Dr. Hellen Greenblatt

Eye Immune Homeostasis, Balanced Inflammation

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.

www.sciencedirect.com/science/article/pii/S0014483502003329
www.ncbi.nlm.nih.gov/pubmed/24174679
www.ncbi.nlm.nih.gov/pubmed/24639355
www.ncbi.nlm.nih.gov/pubmed/23608634
eyewiki.aao.org/Retinitis_Pigmentosa
www.ncbi.nlm.nih.gov/pubmed/22986109
www.ncbi.nlm.nih.gov/pubmed/21787221
www.nhs.uk/conditions/Uveitis/Pages/Introduction.aspx
www.nei.nih.gov/health/uveitis
www.nejm.org/doi/full/10.1056/NEJMoa1500306#t=article
www.nytimes.com/2015/05/08/health/weeks-after-his-recovery-ebola-lurked-in-a-doctors-eye.html?smid=tw-nytimes&_r=0

anti-inflammatory, autoimmune, autoinflammatory, balance, chronic disease, cytokines, Ebola, eye, immune homeostasis, immune system, infection, inflammation, inflammatory responses, pro-inflammatory, Retinitis pigmentosa, uveitis

Imbalances of Inflammatory Responses May Lead to Parkinson’s Disease.

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
www.ncbi.nlm.nih.gov/pubmed/25757798
www.ncbi.nlm.nih.gov/pubmed/25769314
www.ncbi.nlm.nih.gov/pubmed/22166438
www.ncbi.nlm.nih.gov/pubmed/25215472
www.ncbi.nlm.nih.gov/pubmed/22814707
www.medicalnewstoday.com/articles/265378.php

autoimmune, autoinflammatory, balance, chronic disease, cytokines, depression, dopamine, fatigue, immune homeostasis, immune system, inflammation, inflammatory responses, microglia, neurodegenerative, neurological, neurons, Parkinson's, pro-inflammatory

The Importance of Inflammation in Wound Healing

| Posted by in Immune Homeostasis (Immune Balance) | Inflammation | Injury and Trauma - (0 Comments)

Immediately after the body is injured, it starts the processes of stopping blood loss, restoring function, and preventing infection from pathogens on the skin or objects that may have caused the damage. The microenvironment of the injured area is in constant flux with the host cells continuously responding to the fluids, bacteria, and the dead and dying cells at the wound site.

One of the first phases of the healing process is for circulating platelets to attach to a fibrous scaffold, a matrix, to stop blood flow. Platelets, recently defined as immune cells, release cytokines, immune messengers, which permit cells to communicate with one another.

Once the flow of blood ceases, specialized immune cells enter the area setting up an inflammatory response that “cleans” the wound site and removes bacteria, damaged tissues, and foreign matter. In order to achieve the appropriate levels of inflammation, many complex cell-to-cell interactions occur in specific order.

Accumulation of fluids, exudates, results from inflammation, along with swelling at the wound site. Exudates are essential for the healing process and contain debris, inflammatory cells, bacteria, and a large variety of immune proteins. Depending on their concentrations, factors may enhance healing or interfere with the process. Proteins found in exudates have a variety of functions including regulation of inflammatory responses, triggering growth of new blood vessels, and stimulating growth of new cells.

A delicate balance of inflammatory and anti-inflammatory messengers is crucial and it determines the pace, and outcome of healing. Homeostatic, balanced, inflammatory responses are essential. Too little, too great, or too lengthy of an inflammatory response damages healthy tissue and delays healing.

The remodeling phase is one where tissues regenerate and close the wound. Closure occurs as cells cross-link and organize themselves attaching to a scaffold, a matrix that will draw edges of the skin closed and cover the area.

Poorly Healing Wounds

The presence of bacteria, foreign bodies, a lack of oxygen in the tissues, and/or fragments of necrotic, dead, tissue can stimulate inflammatory cells continuously, resulting in uncontrolled inflammation and wounds that heal poorly.

Infection of a wound site also interferes with proper healing. Communities of bacteria tend to organize themselves into a biofilm, a thin sheet of bacteria. Biofilms increase survival of bacteria colonies, reducing chances that inflammatory immune responses, or antibiotics, can control them.

Exudates in poor healing wounds contain an over abundance of inflammatory cells and immune mediators that increase inflammation. Sufficient anti-inflammatory factors to control the damaging effects of excessive inflammation may not be available.

Proteolysis is another one of the steps required for healthy healing. This is an event during which the body degrades necrotic tissue, and dead and dying pathogens. [Think of proteolysis as an acid/enzyme reaction that breaks down tissues.] When immune cells release too many proteolytic proteins over a longer period, they become destructive of healthy tissue, and the body’s ability to heal the wound is overwhelmed.

Individuals with non-healing skin ulcers, such as those found in diabetics, not only struggle with excessive inflammatory responses, but their proteolytic enzyme levels are significantly elevated giving rise to further imbalances in inflammatory responses and interference with the body’s repair mechanisms.

Summary

The sensitive balance between stimulating and inhibitory mediators during diverse repair of wound is crucial to achieving tissue homeostasis following injury. Once unbalanced and excessive inflammation is controlled, will healing begin.

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

www.ncbi.nlm.nih.gov/pubmed/25750642
www.nature.com/jid/journal/v127/n3/full/5700701a.html
www.rndsystems.com/mini_review_detail_objectname_mr02_cytokinewoundhealing.aspx
www.ncbi.nlm.nih.gov/pubmed/25774966
www.uweb.engr.washington.edu/research/tutorials/woundhealing.html
www.ncbi.nlm.nih.gov/pubmed/22564225
www.ncbi.nlm.nih.gov/pubmed/14766366
www.bioscience.org/2004/v9/af/1184/2.htm
www.ncbi.nlm.nih.gov/pmc/articles/PMC3467878

anti-inflammatory, balance, biofilm, cytokines, healing, immune homeostasis, immune system, infection, inflammation, inflammatory responses, injuries, matrix, pro-inflammatory, trauma, wounds

Lyme Disease: The Importance of Inflammatory Balance

Borrelia burgdorferi, is a bacterial infection that results from an infected tick, originally from mammals or birds, biting and injecting the microorganism into a human host. Individuals treated early in infection are likely to recover completely; however, delaying treatment may result in long recovery times, or result in disease that will last for years, or for life.

Infection Affects Multiple Organ Systems
Lyme disease can affect any organ or multiple systems including, skin, joints, nervous system, muscles, and skin. Early symptoms are a red, expanding rash, erythema migrans, that often appears at the tick bite site, and flu-like symptoms such as body aches, fever, chills, headache, and fatigue.

Left untreated, unfocused severe pain may, irregular heart beat and other heart problems, chronic inflammation of the joints (especially the knees, i.e., Lyme arthritis), liver inflammation (hepatitis) and eye problems. Unremitting fatigue, memory problems, and brain “fog” may also accompany the disease.

Incomplete recovery from Lyme disease may result in significant neurological problems, including Bell’s palsy (paralysis of one side of the face), weakness or numbness of limbs, impaired muscle movement, and meningitis (inflammation of brain membranes).

Twenty to fifty percent of patients with neurological issues may continue to experience difficulties for years.

Immune Responses to Lyme Infection
The extent of recovery from Lyme disease depends on factors such as the numbers of bacteria initially injected and the types of immune responses triggered by the infection.

As with healing from most infections, recovery from Lyme disease is a highly complex process requiring the correct interplay of inflammatory and anti-inflammatory cytokines, immune regulating molecules. Successful recovery requires a homeostatic, a balanced immune attack with enough inflammation to kill the organism without damaging by-stander cells and organs.

For example, the cytokine interleukin-6 (IL-6) stimulates inflammation but is also, depending on what the body needs, able to decrease inflammatory responses. (IL-6 is also triggers pain receptors and helps nerve cells regenerate.) Transforming growth factor-β (TGF-β) is another cytokine that helps the body control the amount of inflammation produced in response to infection.

Another cytokine, tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that stimulates certain immune cells to find, engulf, and digest invading organisms. Mice susceptible to Lyme disease are unable to manufacture enough of this factor which may account for their susceptibility.

In humans as well, patients that were recovering well had significantly higher levels of tumor necrosis factor-α compared to those with on-going disease. Once again, these responses likely reflect the powerful inflammatory response that helps the body eliminate the disease.

Additionally, recovering infected individuals had higher levels of transforming growth factor than individuals with severe symptoms. These findings suggest that transforming growth factor was successfully limiting the amount of inflammation being produced in response to infection.

Similarly, in mice with Lyme arthritis, animals that did best were those in which high TNF-α cytokine levels helped kill the bacteria, followed by an aggressive IL-6 response that dampened the inflammatory response.

In further support of these findings, patients with rashes (early infection) had high levels of the anti-inflammatory cytokine, transforming growth factor, as compared to those who had more severe neurological involvement.

Conclusion:
The body uses inflammatory responses to protect itself from infection and heal itself. Inflammation helps the body destroy organisms, almost as if the body was “burning” the infection out. However, just like a forest fire, if inflammation is not well controlled the person with Lyme disease may suffer symptoms for years or for life. This is why it is essential for the body to produce a balanced, immune inflammatory response to infection.

Contact Dr. Hellen at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.

www.mayoclinic.org/diseases-conditions/lyme-disease/basics/definition/con-20019701
www.ncbi.nlm.nih.gov/pmc/articles/PMC1782772/
www.ncbi.nlm.nih.gov/pubmed/23945160
www.youtube.com/watch?v=xuTlC_0KzGU VIDEO
www.ncbi.nlm.nih.gov/pmc/articles/PMC2991005/

anti-inflammatory, arthritis, autoimmune, B. burgdorferi, Borrelia burgdorferi, chronic disease, cytokines, fatigue, IL-6, immune homeostasis, immune system, inflammation, inflammatory responses, joint pain, Lyme, Lyme disease, neurological, pro-inflammatory, TGF, TGF-beta, TNF-alpha, transforming growth factor, tumor necrosis factor

Infertility and Inflammation

The act of conceiving, getting pregnant, requires many steps among which are: release of an egg from a follicle (ovulation), fertilization of the egg by sperm, transport of the egg through the Fallopian tubes to the uterus, and attachment to the uterine wall, (implantation).

Each step to becoming pregnant must occur in the right order and requires interaction with hormonal and immune system pathways.

Infertility is the inability to conceive after 1 year of unprotected intercourse. Ten to 15% of reproductive-age couples are unable to conceive. Thirty percent of the time infertility is due to issues with both the man and the woman, or no cause can be determined (idiopathic infertility).

Infertility Issues:
Hormonal and/or immunological imbalances.
Hormonal imbalances affect the way the body interacts with the immune system and affects the ability to conceive.

Seminal fluid, the liquid from male testicles that delivers sperm to the egg contains hormones, cytokines, and other immune messages that interact with the cells lining the female reproductive tract. The factors in seminal fluid prepare the site to receive sperm and set up the proper environment for implantation of the egg. The sequence of events resembles an inflammatory response, but too much inflammation can result in infertility issues.

Pelvic Inflammatory Disease:
Common pelvic inflammatory diseases such as appendicitis and colitis result in inflammation of the abdominal cavity, which in turn may affect the Fallopian tubes and lead to scarring and blockage of the tubes. Since the Fallopian tubes are the pathway by which the egg gets to the uterus for implantation, implantation may not occur. Abdominal surgery, scar tissue, and sexually transmitted infections can also result in inflammatory pelvic disease.

Endometriosis is an inflammatory and hormonal condition that occurs when the tissues lining the uterus grow and spread outside of the uterus. They release blood at menses, the monthly cycle. Thirty-five to fifty percent of infertility cases in women are due to endometriosis.

Poor Egg or Sperm Quality.
Life style decisions such as abuse of alcohol or drugs, smoking, poor diet, obesity, lack of consistent physical activity, and environmental factors may all contribute to poor viability of the egg or sperm.

Smoking contributes greatly to inflammatory responses of the body.

If either partner smokes, the chances of conceiving, via natural or clinical means, are reduced by 33%. Smoking by men lowers their sperm counts and affects the health of their reproductive organs. Women who smoke take longer to conceive compared to non-smokers and are at increased risk of miscarriage, premature birth, and low-birth-weight babies. Even women who do not smoke, but live in homes where they are passively exposed to smokers, may take more than a year longer to become pregnant than women living in smoke-free homes.

Infections and Medical Conditions.
Women and men with sexually transmitted diseases often show no symptoms. Untreated infections can result in excessive inflammatory responses which damage and scar reproductive organs.

Anti-sperm antibodies
Up to 50% of infertility problems in women and men may be associated with the presence of anti-sperm antibodies, large immune proteins that attach to the sperm and trigger immune responses.

In women, antibodies to sperm may attack her partner’s sperm and result in inflammation and damage of vaginal tissues. Over 70% of all men who get a vasectomy develop anti-sperm antibodies. If damaged sperm fertilizes an egg, chances of a miscarriage increase.

Summary:
The reasons behind idiopathic infertility are not understood. It has been my experience that when couples focus on returning to immune balance, to immune homeostasis, they appear to enhance their chances of having children.

Contact Dr. Hellen with the contact form, or 302.265.3870 (ET) or at DrHellen@DrHellenGreenblatt.info.

natural-fertility-info.com/top-10-causes-of-infertility.html
www.jimmunol.org/content/188/5/2445.full.pdf
yourfertility.org.au/for-men/smoking
www.ncbi.nlm.nih.gov/pubmed/25567620
www.ncbi.nlm.nih.gov/pubmed/25547201
www.ncbi.nlm.nih.gov/pubmed/24996040
www.ncbi.nlm.nih.gov/pubmed/24993978
www.ncbi.nlm.nih.gov/pubmed/25592078
www.ncbi.nlm.nih.gov/pubmed/24863647

anti-inflammatory, anti-sperm, antibodies, balance, chronic disease, cytokines, egg, Fallopian, immune homeostasis, immune system, infection, infertility, inflammation, inflammatory responses, ovum, reproduction, reproductive organs, seminal fluids, sexually transmitted disease, Smoking, sperm

Endometriosis: An Inflammatory Condition

| Posted by in Chronic Disease | Immune Homeostasis (Immune Balance) | Inflammation - (0 Comments)

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

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

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

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

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

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

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

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

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

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

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

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

autoimmune, autoinflammatory, cancer, chronic disease, cytokines, dioxin, endometriosis, immune homeostasis, immune system, infertility, inflammation, menstrual, pain, toxic, uterus

The Role of Inflammation in Periodontal, Cardiovascular, and Alzheimer’s Diseases

| Posted by in Immune Homeostasis (Immune Balance) | Inflammation - (0 Comments)

The mouth is a unique bio-environment for bacteria and other microorganisms. The oral cavity must always be in microbial and immune homeostasis (balance).. Hundreds of types of bacteria need to be properly balanced to protect the mouth from infection or severe gum disease can result from microbial imbalances or “dysbiosis”.

Oral Disease
Many microorganisms in the mouth attach to the teeth. The accumulation of microbes on the surface of teeth is called a “biofilm”, which may eventually calcify into a matrix of hard material called “plaque”.

If not removed, biofilms can lead to inflammation of the gums; a first step in the development of dental caries and “gingivitis”. This mild form of gum disease results in swollen and red gums that may exude pus and bleed easily upon brushing. If left untreated, gingivitis may escalate to periodontitis. In periodontitis, pockets of microbes form and the infection spreads and grows below the gum line, damaging bone, and loosening teeth.

Oral Inflammation
Periodontal-causing pathogens in the mouth trigger defense mechanisms resulting in defensive inflammation. However, when inflammation is not controlled, bone and connective tissues are damaged; the gums pull away from the teeth and leave them in danger of falling out.

When dysbiosis occurs, pathogenic periodontal bacterial communities may overpopulate the mouth. The bacteria are able to circumvent immune cell attacks. As the number of bacteria increase, they stimulate more inflammatory responses leading to bone loss and worsening periodontitis.
As might be expected, treating periodontitis decreases the biomarkers of inflammation throughout the body.

Atherosclerosis and cardiovascular disease
Inappropriate levels of inflammation in the mouth can lead to inflammation throughout the body. It is therefore not surprising that periodontal disease increases the risk of having other inflammatory conditions such as atherosclerosis and cardiovascular disease. Indeed, individuals with atherosclerosis and periodontitis share genes that appear to stimulate similar inflammatory pathways.

Alzheimer’s Disease (AD).
Amyloid plaque accumulation in the brain is a major feature of Alzheimer’s disease (AD); heightened levels of amyloid have been associated with greater risk of periodontal disease. Even in seemingly healthy elderly individuals, those with periodontal disease have more amyloid in their brains than those without oral disease.

Individuals with strong immune responses to periodontal pathogens are at greater risk of developing Alzheimer’s than people who have more limited responses. This has led investigators to suggest that inflammation-associated periodontal disease may be a contributor to Alzheimer’s.

Homeostasis
A major function of the immune system is to keep the numerous bacterial communities on and throughout the body in check. To accomplish this, the body maintains immune homeostasis, exquisitely balanced inflammatory responses.

One might predict that maintaining good oral health would decrease one’s risk of inflammatory diseases including diseases such as cardiovascular and Alzheimer’s Disease.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3183659
europepmc.org/abstract/med/765622
www.ncbi.nlm.nih.gov/pubmed/25434071
www.ncbi.nlm.nih.gov/pubmed/25435361
www.ncbi.nlm.nih.gov/pubmed/25466412
www.ncbi.nlm.nih.gov/pubmed/23746697

Alzheimer’s Disease, balance, biofilm, cytokines, dysbiosis, gingivitis, gums, immune homeostasis, immune system, infection, inflammation, inflammatory markers, inflammatory responses, microbiome, oral, periodontal, periodontitis, plaque, teeth

The Role of Inflammation in Pancreatic Disease

Pancreatic cancer is an aggressive and treatment-resistant cancer that appears to be driven by pancreatitis, inflammation of the pancreas. Although most people with pancreatitis never go on to develop pancreatic cancer, drinking alcohol in excess, obesity, and particularly smoking, has long been associated with a greater risk of having pancreatic disease.

The Role of The Pancreas
The pancreas is a digestive organ with two main functions. It produces digestive enzymes to break food down in our intestines, and it contains clusters of cells, Islets of Langerhans, that help the body regulate its blood sugar levels.

Inflammation as a Contributor to Pancreatic Cancer
Inflammation is a complex immune response. Pancreatic inflammation, mediated by cytokines, immune messengers, up-regulate (increase) inflammation which may lead to pancreatic cancer. Once inflammation is triggered, more immune cells are attracted to the inflamed pancreas and additional cytokines are released that damage pancreatic tissue and attract other damage-causing immune cells.

One of the roles of the immune system is to recognize and destroy cancer cells. There is a significant amount of “cross-talk” between cancerous cells and immune cells. On one hand immune cells track down cancer cells in an attempt to destroy them. They can “turn-on” (up-regulate) or “turn-off” (down-regulate) cancerous cells. Signals from cancerous cells can result in marked imbalances of immune cells, or make them function in odd ways.

Role of Cytokines in Pancreatic Cancer.
For example, pancreatic tumor cells are able to dampen some of the immune responses of the immune system leaving pancreatic cancer cells to multiply more easily. Cytokines from immune cells can change the environment around tumor cells and act directly on them, triggering their growth and migration to other parts of the pancreas and body. Some cytokines transform cancer cells into becoming resistant to chemotherapy.

Others may act either to trigger inflammation or stop inflammation depending on circumstances. In one study of pancreatic cancer, the most invasive parts of a tumor were found in the midst of heavily inflammatory centers.

Bacteria May Drive Inflammation and Cancer
Interestingly, the studies of our microbiome, the bacteria that inhabit our digestive tracts and other parts of the body, suggest that the bacteria that inhabit us may trigger inflammation, thereby promoting the growth of cancers.

In summary, limiting inappropriate inflammation and achieving a state of immune balance, homeostasis, may be a significant contributor in reducing the risk of pancreatic disease.

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

www.ncbi.nlm.nih.gov/pmc/articles/PMC4145756
scitechnol.com/2324-9293/2324-9293-1-e104.php www.ncbi.nlm.nih.gov/pubmed/12020670
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www.nature.com/bjc/journal/v108/n5/full/bjc201324a.html
www.ncbi.nlm.nih.gov/pubmed/24855007

alcohol, anti-inflammatory, bacteria, balance, cancer, chemotherapy, cytokines, immune homeostasis, immune system, inflammation, inflammatory responses, Islets of Langerhans, microbiome, Pancreas, pancreatic cancer, pancreatitis, pro-inflammatory, Smoking, tumors

Concussions, Brain Injuries, and Inflammation

| Posted by in Boosting Immune Responses (Pro-Inflammatory) | Immune Homeostasis (Immune Balance) | Inflammation | Injury and Trauma - (0 Comments)

The brain, being the “control center” of the body is cushioned by fluid, and is protected by bone and layers of membranes that support blood vessels that feed the brain.

Concussions
Direct or indirect mechanical impact to the brain may result from sports activities or workplace accidents. These may result in trauma to the brain. Rapid acceleration or deceleration, e.g., motor vehicle accidents or intense changes in pressure, e.g., blast exposures can also lead to brain damage.

The term “concussion” is commonly used to refer to a brain injury resulting from the head being hit with a great deal of force. Shaking the upper body and head violently can also cause brain damage.

Concussions alter the way the brain functions. The effects are usually short-lived, but may include being dazed, headaches, and problems with concentration, memory, balance, and coordination.

Brain injuries may result in loss of consciousness, but since the majority of cases do not end in “blackouts”, concussions often occur without the individual realizing they have had damage. The impact may seem relatively mild, and the individual may appear only to be dazed and with time and rest they may heal properly.

Serious untreated concussions can result in long-term brain damage and may even end in death.
Repetitive head injuries are a major issue especially when an individual sustains additional head injuries before the damage from the prior injury has been completely resolved.

The effects are cumulative. Cumulative sports concussions increase the likelihood of permanent neurologic disability. Complete recovery from an initial trauma can take from 6-18 months, and multiple concussions over time may result in long-term problems, including neurological deterioration, dementia-like symptoms, memory disturbances, behavioral, and personality changes, Parkinsonism, and speech and gait abnormalities.

In a minority of cases, additional trauma to the brain, even occurring from days to weeks following a prior event, can lead to collapse and death within minutes.

How quickly and completely one heals, depends on a number of factors including one’s genetic makeup. (This would be expected since genes determine a cell’s ability to withstand mechanical stress, regenerate, and heal.)

Inflammation and Concussions
For years it was thought that the membranes around the brain acted as a blood-brain barrier which stopped the brain from responding with inflammatory responses when it was confronted by infection. However, it has now been shown that concussions and other brain injuries, or infection or disease, will trigger inflammatory responses.

The types of immune cells found throughout the body are also found in the brain, but additionally, the brain has unique immune cells. When activated, brain-specific microglia and astrocytes, produce inflammatory cytokines that remain localized in the brain.

In response to brain injury, the immune system releases a tidal wave of pro- and anti-inflammatory cytokines, molecules that trigger and/or stop an inflammatory response depending on what is needed.

In small amounts, these cytokines help protect the brain and heal it. However, prolonged exposure to inflammatory cytokines, or too high a level of these proteins, will result in damage that accumulates after injury. High levels of inflammatory cytokines are localized at the injury site, and may be found on the opposite side of the head from the side that was hit.

There is increasing evidence suggesting that much of the neurological damage that occurs after the brain is injured is the result of a delayed inflammatory response that lasts hours, days, or even for months after the injury. This chronic inflammatory response may cause more damage to the brain tissue than the mechanical impact itself.

Immune Homeostasis, Immune Balance is the Key
Unfortunately, pharmaceutical treatments known to reduce inflammation appear to interfere with the brain’s natural repair mechanisms. Therefore it is necessary for the body to control its inflammatory responses. It has to produce enough of a response to help brain tissue heal, but not an overly exaggerated inflammatory response which may cause more damage after injury.

In order for the brain to heal after trauma, the immune system must generate the proper balance, and types, of pro-inflammatory and inflammatory cytokines. For those with brain injuries, maintaining immune homeostasis, immune balance, may be the best way to minimize damage.

Dr. Hellen is available at 302.265.3870 for discussion on the role of inflammation and immune homeostasis in our health. She may be contacted at: drhellen@drhellengreenblatt.info, or use the contact form. Thank you.

emedicine.medscape.com/article/92189-overview#a0107
www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/
emedicine.medscape.com/article/92189-overview
www.headcasecompany.com/concussion_info/stats_on_concussions_sports
www.ncbi.nlm.nih.gov/pmc/articles/PMC3520152/

anti-inflammatory, astrocytes, balance, brain injuries, cognition, concussions, cytokines, dementia, immune homeostasis, immune system, infection, inflammation, inflammatory responses, injuries, memory, microglia, Parkinson's, pro-inflammatory, trauma

Inflammation is like Real Estate: Location, Location, Location.

During the 1970′s and 80′s, the saga of the “boy in the bubble” was followed with great interest. David Vetter, a young Texas boy had severe combined immunodeficiency (SCID), a disease caused by life-threatening defects in his immune system. His immune system was unable to protect him from infection, resulting in the necessity of having to live in a germ-free, isolation containment center designed by NASA engineers. He lived in this plastic bubble from the time of this birth until he died at the age of 12 following a failed bone marrow transplant.

The containment center was supposed to keep David separated from any pathogens that might harm him. Unfortunately, it was likely that it was a virus-contaminated bone marrow transplant that resulted in lymphoma, an immune system cancer, which ended David’s life.

Living in a sea of pathogens, a functional immune system is essential for our survival. Inflammation is among the first steps the body takes to heal after injury or disease and it uses immune inflammatory responses to protect us from cancer cells and pathogens. But too much inflammation is as serious a problem as too little inflammation. The body constantly struggles to limit the amount of inflammation that it produces, with uncontrollable amounts of inflammation acting like as if it was an out-of-control forest fire, destroying healthy cells in its path.

The four letters “itis” indicate an inflammatory condition. Typically, the name of the disease depends on the location in which the inflammation occurs. For example, arthritis (inflammation of the joints), colitis (inflammation of the intestinal tract, the colon), dermatitis (inflammation of the skin), nephritis (inflammation of the kidney), pancreatitis (inflammation of the pancreas), and uveitis (inflammation of a part of the eye).

Most immune cells do not have specialized names, however some organs have specialized inflammatory immune cells that detect infection and help resolve infection or injury to the body. Kupffer cells are most often associated with the liver. Microglia are associated with the brain and are involved in repairing damaged brain tissue and protecting the brain against disease. Dust cells, also known as alveolar macrophages, carry out similar functions in the lungs.

Inflammation is like real estate: location, location, location. The process of inflammation is substantially the same no matter where in the body the inflammation occurs. The intensity of the inflammatory response is determined by a balance between pro-inflammatory (molecules that cause inflammation) and anti-inflammatory (molecules that dampen inflammation) cytokines, immune messages that are released by immune cells.

The key to healthy immune responses is to be in immune homeostasis, immune balance. We must maintain the balance of enough inflammation to defend ourselves from pathogens, stimulate repair, and healing against the need to limit the amount of inflammation that too often leads to inflammatory diseases.

Contact Dr. Hellen for guidance in utilizing natural means to help the body return to immune homeostasis. She may be reached at: DrHellen@DrHellenGreenblatt.info or or at 302.265.3870.

www.ncbi.nlm.nih.gov/books/NBK22254/
www.ncbi.nlm.nih.gov/pubmed/23720329
www.thedoctorwillseeyounow.com/content/mind/art3792.html?getPage=2
www.hindawi.com/journals/cherp/2012/490804/

anti-inflammatory, arthritis, balance, colitis, dermatitis, immune homeostasis, immune system, infection, inflammation, inflammatory responses, Kupffer, microglia, nephritis, pancreatitis, pro-inflammatory, uveitis

Ebola Virus: Immune Imbalances and Inflammation May Be Major Factors

Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans. As of this post, the virus has spread through many African nations, and is the worst Ebola outbreak every recorded. The virus has infected over 1200 people and abuot 60% of these individuals have died from the disease.

Health practitioners have put themselves at great risk caring for those who have become infected. According to the BBC, one hundred health workers have been affected and half of them have died. At least three high-profile physicians in the forefront of care have succumbed to the virus, and three nurses who worked in the same treatment center as one of the physicians, are believed to have died from the virus.

Two Americans working to battle Ebola in Liberia, one a physician, have tested positive for the virus and are undergoing intensive treatment and workers from Doctors without Borders and the Red Cross are “overwhelmed” for the virus that has no cure.

Depending on the type of Ebola virus, up to 90% of those infected can die a rapid and difficult death. The onset of symptoms may be characterized by a sudden spiking fever, headache, joint, muscle, and stomach pain, diarrhea, vomiting, and in some cases, uncontrolled internal and external bleeding. Infected individuals die from failure of multiple organs in the body such as the nervous system, liver, and kidneys.

The disease is characterized by abnormal immune responses in which the Ebola viruses appear to evade attack of immune cells; dramatic immune imbalances occur in response to infection. There is evidence that the immune system responds with a “cytokine” storm during which certain immune cells “dump” large amounts of pro-inflammatory molecules, cytokines, into the body. Other biological compounds are released as well that contribute to the confused immune response.

Additionally, specialized cells produce insufficient amount of anti-viral cytokines, while at the same time, there is a significant increase in death of other types of immune cells. Scientists at the National Institute of Allergy and Infectious Diseases call this “a mixed anti-inflammatory response syndrome (MARS)”, and suggest that this “catastrophic uncontrolled immunological status contributes to the development of fatal hemorrhagic fever”.

Perhaps some of the symptoms that patients experience are due to autoimmune responses against individual classes of lymphocytes. This would account for the loss of certain immune cells, such as CD4 and CD8 cells. If they were available in higher numbers, they might be able to help the body fight the infection.

Many immunological factors contribute to Ebola virus fatalities. It is my contention that if individuals were able to achieve immune homeostasis, immune balance, they would be better equipped to mount controlled inflammatory responses which might help control the course of the disease.

www.cdc.gov/vhf/ebola/pdf/fact-sheet.pdf
www.cdc.gov/media/releases/2014/t0728-ebola.html
www.who.int/mediacentre/factsheets/fs103/en/
www.nasw.org/users/mslong/2010/2010_09/Ebola.htm
www.vox.com/2014/7/23/5930311/ebola-virus-disease-outbreak-africa-facts-guinea?utm_medium=social&utm_source=facebook&utm_campaign=voxdotcom&utm_content=Sunday
www.ncbi.nlm.nih.gov/pubmed/20957152
www.ncbi.nlm.nih.gov/pubmed/21987781
www.ncbi.nlm.nih.gov/pmc/articles/PMC368745/

anti-inflammatory, autoimmune, autoinflammatory, balance, cytokines, Ebola, immune homeostasis, immune system, infection, inflammation, inflammatory responses, pro-inflammatory

The Role of Inflammation in Post-Traumatic Stress Disorder (PTSD)

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.

www.ncbi.nlm.nih.gov/pubmed/23806967
www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
www.ncbi.nlm.nih.gov/pubmed/24157651
archpsyc.jamanetwork.com/article.aspx?articleid=1833091
www.medpagetoday.com/Psychiatry/AnxietyStress/44519
www.cdc.gov/niosh/topics/traumaticincident/
www.ncbi.nlm.nih.gov/pubmed/19780999
www.biomedcentral.com/1471-244X/13/40
www.ncbi.nlm.nih.gov/pubmed/24948537
archpsyc.jamanetwork.com/article.aspx?articleid=1790358
www.ncbi.nlm.nih.gov/pubmed/24559851
www.ncbi.nlm.nih.gov/pubmed/24875221
circ.ahajournals.org/content/101/15/1767.full
www.veteransandptsd.com/PTSD-statistics.html
www.hindawi.com/journals/cherp/2012/490804/

Afghanistan, aggression, anger, anti-inflammatory, autoimmune, balance, C-reactive protein, chronic disease, combat, cytokines, depression, fat cells, Gulf War, healing, IL-6, immune homeostasis, immune system, infection, inflammation, Inflammatory Bowel Disease, inflammatory responses, injuries, Iraq, metabolic syndrome, military, Obesity, post-traumatic stress disorder, pro-inflammatory, PTSD, QOL, terrorist, veterans, visceral fat

Inflammation Is the Root Cause of Arthritis

Nearly every day people tell me that their joints are swollen and stiff, they hurt all over, and that they look and feel older than their chronological age. Most of these individuals have been diagnosed with rheumatoid arthritis.

Arthritis is a sign of a “boosted” immune system with excessive inflammation leading to joint damage. People report pain in areas such as their backs, fingers, hands, wrists, knees, and shoulders.

Rheumatoid arthritis typically affects the joints of the body. However sometimes even before joint symptoms appear, rheumatoid arthritis can involve other parts of the body including the lungs or eyes. Long-term inflammation of the lungs leads to scarring and shortness of breath, fatigue, weakness, and an on-going, chronic dry cough. If the pleura, the tissues around the lungs, become inflamed, fluid buildup may result in fever, pain when taking a breath, and difficulty in breathing.

Inflammation Is Essential for Our Survival:
Clinicians, and most lay people, focus on the harmful aspects of inflammation and try to stop the inflammatory response at all costs. Instead, all that is needed is to control the this immune response. The process of inflammation is normal, protective, and absolutely essential for our survival. Inflammation is the first step to healing after an injury or when the body is gathering its forces to stop an infection. Immune inflammation also helps the body destroy cancer cells before they grow and multiply.

When the body recognizes it has been injured or infected, the immune system releases antibodies and cytokines, smaller proteins that attract different types of immune cells into an area, to help eliminate and destroy threats to the body.

Once healing has started, the amount of inflammation that the body produces must be controlled. The genes that control inflammation have to be “turned off”, down-regulated, so that inflammatory responses are limited.

Arthritis is an Autoimmune Disorder:
Arthritis is one of many autoimmune disorders in which the body mistakenly produces autoantibodies, antibodies against its own tissues that attach to joint linings, and cartilage which acts as a shock absorber. The presence of autoantibodies may trigger immune cells to release inflammatory molecules that cause damage to the joints and other organ systems.

The Effect of Stress and Weight on Arthritis:
There are many factors that contribute to the discomfort experienced by individuals with joint issues. Two of these most recently investigated are: stress and weight.

Stress:
The body increases the amount of inflammation it produces when it is exposes to constant stress and the stress of pain. It becomes part of a vicious cycle. Stress causes inflammation, and inflammation leads to more stress. There is crosstalk between the nervous, hormonal, and immune systems. Changes in one system effects the other system.

Stressed individuals suffering from rheumatoid arthritis produce much higher levels of most cytokines than people without arthritis. Immunologically they respond differently to stress.

Weight Issues:
Overweight and obese patients with rheumatoid arthritis have more pain and respond less well to medication, as compared to normal weight patients. Obesity is an inflammatory disease during which fat cells, especially those concentrated around the inner organs, pump out large numbers of inflammatory molecules. Certain inflammatory proteins are found in high number in the abdominal fat tissue of overweight and obese individuals.

Importance of Immune Balance/Immune Homeostasis:
Immune inflammation is tightly regulated by the body. It consists of a) triggering and maintaining inflammatory responses, and b) producing immune messages that decrease and/or entirely stop the inflammation. Imbalances between the two phases of inflammation results in unchecked inflammation, loss of immune homeostasis, and may result in cell and tissues damage like that experienced in rheumatoid arthritis.

The key is to incorporate lifestyle changes to help the body maintain immune balance.

Help your body return to immune balance. Dr. Hellen may be contacted at: 302.265.3870 ET USA, or use the contact form. Thank you.

www.mayoclinic.org/diseases-conditions/arthritis/basics/definition/con-20034095
www.hopkinsmedicine.org/Press_releases/2003/10_17_03.html
www.ncbi.nlm.nih.gov/pubmed/24846478
www.ncbi.nlm.nih.gov/pubmed/24738934
www.ncbi.nlm.nih.gov/pubmed/24850878
ard.bmj.com/content/early/2014/05/12/annrheumdis-2013-205094
www.fasebj.org/content/27/12/4757

anti-inflammatory, antibodies, arthritis, autoimmune, balance, cytokines, exercise, fat cells, healing, immune homeostasis, immune system, immunoglobulins, infection, inflammation, inflammatory responses, injuries, joint pain, multiple sclerosis, Obesity, pain, pro-inflammatory

Obesity and the Inflammatory State

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

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

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

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

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

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

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

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

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

diabetes.diabetesjournals.org/content/56/6/1517.full
www.ncbi.nlm.nih.gov/pubmed/14679176
www.ncbi.nlm.nih.gov/pubmed/23562157
www.ncbi.nlm.nih.gov/pubmed/22429824
www.ncbi.nlm.nih.gov/pubmed/24761347
www.nature.com/icb/journal/v78/n5/full/icb200073a.html
online.liebertpub.com/doi/abs/10.1089/jmf.1998.1.171
brevets-patents.ic.gc.ca/opic-cipo/cpd/eng/patent/2355168/summary.html?type=number_search

anti-inflammatory, antibodies, autoimmune, balance, chronic disease, cytokines, fat cells, immune homeostasis, immune system, immunoglobulins, infection, inflammatory responses, Obesity, overweight, pro-inflammatory

Sickle Cell Anemia: The Role of Inflammation

| Posted by in Chronic Disease | Immune Homeostasis (Immune Balance) | Infections - (0 Comments)

In a previous post, I discussed the role of excessive inflamation in thalassemia, a blood disorder in which individuals suffer from low numbers of red blood cells and hemoglobulin levels. This post focuses on another blood disorder that results in low hemoglobulin levels, sickle cell anemia.

Abnormal Red Blood Cells
Normally, blood cells are rounded, disc-shaped, and flexible enough to move easily through blood vessels. In contrast, people with sickle cell anemia have crescent, sickle-shaped, red blood cells that are stiff and sticky, and tend to become “stuck” in various tight spots in blood vessels. This blocks blood flow leading to pain and organ damage from inflammation in response to the blockages. Additionally, since their hemoglobin structure is abnormal, the red blood cells are unable to carry their full complement of oxygen throughout the body, resulting in oxygen deficits.

Red blood cells typically live for about 4 months in the blood stream, but sickle cells die after only 10-20 days. Individuals with sickle cell anemia, cannot make fresh red blood cells fast enough to replace the dying red blood cells. The lack of oxygen leads to fatigue, feelings of weakness, shortness of breath, dizziness, headaches, cold hands and feet, pale mucous membranes, and a yellowish tinge to skin or the whites of the eyes.

Pain Crises
Perhaps the most devastating symptom that many individuals with sickle cell anemia experience is excruciating pain that lasts for hours, weeks, or months. These are called “pain crises”. Painful crises are the leading cause of emergency room visits and hospital stays for people who have sickle cell anemia.

The pain results from inflammation and damage to blood vessels by the sickled cells. When the red blood cells block the flow of blood to limbs and organs, immune cells come into the area and release inflammatory cytokines, immune molecules that result in a vicious cycle of more inflammation and pain.

Some individuals experience these crises a few times a year, others may more frequent episodes. Repeated crises can damage the bones, joints, kidneys, lungs, eyes, heart, and liver. Moreover, in children, damage to their spleen, an immune organ, can leave them more susceptible to infection.

Cascade of Inflammation
Inflammation not only plays a major role in damaging blood vessels, but the immune cells release inflammatory cytokines, molecules that trigger inflammation, and biological compounds that cause cells to become “sticky”. The blocked blood flow leads to pain and other health issues.

When compared to those without sickle cell disease, individuals with sickle cell anemia have different profiles of messenger cytokines. For example IL-6, which helps the body return to immune balance, immune homeostasis, is at significantly higher levels in sickle cell anemia patients.

Summary
Inappropriate levels of inflammation pose major challenges for the quality of life of individuals with sickle cell disease. A rational approach to benefiting individuals with sickle cell is to help their bodies achieve inflammatory homeostasis, immune balance.

Help your body return to immune balance, immune homeostasis. Dr. Hellen may be contacted at: 302.265.3870 ET USA, or use the contact form. Thank you.

http://umm.edu/health/medical/reports/articles/sickle-cell-disease
www.ncbi.nlm.nih.gov/pubmed/8746787
http://www.ncbi.nlm.nih.gov/gene/3569
http://www.ncbi.nlm.nih.gov/pubmed/24383847
www.ncbi.nlm.nih.gov/pubmed/24589266
http://arthritis-research.com/content/8/S2/S3

anti-inflammatory, autoimmune, balance, chronic disease, cytokines, immune homeostasis, immune system, inflammation, pro-inflammatory, sickle cell anemia

The Role of Inflammation in Enteroviruses and Paralysis

Over the last 18 months, at least 25 children have been affected in the California area by a “polio-like” illness resulting in partial paralysis of five of the children. As of this week, two out of five of these children have tested positive for enterovirus. According to the news media, Australia and Asia have also report similar cases.

A commonly found virus, enteroviruses typically result in only mild symptoms such as runny nose, coughing, muscle aches, and sneezing. However, there are 60 different varieties of enteroviruses, and infection with certain types of these viruses results in spontaneous abortion, stillbirth, and congenital anomalies. Infection with other varieties of enteroviruses can lead to damage of various tissues including skin, muscles, brain, spine, nerve cells, liver, and heart.

Some enteroviruses appear to specifically target the brain and the nervous system, leading to short- or long-term paralysis affecting mobility. So for example, polio enteroviruses attack the nervous system triggering an inflammatory response to destroy the viruses. The resulting inflammation may lead to mild paralysis, or to an individual becoming completely paralyzed within hours.

Some persistent enteroviruses survive in the body for a prolonged time with continued inflammation and damage to tissues. So for example, polio patients that initially recover from their disease may continue to experience damage of nerve and muscle cells by inflammatory processes. This resurgence of symptoms can result in a post-polio syndrome (PPS) years after their original exposure to the virus.

Individuals with post-polio syndrome have high levels of inflammatory cytokines, immune factors, in the spinal fluids between the thin layers of tissues that protect the spinal cord. Other conditions resulting from enterovirus infection are often associated with the production of inflammatory molecules. Even patients with relatively mild symptoms and no nervous system complications may show increased blood levels of inflammatory immune factors. This suggests that excessive inflammatory responses are occurring throughout the body.

A delicate balance exists between inflammatory and anti-inflammatory responses of the body. The immune system is always on alert defending itself against infection. However, once the process is triggered, the inflammation must be a measured, controlled response that does not destroy healthy tissue.

www.decodedscience.com/polio-like-virus-california-enterovirus-68-paralyzing-kids/43034
www.ncbi.nlm.nih.gov/pubmed/18219253
www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm
www.ncbi.nlm.nih.gov/pubmed/24367714
www.enterovirusfoundation.org/associations.shtml
www.ncbi.nlm.nih.gov/pubmed/22776106

anti-inflammatory, autoimmune, autoinflammatory, balance, chronic disease, cytokines, enteroviruses, immune homeostasis, immune system, inflammatory responses, microbes, nervous system, paralysis, polio, post-polio syndrome, pro-inflammatory

The Role of Inflammation in the Blood Disorder Thalassemia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ventilators Can Result in Excessive Inflammation of Already-Damaged Lungs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Microbes, Gluten, Celiac Disease, Diabetes, and Inflammation

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

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

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

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

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

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

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

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

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

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

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

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

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

Alcohol Abuse, Immune Balance, and Inflammation

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

Immune System Effects

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

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

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

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

Hormone Effects:

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

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

Nervous System Complications:

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

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

Bone Loss

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

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

Skin and Injuries

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

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

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

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

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

Summary:

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

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

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

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

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

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

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