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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

“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).
www.niams.nih.gov/health_info/lupus/lupus_ff.asp
www.hindawi.com/journals/bmri/2011/432595/
www.ncbi.nlm.nih.gov/pmc/articles/PMC3320801/
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www.ncbi.nlm.nih.gov/pubmed/28491039
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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.

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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!

 
afsp.org/wp-content/uploads/2016/06/2016-National-Facts-Figures.pdf

www.sciencedirect.com/science/article/pii/S1043466615300090

www.ncbi.nlm.nih.gov/pubmed/28211584

www.ncbi.nlm.nih.gov/pubmed/28135675

www.ncbi.nlm.nih.gov/pubmed/27824355

www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00794-X/fulltext

Given all the current social, political and economic uncertainties, the holidays 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 during the holidays.

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 the holidays or daily activities increase stress, the amount of inflammation produced by the body increases as well.

stress-and-inflammation

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.

Especially during the holidays, the four best ways to help the body balance are:

Be physically active for at least of 2.5 hours total per week.

  1. Incorporate a daily immune balancing supplement into your diet.
  2. Eat a smart, healthful diet.
  3. 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.
www.psychcentral.com/holidays/
www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20047544
www.apa.org/news/press/releases/2006/12/women-stress.aspx
www.ncbi.nlm.nih.gov/pubmed/27859423
www.jci.org/articles/view/25102
www.ncbi.nlm.nih.gov/pubmed/12480495
www.ncbi.nlm.nih.gov/pubmed/24062448
www.ncbi.nlm.nih.gov/pubmed/27862176

 

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.

    Scales Immune Reponses Partial

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).

  

nutrition.ucdavis.edu/content/infosheets/fact-pro-phytochemical.pdf
www.hsph.harvard.edu/nutritionsource/fish
www.harvardprostateknowledge.org/high-intake-of-omega-3-fats-linked-to-increased-prostate-cancer-risk
www.ncbi.nlm.nih.gov/pubmed/17047219?dopt=Citation
www.ncbi.nlm.nih.gov/pubmed/22893204
www.ncbi.nlm.nih.gov/pubmed/22122770
www.ncbi.nlm.nih.gov/pubmed/27357102

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Without the ability to produce inflammation we die.  The inflammatory response is the main weapon that the immune system uses to protect us from infection, keep cancer cells from growing out of control, and help tissues heal when they are damaged.

However, one has to have the right balance of inflammation to be healthy.  We need enough inflammation to protect us, but  too much of an inflammatory response leads to increased risk of developing diseases such as irritable bowel disease, multiple sclerosis, arthritis, lupus, and diabetes.

The mind as well as the body is negatively affected by run-away inflammation. Emotional problems such as depression, spikes of high or low moods (bipolar disorders), or schizophrenia are accompanied by uncontrolled inflammation.

Genes control the amount of inflammation that the body produces. When “inflammatory” genes are turned on, up-regulated, immune cells produce cytokines, inflammatory immune messengers, along with biological compounds such as C-reactive protein (CRP).

LONELINESS AND ANHEDONIA

Loneliness and feelings of isolation are linked to an increased risk of chronic disease and death and are associated with increased levels of inflammation.

Some depressed individuals experience anhedonia, a condition in which they   lack motivation and do not enjoy  life.  These people find no joy in food,   spending time with their family or friends, concerts, or activities that others find pleasurable.

Individuals with anhedonia experience persistent brain inflammation, among other biological events and typical treatments for depression are often not helpful.

BRAIN REGIONS COMMUNICATE WITH ONE ANOTHER

Different parts of the brain communicate with one another as they control a person’s response to pleasure and rewards such as social interactions, food and sex.  Reacting positively to these stimuli motivates one to repeat them in the future.  The ability of these regions to communicate with one another is called “connectivity”.

Individuals with low connectivity have increased inflammation and deeper feelings of anhedonia.  High CRP (an inflammatory marker) levels were also correlated with the inability to experience pleasure.

One of the medications used for individuals suffering with anhedonia is infliximab.  This medication is prescribed for patients with inflammatory conditions such as bowel disease and arthritis.  Additionally, administrating cytokines, immune messengers of inflammation, changes the reward-related regions of the brain.

DOPAMINE
Dopamine, which is produced brain cells, is strongly associated with the brain’s pleasure/reward regions. Dopamine helps us feel enjoyment and motivates us to participate in or continue to engage in activities that give us pleasure.

Decreased production of dopamine is associated with heighted inflammation and decreased connectivity between the pleasure centers of the brain. Administering inflammatory cytokines over a long period of time may lead to decreases in dopamine production.

THE LINK BETWEEN PHYSICAL ACTIVITY AND DEPRESSION

Every time muscles contract, they release anti-inflammatory molecules that help the body balance the amount of inflammation it produces.  Additionally, exercise activates the brain’s pleasure centers. The evidence shows that there is a strong link between physical activity and mental and physical health.

Regular physical activity decreases one’s risk of depression.  Researchers tracked individuals that experienced their first heart attack and had been physically active for 10 years prior to the event. Heart attack survivors who exercised for years prior to the event had a 20% lower risk of developing depression compared to individuals that had not been physically active.

Also, people who had become physically active before their first heart attack had a better protection against depression compared to those who had been active at one time,  but then became inactive.

SUMMARY

Increased inflammation has been associated with depression and other negative emotional states.  Maintaining the body’s balance of inflammatory and anti-inflammatory responses helps support healthy emotional responses.

Dr. Hellen’s major passion in life is helping people to enjoy life at its fullest. She may be contacted by using this form, at  drhellen@drhellengreenblatt.info, or at:  302.265.3870 (ET, USA).

http://www.npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems
medicalxpress.com/news/2015-11-cellular-symphony-responsible-autoimmune-disease.html
http://www.news-medical.net/news/20151121/Brain-imaging-reveals-distinctive-aspects-of-high-inflammation-depression.aspx
http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2015168a.html
http://www.ncbi.nlm.nih.gov/pubmed/26360770
http://www.ncbi.nlm.nih.gov/pubmed/26272539
http://www.ncbi.nlm.nih.gov/pubmed/24286171
http://www.amjmed.com/article/S0002-9343(15)00786-X/abstract
http://www.news-medical.net/news/20151030/Study-shows-link-between-physical-activity-and-depression-in-patients-at-risk-for-heart-disease.aspx
http://neuroscience.mssm.edu/nestler/brainRewardpathways.html
http://www.ncbi.nlm.nih.gov/pubmed/26302141
www.ncbi.nlm.nih.gov/pmc/articles/PMC3181880/
www.pnas.org/content/early/2015/11/18/1514249112.full.pdfcause-illness-and-early-death.html
www.psychologytoday.com/blog/the-compass-pleasure/201104/exercise-pleasure-and-the-brain
http://www.pnas.org/content/early/2015/11/18/1514249112.abstract
www.psychologistworld.com/biological/neurotransmitters/dopamine.php

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

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

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

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

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

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

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

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

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

 

Parkinson’s is a disease of the nervous system that affects mobility, memory, and cognition.  Individuals may eventually experience rigid muscles, tremors of the limbs and head, loss of muscle control, monotonous speech levels, and a slow, shuffling gait.

Individuals tend to develop the disease as they age. Having a close relative with Parkinson’s disease (PD) increases the likelihood of developing Parkinson’s, with men more than 1.5 times more likely to develop the disease than females.

Although the causes of Parkinson’s disease are not clear, a recent study suggests that individuals with a specific gene are at a higher risk of getting Parkinson’s disease if they were exposed to pyrethroids, a class of chemicals found in the majority of household insecticides.  Exposure of individuals to these pesticides may result in brain tissue inflammation.

Inflammation and Autoimmune Responses

In Parkinson’s disease, the body mounts an inflammatory response against its own brain cells, its dopaminergic neurons. (An immune response against oneself is called an autoimmune response.)

These specialized brain cells produce a biochemical called dopamine with many functions including controlling bodily movements, memory, ability to think, mood, and learning.  The body’s long-lasting inflammatory response against its own nervous cells gradually destroys the dopaminergic neurons resulting in abnormal dopamine levels and brain activity, symptoms associated with Parkinson’s disease.

Microglial cells are specialized immune cells located in the brain. They are considered the “canary in the mine”.  When microglial cells sense a threat, they become “activated” and release immune factors that may, depending on the types and amounts of these molecules, be beneficial or cause damage to nerve cells.

Activated microglial cells are found in large numbers in the brains of Parkinson’s patients, along with high levels of cytokines, biochemical molecules responsible for inflammation.

The brain and spine of the nervous system are cushioned by cerebrospinal fluid. This fluid helps to provide nutrients to the nervous system and removes waste products from the brain.

Individuals with Parkinson’s disease have high levels of immune inflammatory molecules in their spinal fluid.  The more concentrated the molecules, the more likely the person is to severe fatigue, depression, and cognitive impairment.

Summary

Certain genes that control immune system responses are also strongly linked with the development of Parkinson’s disease.

Increasingly, scientific studies suggest that inflammation and autoimmune responses result in Parkinson’s disease.

Helping the body limit out-of-control inflammation, and achieving a more homeostatic, more balanced immune response, may go a long way towards changing the quality of life in individuals with Parkinson’s.

Feel free to contact Dr. Hellen. There is no fee for speaking with her. Dr. Hellen may be contacted by using this form or at: 302.265.3870 (ET).

 www.nature.com/npjparkd/
www.sciencedirect.com/science/article/pii/S1357272504003711
physrev.physiology.org/content/91/2/461
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This month was the 13th anniversary of the haunting September 11 event that has changed us, our Nation, and the world we thought we knew. It seems like yesterday that these events happened.

Three years ago, I posted my frustration of my inability to get First Responders, and/or their health practitioners, to consider addressing the issue of immune homeostasis, immune balance, to enhance the quality of life of individuals that had put themselves at risk to save others.

 Exposure to Air-Borne Particles

The World Trade Center Health Registry estimates about 410,000 people were exposed to air-borne particles and toxins attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings.

 Despite the fact that early in the World Trade Center (WTC)’ construction, builders abandoned asbestos as a fireproofing material, over 400 tons of asbestos were used in the building of the World Trade Center (WTC). Additionally ”mineral wool”, minerals that were melted and spun into fibers and bound together by cement like components was used in construction.

 Massive amounts of hazardous fiber, asbestos, glass, gypsum, and cement were pulverized into ultra-fine particles when the Towers imploded and collapsed on September 11. Virtually every surface was covered with a fine, white particulate dust, and downwind from the complex, the fine particulate matter settled to a depth of 3 inches or more.

Affected groups of Responders include firefighters, police, health professionals, clean-up crews, construction workers, truck drivers, transit workers, lower Manhattan residents, and office workers.

 Increase Risk of Cancer

Responders were exposed to hundreds, if not thousands, of toxic particulates, dust, and gases at Ground Zero. As many of these are known to be potential carcinogens, it is not surprising that two years ago, 58 different types of cancers were added to a list of diseases with which many World Trade Center responders suffer.

 Overall, First Responders at Ground Zero have a 15% increased cancer risk with a 239% higher risk for thyroid cancers. However, unfortunately, asbestos-related lung cancers such as malignant mesothelioma may not appear for 20-40 more years.

 Signature Illness: PSTD and Respiratory Illness

If having a significant increase in cancer risk was not enough, according to the findings of the Stony Brook [NY] Medicine’s World Trade Center Health Program, as many as 60% of 9/11 World Trade Center responders continue to experience “clinically significant symptoms of post-traumatic stress disorder (PTSD) and … respiratory illness”.

Coughing and breathing problems have been a major issue, even in Responders that were only “moderately” exposed. Additionally individuals with the most exposure were more likely to find that their asthma symptoms became worse.

Benjamin Luft, MD, Medical Director of the Stony Brook Program is of the opinion that “a signature illness” of a WTC Responder is having both PTSD and respiratory problems at the same time.

 Respiratory Difficulties and Inflammation

Inflammatory biomarkers have been monitored in those exposed to WTC dust and smoke. Elevated levels soon after exposure were associated with increased risk of difficulty breathing in the years that followed.

 PTSD and Inflammatory Responses

A few months ago I stated “Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.”

 “…individuals with PTSD are more likely to have significantly higher amounts of circulating CRP [an inflammatory marker] than those not diagnosed with PTSD.”

 The Combination of PTSD and Respiratory Issues

To repeat from my previous post,“The immune system mounts an immune, inflammatory response when the body is exposed to pathogens, pollutants, or toxins. The inflammatory cells release immune factors, such as cytokines, cellular messages, that are involved in cell-to-cell communication with the “purpose” of recruiting more inflammatory cells into an area to help eliminate a perceived threat.”

 “Pollutants and chemicals … trigger airway inflammation and increase mucous production. Other immune molecules cause narrowing of airways resulting in the contraction of the muscles lining the airways. The combination of inflammation and increased mucous makes it difficult for air to enter or leave the lungs and can result in breathing issues.”

“Additionally, lungs that do not function properly, are ideal for the multiplication of molds, bacteria, and viruses. The lungs continue their struggle to eliminate pollutants and pathogens, resulting in a chronic, persistent, dry cough and worsened lung function.”

 A Plea to Readers

I am convinced that immune inflammatory imbalances contribute in large portion to the reason that that First Responders experience so many health challenges.

 It is my heart-felt hope and expectation that helping individuals return to immune homeostasis, immune balance, may be the key to changing their quality of life. Despite numerous attempts and avenues, I have been unable to make reliable contact with decision makers or Responders.   I hope that you will forward my note to individuals that are still suffering the consequences of serving others.

 I can be reached at: DrHellen@DrHellenGreenblatt.info or at 302.265.3870. Thank you.

www.asbestos.com/world-trade-center/
sb.cc.stonybrook.edu/news/general/140910wtc.php
911research.wtc7.net/wtc/evidence/dust.html
www.sciencedaily.com/releases/2014/09/140910185910.htm
www.health.ny.gov/environmental/investigations/wtc/health_studies/responders.htm
www.cnn.com/2013/09/11/health/911-cancer-treatment/
www.thelancet.com/themed-911
www.mesothelioma.com/blog/authors/barbara/help-running-out-for-911-first-responders.htm
www.ncbi.nlm.nih.gov/pubmed/21998260

Post-traumatic stress disorder (PTSD) occurs in some individuals that are exposed to emotionally disturbing events such as combat, rocket, and terrorist attacks. Individuals that have suffered traumatic brain injury (TBI) or experienced natural disasters and sexual assault are also at higher risk of having this disorder.

Symptoms may include quality of life issues such as explosive outbursts of anger, difficulties in concentrating, being easily startled, feeling constantly “on guard”, expecting a threat to occur at any moment, depression, problems sleeping, avoiding people and circumstances that can trigger unpleasant memories or outbursts, limiting emotional relationships, and avoiding crowded locations.

Up to twenty percent of veterans serving in Iraq and Afghanistan, 10% of Gulf War (Desert Storm), and 30% of Vietnam Veterans have been diagnosed with post-traumatic stress disorder.

PTSD is not only a psychiatric issue. Individuals suffering with PTSD are at higher risk of being physically ill, and at increased risk of death from a multiple of causes.

PTSD is Associated with Inflammatory Responses.
Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.

A combination of high blood sugar, cholesterol, and blood pressure, coupled with excess fat around the abdomen (abdominal visceral fat), increases the risk of individuals for stroke, heart disease, and diabetes. This cluster of symptoms, metabolic syndrome, is associated with inflammation and is found in 48% of individuals with post traumatic stress syndrome compared to 25% of controls. Such clinical issues result in patients with PTSD utilizing a greater proportion of medical services and prescription medications.

IL-6 is a cytokine, an immune messenger, which plays a major role in inflammation, helping the body heal after tissue injury, and defending the body from pathogens. C-reactive protein (CRP) is another biological marker that is strongly related to heightened levels of inflammation. Elevated levels of IL-6 and CRP are associated with an increased risk of heart attacks and other cardiovascular events that are inflammatory in nature.

Reports of increased presence of inflammatory cytokines in individuals with PTSD are inconsistent. However, the evidence suggests in military personnel with PTSD or depression, IL-6 levels are higher than found in control subjects, and that the quality of life of these soldiers is poorer as well. Similarly, individuals with PTSD are more likely to have significantly higher amounts of circulating CRP than those not diagnosed with PTSD.

Intermittent explosive disorder is one of the more troubling aspects of some individuals with post traumatic stress disorder. This condition involves repeated episodes of impulsive, angry, verbal outbursts, and violent and aggressive behavior. CRP and IL-6 levels are significantly higher in personnel with intermittent explosive disorder compared with normal or other psychiatric controls, suggesting a direct relationship between inflammation and aggression.

Summary:
Fifty percent of individuals with post traumatic stress syndrome do not seek treatment, and of those that do, only half of these persons will get “minimally adequate” treatment. Until now, the primary treatments for PSTD are psychological counseling and psychiatric medications.

Inflammation is the result of a delicate balance between inflammatory and anti-inflammatory responses, and the body constantly strives to maintain a state of “immune homeostasis”, immune balance.

As in most disease, chronic low-grade inflammation is a likely contributor to post traumatic stress syndrome. If individuals with PTSD better controlled the amount of inflammation produced by their bodies, their quality of life would improve, both emotionally and physically.

 

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

 

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www.hindawi.com/journals/cherp/2012/490804/

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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www.ncbi.nlm.nih.gov/pubmed/23981442

 

 

 

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.

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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.

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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. 


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It is ten years since the horrific 9/11/01 attacks on the World Trade Center in New York City, The Pentagon in Washington, DC, and Flight 93 in Pennsylvania. On that day at the World Trade Center alone, there were approximately 3,000 murders.

These events have not only left the families, friends, and citizen survivors distraught and at great emotional and financial risk, but the heroic responders, the rescuers, recovery, and clean-up personnel, and civilians that lived and worked in the area, continue to pay a significant price in terms of their health.

There will never be a true accounting of how many individuals were exposed to smoke, thick-coatings of dust, combustion materials, asbestos, polychlorinated biphenyls (PCBs), dioxin, asbestos, and metals. Fire fighters, police, military members, paramedics, construction and iron workers, municipal employees, security workers, residents and workers in the area, and those that came from afar to help, were exposed to these toxic chemicals for days, weeks, and months. Fires burned for 69 days and even eight months after the destruction, workers were still searching for body fragments (1).

For some, the years may be receding from memory, but there are many individuals, and rescue and recovery dogs, that have, or are, still, paying a significant price for their heroic sacrifices. If they are still alive, their emotional and physical health has declined significantly, and no one seems to be able to help them.

Only limited funding has been available to study and monitor individuals that were at Ground Zeroand its surrounding environs. When researching information for this article I was surprised at the relatively few, peer-reviewed publications on this topic, and there is even less information on the effects of this trauma on children and adolescents.

Multiple Health Issues

A primary investigation now led by Dr Juan Wisnivesky, Mount Sinai School of Medicine in New York, has said, “Our findings show a substantial burden of persistent physical and mental disorders in rescue and recovery workers who rushed to the site of the WTC and labored there for weeks and months. Many of these individuals now suffer from multiple health problems (2), since World Trade Center-related mental and physical health conditions often co-exist (3).

Mental Health Issues Persist

One year after 9/11, it was estimated that more than 420,000 people New Yorkers were suffering from post traumatic stress disorders (PTSD) as a result of the attacks (1). This month, the prestigious British journal, Lancet, reports that 32% of tested personnel experienced post traumatic stress disorders and 28% per cent experienced depression at some time after 9/11. The incidence of most of the disorders was highest in workers with greatest World Trade Center exposure (3,4). Other emotional problems such as recurring nightmares, flashbacks, self-medication with alcohol, etc. have also been persistent issues.

Tomorrow: 9/11 Responders: Cancer Risks, Pulmonary Function, Immune Homeostasis, Balance.

1) www.guardian.co.uk/world/2002/aug/18/usa.terrorism

2) www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61180-X/abstract

3) www.guardian.co.uk/world/2011/sep/02/world-trade-centre-rescuers-health-risk

4) www.thelancet.com/journals/lanonc/article/PIIS1470-2045(01)00543-5/fulltext

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