Inflammation is your body’s response to what it perceives to be an outside invader or irritant. When caused by infections, the inflammation can sometimes be rather obvious as occurs with pneumonia. Other times, it can be very subtle. Keep in mind the following key points regarding inflammation and pain, address the underlying infections or irritants when able.
1. Often the inflammation causes more harm than good. It is often worthwhile to simply decrease the inflammation using natural remedies, diet, and nutrients.
2. Sometimes the inflammation is obvious because it causes redness, heat, and swelling. At other times, it can be quite subtle and needs to be looked for.
There are many different autoimmune and inflammatory illnesses. Lupus (Systemic Lupus Erythematosus or SLE) is a common autoimmune disease that often results in significant fatigue and pain. What most rheumatologists don’t realize is that the secondary fibromyalgia caused by lupus and many other rheumatologic diseases (including rheumatoid arthritis) may be a source of many, if not most, of the symptoms and much of the disability in these patients. Flaring fibromyalgia may also be misinterpreted as a flaring of lupus, or other inflammatory disease activity. Fortunately, fibromyalgia can now be effectively addressed.
When one addresses the associated fibromyalgia, patients often find that their lupus is actually a minimal problem. In addition, several studies have shown that taking DHEA, 200 mg a day, significantly improves the outcome of lupus and allows the patient to get by with a lower dose of prednisone. The main side effects of a too high DHEA level are darkening of facial hair and acne. If either of these occurs, lower the dose. It is unnecessary to follow blood levels of DHEA at this dose, because this is a very high dose and you can assume the blood level will be high. Lower doses, however, are not as effective as 200 mg a day. As many, if not most, inflammatory and/or autoimmune illnesses can cause a secondary fibromyalgia, and fibromyalgia is now addressable, it is important to keep this possibility in mind. If you have widespread pain, fatigue, and insomnia, look for and address the associated fibromyalgia!
Inflammation (In General)
Inflammation is a common cause of pain and many other medical problems that we experience in Western society. For example, anything that ends in the letters “itis” means that the problem is inflammatory. This includes things like arthritis, tendonitis, bursitis, spondylitis, appendicitis, etc. Inflammation is obviously a major cause of pain.
Our body’s armies of inflammation are often on high-alert when they don’t have to be. Much of this occurs because of the high amounts of animal fats relative to fish and vegetable oils in our diets. Land animal fats tend to contain arachadonic acid (in the “omega 6 fatty acids” family), which stimulate inflammation. Fish oils and some vegetable oils, such as flaxseed, contain what are called “omega-3 fatty acids.” These decrease inflammation. Over the last few hundred years, we have markedly decreased anti-inflammatory omega 3 fatty acids and increased pro-inflammatory omega 6 fats in our diet. This often results in our bodies being on “inflammatory overdrive” unnecessarily. This excess inflammation has been associated not just with an increased tendency to pain, but at times with increases in heart attacks and other diseases as well. You can sometimes see this tendency to over-inflammation in yourself when you get a paper cut. Sometimes the paper cut heals so quickly that you barely notice it’s there. At other times, the same type of cut will be red and inflamed and will continue to hurt beyond the initial few seconds of the cut.
How Do I Decrease My Tendency to Excess Inflammation?
Medically, we do this by using steroids such as prednisone or the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs, e.g. medications in the Motrin® family). Unfortunately, both of these can be fairly toxic. In the long run, using diet and nutrition is a much safer and more effective way to get your inflammatory system into balance.
A recent study, for example, showed that taking a multivitamin can reduce inflammation with vitamin C and B6 seeming to play the largest role. A good multivitamin powder replaces 35 tablets of supplements with one good tasting drink, and makes nutritional support easy. Many other natural therapies (see below) are also helpful in decreasing inflammation.
For acute injury, remember the old standbys. These have the initials R.I.C.E., which stand for Rest, Ice, Compression and Elevation. These are the standard therapies recommended by coaches, trainers, and other professionals to address muscle or joint injuries such as sprains or strains. When combined with Traumeel (one of several wonderful products for traumatic injuries that contains arnica), acute injuries heal much more quickly. Adding another supplement called MSM can help when tissue healing is necessary (e.g., sprains or broken bones). A good multivitamin powder can also give overall support for healing as well.
Inflammation is part of our natural healing process. Whenever there is injury, our body puts out “cytokines” in those areas to bring in white blood cells to knock out any infections and bring in other cells to begin the healing process. Because of this, healthy inflammation is a very beneficial tool that our body uses to heal. The cells come in, eliminate any infections, fix the problem, and then dissipate. When healthy, it is almost always localized and short-term.
Inflammation can become unhealthy, however. In these situations it is often generalized throughout the body. In addition to causing pain and disability, it can also cause premature aging. As noted above, anytime you see the letters “-itis” at the end of the word, it tells you that unhealthy inflammation is present. Excess inflammation is very common. For example, over 40 million Americans have arthritis. The inflammation can then damage the joints, causing deformity. Allergic rhinitis, which causes swelling of the nasal passages, is also common, affecting approximately 40 million Americans. Gastritis and colitis, which cause abdominal pain, are two other examples. Dermatitis, including psoriasis and eczema, are inflammatory illnesses of the skin. Even Alzheimer’s disease and heart disease have been associated with increased inflammation. Asthma, with its associated bronchitis, is also an inflammatory condition—and one that has doubled in frequency during our lifetime. In addressing these allergies and asthma, we sometimes mistakenly focus on the trigger. But the trigger is not the main problem because most people don’t have problems when they come in contact with that trigger. It is more important to look at the cause of the overall reactivity in each individual.
We are now beginning to understand why we are so much more prone to inflammation these days than we were in the past. As noted above, clues for understanding this can be found by looking at how the modern diet has changed over the last several thousand years.
Research shows that prehistoric hunter gatherers were much less likely to have degenerative diseases; their main problems were infection and trauma. They had a high-protein, high complex carbohydrate, and high-fiber diet. Most importantly, their diet was high in omega-3 fatty acids and low in inflammation stimulating omega 6 fatty acids (e.g. fats from meat, saturated and trans fats, shortening, margarines and grains). Their diet was also high in antioxidants, nutrients that put out the “inflammatory fires.” Foods were also unprocessed and low in refined sugar.
As society became more farming-based, our diet included more grains, and cattle were more likely to be grain fed. All this resulted in higher levels of the omega 6 pro-inflammatory fats. These omega 6 fats stimulated cytokines and inflammation. At this time, inflammation began to increase. This problem had been seen once before in recorded history in ancient Egypt. This civilization also had the osteoporosis and inflammatory diseases seen today.
Our current diet has continued to degenerate to where we are getting as much as 12 to 20 times as many inflammatory fats in the diet as we used to! In addition, we have a massive amount of sugar, potatoes, and white flour in our diet. This stimulates insulin resistance and release, further increasing the production of pro-inflammatory hormones (arachadonic acid) from these omega 6 fats. At the same time, our intake of antioxidants to put out these fires has markedly decreased.
What Does Modern Medicine Do About This?
Doctors give anti-inflammatories like Motrin and Celebrex, which block conversion of the omega 6 fats to the pro-inflammatory cytokines by blocking the enzyme cyclooxygenase. Unfortunately, these also block your body’s ability to make anti-inflammatory messengers. This is one reason why over 16,000 Americans a year die from NSAIDs and ~ 139,000 have had heart attacks or strokes from Vioxx. We also use high dose steroids as anti-inflammatories, which used long-term, can be highly toxic. Other therapies include new tumor necrosis factor blocking medicines for rheumatoid arthritis that cost $10,000 a year. We focus on prescription medications because that’s where the money is—so the pharmaceutical industry makes sure that we learn about them!
What Natural Alternatives Do We Have that Are Safer and Effective?
Substituting olive oil for other oils can be very helpful. In addition, increasing fish, nuts and seeds, berries, free range chicken and grass fed meats, spices and herbs, and green leafy vegetables (not potatoes and grains) can be a very helpful start. For more information on this, there is an excellent book you can read, The Inflammation Syndrome: The Complete Nutritional Program to Prevent and Reverse Heart Disease, Arthritis, Diabetes, Allergies, and Asthma by Jack Challem. In addition to this book, an excellent set of two cassette tapes will help you understand excess inflammation in more detail. Inflammation and Aging by Ronald E. Hunninghake MD (tapes 1 and 2) are available by calling 1-800-447-7276. You can either pay $10,000 a year to use the new tumor necrosis factor blocking medicines for rheumatoid arthritis, or you can take fish oil and other nutrients and clean up your diet (do it in ways that taste good)! Which one do you think the drug companies will be encouraging your doctor to recommend?
Does that mean you should only eat things that you hate? Of course not. You may find that substituting a wide variety of nuts such as peanuts, cashews, walnuts, etc. for chips and sugary snacks actually tastes better. Eating more salmon and tuna is not a big deal if you like these. If you don’t like them, don’t eat them. You can always add fish oil (using one, of course, that is mercury free) instead. Take 1/2 to 2 Tbsp daily or 1 softgel 3 times a day. When you feel better you may be able to lower the dose.
When you’re shopping for meat, go to Whole Foods Market, Wild Oats, Sprouts, or a similar store where you can get free range chicken and grass fed beef. Although it is a bit more expensive, it tastes much better, may not make you put on as much weight, and will save you a fortune on doctor bills. Olive oil is also tasty and can be used for frying, cooking, and instead of butter on your bread. Substitute stevia or saccharin for sugar. Use sugar-free chocolates (Russell Stover® makes a delicious line and there are now an enormous amount of yummy sugar-free options for those on the Atkins’ diet). They taste just as good as foods with sugar but will not make you sick. In addition, as a general rule of thumb, the more colorful a vegetable the healthier it is. For example, sweet potatoes or carrots are a lot healthier than white potatoes. A good multivitamin powder will also supply extensive antioxidant support, simplifying the process dramatically.
The effects of therapy with diet are not subtle. In a study done at the University of Washington, it was found that women who ate 1 or 2 servings of fish a week were 22 percent less likely to have rheumatoid arthritis. Those who had more than 2 servings a week were 43 percent less likely. Those who had deep fried fish (usually fried in omega 6 fats), however, were more likely to have rheumatoid arthritis. In another study done in Scotland, 64 men and women with rheumatoid arthritis were given fish oil. They began to feel better in three months. By one year, they had decreased NSAID medicine use by 40 percent. There is also evidence suggesting that fish oil helps heal the joints and may decrease osteoporosis as well.
Unlike prescription medications, which can result in quick results (but some such as like steroids and NSAIDs cause long-term toxicity), natural and dietary therapies take longer to see the full effect. They are more likely, however, to build up and heal your system. I find that benefits usually start to be seen by 6 to 12 weeks and continue to build over years as the person gets healthier and healthier. Because of this, I tend to use medications as an initial “band-aid,” while the natural therapies heal the underlying problem over time.
What Natural Anti-inflammatories Can I Use?
In addition to using fish oil, it can be very helpful to use an herbal pain-relief supplement that contains willow bark, boswellia (also known as frankincense), and cherry. These natural elements can wonderfully decrease both pain and inflammation.
Can You Summarize What I Need to Do?
If you have excess inflammation, your body can often repair the damage over time. This means decreasing sugar and simple carbohydrates (keep chocolate but make it sugar free), increasing protein and healthy oils (e.g. fish, olive, nuts), and getting optimal nutritional support (e.g., a good multivitamin powder. Use herbal pain-relief supplements to decrease inflammation as well.
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.