Chronic inflammation, a condition characterized by persistent activation of the body’s immune response, has become a growing concern in our society. Inflammation, a self-preserving defense mechanism, protects the body from threats but can become problematic if an acute response becomes chronic. This shift can occur for many reasons, which will be discussed in this article.
Chronic inflammation can have profound implications on health, including the manifestation of chronic disease and metabolic dysfunction. It’s stated that long-term inflammation is responsible for 50% of deaths worldwide. One avenue that chronic inflammation can impact health is difficulty managing body weight. A comprehensive clinical consult and functional medicine testing investigate the complex relationship between inflammation and weight. Utilizing integrative medicine tools to address chronic inflammation and the many components of weight gain can arm you with tools to overcome this vicious cycle.
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What is Chronic Inflammation?
Inflammation is a defense mechanism the body undergoes when faced with a threat. It primarily involves the immune system responding to external stimuli or internal dysfunction. The process starts as an acute inflammatory response where immune cells and non-immune mediators react to viruses, bacteria, and toxins. The job of the inflammatory response is to eliminate the threat, repair the cells, and recover the body.
Due to lifestyle factors, environmental exposures, and physiological and biological factors, acute inflammation resolution can be halted, becoming a non-infectious systemic chronic inflammatory response. This leads to a decline in immune system tolerance and function, ultimately opening up the floodgates for further susceptibility to disease and dysfunction. There are varying degrees of chronic inflammation based on the causative agents, an individual's lifestyle, and the ongoing inflammatory process.
Common chronic inflammation conditions include autoimmune disorders, chronic pain syndromes, arthritis, cardiovascular disease (CVD), diabetes, allergies, and respiratory conditions like COPD.
What Are The Possible Causes of Chronic Inflammation?
Six common causative factors are linked to chronic inflammation. Here they are, in no particular order.
Infectious Agents
When an acute infection goes untreated, it can become a chronic inflammatory condition. This is often seen in conditions like Epstein-Barr virus, Lyme disease, Mycobacterium tuberculosis, parasitic infections, and fungal infections. Many of these pathogenic agents can take a toll on the body, lay dormant, and exacerbate symptoms when the body is under stress or ill from other acute infections.
Autoimmunity
Conditions categorized as autoimmunity have a bidirectional relationship with inflammation. While autoimmunity can propagate the inflammatory process, ongoing inflammation can trigger dysfunctional immune responses, leading to autoimmunity. During acute inflammation, the innate immune system is doing most of the responding. The answer switches over to adaptive immune cell response when the inflammation has been ongoing and persistent. This leads to immune memory and the release of inflammatory cytokines, which will trigger the innate immune system. This self-triggering cycle of the immune system is what leads to the disarray of autoimmunity.
Recurrent Acute Inflammation
Acute inflammation is an innate immune system response to a specific injury, pathogen, or environmental factor. Much like autoimmunity, when acute inflammation cannot heal in 6 weeks, it will cause chronic inflammation to set in. Being more prone to getting acute infections can increase the odds of developing a chronic state. One example is when you have an acute sore throat due to a strep infection, but these then become more chronic, causing tonsilitis. Children with recurrent strep throat often get a tonsillectomy due to the chronic inflammation in the tonsils.
Oxidative Stress
Oxidative stress is the excess production of reactive oxygen species (ROS). This occurs in tissues and cells when the body's defense mechanism can neutralize them. ROS has a place in cellular homeostasis, but when not kept in check by the antioxidant system, they can lead to damaged DNA, lipids, and proteins. Excessive ROS can release pro-inflammatory cytokines like TNF-alpha, oxidized lipoproteins, dysfunctional homocysteine, and advanced glycation end products (AGEs), which can play a critical role in the manifestation of chronic inflammation and disease.
What is The Relationship Between Chronic Inflammation and Weight Gain?
Chronic inflammation can lead to weight gain through various physiological and lifestyle factors. The release of cytokines during the inflammatory process can increase visceral fat. Inflammation can also alter appetite by interfering with the body's natural satiety hormones, which leads to overeating and, ultimately, weight gain. Joint pain and fatigue are often present with chronic inflammation, which is a source of interactivity and a more sedentary lifestyle.
This relationship is bidirectional. Adipose tissue, or fat cells, can contribute to the secretion of inflammatory mediators. When there are excessive fat cells, this stimulates the release of pro-inflammatory mediators like IL-6 and TNF-alpha. The increase in these mediators can cause oxidative stress and increase C-reactive protein, a key marker of inflammation. One study looked at obesity and inflammatory markers and found that obesity may be more responsible for inflammation rather than the opposite.
How Can Labs Be Used to Test For Chronic Inflammation?
Utilizing functional medicine testing to determine the underlying root cause of inflammation can assist in treatment and healing. Listed below are key tests to consider in chronic inflammatory presentations.
Inflammatory Makers
There are four common tests used to detect inflammation in the body. This includes Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Ferritin, and Fibrinogen. Although not diagnostic for any specific condition, these will give an overview of the severity of inflammation in the body.
Viral Panel
Chronic viral infections can cause a low-grade inflammatory response in the body. The Viral Panel Premier will look at six key viruses that can cause lead to chronic illness. This includes the herpes simplex viruses (HSV-1 and HSv-2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human herpes type 6 (HHV-6) and Cytomegalovirus (CMV).
Autoimmunity Markers
An ANA is a screening test that can be used to detect autoimmunity. If autoimmunity is already suspected, running antibodies for common autoimmune diseases, such as SLE, Hashimotos thyroiditis, and Rheumatoid arthritis, maybe the better route. AutoImmune Analyzer will assess 16 autoimmune biomarkers, which are correlated to different inflammatory-based conditions.
Environmental Toxins
There are a variety of functional medicine environmental panels that can assess if water, soil, and air pollutants are causing inflammation in your body.
Markers of Oxidative Stress
There are a few markers of oxidative stress that can be indicative of inflammatory processes occurring in the body that lead to cellular destruction, like mitochondrial dysfunction. This includes Interleukin-6, oxidized LDL, and Homocysteine. Addressing oxidative stress through lifestyle and supplementation can assist the physiological function of the body.
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Integrative Medicine Treatment For Chronic Inflammation To Help With Weight Loss
Utilizing integrative medicine tools and services can provide an anti-inflammatory approach that can support a weight loss goal. Discussed below are nutrition options, supplements, and complementary therapies to consider.
Nutritional Recommendations for Chronic Inflammation
Metabolic health is paramount when addressing inflammation and weight loss. Optimizing your metabolic function through diet and nutrition can decrease the inflammatory response and allow your body to respond appropriately. Eliminating inflammatory foods like soda, refined carbohydrates, processed foods, saturated fats, seed oils, and packaged food items is key to this process.
Metabolic health is predicated on controlling blood sugar and insulin. Consuming a low-glycemic diet that is focused on fresh produce, adequate-protein, appropriate complex carbohydrates, and high dietary fiber will help stabilize blood sugar and decrease the inflammatory process. One study found that implementing an anti-inflammatory diet in those with elevated inflammatory markers showed a decrease in visceral fat, cardiometabolic, and inflammatory markers.
Supplements & Herbs for Chronic Inflammation
A number of supplements and herbs have the potential to help control inflammation and help with weight loss.
Curcumin
The active component in turmeric, a root plant with the active ingredient curcumin, has been used for centuries for many health benefits. In regards to inflammation, curcumin has antioxidant capabilities by suppressing pro-inflammatory pathways that lead to the secretion of tumor necrosis factor. This constituent can also act as a free radical scavenger and decrease problematic interleukins. While there is more than curcumin can do, these are the main components of how it can benefit those with chronic inflammation. Curcumin can be taken at doses between 4,000 to 8,000 mg/day. Consult with your integrative practitioner on the appropriate dose for your situation.
Resveratrol
The plant extract comes from fruits that are high in polyphenols. You can find it in berries and grapes, but it also comes in supplement form. Studies have shown that Resveratrol can decrease reactive oxygen species and inflammatory mediators like tumor necrosis factor and IL-6. This extract can also help in conditions like type 2 diabetes by improving cholesterol and modulating blood glucose, which can assist in a weight loss journey. A recommended dose for those trying to lose weight is 500mg of Reveratrol daily.
Glutathione
This “master antioxidant” can help decrease inflammatory processing by supporting organ systems. Glutathione is necessary for detoxification processes, immune mediation, liver support, and free radical damage. In terms of weight loss and glutathione, this study found that obese individuals with higher reduced glutathione levels lost more weight and body fat. The oral supplementation guideline for adults is 500mg/day for two months.
Essential Fatty Acids
Omega-3 fatty acids, in the form of DHA and EPA, are great for both the anti-inflammatory process and weight loss for obesity. One investigation found that 1020mg of a combo omega-3 fatty acid supplement can significantly bring down body fat mass and percentage in overweight individuals.
Complementary and Integrative Medicine
Incorporating holistic modalities to assist in your weight loss journey can bring about a new perspective and successful intervention. Here are two areas to check out to see how you can benefit.
Acupuncture
Chinese medicine teachings use small needles to intercede and align energetic channels throughout the body. Engaging and correcting imbalances in this system can bring about harmony. It’s been shown that acupuncture can assist in weight loss and observed BMI and waist circumference. This modality has been used for decades to assist in decreasing inflammation as well, even in condition-specific inflammatory states like arthritis, asthma, atherosclerosis, and cancer.
Yoga
Yoga is both a physical and mind-body practice that can address discord going on in the body. Being in an appropriate state of mind is half the battle of a weight loss process. Incorporating tools that can help with mindset, managing emotions, and the ups and downs that come with chronic health issues and weight loss should be a key component of your intervention.
One study showed that in patients with rheumatoid arthritis, yoga can assist with decreasing systemic inflammatory markers like ESR while also improving the participants’ depression rating. Yoga can also assist with long-term weight loss, as participants in this particular study were more apt to stay with this course of treatment for their health and wellness. Finding a yoga routine that works for you is a therapeutic intervention worth considering.
Grounding
Grounding, also known as earthing, is the concept of making direct skin contact with natural elements of the Earth’s surface. Our planet has a limitless supply of mobile electrons in the form of negative charges. This charge has been shown to neutralize ROS, which, as explained in this article, can be a key player in the inflammatory response. Making direct contact with grass, water, soil, and rock is a few ways to neutralize the body’s build of positive electrons and, therefore, dissipate inflammatory mediators. Implementing a barefoot routine for a minimum of 30 to 40 minutes per day is one way to reduce inflammation, along with associated pain and stress in the body.
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Summary
Understanding chronic inflammation and its underlying causes is crucial in today’s world, where the prevalence of inflammatory conditions is on the rise. Autoimmunity, cardiovascular disease, diabetes, allergies, and obesity are just a few conditions associated with persistent inflammation.
Addressing inflammation in its acute state can help mitigate the progression to a chronic state. In many instances, patients are not aware that the inflammatory process is what is driving their chronic health issues. In these cases, it is best to collaborate with an integrative healthcare practitioner who can assist you in getting to the root cause, establish a comprehensive treatment plan, and assist you with your health goals, such as weight management.
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