The Fundamentals of Functional Medicine series is intended to be an overview of the common elements and underlying imbalances behind chronic illness of all kinds, including inflammation, oxidative stress, mitochondrial dysfunction, and gut dysbiosis.
The Problem: Chronic Inflammation
Inflammation is a term that is tossed around a lot, but often misunderstood. When they hear the word “inflammation”, most people think of the very obvious inflammation or swelling they can see and feel when they are, for example, injured.
In the world of wellness and functional medicine, there is a broader general understanding of inflammation, and it is something of a dirty word. From the information that we gather online, we may know that it’s “bad’, or that it’s linked to chronic disease of all kinds, but we don’t necessarily know why, what that means, or what to do about it.
Inflammation is not inherently “bad”. When regulated and under control, it’s an essential component of immune system function, and necessary for fighting pathogens and healing from injuries.
Problems arise when inflammation is not regulated, not under control, when it becomes chronic and spreads throughout the body.
We mentioned that inflammation is a popular topic in functional medicine, but it’s not that chronic inflammation is not recognized as a problem in conventional medicine. In fact, chronic inflammation is recognized as problematic in all areas of medicine. The problem is that in general, specialists are focused on treating the effects of inflammation on the area of the body in which they specialize, rather than addressing the root cause of a systemic problem.
These days, it’s not uncommon to have multiple diagnoses of chronic illnesses. One person might have four “separate” conditions; for example, diabetes, high blood pressure, IBD, and asthma.
Inflammation is at the root of all of these conditions. But rather than identify this systemic inflammation as the underlying cause of the body’s state of disease, four separate specialists are likely to be treating each diagnosis as though it stands alone, and often prescribing medications that will reduce the symptoms or effects of inflammation within their designated part of the body, an approach that may provide symptom relief but that does not address the larger problem.
In functional medicine, we look at the body as a whole. Rather than simply asking “how can we reduce inflammation as it relates to this body part, symptom, or diagnosis” – a question that is still important – we want to dig deeper, and ask “why is there so much inflammation in the body, and what can we do about it?”.
Chronic disease is on the rise, and just about every chronic illness you can think of is linked to unruly inflammation, from heart disease and diabetes to depression and dementia. Inflammation is also linked to common, undiagnosed concerns like fatigue, brain fog, and digestive issues, and as we are seeing more and more of, histamine intolerance.
It’s not a coincidence that inflammation is behind an endless number of chronic diseases. Although genetics may play a role, generally speaking, we don’t just “get” chronic illnesses the way we might catch a virus or get food poisoning.
Inflammation: A Basic Overview
Let’s take a quick step back and look at what inflammation is, and why it exists. When the body encounters unwelcome invaders like viruses, infections, and toxins, white blood cells (including mast cells) release inflammatory chemicals in order to signal that there is a problem. Inflammation is also an important part of the healing response when we’re injured.
When you catch a virus, your body will release specific kinds of inflammatory messengers that travel throughout the body and create symptoms, from headaches to achy bones. It is not the virus itself that creates these symptoms, it is the inflammatory response. That’s why we find so much relief from NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like Advil. Similarly, when we have an allergy, it is not the allergen itself that is causing us to break out into hives or start sneezing, it is the inflammation that our bodies have created in response to the allergen.
Generally, when the problem has been addressed and cleared away, as in the case of a virus or an allergic reaction, the inflammation subsides and everything goes back to normal. The problem occurs, of course, when something is amiss and the inflammation does not subside. This often happens because of chronic, low grade exposure to something that causes inflammation (toxins, foods one is sensitive to, a persistent low grade infection, etc).
Digging Deeper: What Causes Chronic Inflammation?
So, what causes chronic inflammation? Usually, it’s a combination of factors, many of them diet and lifestyle related. Causes and contributing factors can include a poor diet or unrecognized food sensitivities including to gluten or casein, exposure to toxins, nutritional deficiencies, the use of certain kinds of medications, chronic stress, insufficient exercise, insufficient sleep, low grade infections, and gut imbalances, to name a few.
Inflammation is complex, and the specific factors that contribute to the problem are unique to each individual. So in addition to identifying a state of chronic inflammation as a problem, we have to work to understand which factors are contributing to an individual’s inflammatory state, which is done with the help of specialized testing, and comprehensive reviews of health history, diet, and lifestyle.
There are lab tests available for inflammatory markers, including C-Reactive Protein (CRP), which can confirm that inflammation is elevated, but there is still more digging to do in order to figure out why. There are a number of specialized tests we use in functional medicine to look for things like gut imbalances, micronutrient deficiencies, and food sensitivities, which can help to identify where things are going wrong and what we need to do next. A hidden food sensitivity or nutritional deficiency can end up being the primary factor when it comes to a state of chronic inflammation and disease.
How to Reduce Inflammation
There are a few things that we can all do both as preventative strategies and to reduce our overall burden of inflammation. Simple diet and lifestyle changes are in many cases enough to make a significant difference on a person’s state of wellbeing and quality of life.
- ➢ Clean up your diet. Some foods are inflammatory, others are anti-inflammatory. So you can think of every food you choose to put into your body as either contributing to the problem, or contributing to the solution. Cut out sugar, packaged food, processed food, and fast food. Focus on fresh, whole, anti-inflammatory and antioxidant foods like dark, leafy greens, wild-caught salmon, olive oil, and almonds (to name just a few examples). Here’s more on building a healthy diet.
- ➢ Know when to choose organic. Every year, the Environmental Working Group (EWG) puts out a guide that breaks down which produce items are most important to buy organic (the Dirty Dozen). (Note: organic is always recommended when it comes to meat and poultry). The EWG also offer a number of resources to help with choosing cleaning products and personal care products that aren’t filled with toxic, harmful chemicals.
- ➢ Manage stress. High or chronic levels of stress contribute to inflammation. It’s easier said than done, but work on removing yourself from stressful or toxic relationships and situations when possible, and make time for yourself to practice mindful meditation, yoga, nature walks, or whatever else brings you peace.
- ➢ More sleep, less screen time. These go hand-in-hand. Keeping your devices out of the bedroom at night is a simple rule and one of the best ways to improve sleep quality.
- ➢ Filter your water. A large investigation into tap water in Canada recently published some alarming findings about the levels of toxic metals we’re consuming. Use a water filter — for example the Zero Water system.
- ➢ Exercise. A sedentary lifestyle contributes to inflammation and chronic disease. Regular exercise has been shown to reduce the risk of disease across the board, and may even work better than antidepressants for depression.
- ➢ Limit use of NSAIDs. Over-the-counter NSAIDs like Ibuprofen (Advil), Aspirin, and Naproxen (Aleve) might help with acute symptom relief, but an over-reliance on them can contribute to a chronic inflammatory problem. NSAIDs also inhibit DAO, the enzyme that breaks down dietary histamine, which means they can be a big problem for those with histamine intolerance. (Of course if NSAIDs or any other medications have been recommended by your doctor, consult with them before discontinuing use).
- ➢ Consider targeted supplementation. This should be done under the supervision of a practitioner, but there are a number of supplements that can help with chronic inflammation, including vitamin C, magnesium, B vitamins, probiotics, curcumin, and omega 3 fish oils.
In more complex cases of chronic disease, more detailed investigations, specialized testing, and personalized protocols are necessary, but it’s best to start with a few basic diet and lifestyle changes that will help to reduce the overall burden of inflammation.