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Low Back Pain and the Role of Inflammation

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

Back pain is one of the most common health complaints among adults in the US. From 75-80% of individuals will suffer from lower back pain sometime in their lives.

Symptoms of back pain include shooting or stabbing pains in the back, limited mobility, and/or pain that radiates down the leg.

The majority of individuals experiencing back pain will become more comfortable within days or weeks without medical treatment. Some people however may experience chronic pain lasting 2-3 months or more.  Nonetheless, all low back pain results in major economic and social repercussions for both sufferers and society.

 

DrHellen 2018 (c)

There is no known cause of the pain in approximately 90% of patients; it is what is termed “idiopathic”.  However, sitting too long or doing a physical task incorrectly may trigger back problems.  The lack of physical activity, excess weight, genetics and the physical demands of a job also contribute to lower back pain. Sedentary lifestyles are associated with 1.41 times greater risk of developing back pain. Individuals that are not physically active, are 1.23 times more likely to develop lower back pain.

Individuals with back pain frequently have the same anatomically “abnormalities” as people without back complaints. Patients with occupation-related back pain who had magnetic resonance imaging (MRI) of their back were 8 times more likely to get surgery as those who had just x-rays. Since symptoms do not correlate with imaging testing, many practitioners will not recommend imaging testing within the first six weeks of pain (unless there is a strong suspicion of other underlying conditions)..

Inflammation in the body is tightly regulated, involving signals that initiate and maintain inflammation and others that turn inflammation off. Imbalances between the two, lead to unchecked inflammation.

Inflammation causes pain, and pain causes more inflammation.  When the body hurts, inflammatory cytokines, immune molecules, are triggered that initiate the healing process. The release in the spinal cord of certain cytokines is associated with inflamed nerves and pain.

CRP (C-reactive protein) is a biological marker of inflammation. Individuals with the most severe lower back pain have nearly twice the amount of CRP levels as those with less pain.

Back surgery may relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own. There are a number of treatments that are used to reduce inflammation and pain: nonsteroidal anti-inflammatory drugs (NSAIDS), epidural steroid injections, topically applied creams or sprays, and for some, hot and cold packs.

One of the best approaches to relieving lower back pain is exercise, especially McKenzie exercises [find the exercise best for you on YouTube].  Individuals that do back exercises find significant relief and if practiced consistently will find that their backs will be strengthened and they will have less discomfort.

[As previous posts have suggested, backed by clinical trials, exercise increases naturally-occurring anti-inflammatory cytokines and can provide significant and faster relief to those suffering with lower back pain.]

Summary:

The key to healing is a balanced immune response.  The body needs the right amount of inflammation to heal, but too much inflammation results in illness.

If you want to change how you feel, contact Dr. Hellen. No fee is charged for the first 30 minutes of consultation. Dr. Hellen may be  contacted by using this form or calling:  302.265.3870 (ET-USA).
mayohealthhighlights.startribune.com/2017/09/22/low-back-pain-caused-by-spinal-degeneration-and-injury/
www.statista.com/topics/4333/back-pain-in-the-us/
www.ncbi.nlm.nih.gov/pubmed/19407734
www.ncbi.nlm.nih.gov/pmc/articles/PMC4137474/
www.ncbi.nlm.nih.gov/pubmed/29740548
www.ncbi.nlm.nih.gov/pubmed/23270761
www.ncbi.nlm.nih.gov/pmc/articles/PMC5931150

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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

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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/

 

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

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

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
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circ.ahajournals.org/content/101/15/1767.full
www.veteransandptsd.com/PTSD-statistics.html
www.hindawi.com/journals/cherp/2012/490804/

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Inflammation Is the Root Cause of Arthritis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The Role of Inflammation in the Blood Disorder Thalassemia

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

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

 

 

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Ventilators Can Result in Excessive Inflammation of Already-Damaged Lungs

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

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/
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researchnews.osu.edu/archive/lungvent.htm
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www.medicine.uiowa.edu/Newsarticle.aspx?id=22193
www.ncbi.nlm.nih.gov/books/NBK6868/
 

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Alcohol Abuse, Immune Balance, and Inflammation

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

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

Immune System Effects

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

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

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

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

Hormone Effects:

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

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

Nervous System Complications:

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

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

Bone Loss

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

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

Skin and Injuries

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

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

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

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

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

Summary:

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

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

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

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

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

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

 

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

 

 

 

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Complementary Methods of Reducing Inflammation and Pain

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

 Role of Balancing Inflammatory and Anti-inflammatory Immune Factors (e.g., Cytokines):

An injury requires enough inflammation to start the healing process, but not so much that it starts a cascade of immune inflammation that causes damage to by-stander tissues. Cytokines are immune factors generated by white cells that initiate pro-inflammatory (inflammatory) responses and anti-inflammatory responses in response to infection or injury. A healthy person produces appropriate levels of these factors depending on the challenge it encounters. A body in immune homeostasis will either up-regulate, increase immune inflammation, or down-regulate, limit its inflammatory responses, depending on the body’s needs.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Doctors often suggest non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin when a patient complains of a sprain or other work- or sport-related injury.. These pharmaceutical compounds inhibit the production of immune inflammatory molecules such as cytokines. Limit the amount of inflammation and its resulting pain and stiffness are decreased.

The problem is that many of these medications put people at risk of significant digestive, cardiovascular, kidney, and muscular/skeletal problems. For example, according to the American College of Gastroenterology, the regular use of non-steroidal anti-inflammatory drugs is the major cause of potentially life-threatening ulcers and stomach bleeding.

Also, some practitioners question whether the use of NSAIDs may be the cause of increases in osteoarthritis and the high level of knee and hip replacements.

Because of concerns about health risks, some health practitioners physicians suggest complementary, more natural methods, to decrease pain and inflammation, and perhaps even prevent damage from muscle injury.

Complementary Approaches:

Glucosamine: Glucosamine is a natural substance produced by the body that encourages cartilage regeneration and the production of synovial fluid that helps “lubricate” the joints. There is evidence that glucosamine has anti-inflammatory properties.

 Omega-3 Fish Oil:  Omega-3 fish oils have been shown to have anti-inflammatory properties and help the body control pro-inflammatory cytokines and the pain that results from up regulating, increasing, inflammation.

 Vitamin D3:Vitamin D appears to affect immunological function such as inflammation. Vitamin D supplementation has been found to provide therapeutic relief.

Hyperimmune Egg: Hyperimmune egg, an all natural, food-based ingredient, is another approach to helping the body return to immune inflammatory homeostasis. In a study conducted at a major hospital in NYC, individuals on hyperimmune egg for 30 days reported higher levels of joint comfort.

When certain types of glucosamine are added in combination with hyperimmune egg, joints appear to heal more rapidly and individuals report changes in their quality of life.

 Summary:

When experiencing sprains, strains, or other injuries due to work, sports, or accidents, one might wish to consider the use of complementary ingredients prior to starting on prescription medications.

 

http://www.ncbi.nlm.nih.gov/pubmed/20424410
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http://HyperimmuneEgg.org
www.google.com/patents/about/6706267_Glucosamine_and_egg_for_reducing.html?id=SAwRAAAAEBAJ

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Sprains, Strains, Injuries, and Inflammation

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

Exercise is essential for workers such as firefighters and paramedics that have physically-and emotionally-demanding jobs, and is mandated by most departments.

According to a study by the University of Arizona, Tucson, AZ and the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 30% of the strains and sprains that firefighters and paramedics experienced, happened as they were working out. Seventeen percent of injuries, and almost half of time off work for injuries, were caused by strains and sprains resulting from workers carrying individuals.

Pain and inflammation “feed one another”. Pain triggers more inflammation and inflammation  leads to more pain. It is not clear how the body senses pain, nor biochemically, the exact events that lead to the sensation of pain. We know however, that pain signals from our back or limbs travel along nerve cells to the spinal cord and up to the brain, and that inflammation in the spinal cord and brain is either the direct cause of pain, or a major contributor to pain sensations that we experience.

When muscles and tissues are injured, immune cells respond by entering the area and releasing cellular factors (e.g., cytokines) that will up-regulate inflammation as a way to help the body heal.

However, it is as important for the body to decrease its inflammatory responses after a challenge is met, as it is to increase the response in the first place. Decreases in inflammatory responses, down-regulation, result from the production of different amounts of anti-inflammatory cytokines and their ratio to pro-inflammatory cytokines that cause inflammation. It all about the appropriate balance of immune responses, immune homeostasis.

(Please watch for the next posting discussing natural methods of helping the body achieve immune homeostasis, and recover, and heal faster.)

injuryprevention.bmj.com/content/early/2011/11/03/injuryprev-2011
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Inflammation, Homeostasis, and Sports Injuries

| Posted by in Immune Homeostasis (Immune Balance) | Inflammation | Sports Recovery and Performance - (0 Comments)

>Gina Kolata of the NY Times reports that many athletes, both professional and amateur, often have difficulties in finding the right approach when they injure themselves. They spend thousands of dollars visiting physicians who are confident that they can help, but too often, the procedures are not very helpful.

Research clinicians are questioning the benefits of certain procedures recommended by physicians. Their concern is that there is little “credible evidence” to back up many of the methods that their colleagues use (1).

Most physicians would probably agree that the pain their patients experience is due to excessive levels of inflammation. Inflammation is essential for good healing, but it is just as important that inflammation be a controlled event.

“Inflammation is the immune system’s response to injury and infection, and quick decisions must be made when one or both are present. If the immune system detects an infection, it also looks for signs of injury (broken cell parts, spilled cell constituents). The reverse holds as well — after sensing an injury, the immune system searches for telltale signs of the presence of microbes launching an infection. In many cases, both an infection and an injury set off an inflammatory response. After massive tissue damage caused by trauma …, a systemic inflammatory reaction can set in (2).”

Tissue injury is associated with “an inflammatory soup bathing small nerve fibers”. The immune factors, cytokines, that make up this “soup” are initially pro-inflammatory (2).  They trigger inflammation, resulting in pain sensation that occur throughout the body, including in the brain.

When athletes are injured, the key is for the body to heal the injury, and then down-regulate, “calm-down”,  the inflammatory response and return to immune homeostasis.

(1) www.nytimes.com/2011/09/05/health/05treatment.html?ref=health
(2) www.gluegrant.org/inflammation101.htm
(3) www.ncbi.nlm.nih.gov/books/NBK57275/

 

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