Wednesday, March 19, 2014

Wisdom Wednesday: Inflammation – Part 1

Regardless of what symptoms you have, inflammation is the key component. I frequently tell my patients, “if I had a magic wand and waved it to get rid of your inflammation, 80% of your symptoms would be gone.” There are several known chemical pathways for inflammation in the body. I will review the first three in this blog and cover the remainder in subsequent posts of Wisdom Wednesday.

The most common form of inflammation in the human body comes from prostaglandin production. At the site of injury, prostaglandins are released from damaged cells. The liver responds to this and releases large amounts of prostaglandins that promote systemic inflammation. That is why you often will “hurt all over” after a localized injury.

Typically musculoskeletal injuries, whether chronic or acute, will follow this prostaglandin pathway. NSAIDS (non-steroidal anti-inflammatory drugs) like Advil, Aleve, and aspirin block the prostaglandin pathways, reducing inflammation, and often providing relief. Unfortunately, they also block the prostaglandin anti-inflammatory pathways that omega 3 and omega 6 fatty acids follow. When taken for more than three days, these drugs interfere with cell membrane production and repair. With chronic use, GI bleeds, liver failure and heart attacks can occur. Several studies have documented that a minimum of 16,500 people in the US die each year from taking NSAIDS. Less than a third have any warning signals.

Omega 3 fatty acids often will block prostaglandin inflammation. I believe that the rampant inflammation seen in this country is due, in part, to omega 3 fatty acid deficiency. It is rated as the most common deficiency in America. Sometimes, omega 6 fatty acids are also necessary to block prostaglandin inflammation. However, if you have any of the attributes of metabolic syndrome (see earlier blogs), your body often will shunt the healthy omega 6 fatty acids from the anti-inflammatory pathway to make even more inflammatory prostaglandins.

A slightly less common inflammatory pathway is governed by leukotrienes and cytokines. When these chemicals are released from injury sites, they stimulate the immune system rather than the liver. The immune system then releases large amounts of leukotrienes and/or cytokines to promote systemic inflammation. This is a common occurrence in auto-immune diseases like rheumatoid arthritis, psoriasis, and Crohn’s Disease. NSAIDS have no effect on these inflammatory compounds. In fact, when NSAIDS block prostaglandins and the injury is not resolved, the body often defaults into the leukotriene/cytokine pathway. That is why NSAIDS often stop providing relief with continued use. Fortunately, leukotrienes and cytokines often will be reduced by two common herbs – ginger and boswellia.

Approximately 1500 herbs are used medicinally world wide. Of these, only 80 have had really good research. Both boswellia and ginger are part of those elite 80.

Ginger works by denaturing an enzyme called lipoxygenase. Lipoxygenase is required to form both leukotrienes and cytokines. Boswellia has an effect of the vagus nerve that results in reduced leukotrienes and cytokines. It is also often very effective in relieving asthma. In my office I prefer the ginger as it is inexpensive and easier to administer. Boswellia is quite expensive and must be taken with fat to be properly absorbed.

If you suffer from inflammation, and I know you do, try supplementing omega 3 fatty acids. Chances are you are deficient anyway – it’s not in your diet anymore. If you have any factors associated with metabolic syndrome – central obesity, high blood pressure, high serum lipids, low thyroid function, or insulin resistance – limit your omega 6 fatty acid intake. Consider adding sesame seed oil to your diet. That will help block the conversion of healthy omega 6 fatty acids to inflammatory prostaglandins.