Quenching Inflammation

by Elizabeth J. Hall

INFLAMMATION:  WE ALL NEED IT from time to time. As the response of living tissue to damage, it is a wonderful defense mechanism.  Physical trauma, an infectious agent, or an allergen** invades a tissue. The inflamed area becomes red and warm.  This is caused by an increase of circulation to the affected area, stimulated by body chemicals called mediators. When released, these chemicals cause small blood vessels adjacent to the area of the tissue damage to dilate.

The increased blood flow brings more white blood cells to the area to destroy and remove debris, germs, or allergens. The capillaries become more permeable, permitting protein to leak out of them, and water is attracted into the tissue spaces.  Swelling and pain follow. Inflammation then, is a process that tries to localize and stop the spread of infection or damage.

When friend becomes foe

Hopefully, the increased numbers of white blood cells destroy the bacteria or allergens, and tissue repair follows.  But if they don’t, and some of the original invaders or irritants remain, more trouble follows, including the development of many chronic and acute diseases such as arthritis, gum disease, ulcers, liver disease, atherosclerosis, diabetes, cancer, and Alzheimer’s, to name a few.  In fact, inflammation fuels most common diseases as well as autoimmune diseases.

Inflammation of any type generates free radical production.  These unstable molecules wreak havoc, causing more tissue damage.  Other factors besides bacteria and injury, as we will soon see, can trigger dangerous inflammation.  In this article we will identify some key players in inflammation.  We shall also explain how unhealthful lifestyle practices actually increase their activity and promote dangerous inflammation and how healthful lifestyle practices curtail their activity.  And we will share the latest scientific information on how natural remedies can actually quench harmful inflammation.  And in order to better appreciate what the latest scientific studies have to offer, we will need to cover a bit of basic chemistry and physiology.

Let’s start with an abbreviated course in prostaglandins and inflammation. Prostaglandins (PGs) are one group of hormone-like chemicals that regulate inflammation in tissues.  Specifically, PGE-2 tends to increase inflammatory processes, while PGE-1 and PGE-3 generally curb it.

Too much PGE-2 spells Trouble.

An adequate level of PGE-2 does its job of stimulating inflammation appropriately, but when an excessive amount of PGE-2 is produced in the body, excessive inflammation results.  In addition, the immune system is suppressed, pain tolerance lowered, and fluid retention increased.  What causes us to get too much PGE-2?

The precursor chemical to PGE-2 is a fatty acid called arachidonic acid.  Excess arachidonic acid promotes excess PGE-2 which causes inflammation. Meat, too much omega-6 fat (such as corn, safflower, sesame, and peanut oils), fried foods, and over-eating, all encourage the production of excess arachidonic acid.  So, what can we do to reduce inflammation from excess PGE-2?

● Eliminate meat.

● Seriously reduce the consumption of refined oils.

● Eat temperately.

Bromelain from pineapple, if taken on an empty stomach, and olives, inhibit PGE-2 production.

Are Drugs the Answer?

Now to focus on this problem a little more:  an enzyme called Cox-2 speeds up the conversion of arachidonic fatty acid into PGE-2.  So an excessive amount of arachidonic acid plus an extra amount of COX-2 increases production of PGE-2.  This excessive amount of PGE-2 increases inflammation, suppresses the immune system, and promotes cancer.  The pharmaceutical world has developed COX-2 inhibitors which, in turn, reduce PGE-2 production.  These new medications are proving effective in curtailing inflammation.  Celecoxib, for example, reduces pain in arthritis, and early studies indicate that it might be useful in the prevention of cancer and Alzheimer’s Disease.  However, this drug has an unfortunate side effect.  It and its cousins might actually increase the risk of cardiovascular events- which means heart attacks and strokes.  Although there is early evidence that some of the COX-2 inhibitory drugs might retard some aspects of cognitive (mental acuity) decline and colon cancer, many COX-2 inhibitory drugs can damage the kidneys, the stomach’s mucosa, and reduce skeletal muscle repair.[i]^{, [ii]}

Recent news underlines these concerns.  Merck, a major pharmaceutical company, has withdrawn its popular COX-2 inhibitor/anti-inflammatory drug, Vioxx*** from the market.  Why?  Recent studies showed that those taking it for 18 months experienced a two-fold increased risk of heart attacks and strokes.  Vioxx also has been shown to increase undesirable clotting, which is associated with 80 percent of heart attacks and many strokes.  This is a significant step for Merck to take.  They have apparently considered these cardiovascular risks serious enough to open themselves up to substantial financial loss, including future lawsuits.

So the question becomes all the more pertinent: what can we safely do to inhibit excess COX-2 production?  Is there a better way than risking the potentially adverse drug effects?

Now for Some Good News

Indeed there is!  Scientific studies have confirmed that the yellow pigment, curcumin, found in turmeric, Boswellia serrata, ginger, resveratrol in red grapes, garlic,* vitamins E and C, milk thistle, narinogen in citrus fruit, and quercetin in cabbage, greens, pears, grapes, apples, and onions, all significantly reduce COX-2 production or activity, thus reducing excessive inflammation as well.[iii]^, [iv]^, [v] With so many natural COX-2 inhibitors, one wonders after reviewing the scientific literature, if COX-2- inhibiting drugs would be necessary if these natural ingredients were more routinely used.

PGE-1 Combats Inflammation

PGE-2 encourages inflammation; however, there are two other prostaglandins that we want to mention that actually inhibit it.  PGE-1 is a prostaglandins is not only essential for a healthy nervous system, but is also a mild anti-inflammatory agent and an immune enhancer.  How do our bodies make this beneficial anti-inflammatory agent?

Linoleic acid in nuts and corn, safflower, sunflower, and sesame oils is converted into gamma-linolenic fatty acid which is then converted into DGLA (dihomo-gamma linolenic acid), from which PGE-1 is derived.

To make the anti-inflammatory PGE-1, we must eat foods (nuts or oils) that have linoleic acid.  This fatty acid is not made in the body, so it is essential to obtain it from our diet.  The body will eventually convert it into DGLA.  DGLA can go into either of two biochemical routes.  It can be converted into arachidonic acid and promote inflammation via excessive amounts of PGE-2, or it can be converted into anti-inflammatory PGE-1, the preferred route!  Are there any factors that affect which route is taken?

Excessive insulin promotes inflammation

Too much insulin is one such factor.  Why?  A special enzyme, delta-5 desaturase, is necessary for the DGLA to stimulate arachidonic acid synthesis.  Too much insulin increases this enzyme and therefore arachidonic acid production. The more arachidonic acid, the more PGE-2.

Obesity, visceral (abdominal organ) fat, overeating, snacking, a high fat diet, high blood pressure, physical inactivity, oral contraceptives, and prolonged stress damage the insulin receptors on the cell membranes.  If insulin cannot bind to its receptors, the blood glucose remains high.  And anything that compromises the ability of insulin to bind to its receptor cells coaxes the pancreas into making even more insulin.[vi] The pancreas is stimulated to produce more insulin to lower the glucose level. However, it doesn’t achieve this because the insulin receptors are faulty. The insulin level in the blood remains high.  This increases delta-5 desaturase, which encourages DGLA to be converted into arachidonic acid and PGE-2 and other pro-inflammatory agents.

Fortunately, weight reduction, a low-fat and high-fiber diet, physical exercise, and sufficient chromium and magnesium intakes can improve insulin sensitivity and consequently reduce inflammation.  Sesamin, a nonfat constituent in sesame seed, inhibits delta-5 desaturase activity and consequently decreases the formation of PGE-2.[vii]

Another Anti-inflammatory Prostaglandin to the Rescue!

Now let’s look at the second of numerous PGs that can inhibit inflammation – PGE-3.  To make this mildly inflammatory PG, the body must have a form of omega 3- fat, which can be obtained from flaxseed, soybeans, walnuts, spinach, or any green salad item.

Something Fishy?

You may have heard that fish are a good source of omega-3 fat.  Although it is true that it does contain omega-3, fish consumption presents other health concerns that might very well outweigh any benefit.  It would be far better to obtain your omega-3 needs first-hand, rather than second – that being through the fish’s digestion of its green, marine salad items!  Pollutants, heavy metals (such as mercury), and toxins defile many lakes and oceans and accumulate in the fatty tissues of fish.  In fact, pregnant women were recently admonished not to eat more than one serving of salmon per month.  Other authorities advise eating fish not more often than once a week.  There are even signs with similar warnings along the Tennessee River in the Chattanooga, Tennessee area in which I live.

Selenium toxicity is also a growing concern in many U.S. lakes.  Although fish do contain significant amounts of omega-3 fat, fish oil can elevate cholesterol levels and exacerbate diabetes.  Some studies show that it actually increases the production of some pro-inflammatory chemicals.  In addition, its consumption decreases some anti-inflammatory agents.  Indeed, fish oil under some conditions can have a pro-inflammatory effect overall.[viii]

Essential fatty acids, like EPA in fish,  are precursors to anti-inflammatory PGE-3. But there is really no need to consume bio-hazardous fish to get EPA.  Is there a better way to get omega-3’s without the risks and side effects that come from eating fish?  Yes.  The enzyme delta-6-desaturase can change alpha-linolenic fatty acid into EPA.

Again, lifestyle is pivotal in producing this beneficial PGE-3.  A diet high in saturated or trans fat (from hydrogenated fats), elevated cholesterol levels, high stress, alcohol, diabetes, too much sugar or salt, smoking, fasting, obesity, and elevated blood sugar, all decrease this valuable enzyme, delta-6-desaturase.  The result is less PGE-3 and more inflammation.  One more important point: deficient or marginal intakes of magnesium, zinc, antioxidants C, E, and A, and vitamins B3 and B6 decrease PGE-3.  These vitamins are needed so that delta-6-desaturase can work.

Enter NF-kappa B

Among its various other effects, the NF-kappa B protein is integrally involved in the inflammation of atherosclerosis.  NF-kappa B is present in most human tissues, but is usually inactive unless needed.  It stimulates pro-inflammatory processes.  Scientific research has discovered that excessive NF-kappa B activity is associated with inflammatory and autoimmune diseases, for example, rheumatoid arthritis, asthma, and inflammatory bowel disease, as well as atherosclerosis, cancer, complications from diabetes and Alzheimer’s.

However, NF-kappa B has a dual nature because it can also stimulate tissue repair and help achieve balance between cell survival and death in the body.  Bacterial and viral invaders, chemical and physical stressors, and aging all increase it.  So how can we avoid sending NF-kappa B into overdrive?

Obesity’s Role

Obesity (low-muscle, high-fat mass) triggers inflammatory problems.  Fats cells are actually endocrine cells that make a whole host of chemicals, many of which, if produced in excess, promote inflammation.  In fact, some authorities think that visceral fat (centered largely around the abdominal organs) is the major production site of inflammatory products in the body!  Alpha-Tumor Necrosis Factor (alpha-TNF) is a chemical, produced by the adipose cells, that revs up NF-kappa-B activity.

An additional characteristic of NF-kappa B: for it to act, it must first bind to DNA.  One experiment showed that weight-gaining rodents had more NF-Kappa B binding to their DNA (as found in the heart and lungs), whereas weight-losing rats had less.  This means, if all other factors for heart and lung disease were equal between the two groups, the weight-gaining rats would suffer more damage to their hearts and lungs.[ix] Exercise, reduced-caloric intake, and the surgical removal of fat decrease the production of these inflammatory chemicals.

Diet and NF-kappa-B Activity

Too much homocysteine activates NF-kappa B.  Homocysteine is formed from the degradation of the amino acids methionine and cysteine.  High levels of homosycteine encourage inflammation, atherosclerosis, stroke, and certain forms of dementia.  Individuals with high levels of homocysteine tend to have low levels of folic acid, B12, or B6.  Vitamin A deficiency, cocaine, and a diet high in saturated fat, all activate NF-kappa B levels.

Certain dietary factors, as mentioned above, can exacerbate excess NF-kappa B levels, but a good diet has the opposite effect.  Scientific research has discovered that genistein from soy,[x] and certain compounds in garlic help to restrain NF-kappa B activity.[xi] The amino acid arginine (from nuts and legumes) also reduces activation of NF-kappa B.  Germinated barley lessens its activity in the intestines and has therapeutic effects in ulcerative colitis.  Gradual, wise caloric restriction decreases it in the kidneys.  In addition, there are documented studies that show resveratrol from red grapes can reduce NF-kappa B activity in the brain.  Vitamin E reduces it, especially in cases of liver cancer.  Anthocyanins, the colorful pigments from red, blue, and purple fruits, lower NF-kappa B activity.  And the phytochemical indole-3-carbinole, found in broccoli, cabbage, Brussels sprouts, tofu, and dark green leafy vegetables, also lessens its activity.

Herbs and NF-kappa B Activity

Curcumin from tumeric inhibits NF-kappa-B activity as well, especially in the pancreas and liverWhat about inflammation occurring in the arteries?  Ginkgo biloba reduces its activity of NF-kappa B in the blood vessels.  Experiments with pigs indicate that chronic antioxidant supplementation can mitigate NF-kappa B activity in the innermost lining of the arteries.   This knowledge is helpful because inflammation increases atherosclerosis.  The phytochemical alpha-lipoic acid,[xii] found in tomatoes, spinach, broccoli and over-the-counter supplements, inhibits NF-kappa B activity in the aorta, the big artery that takes the blood away from the heart.  We surely don’t want inflammation in the form of atherosclerosis there!

Alpha-lipoic acid helps to reduce elevated blood sugar levels.  Better control of blood sugar in diabetic individuals means less NF-kappa B protein activity, which spells fewer inflammatory complications.

Leukotrienes: Not Arachidonic Acid, Again?

Not only can arachidonic acid be converted into PGE-2, but also into leukotrienes, which are exceedingly more potent pro-inflammatory chemicals.  Is there anything we can do to avoid the formation of these most harmful chemicals?  Sesaminol from sesame seeds and quercetin inhibit leukotrienes.  The herbs turmeric, ginger, Boswellia serrata, garlic, and feverfew inhibit not only COX-2, but different leukotrienes as well.  Indeed, curcumin in turmeric has been shown to reduce at least 14 pro-inflammatory agents in the body!  And, gamma-tocopherol, a form of vitamin E, can reduce the dangerous leukotriene known as LTB-4.

It is interesting to note that anti-inflammatory drugs which inhibit COX-2 and thereby reduce PGE-2-induced inflammation, fail to stop inflammation caused by leukotrienes.  Another thing to consider – significant liver disease from excessive alcohol consumption or excessive abdominal fat may impair the removal of leukotrienes.  Excessive amounts of the B vitamin niacin can increase leukotriene production, which could adversely affect individuals with heart disease.

Hydrotherapy

For acute inflammation of the skin, applications of cold for 15 minutes at a time can quench some of the harmful inflammatory chemicals and ease discomfort.  Once the swelling and heat subside, alternating hot and cold applications speed up the circulation and tissue repair.*

Charcoal

Charcoal works well as the first therapy when signs of inflammation develop – tumor (swelling), calor (heat), rubor (redness), and dolor (pain).  This simple material is the most powerful medical adsorbent known.  Because of its plant source, charcoal’s structure permits – depending on the specific wood – absorption into its many microscopic fissures up to thousands of times its own weight.  It has a peculiar affinity for many of the toxic chemicals resulting from inflammatory processes, and is recommended in poison centers for treatment of most emergencies caused by swallowing even lethal amounts of many harmful substances.

Taken internally with water, charcoal can help alleviate gastroenteritis and the inflammatory components of many types of diarrhea.

A charcoal-flaxseed poultice* applied to a sting, acute sprain, or even a broken bone (one that cannot be casted) has the wonderful effect of drawing out toxins and reducing inflammation.  If a person who has severely sprained his ankle immediately applies a charcoal poultice (secured by an Ace bandage, covered with a soft-gel ice bag, and then elevated), he can usually bear his full weight on the ankle within 24 hours or less.

Poultices are also very helpful in reducing the swelling and pain of insect bites and stings.  Poultices applied externally provide very effective relief from the pain of inflammation, and expedite healing.

As ever, one needs to ascertain the cause of the inflammation before attempting to treat it; to treat symptoms before understanding the cause is very unwise.

Don’t Forget to Exercise as You Get Older

Aging is accompanied by a 2- to 4- fold increase in plasma inflammatory indicators.  Two other inflammatory agents, alpha-TNF and IL-6, aggravate or cause age-related disease.  Indeed, elevated levels of these pro-inflammatory markers, IL-6 and alpha-TNF, are significant risk factors for fragility, mortality, and morbidity in the elderly.  These elevated inflammatory markers are good predictors of mortality risk independent of other factors.  The good news is that a good diet, with exercise, can reduce inflammatory markers, particularly in obese, postmenopausal women.

In one study, moderate exercise over a period of 10 months increased anti-inflammatory chemicals which helped to relieve some of the symptoms found in individuals with Parkinson’s Disease.  Indeed, the body’s own “morphine” (endorphin) increased when a regular exercise program was followed.[xiii] Regular, light-to-moderate exercise, as tolerated, makes the muscles of elderly individuals less vulnerable to inflammation.

Mental Influences

Inflammation in the brain can promote cognitive decline and degeneration of the brain cells, as found in Alzheimer’s.  Negative emotions and stressful events often fuel inflammation. Stress increases IL-6.  Major depression is associated with a production of inflammatory cytokines (proteins released from inflammatory white blood cells), and systemic and localized inflammation.  One study showed that participants with most severe symptoms of depression had higher levels of IL-6 before being given a flu vaccination than participants with few or no symptoms of depression.  Even two weeks after the flu vaccine, the IL-6 levels of those with the greatest symptoms were still high. Even a modest number of depressive symptoms can amplify and prolong inflammatory responses in older adults, as well as healthy younger men.[xiv] These, in turn, can exacerbate a wide variety of age-related diseases. Women experiencing burnout and sleep deprivation seem to have elevated levels of alpha-TNF.

More Patience and Trust, Please

Hostility, as characterized by anger, aggressiveness, and generalized distrust, even in healthy men, is associated with increased inflammatory agents.  Hostile men have more alpha-TNF, elevated levels of which are associated with higher risk of heart disease caused by atherosclerosis.

Now a Word Regarding Cortisol

In optimal amounts, cortisol tightens up the cell membranes (thus reducing likelihood of allergies) and reduces inflammation.  But excess cortisol causes problems, including frequently inhibiting important protein synthesis in the body’s production of antibodies and digestive enzymes such as repair enzymes and neurotransmitters.  Elevated levels of cortisol are involved in, contribute to, or aggravate peptic ulcers, high blood pressure, dementia, impaired memory, shrinkage of certain key areas in the brain, and a suppressed immune system.  If the prolonged stress is unresolved and becomes unmanageable, the adrenal glands that produce excessive amounts of cortisol levels can wear out, as it were.  The resulting low levels of cortisol will consequently contribute to allergies and a whole host of other inflammatory responses.  What can cause increased cortisol production?  Prolonged stress, and often, major depression are two major culprits.

Obviously we would want to lower elevated levels of cortisol – to prevent damage to our bodies and save ourselves from inflammatory problems in the future.  Studies show that a diet emphasizing whole grains and fruits, vegetables, and legumes can reduce elevated levels of cortisol.  Therapeutic massage can also lower it.  Daily walking enlarges and strengthens the adrenal cortices which produce cortisol, thus enhancing output capacity.  Moderate this healthy production of cortisol with peace of mind and trust, which reduces excessive cortisol levels, and you are on your way to well-balanced adrenal gland function.

To Wrap Up

Almost all pro-inflammatory agents have a dual nature.  They benefit us under certain circumstances.  However, the typical fast-paced Western lifestyle stimulates the over-production of pro-inflammatory agents – thus producing harmful effects.

You may be asking yourself, after reading this article, “How can I know if my PG and NF-kappa B levels are in order, if I’m getting too much arachidonic acid, or if my body is producing too many leukotrienes?”!   But no need to worry.  Consider the somewhat complicated scientific information presented here as a background to better understanding inflammation.  The take-away kernel is this: the lifestyle measures presented or implied in this article, including temperance, appetite control, eating a diet rich in fruits, vegetables, nuts, whole grains, and legumes, moderate exercise, trust in Divine Power, judicious use of herbs and supplements, hydrotherapy, charcoal, massage, adequate rest, and the correction of unhealthful lifestyle habits can, from several angles, both assist inflammation in aiding recovery, and quench it when it exceeds beneficial levels.  Thus we may greatly prevent or correct the inflammation that underlies so much of the chronic degenerative diseases that we see in society today.

The article originally appeared in The Journal of Health and Healing and is used with their permission. All rights of the article belong to the author, Elizabeth J. Hall, 2009.  For permission to duplicate, publish on the web, or distribute contact her at lizjhall@healthevangelism.com