Health Revolution. Maria Borelius
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and anti-inflammation. What is this all about? I have to learn more.
I begin racking my brain for long-ago facts from my university studies in immunology. I think I took that course in the red building at the old Veterinary College in Frescati in Stockholm, if I remember correctly, and we learned something about the two forms of inflammation – because inflammation is not always a bad thing.
The first type of inflammation is purely positive, a helping process. Imagine a cut from a kitchen knife, a finger squeezed in the car door, a urinary tract infection or a sore throat. When you’re injured or infected, your immune system starts producing inflammation as a defence mechanism. A teacher I once had used this image to describe it: imagine a land that is being attacked by an external enemy and wants to defend itself. That’s how the immune system works. The outer injury is the external enemy, the immune response is the country’s government and defence, and the inflammation is part of what you have to do to defend yourself. There are a number of different foot soldiers who help. These soldiers in turn have many different specialist functions, just like in a regular army, with bridge builders, telegraph operators, explosives experts and intelligence agents.
In human blood, the blood platelets constantly wander around looking for problems in the blood. The blood platelets gather around the problem – the cut, the bruise or the infected body part – and then send a chemical signal to the immune system.
‘Problem at g, come here right away,’ say the blood platelets.
The signal is intercepted by the white blood cells, who answer, ‘On our way.’
An advanced line of defence is set up, with many different types of foot soldiers. They’re called cytokines, leukotrienes, prostaglandins, chemokines, thromboxanes and so forth, and they function like support troops, where each one sets out with its own task. They expand the blood vessels at the site of the affected tissue and make the area around it more ‘transparent’. This means that more cells from the immune system can reach the injury, attack enemy bacteria, clean out old junk and then repair and build up new and fresh tissue.
In medical training around the world and through the centuries, students have had to learn to recognise an inflammation the traditional way, which originates with the ancient Roman Celsus, who wrote great reference books about the body. Celsus’s favourite treatment was to simply open the veins and empty out the ‘extra blood’, a procedure he recommended for many types of health problems, as well as for people ‘with big heads’. Celsus also described the signs of inflammation in Latin: rubor, tumor, caldor, dolor. Redness, swelling, warmth, pain. Which is exactly what you feel in your throat when you have a sore throat. These signs of inflammation can in turn be counteracted by RICE, or rest, ice, compression, elevation. (Exactly what you do with a sprained ankle.)
The whole point, in short, is that inflammation works like a kind of fire department. It rushes out, attacks the enemies, cleans out and repairs. Then the system goes back to resting status.
This acute type of inflammation has a rhythm. There’s an ebb and flow, a clear beginning and an end, and the rhythm signals a healthy and active immune defence. It isn’t this type of inflammation that’s problematic but rather another one, which seems to be affected by food and contributes to illness. I wondered who might be able to tell me more about it.
I investigate some more, and after a while I find a new trail. There’s a researcher in the United States, Barry Sears, who has been on this track for a long time and founded an organisation for research in that area, the Inflammation Research Foundation. I’m not able to travel to meet him, but I don’t want to just send him an email, since there’s so much that I don’t understand. We need to actually talk.
I’m able to reach him by phone, and he gets right to the point.
‘This is a new area for most doctors. I’ve been working in the field for a while, but in general way too little research has been done.’
He mentions how many different kinds of diseases the low-grade systemic type of inflammation is linked to. We’re talking about heart disease, high cholesterol values, diabetes, joint problems and neurodegenerative disease, but also certain forms of cancer.
‘But what exactly does this low-grade systemic type of inflammation do?’ I wonder.
He begins to explain very fast, and it’s hard to follow him since the connection breaks several times during our call.
‘Okay, how about this: I’ll send you a scientific article,’ Dr Sears says.
He soon emails me an article from European Review of Medical and Pharmacological Sciences. I click it open.
‘The inflammatory response was developed over millions of years and allowed us to coexist with a number of microbes. The same inflammatory response also made it possible to repair physical damage . . .’
Okay, I think, acute inflammation is an ancient mechanism with benefits, millions of years old . . .
‘But there are also equally important anti-inflammatory mechanisms in the inflammation cycle that allow cell repair and renewal. Only when these two phases are continually balanced can the cells effectively repair the small damages that arise with inflammation.’
This is new to me. Does this mean there’s a need for balance inside the system itself – perhaps that just as there’s an inflammation yin, there also needs to be an inflammation yang?
‘But if the proinflammatory phase continues in a low but chronic level under the pain threshold, it can drive many chronic illnesses. In the end it can result in organ damage, loss of organ function and lead to severe illness, in spite of the fact that the initiating illness-causing events may have taken place decades earlier, triggered by an underlying and ongoing chronic inflammation process.’
So, low-grade inflammation arises from imbalance – from a steadily ongoing inflammation that doesn’t cause a ‘fire department’ type of acute inflammatory response but in the long run can act as a catalyst for small seeds of illness that have been germinating in the body for a long time.
Is this the type of inflammation that we bring about through an unhealthy lifestyle? In other words, might bad nutrition, stress, environmental toxins and other lifestyle factors give us inflammation, which in turn makes us sick? Perhaps that’s why the wrong food can lead to illness and not just to us ingesting too many calories.
And is it true that long before we actually become ill, the low-grade inflammation affects us so that we start to ‘lose steam’? When I went to the doctor complaining about my back pain, depression and listlessness and looked for explanations based on external things (‘the kids are moving away from home’), maybe it was actually a low-grade inflammation, an imbalance in my immune defence caused by a number of lifestyle choices, leading to my bad back, blue mood and bloated stomach. And maybe this is what I’ve ‘cured’ with my new lifestyle choices?
I go on looking to see if my symptoms, like back pain, fatigue and a ‘low’ feeling, could have been signs of low-grade inflammation. I find the following symptom list:
• The skin looks older, is drier, and has more wrinkles
• Lower energy
• Less stamina when exercising
• Swelling in the face
• Swelling around the belly
• Increased risk of either constipation or loose bowels
• Less ability to concentrate
• Fluctuating appetite
• Fluctuating blood sugar levels