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What is chronic inflammation?

By , DO 

Chronic inflammation happens as a result of the body’s natural healing process of inflammation turning harmful when it continues long after the original response was first needed. While it’s a relatively complicated process, inflammation becomes “chronic” if your internal “emergency alarm” fails to shut off when it should. This ends up allowing chronic inflammation to destroy healthy tissue and create related symptoms.

A woman frustrated with chronic inflammation thinking about her treatment options

More and more research continues to come out about the role of chronic inflammation in the development of many diseases and cancers. I make a point to talk with all of my patients about what chronic inflammation is so they can reduce their risk for developing it.

Even if you’re already experiencing the warning signs of chronic inflammation, you can still take effective steps to stop it in its tracks and you can start today.

When is inflammation harmful?

You’ve likely experienced acute inflammation with the heat of a fever, the swelling of an injured knee and the redness of a newly-formed cut. This healthy inflammation is an immune response that’s triggered when your body is injured, exposed to chemicals and toxins, or invaded by bacteria, viruses or parasites.

Acute inflammation is a short-term, necessary function of the body. During a healthy immune response, the body floods the attacked or wounded region with immune cells, nutrients and molecules that destroy the intruder and damaged tissues. This process creates a protective wall of defense and can occur in any part of your body – from bones to blood vessels.

But this responsive process is only meant to be a short burst of powerful destruction. Once the trauma goes away, inflammatory cells and molecules are supposed to recede so the healing process can begin.

Chronic inflammation is an ongoing, destructive process. When inflammation doesn’t turn off like it should, it turns harmful. Chronic inflammation is damaging because it acts like a slow-burning fire, continuing to stimulate pro-inflammatory immune cells that attack healthy areas of your body.

Chronic inflammation can occur everywhere in the body, and plenty of research indicates that it is a common trigger for and contributor to multiple chronic diseases. For example, excess immune cells and their signaling molecules circulating in your system can damage blood vessel linings (in atherosclerosis), pancreatic tissue (in diabetes) and joint tissue (in arthritis).

Symptoms of chronic inflammation

  • Body aches and pain
  • Fatigue
  • Depression and anxiety
  • Gastrointestinal issues
  • Congestion
  • Frequent infections
  • Dry eyes
  • Shortness of breath
  • Skin outbreaks
  • Weight gain/obesity

What are the symptoms of chronic inflammation?

Chronic inflammation generates a wide range of symptoms. In my practice, the most common symptoms I see are:

  • Pain: generalized pain, in muscles and joints with associated intermittent swelling and stiffness. Usually dull and achy in nature.
  • Fatigue: fatigue is constant, with associated insomnia or poor quality sleep.
  • Depression and anxiety: inflammatory cells and molecules within the central nervous system can disrupt the metabolism of mood-related neurotransmitters such as serotonin. It’s thought that this imbalance can potentially lead to mood disorders such as depression and anxiety.
  • Gastrointestinal issues: abdominal pain, constipation, diarrhea, gas and acid reflux.

As these symptoms can overlap with other health issues, be sure to talk with your doctor to see if your symptoms stem from chronic inflammation.

Symptoms of chronic inflammation may spread slowly, eventually leading to a serious metabolic breakdown, and chronic disease. Chronic inflammation can have vast implications for long-term health. The best way to understand its effects is to look at a known inflammatory disease such as rheumatoid arthritis. I have a young patient with this painful autoimmune disease, and she has all the symptoms of severe chronic inflammation: chronic pain, fatigue, obesity, memory loss, insomnia and more. For her, the solution is to shut down her immune system to control her symptoms. For someone like you, the goal is probably to stop chronic inflammation trigger before it causes illness.

What’s at the root of chronic inflammation?

An imbalanced immune system contributes to chronic inflammation by sending your body misdirected signals that inflammation is still needed long after the initial reason has passed.

Studies have demonstrated that women with chronic inflammation have increased levels of certain pro-inflammatory markers such as C-reactive protein (CRP), IFN-gamma, IL-1, IL-6, and TNF-alpha. While these same markers are also elevated during an acute reaction, if the immune system is well-balanced, the inflammatory reaction will turn off as it should — when the job is done. If the inflammation continues, your body will stay constantly on the defensive and that can lead to damaging effects on your health:

  • Inflammation drains your body’s energy and resources and leaves it vulnerable.
  • Inflammatory cells are very powerful (this helps get rid of invaders before they can do harm) — and produce a constant, low-grade flow of strong inflammatory markers into the blood stream that can cause damage with time.
  • Once the balance is disrupted, the immune system’s inflammatory hyperactivity can self-perpetuate and quickly spiral into disease.

woman going over her test results with her doctor

Are there tests to identify chronic inflammation?

Unfortunately there isn’t a highly effective laboratory measure to assess patients for chronic inflammation. It really is a diagnosis by process of elimination – which means other possibilities must be ruled out.

One test measures CRP protein in your blood. Higher levels indicate inflammation in your system. But while an elevated CRP indicates that inflammation is happening, it can’t tell the difference between acute inflammation and chronic inflammation. It also can’t measure the extent of inflammation going on in your system.

More research is showing marked elevation of major inflammatory markers with diseases we suspect are due to chronic inflammation. For example, women with type II diabetes have been found to have elevated CRP and IL-6. It is likely we will have a laboratory measure for chronic inflammation in the future as we further investigate these chronic diseases.

How do I know if I have chronic inflammation?

So how do you tell if you are suffering from chronic inflammation? Take a look at the following factors to see what you should investigate further:

  • Learn your genetic risk factors. Major risk factors for chronic inflammation include a family history of autoimmune issues or chronic disease like heart disease, Alzheimer’s, and cancer. This is probably your most important assessment because it tells you how you are genetically pre-disposed to manage inflammatory processes.
  • Look at your symptoms. If the symptoms in the lists above sound familiar, you may want to discuss chronic inflammation with your healthcare practitioner.
  • Know what has been ruled out. Depending on your symptoms, your healthcare practitioner may want to do tests to rule out other possible causes for your symptoms such as more serious autoimmune processes like rheumatoid arthritis.
  • Examine your lifestyle: Obesity, poor diet and low-activity level are all major risk factors for inflammation. You can change these using our steps for living an anti-inflammatory lifestyle.

Are aspirin and NSAIDs helpful for chronic inflammation?

I’m sometimes asked if women should routinely take aspirin or NSAIDs (nonsteroidal anti-inflammatory drugs) like Motrin and Aleve to stop inflammation. In my opinion, they aren’t helpful for chronic inflammation because they don’t address the root causes of inflammation – and can even lead to additional health risks.

Ongoing use of even mild anti-inflammatory drugs can lead to digestive issues, ulcers, increased bleeding, and kidney problems. The United States Preventive Services Task Force currently recommends the regular use of aspirin for the primary prevention of cardiovascular disease and colorectal cancer in women ages 50-59 with high risk for cardiovascular issues. For women older or younger than this age, aspirin use is dependent on a risk-benefit ratio. Since aspirin consumption does have its own set of risks, discuss your risks with your doctor before starting an aspirin protocol.

In addition, NSAIDs 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.

How to really reduce inflammation

If you think you are at risk for chronic inflammation, you can reduce inflammation with a natural approach – and it’s much easier than you might think. See how you can get started right now with 7 steps to an anti-inflammatory lifestyle.

References

“Inflammation and Heart Disease”, American Heart Association. Updated April 18, 2016. https://www.heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp#.V9M0nEIdJFI

Karim El Kholy, Robert J. Genco and Thomas E. Van Dyke. (2015) Oral infections and cardiovascular disease. Trends in Endocrinology & Metabolism 26:6, 315-321. Online publication date: 1-Jun-2015

Lund A, Hurst T, Tyrell R and Thompson D, “Markers of Chronic Inflammation with Short-term Changes in Physical Activity.” Med Sci Sports Exercise. 2011; 43(4):578-583

Want X, et al. “Inflammatory Markers and Risk of Type 2 Diabetes” Diabetes Care, Volue 36, January 2013

Salim S, Chugh G, Ashgar M “Inflammation in Anxiety,” Adv Protein Chem Struct Bio 2012; 88:1-25

Dantzer R, O’Connor J, Freund G, Johnson R and Kelley K “From Inflammation to sickness and depression: when the immune system subjugates the brain. “ Nat Rev Neurosci 2008 Jan; 9)1_: 46-51

Wyss-Coray T and Rogers J “Inflammation in Alzheimer Disease—A Brief Review of the Basic Science and Clinical Literature” Cold Spring Harb Perspect Med. 2012 Jan;2(1)

Egger G “In Search of a Germ Theory Equivalent for Chronic Disease” Prev Chronic Disease 2012; 9

Kidane D et al. “Interplay between DNA repair and inflammation, and the link to Cancer.” Crit Rev Biochem Mol Biol. 2014. Mar-Apr 49(2): 116-139

USPSTF Final Recommendation Statement: “Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medicine” https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer#Pod8

Last Updated: June 9, 2021
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