4 Pieces Of Misinformation Around Inflammation
We’re fresh off our podcast, Inflammation: The Silent Killer. Yes, a very dramatic title.
As always, I spoke about misinformation. Misinformation around inflammation. Inflammation misinformation. That phrase kicked around in my noggin for about 3 seconds before I invented my new favorite word: Mis-Inflammation.
Today we discuss 4 pieces of Mis-Inflammation. We’re going to do some fact checking around claims I saw on various blogs as I was trying to get a sense of what most people are bombarded with when reading about inflammation.
What Is Inflammation?
Inflammation is a natural response to some stimulus. What does that mean? Something interacts with the cells of our body and normally causes that cell to pop. The cell releases these complicated signallers that tell the immune system that a cell has been destroyed, we don’t know why, and we need help. When the cell pops, it kind of looks like this:
Those stimuli are things like bacteria or other bugs, chemicals like pesticides or herbicides, allergens like pollen or mold, or actual physical damage to the tissues from scratches, cuts, pulls, and breaks.
The early response to these chemicals is inflammation. The inflammatory response classically has swelling, redness, heat, and pain that we can see or feel. If you want to see for yourself, scratch down your forearm about 1-2 inches. Don’t hurt yourself now. Within 5-10 seconds, you’ll probably see that redness and notice some warmth. That is inflammation.
So inflammation is a completely normal, rapid response of the immune system. It’s telling the area that we need further immune support to clean out bad stuff, clean up dead cells, and start the repair process and healing of the tissue. This brings us to our first point of Mis-Inflammation.
1. “Inflammation is bad”
Inflammation is not bad. This early response, called acute inflammation, is a very necessary part of our immune system. If we were to anti-this-inflammation, we’d be in REAL trouble. Imagine a bacterial infection where our immune system doesn’t alert the rest of the body that we have an invader. The bacteria could cause FAR more damage. It could be fatal. It is the suppression of early immune responses that we worry about most in medicine; these patients are considered immunocompromised.
Chronic inflammation, though, is bad. After a while, inflammation changes.The cells shift. Instead of being helpful, immune cells like the white blood cells become a mix of helpful and harmful. There’s a simultaneous destruction and repair that is happening.
Chronic inflammation happens because those “stimuli” don’t leave. But sometimes, there’s this low level inflammation going on for no real apparent reason. Our lifestyle choices can create this situation. Poor diet, stress, poor sleep, lack of exercise, extra body fat, and more all create oxidation and inflammation on a low, long term basis.
Think of it like this: Inflammation is like tending to a farm. You have to get rid of weeds and bugs, keep the soil healthy, and grow great crops. Chronic inflammation is doing this in a war zone.
Chronic inflammation is the bad type of inflammation that needs to be prevented at all costs. We all should be worried about creating a state of chronic inflammation in our bodies.
Chronic inflammation is connected to chronic diseases, which are of course connected to really bad health consequences.
This brings us to our next point of Mis-Inflammation.
2. “Inflammation is the root of all disease.”
On the web, bloggers and fake wellness experts like to get a little dramatic. I’m leaning towards they don’t have much to say and are trying to fill up a page and start throwing words around. They now state that all diseases are rooted in and caused by chronic inflammation. Now who’s the dramatic one?
Inflammatory diseases are a real thing. There are many links between chronic diseases such as diabetes, heart disease, allergies, lung disease, arthritis and inflammation. Right now, however, much of the science saying inflammation is the cause isn’t on solid ground. It’s certainly involved. Someone with diabetes will sure enough have inflammation. We can’t say for certain that it was a result of the inflammation that the person developed diabetes.
I’m sure for some diseases, the links are stronger. Right now, it’s chicken vs egg. Did I get diabetes because of inflammation? Do I have inflammation because of diabetes? What I’m leaning towards is this: I had risk factors that contribute to a state of chronic inflammation, and that chronic inflammation along with other things lead to the development of this disease, and now chronic inflammation is making it so the progression of these diseases is faster or worse than before.
People will often panic once they realize there’s a connection between chronic inflammation and disease. Some of the charlatans will try to get you to part with a few hundred bucks and get a test to determine if you have inflammation and to see how bad it is. Guess what? This is Mis-Inflammation point #3.
3. “You need a test to check if you have chronic inflammation.”
There are tests available. These blood tests will measure levels of the different bits of glitter - the signallers of inflammation. High amounts of those numbers, high inflammation.
Testing for chronic inflammation for the general public is almost entirely unnecessary. Here’s why:
Tests are unstandardized and expensive
There are a few tests that many people have heard of around inflammation. C-Reactive Protein (CRP) is one, fibrinogen is another. You can even measure homocysteine if you really wanted. Those are pretty standard tests. Others, such as testing for many individual markers of inflammation, are not. Those tests are not often covered by insurance and can be expensive.
What if the numbers are high?
If you take these tests and you find that your numbers are elevated, what does that really mean? It means there’s inflammation. But is this inflammation due to some acute infection or inflammatory process? “Oh yeah, my foot fell off last week… Geez, I always do that!” There is no differentiating between acute inflammation (I’m sick right now without symptoms yet) and chronic inflammation (mmm cheeseburgers all day every day) with these tests.
And so what? If the numbers are high, are you going to change your life around? I’d argue that you should make the changes to manage chronic inflammation no matter what. You don’t need a test to tell you to do that.
What if the numbers are low?
So you take the test and your number is low. Does that mean you don’t have risk factors leading to chronic diseases? Does that mean you’re free to do as you want? No, of course not. A false negative could give you confidence to keep making bad decisions instead of managing risks.
I’d recommend that, for most of us, skipping the test and instead aggressively managing risk factors (diet, stress, exercise, etc) as if you have the worst possible chronic inflammation is the best idea.
The final, biggest piece of Mis-Inflammation is around treatment of chronic inflammation.
4. “Natural anti-inflammatory compounds or supplements are safer (and better) than medicines.”
I believe we’re taught there’s a battle between traditional medications and natural supplements. Natural products are better because they’re natural. They’re painted as safer because they don’t have the long list of side effects like the drug commercials have. I believe that both medicines and natural products have examples of “best choices”, meaning they do help a lot without all of the negatives. But to broadly assign the idea that one is better or worse to either drugs or supplements is not honest or objective. They’re both jerks and we have to keep it real. We have to stay on the Middle Path.
Here’s the deal, in a big picture view. There are a limited number of pathways any outside substance (herb, vitamin, drug) can manipulate to have a desired effect. When it comes to inflammation, there are two major pathways. Most anti-inflammatory supplements and medicines will affect the same paths. It’s just a question of how strongly.
If that is true, then the other side of the coin is true: if these things affect the same pathways, wouldn’t the potential side effects be the same? In many cases, yes.
We know it’s a bad idea to take high dose or long courses of anti-inflammatory drugs like NSAIDs. There are numerous downsides, like GI bleeds, bleeding irregularities, kidney risks, or heart disease. We don’t need anyone getting a heart attack trying to prevent heart disease.
No, that doesn’t mean EVERYONE will have these side effects. It means it’s something we should be aware of, monitor for, and try to minimize because sometimes the benefits of these compounds are greater than the risks.
Here’s my fear:
- We use supplement forms of plants to reduce inflammation thinking they are safer.
- We’re more likely to use them longer, even pushing the envelope of dosing (going higher than we should).
- We expose ourselves to risks because we aren’t watching for them.
- Many people get hurt, all while they were trying to make better decisions for their health.
I can’t stand by and let that fear become reality!
The risks of supplements are sometimes unknown and often downplayed. We did an article about Apple Cider Vinegar that got people all worked up. I heard so many anecdotes saying how it works for them. I am very happy for anyone who finds success using whatever options are available to them. I really am - I was so happy to hear these anecdotes.
But, I also heard far more accounts of side effects from reflux, ulcers, and tooth decay. The next day I visited a dentist and mentioned the article, she stated she is constantly fixing and repairing teeth due to Apple Cider Vinegar decay.
There are risks to anything. Just because they are not 100% announced or fully understood doesn’t mean they’re not there.
I’ve said it before, I believe the non-judicious use of anti-inflammatory supplements (I’m looking at you Turmeric!) will be the next oopsie moment from the natural products industry.
I’m not saying natural options aren’t options, I’m just saying we “gotta keep it real.” I have some thoughts around this bit of Mis-Inflammation.
Our Recommendations For Managing and Preventing Chronic Inflammation
We’ve taken some care to address the Mis-Inflammation. But how do we go about best avoiding chronic inflammation to begin with? What do we do if we have chronic inflammation and pain already, whether that’s with one of the chronic illnesses, or long term joint pain, or even inflammatory gut disease?
The answer is the same for both. Managing risk factors. Being healthy. Avoiding the hype.
Here are my recommendations for managing and preventing chronic inflammation in a truly holistic manner:
- Start with lifestyle modifications. Diet, exercise, stress, sleep, etc.
- Use natural products that actually will do something around pain and inflammation like turmeric or boswellia in the proper forms and doses.
- Avoid aspirin-like compounds like white willow bark. Aspirin, if it came out today, would be a blood thinner more than it would be an anti-inflammatory drug. Aspirin and aspirin-like compounds should be reserved for situations outside of pain and inflammation.
- Any anti-inflammatory supplement should be used at the proper dose for only a short period of time. This means 6 months. If you need longer use, loop your doctor in so they can keep an eye on your gut, heart, and kidneys.
- Instead of looking for the anti-inflammatory compounds all the blogs talk about and using them as supplements, incorporate foods rich in them into a varied, healthy diet filled with anti-inflammatory foods. Don’t take ginger, but add it, turmeric, cayenne, sage, green tea, and more to your healthy diets on occasion. These are delicious foods we normally don’t get exposed to, and their benefits will probably go beyond inflammation from our diets.
- It bears repeating: use diet, stress management, exercise, sleep, and environmental control as your first line in preventing chronic inflammation.
- An anti-inflammatory diet will be rich in reds, greens, and blues, healthy fats rich in Omega-3 fatty acids and properly made olive oil, and protein sources like fish, chicken and pork. In other words, the mediterranean diet. If you’re a vegan or vegetarian, then find healthy protein sources that are varied and watch your saturated fat intake. Avoid trans fats and fraken-foods like vegetable oils. Check out our Guide To Fats and Eat To Fuel Your Fire for some basic nutrition advice.
- Aggressively treat chronic illnesses that lead to worsening of inflammation. This means cholesterol, blood pressure, diabetes, and more.
In the very near future we’ll be releasing our new eBook, “Anti-Inflammation Roadmap.” Sign up for our email list to be notified when that releases!
Saying What Others Won’t
I know that at any point in time, you can google “anti-inflammatory supplement” and get 40 million blogs that are talking about the anti-inflammatory benefits of this or that supplement. That is not who I am trying to be for you here.
Instead, I want to be the voice calling out the B.S. Those articles are filling space on a page. They need to talk about the anti-inflammatory compounds in a mystical way to fluff out their websites and get links.
When they aren’t being honest and talking about what that anti-inflammatory benefit really means, it subverts the message. Just because something has anti-inflammatory properties doesn’t mean it will do anything to help you manage your chronic inflammation or make you healthier. It also doesn’t mean that there are no risks to taking such a compound.
It bugs me that these naturally-focused ‘experts’ are promoting things to take over the things we should be doing. When it comes to making ourselves the healthiest we can be, we need a holistic approach. This requires lifestyle modifications, natural products and medicines that are carefully selected and used correctly, and medical care. Anything else is simply Mis-Inflammation.
Just trying to keep it real...
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth