended up with complications such as delirium, cardiovascular issues, or infection. The levels of CRP in their blood were predictive as to how fully they recovered.
A recent study measured the levels of 12 different inflammatory and anti-inflammatory cytokines in older patients undergoing surgery. Those having episodes of delirium had consistently high levels of inflammatory cytokines as compared to patients that did not have high levels of cytokines. Similar results were seen in patients that developed delirium after procedures such as open-heart surgery and hip fracture repair.
Conclusion
In order for the body to heal after it is hurt, or to fight an infection successfully, a delicate balance of cytokines, immune messages are required. Too little of an inflammatory response and the individual may not survive an infection. Too much of an inflammatory response and healthy tissue is destroyed. Homeostasis, balance, is what the body strives for every moment.
Dr. Hellen would be pleased to provide guidance to helping enhance your quality of life. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
For over two decades I have noticed that individuals in immune homeostasis, immune balance, are on fewer medications or no medications than their cohorts, and the majority of them look and feel 10 years younger than other people their age. Comparing photos of how these individuals look now with photos as how they looked 10-20 years ago, it is amazing how great they look! Their youthfulness is especially apparent when I compare these photos to those of individuals that have not made the effort to control inflammation.
Too many older individuals suffer from chronic inflammatory diseases such as arthritis, diabetes, cognition deficits, Parkinson’s disease, lung, kidney, and bladder problems. Over the years there have been numerous studies associating chronic (long-term) inflammation with the development of mutating cells and cancers. However because of the time it takes to do longevity studies it is difficult to prove that limiting inflammation makes a difference in how well people age.
Just this month, a team of scientists from Keio University School of Medicine, Tokyo, Japan and the Newcastle University’s Institute for Ageing in the UK published a study of the immune status of over 1500 individuals ranging in age from 100-115 years.
The study group was divided into two: centenarians, 100-104 years of age, and semi-supercentenarians aged 105 and above. The result was that these long-lived individuals had lower levels of inflammation as compared to the general public.
Dr. von Zglinicki, one of the investigators, said, “Centenarians and supercentenarians are different – put simply, they age slower. They can ward off diseases for much longer than the general population… it’s only recently we could mechanistically prove that inflammation actually causes accelerated ageing in mice…This study, showing for the first time that inflammation levels predict successful ageing even in the extreme old….”
Dr. Yasumichi Arai, the first author on the study said, “Our results suggest that suppression of chronic inflammation might help people to age more slowly…However, presently available potent anti-inflammatories [medications] are not suited for long-term treatment of chronic inflammation because of their strong side-effects. Safer alternatives could make a large difference for the quality of life of older people.”
As I have pointed out for decades, controlling the delicate balance of inflammatory responses, i.e., achieving immune homeostasis, makes all the difference in one’s youthfulness and quality of life.
P.S. My post of May 20, 2013also discusses the role of inflammation in longevity.
Please contact me directly if you would like to learn simple approaches to making a difference in your health.
Idiopathic pulmonary fibrosis (IPF) is a disease in which the tiny air sacs or “alveoli” that make up the lungs become inflamed and are gradually replaced by scar tissue (fibrosis). As the amount of scar tissue increases, the lungs stiffen and are unable to transfer oxygen from the lungs to the blood stream. This results in the brain and other organs becoming oxygen deprived.
As IPF progresses, day-to-day activities such as walking short distances, climbing stairs, dressing, or even talking on the phone become a problem because the person cannot catch their breath (dyspnea). The person feels as if they are suffocating and may require supplemental oxygen.
Advanced idiopathic pulmonary fibrosis makes people more susceptible to getting and fighting infections.
The term “ idiopathic” suggests that clinicians do not know what causes the disease. Lung inflammation may be triggered by infection with pathogens, airborne hazards, or certain types of medical treatments. Exposed to these types of challenges, the immune system boosts its inflammatory response to attack the pathogens and remove hazards or damaged tissues. In a vicious cycle, the uncontrolled inflammation results in greater lung damage.
Idiopathic pulmonary fibrosis may be considered an inflammatory autoimmune disease. Autoimmune (meaning against oneself) conditions result from the body’s overactive, defensive, inflammatory reactions to an immune challenge. The body’s own immune cells mistakenly attack and destroy previously healthy by-stander tissues or organs, very much like a forest fire damages healthy trees.
The body responds to injury by forming scar tissue, made mainly of the key protein collagen. Pulmonary fibrosis results in inflammation and scarring that occurs again and again. It is an imbalance between the build-up of scars, and the breakdown of collagen that is needed for tissue repair. In IPF, lungs with old scar tissue is found layered over old damage, while fresh scarring is seen over more recent damage.
Lung damage in IPF patients is due to imbalances between inflammatory and anti-inflammatory cytokines, immune messengers generated in response to substances or circumstances that initiated the lung damage in the first place. Imbalances of cytokines results in more and more fibrosis.
Individuals with IPF may find that if they are able to control the amount of inflammation produced by their immune systems, if they can stay in homeostasis, balance, their quality of life may change for the better.
Please contact Dr. Hellen if you wish her assistance in changing your quality of life. There is no fee for her services. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
Mutating cells and invasion by pathogens triggers inflammatory responses in the body. Inflammation consists of a series of events involving cytokines (immune messages), other immune factors, and circulating white blood cells. Uncontrolled levels of inflammation damages healthy tissues and organs.
Excessive inflammation of the eyes may result in sight-threatening condition.
Uveitis
Uveitis describes a group of eye inflammatory diseases. Symptoms can develop gradually over a few days, or occur suddenly. Symptoms may include: photophobia (sensitivity to light), cloudy or blurred vision, increased floaters, difficulty in vision focus, headaches, “red eye” with pain ranging from a mild ache to intense pain, and loss of peripheral vision (ability to see objects at the side of one’s field of vision). Severe uveitis may lead to permanent damage to vision.
Many cases of eye tissue inflammation are “idiopathic”, i.e., without a known trigger. Some clinicians suggest that uveitis is caused by: a) autoimmune responses in which the body’s immune system mistakenly targets and attacks its own eye tissues, b) infections or cancer, c) trauma to the eye, or d) exposure to toxins. Uveitis is more likely to occur in individuals that have other immune and inflammatory conditions.
Ebola and Uveitis
Two months after an American physician was treated for Ebola, and despite the fact that the virus was no longer detectable in his blood, there were high levels of Ebola virus in his eye. His eye infection was accompanied by an intense inflammatory reaction, uveitis. After much effort, the physician was successfully treated and thankfully did not lose his sight.
In a study of 85 Ebola Virus Disease survivors in Sierra Leone, 40% reported that they had some sort of “eye problem”. (It is not known whether they also had uveitits.)
Retinitis Pigmentosa
Retinitis pigmentosa is a genetic disorder in which the light-sensitive retina, the “screen” at the back of the eye that captures images, becomes damaged . Its photoreceptors, rods and cones, begin to die off resulting in a loss of vision. This condition may end in blindness.
There are conflicting opinions as to whether inflammation plays a major role in this disease.
One study that support the contention that immune responses are involved in retinitis pigmentosa measured the levels of TNF-alpha. TNF-alpha is a cytokine, that among other functions, helps regulate immunological responses. Depending on when and how much of the cytokine is produced , TNF-alpha may be pro-inflammatory (initiate inflammation), or anti-inflammatory (inhibit inflammation). In animals with uveitis-like conditions, the levels of TNF-alpha in the eye are increased between 5-10 fold over control animals.
Also, in retinitis pigmentosa, immune white blood cells are attracted to the retina, perhaps to clean up debris from dying cells. Some investigators suggest that when these immune cells are overly stimulated, they initiate an autoimmune response, destroying other light-sensing centers in the retina.
Immune Homeostasis, Immune Balance
Immune inflammation is essential to defend the body against cancerous cells and invading microorganisms. However, the appropriate levels of “protective” cytokines are needed to balance the “destructive” cytokines produced in the eye so that it can maintain immune homeostasis, immune balance. Unchecked inflammation results in tissue damage and an inability of the body to mount stable and proper immune responses in the face of various challenges.
Dr. Hellen is available at 302.265.3870 for discussion on the role of inflammation and immune homeostasis in one’s health. There is no charge to speak with her. She may be contacted at: drhellen@drhellengreenblatt.info, or use the contact form. Thank you.
