What is chronic inflammation?
An integrative approach to explaining systemic, or chronic, inflammation and its
significance to your health.
by Marcelle Pick, OB/GYN NP
I’m thrilled that inflammation is
the new buzz word among many health and medical circles — I’ve been
trying to raise awareness about its importance for years! But among all the talk,
there is some confusion around what chronic inflammation is and what you can do
Like an unattended fire, chronic inflammation can slowly spread and lead to serious
metabolic breakdown, with vast implications for your long-term health. You may have
heard that disorders like rheumatoid arthritis, inflammatory bowel disease, and
eczema stem from inflammation. But chronic inflammation has now been connected to
a host of modern diseases, from obesity, diabetes, atherosclerosis, and high blood
pressure, to Alzheimer’s, osteoporosis, Parkinson’s, cancer, and even
depression! In the functional medical world, we view all chronic and degenerative
illnesses — and even biological aging — as rooted in chronic inflammation.
The good news is that there are so many things you can do in your life to cool your
inflammation — even if you’ve already been diagnosed with an inflammatory-related
condition or have an elevated CRP. And doing something about it now is one way to
ensure aging with vitality and strength. As a functional medicine practitioner,
I’ve seen firsthand how simple things like cutting back on red meat and soda,
getting more sleep, and regular exercise (without overdoing it) make a difference.
So let’s take a closer look at the concept of chronic inflammation and give
you some resources to turn back the clock, prevent disease, and curb your inner
Acute and chronic inflammation — when a good thing goes bad
Are you inflamed?
Here is a list of symptoms commonly associated with low-grade chronic inflammation.
- body aches and pains
- frequent infections
- dry eyes
- shortness of breath
- skin outbreaks
- weight gain/obesity
For more about why inflammation is on the rise, see our page on
the causes of inflammation.
For more on the effects of inflammation, take a look at our list of
symptoms, conditions, and related inflammatory disorders.
Just as the plants in your garden need a good mixture of sun and rain to thrive,
we all need a measure of inflammation to survive. Acute inflammation is the short-term
immune response our bodies mount in cases of trauma, infection, and
allergy. Whether you’ve broken a bone, burned yourself on a hot stove,
or been exposed to a foreign microorganism, the body is programmed to carry out
a similar response. In this response, it will identify the infectious or dangerous
substance, determine which cells are “self” cells (non-threatening)
and which are “non-self” cells (threatening), assess the level of the
threat, mount a response, and repair any resulting damage. In a perfect world, this
response occurs just as it should, releasing pro-inflammatory compounds when needed
and then turning them off with anti-inflammatory compounds when the threat has been
Chronic inflammation arises when this response is not completely turned
off or extinguished. It acts like a slow-burning fire, continuing to stimulate pro-inflammatory
immune cells when they may not be needed. What happens when these excess immune
cells are circulating in our systems? They can damage healthy areas in our bodies,
such as blood vessel linings (as in atherosclerosis), pancreatic tissue (in diabetes),
joint tissue (in arthritis), gut mucosa (in lactose and gluten intolerance) —
just for starters.
Let’s look at the GI tract system as an example. I had a patient, Debra, who
was sensitive to gluten, but it wasn’t enough of a sensitivity to cause her
to completely eliminate gluten from her diet. Each time she ate bread or pasta or
anything with gluten in it, her body mounted a small immune response in the gut.
This gave her some gas and discomfort, but not enough to send off any alarms. Over
time, the immune cells that were continuously activated began to disrupt the mucosal
lining of her bowel. This led to what is commonly called “leaky gut syndrome,”
where particles in the digestive tract leak into the bloodstream through perforations
in the gut, causing the immune system to be on higher alert. With each passing day,
Debra’s inflammation increased, and soon she started to see more symptoms.
The root of chronic inflammation: an imbalanced immune system
Many of my patients ask about the underlying cause for inflammation, and it doesn’t
come as much of a surprise that the root of chronic inflammation is an imbalanced
immune system. Your immunity is comprised of two major systems: your innate immune
system and your acquired immune system. The innate immune system
is what we were all born with and deals with many of the more nonspecific threats
to our bodies. The acquired immune system is what we develop based on our behavior,
environment, and exposures. In other words, the more bugs or allergens we’re
exposed to and successfully fend off, the more our acquired immune system grows
These two branches of the immune system are constantly communicating with each other
to maintain balance in the body. Their communication system involves specialized
sensors and signals that unleash a cascade of biochemical reactions, producing metabolites
that activate genes to relay protein messages that communicate an inflammatory call-to-action.
Most critically, they are designed to turn that action off when they aren’t
needed anymore. But patients with chronic inflammation may show increased levels
of certain pro-inflammatory markers,
even when there is no obvious reason for inflammation. Some of these markers include
C-reactive protein, IFN-gamma,
IL-1, IL-6, and TNF-alpha. These are the same mediators that become elevated in
an acute reaction — but the difference is that the acute phase is turned off
when the job is done.
As I’ve mentioned above, we need a healthy balance of inflammation to stay
healthy. But if your body is constantly on the defensive, it makes sense that your
overall health would be compromised. First of all, inflammation takes a lot of your
body’s energy and resources. Second of all, our inflammatory cells have evolved
to be powerful (this helps rid us of invaders before they can do harm!) —
and having a constant, low-grade flow of powerful inflammatory markers in the blood
stream can cause damage with time. To make matters worse, once the balance is disrupted,
the immune system’s hyperactivity can self-perpetuate and quickly spiral into
Recent research at Harvard Medical School supports the connection between an imbalanced
immune system and metabolic disorders, like type 2 diabetes. Scientists found an
abundance of immune cells called mast cells in diabetic and obese mice.
In healthy individuals, mast cells help to heal damaged tissue, but they accumulate
in the fat tissue of obese and diabetic mice and can leak “molecular garbage”
into this tissue when unstable. The good news is, the group of mice given a healthy
diet and immune system support, had nearly a 100% recovery! We’ll have to
wait and see if the same results play out in humans.
Aspirin and other NSAID’s vs. nutritional and lifestyle changes
If you pay attention to Oprah, you may have heard about Dr. Oz’s advice to
take two baby aspirin per day as an anti-inflammatory approach to prevent heart
disease, cancer, and possibly even wrinkles. Relative to
heart health, the research shows this approach is both gender-specific and
age-specific — its benefits are not equally distributed across the board.
I think Dr. Oz has some wonderful advice about health, but I have to say I’m
skeptical of having my patients regularly take baby aspirin. This is because even
the use of mild anti-inflammatory drugs can lead to concerns like leaky gut, ulcers,
increased bleeding, and kidney problems. While it may be helpful for some women,
in others, like Debra, long-term use of even baby aspirin can lead to small perforations
in the small intestine that allow pathogens and incompletely digested food particles
into the bloodstream. The body recognizes these particles as “foreign antigens”
and mounts an immune response every time you eat, only furthering inflammation in
Dozens of pharmaceutical drugs have been developed to override the inflammatory
cascade, and many more are in the pipeline. NSAID’s (nonsteroidal anti-inflammatory
drugs) like Motrin and Aleve disrupt the production of prostaglandins, which are
needed to regulate inflammation, constrict or dilate vessels, and much more. Corticosteroids
like prednisone, COX-2 inhibitors like Vioxx and Celebrex, and antihistamines each
shut down a different inflammatory mechanism, leading to further long-term risks
in the body.
Routinely taking aspirin or other NSAID’s runs counter to the functional medicine
approach to inflammation, which strives to support the body’s natural healing
mechanisms. As a functional medicine practitioner, I urge my patients instead to
look closely at their diets, and to supplement with omega-3’s and other natural
anti-inflammatories before turning to aspirin or other non-aspirin NSAID’s.
Let’s look at some simple drug-free ways to put out the flames.
Five things you can do right now to reduce inflammation
It’s sad to say that we are living in a toxic world, where fuel for inflammation
is present at every turn. We’re unintentionally exposed to toxins like lead
and mercury in our environment; industrialized foods are replacing many of the natural
anti-inflammatory foods once prevalent in our diets; and stress and lack of sleep
are everyday events for many of us. What’s exciting to me and many of my patients
is that we still have a lot of choices. There are so many things you can do to reduce inflammation naturally
— I’ve written a whole article on the subject, and even that doesn’t
cover it all! But here are five simple steps you can take right away.
- Revise your diet. Start by limiting or cutting out your
intake of trans fats and refined carbohydrates. Replace these with healthy fats,
such as omega-3’s and olive oil, and unrefined carbohydrates, like antioxidant-rich
fruits and vegetables.
- Add omega-3’s. There is an extensive and growing
body of evidence that omega-3’s can reduce inflammation. In our modern diets,
we consume an overwhelming amount of omega-6’s in proportion to omega-3’s.
This imbalance may well be a predominant cause of runaway inflammatory health issues.
- Get a good night’s sleep! Between seven and nine
hours of uninterrupted sleep can do wonders to repair and restore your system. Though
many scientists are still debating why we sleep, we know that a good night’s
sleep is one of the best anti-inflammatories out there! So make getting to bed on
time a priority.
- Supplement with a high-quality multivitamin/mineral. Folic
acid, B vitamins, and vitamins D, C, and E all have anti-inflammatory effects in
your body. For a strong anti-inflammatory base, take a high-quality daily multivitamin–mineral
complex like the one we offer in our Personal Program.
- Rebalance your immune system with probiotics. The beneficial
flora (probiotics) in your body work hard to protect and rebalance your immune system.
You can help them help you by eating more naturally fermented foods like yogurt,
kefir, sauerkraut, kombucha, and kimchee, as well as plentiful fiber. There are
also many superb probiotic supplements available, as well.
Restore balance and prevent disease
It’s certainly disturbing that chronic inflammation is at the root of nearly
every modern disease on the rise today. But accompanying that news is the opportunity
to make everyday choices that limit the fuel for the fire and profoundly lessen
our chances of disease. Simply being aware of inflammation is a great start. And
the more I learn about the human body, the more I appreciate that we’ve evolved
with all the natural tools needed to maintain healthful balance in our systems.
Start reducing chronic inflammation now, so you can improve your health for the
rest of your life!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
Related to this article:
References & further
reading on chronic inflammation
Last Modified Date: 04/20/2011
Principal Author: Marcelle Pick, OB/GYN NP