Why Reducing Inflammation Can Improve Chronic Health Conditions

Written By Lou Chalmer

In 2017, when I really began my journey towards better health and wellbeing, I had barely heard of inflammation. I just knew that things were bad and I needed to do something to regain control of how I thought and felt. Over the course of months of research, I finally came to the realisation that all of my various physical complaints - Hashmoto’s Thyroiditis, Fibromyalgia, Arthritis, gut complaints, insomnia, panic attacks and constant hypervigilance associated with CPTSD, oestrogen dominance, insomnia - were all related to inflammation.

Inflammation is a bit of a buzz word these days. It seems to be everywhere. But I feel as though, even though we hear so much about it, not many of us know what inflammation is, why our body creates it, or how we end up with poor health through chronic inflammation.

In this article, I’m going to take you through what inflammation is and why it’s actually good for us in small doses, why it can become chronic, what conditions it’s related to, how to know if you have chronic inflammation, and what I believe are the three most important things you can do to reduce and prevent chronic inflammation.

Let’s get started.

What is inflammation?

Inflammation is a normal part of immune system functioning. We actually need to be able to produce an inflammatory response when we are infected with a virus or get some kind of physical injury, like a cut or a wound. The inflammation in these instances acts as a signal to our body to channel resources to the problem area to stop the problem from spreading and to heal. This is called an acute inflammatory response, and can last for anything from a period of a few minutes to several days or weeks. This is what happens when our immune system is functioning normally.

We run into problems when our immune system is unable to resolve a real or perceived risk. Our inflammatory response then stays active for an extended period of time, in the process doing internal damage to tissues and organs or impairing their function in some way. At this point, we are subject to chronic inflammation, which becomes pathogenic, often creating more problems than the one the inflammatory response was originally activated to solve. Chronic inflammation is thought of as a product immune system dysfunction, meaning that the wires have gotten crossed somewhere and your body is acting inappropriately in response to your surroundings OR your immune system doesn’t actually have the capacity to resolve whatever it is acting in response to.

Causes of Inflammation

There are four main causes of inflammation:

  1. Diet imbalances or deficiencies.

  2. Environmental and dietary toxins.

  3. Mental and emotional stress.

  4. Physical stress.

Let’s have a quick look at each of these so that we can understand how they might contribute to chronic inflammation.

Diet imbalances and deficiencies can contribute to inflammation as they can lead to things like impaired energy production or detoxification pathways. For example, glutathione is the body’s main antioxidant that it uses to clear inflammation and remove potentially harmful molecules known as free radicals from the body. You can read more about free radicals and glutathione here.

Glutathione is made from the amino acids (proteins) cysteine, glutamate, and glycine. If we don’t have enough of each of these in our diet and in the right proportions, our ability to produce glutathione will be impaired, meaning that our ability to remove free radicals, which trigger our inflammatory response, will also be impaired.

Environmental and dietary toxins can come in all sorts of shapes and forms. These are substances which act at a molecular level to promote an inflammatory response. For example, glyphosate (the active ingredient in RoundupTM) has been shown to lead to gut dysbiosis in humans, probably because it disrupts a process known as the shikimate pathway in our gut microbiome. This in turn has been shown to lead to an inflammatory response that leads to disruption of the human endocrine system, leading to impairments in lung function and thyroid hormone activity. Likewise, chronic exposure to particulate air pollution can lead to chronic inflammation of the lungs and airways, priming us for allergies and asthma. I’m including pathogens in this category, such as viruses and bacteria that cause illness, because the body recognises them as a foreign body.

Mental and emotional stress gets a lot less airtime than toxins and diet in the context of chronic inflammation, yet I think that these days it’s one of the biggest contributors to chronic inflammation, given how prevalent mental illnesses are globally. For example, research has shown that post traumatic stress disorder (PTSD) leads to the activation of inflammatory processes in the brain. Concurrently, inflammatory processes that originate in the body are upregulated, leading to a self-reinforcing inflammatory feedback loop. This is one of the reasons why PTSD can be so difficult to overcome and often leads to comorbid conditions - the brain and body are working in tandem to keep the person suffering from it on high alert via the immune system’s inflammatory response.

Physical stress is also an often overlooked contributor to chronic inflammation. Any kind of exercise or physically demanding task will produce an inflammatory response of some sort. This is actually the mechanism by which we get fitter. An acute inflammatory response produced in the muscles that have been worked hard lets our body know that we need to repair tissue damage, as well as increase the tissues capacity to do similar strenuous work in the future, for example by producing more mitochondria so that we can produce more energy in that area. But with inflammation comes oxidative stress, which we need to be able to resolve with antioxidants (glutathione). If we continually exercise at a strenuous level and don’t give our body the time it needs to repair the damage that’s done each time, we may inadvertently cause chronic inflammation. This is why it’s important to have an appropriate amount of rest between high intensity workouts and to limit them to 2-3 times per week.

It’s important to note that, while I’ve just outlined each of these factors individually, real life doesn’t work like that. These factors are cumulative, meaning that they pile on top of each other. So if you’re feeling burnt out and stressed from work then go and try to push yourself hard with high intensity intervals five days per week, the effects on the immune system will combine to give you a heightened immune response, so more inflammation than you would get from either of them on their own.

This compound effect explains part of why some people fared worse from Covid-19 than others. Those who had chronic inflammation prior to contracting the virus tended to be amongst those with the worst symptoms. Because their bodies were already overloaded and on high alert for threats, they allocated more resources to handling the threat than they might have otherwise, producing a more acute response to Covid-19.

In some people, it also triggered a heightened immune response through what’s known as pro-inflammatory cell death, triggering an inflammatory cascade effect that results in what we now call Long Covid-19. In essence, Long Covid is an inflammatory condition with the potential to make pre-existing inflammatory conditions worse.

Chronic Inflammation and Chronic Disease

I’ve already hinted at a couple of conditions associated with chronic inflammation but there are many, many more. Too many to list here in fact. What I will tell you is this - inflammation is implicated in pretty much any chronic disease.

This means that conditions that range from heart disease, diabetes, and autoimmune disease right through to mental illness and neurodegenerative disorders are all linked to inflammation. Cancer is included in this list.

The tricky thing about inflammation and chronic disease is that it’s not a one-way street. Diseases caused by immune system dysfunction can also cause immune system dysfunction. Take Hashimoto’s Thyroiditis as an example. Hashimoto’s (which I had but am now in remission from) is an autoimmune disease involving impaired thyroid hormone production and/or conversion, affecting energy metabolism and producing a range of potentially devastating cascading effects. One of the things that happens in the manifestation of any autoimmune condition is that the body produces antibodies that mistakenly attack its own cells. In the case of Hashimoto’s, these antibodies attack the thyroid gland, which resides in our neck. Over time, these attacks in the thyroid can result in small nodules developing, which result in local inflammation and in some cases, may result in the development of cancer in the thyroid.

When I discovered that I had Hashimoto’s, I had an ultrasound done and discovered that my thyroid gland was dotted with micro nodules. Luckily for me, they weren’t cancerous at that point and I have since been able to heal them completely. At my last ultrasound, the technician was puzzled at what she was meant to be looking for. Not a trace of them remained.

This means that yes, it is possible to reverse autoimmune disease and many, many other chronic conditions. The trick is to isolate what’s causing your chronic inflammatory response and address that. Let’s take a look at how you might go about doing that.

Symptoms of Inflammation

There are a couple of pretty big indicators of chronic inflammation which you can use to gauge whether or not it’s worth you going down a diagnostic path to isolate what some contributing factors might be. If you have any of the following, you may want to investigate your inflammatory status further:

As you can see, this is a pretty exhaustive list. There are literally hundreds of ways that chronic inflammation can manifest. If you don’t have any of these conditions but still suspect that you have inflammation, there are some tests you can run to check if you have elevated levels inflammatory biomarkers which are associated with many of these conditions, which I will outline briefly below.

Testing for Inflammation

If you already know that you have any of the conditions outlined above, it may be worth checking your inflammatory biomarkers anyway, so that you can see how exactly inflammation is manifesting in your body and monitor your condition. Your doctor may already be doing this with you, but if not, consider asking to have the following tested. Alternatively, if you can’t find a doctor who will do this for you, you can get them tested independently directly through labs, but they won’t be included or Medicare if you choose to go along this path.

Here are some of the most common inflammatory biomarkers to test for;

  • C-reactive protein (CRP)

  • Serum amyloid A

  • Fibrinogen

  • Procalcitonin

  • Tumour Necrosis Factor Alpha (TNFα)

  • Interleukins 1β, 6, 8, 10 and 12

This isn’t a complete list; there are hundreds of inflammatory biomarkers, some of them disease-specific. These are more generic but may serve to give you an indication that something’s amiss and worth investigating further or taking action.

Strategies for Reducing Inflammation

The way that inflammation manifests for each of us individually is slightly different depending on our genetics, what’s already been happening in our bodies, and the environment around us. For example, we know that Alzheimer’s Disease is a genetic inflammatory condition. It often runs in families due to inherited genes, but just having the gene doesn’t necessarily mean that you will develop Alzheimer’s. The genes for it need to be switched on via inflammatory processes. If you do a great job of minimising your inflammation throughout your life, you may never actually develop Alzheimer’s or its manifestation may be less severe compared to someone else in your family who doesn’t manage their inflammation as effectively.

There’s an entire scientific field out there called epigenetics, which investigates how genes like the one for Alzheimers are switched on and off. There’s still a lot to learn but what I think is important to know is that every single gene we carry can be switched on and off. In theory, we could even change the colour of our eyes if we carry more than one gene for eye colour and can work out the specific signals needed to turn the dominant one off and the less dominant one on. Sounds crazy, right? But this is how I knew, when I was diagnosed with Hashimoto’s, which is also considered a genetic condition, that I could reverse it by targeting inflammation.

Given the complexities of inflammation, I think it would be misleading to say that there’s one best strategy to reduce it. If you have a severe inflammatory condition, I would suggest that it’s more likely you will need to do several things to address it. What they are will depend on what exactly is causing it in your environment, your genes, and the resources that you have available to assess and address it. But, if I had to pick three broad strategies as a starting point, they would be the ones that I’ve outlined below.

Increase Vagus Nerve Activity

I think it’s no secret that I’m a massive fan of the Vagus nerve. I’m going to do a more detailed post on the Vagus nerve later (so keep your eyes peeled) but here’s a brief explanation of it and what you can introduce to increase its activity.

The Vagus nerve is the largest nerve in our body, running from the base of our skull, down the spine, with direct connections to all of our major organs and indirect connections to literally every part of our body. It forms a part of our autonomic nervous system, which is responsible for regulating all of the things that we do automatically, like breathing, our heart’s beating, and digestion. It also acts as a messenger, relaying information from the brain to the body and vice versa.

There are three main branches of the autonomic nervous system: the enteric nervous system, the sympathetic nervous system, and the parasympathetic nervous system. The enteric nervous system is increasingly being seen as a therapeutic target because of its role in the regulation of the gut-brain axis. The sympathetic nervous system is responsible for priming your body for physical activity. For instance, if left unchecked, it would have your heart beating at a constant rate of around 120 beats per minute, even when you’re not working out. The parasympathetic nervous system acts like a brake on the sympathetic nervous system, keeping us from running constant overdrive. This is why our normal heart rate is around 60 beats per minute rather than 120 - it’s the combined effect of the two systems working together.

The sympathetic nervous system also plays a role in promoting our immune response. This is why you may notice that you have an elevated heart rate when you’re sick, because your sympathetic nervous system is slightly more active. It’s working hard to make sure that all the right nutrients are being pumped via your blood to the site of infection, up regulating immune system activity. This is great when we are genuinely sick. But when, as in the case of autoimmune disease or mental illness, we want to down-regulate our immune response, it can be useful to put the brakes on the sympathetic nervous system via increasing parasympathetic activity. We can do this by directly targeting the Vagus nerve, which plays a major role in regulating parasympathetic nervous system activity.

There are many, many ways to do this. You’ve probably heard of some of them: cold showers, strength training, meditation, yoga, diet, high intensity interval training… the list goes on. But perhaps the most powerful way to train your Vagus nerve which doesn’t get a lot of airtime is feeling LOVE. When we feel love, our Vagus is at its most powerful because it signals our heart and brain to release oxytocin, giving the signal that we are safe and that threats are absent. Spending time thinking about or being with loved ones will do wonders for your immune function. This goes for pets as well as humans, and can even extend to special places. I also teach the Heartmath Quick Coherence technique in my Vagus nerve workshops, which is something you can use to quickly and effectively increase Vagus activity using the power of love in combination with visualisation and breathing techniques.

Increase Your Glutathione Status

As I mentioned earlier, glutathione is the main antioxidant used in the body to remove pro-inflammatory molecules, known as reactive oxygen species (ROS). Our body actually produces ROS, for instance in response to infection as a way of killing off bacteria. But if our glutathione status is low, then it’s unable to clear the ROS once they’ve done their job, resulting in lasting inflammation. Or, if we persistently have so many ROS entering our body via air pollution or in our diet that our glutathione simply can’t keep up, then we will again end up with lasting inflammation which becomes chronic.

There are two main ways to increase your glutathione status: increase production of it and reduce the amount of oxidative stressors that enter your body.

In my case, when I got really sick with Hashimoto’s Thyroiditis, I didn’t have a huge amount of ROS entering my body. I did live in the city, so was probably subject to air pollution but other than that, I wasn’t breathing in or ingesting a lot of toxins as I rarely used chemicals to clean and ate mostly organic unprocessed foods. Nor was I getting infections a lot. I actually hadn’t been sick from so much as a cold in years. What was probably happening for me in the context of glutathione was that I was producing a lot of ROS internally via my stress response due to increased production of glucocorticoids like cortisol and norepinephrine. At the same time, the amount of glutathione that I was producing was likely insufficient to meet my needs because I wasn’t eating enough of the proteins that glutathione is composed of. I also think that I made things worse by going on a ketogenic diet, which can produce a stress response in some people and negatively impact thyroid hormone production. Low insulin has also been implicated in reduced glutathione production, as insulin can act as a signal to the body that it’s safe to funnel resources into glutathione production.

What has helped me a lot in my recovery has been increasing my protein intake and particularly focusing on getting a more complete range of proteins. You can do this through nose-to-tail eating (if you eat meat) and through including a wide range of plant foods high in protein in your diet. If you don’t eat meat, it may also be worth considering supplementing with marine collagen to get enough glycine in your diet. If you use a lot of chemicals for cleaning, it’s worth considering a swap to more natural cleaning products or even just using hot water to clean surfaces and dishes. You might also want to think abut swapping out synthetic self-care products for more natural, low-to alternatives.

Take a look at the post here for more details on how to improve your glutathione status.

HIIT Training

We all know that exercise is good for us but when faced with chronic inflammation, we need to be very careful to engage in the right type of physical activity. Gentler exercises like pilates and yoga have been shown to be very beneficial for inflammation, but if you’re like me and like to get your sweat on, high intensity interval training (HIIT) can be incredibly beneficial.

Beware there, because there’s HIIT and then there’s high intensity continuous training (HICT), which often poses as HIIT but actually isn’t. It’s slightly less strenuous (designed to have you working at 70-75% of your maximum effort compared to 80-85%) but more constant. This can result in greater sympathetic activation and lead to cortisol production. Conversely HIIT is performed for a shorter duration and has significant rest periods in between efforts. The intervals (periods of effort) should be short enough that they don’t result in cortisol production and the rest periods train your body to go back to a healthy baseline in between intervals. The more strenuous efforts will also train your body to adapt to periods of stress so that you can return to a healthier baseline more quickly. Aside from being a very quick and effective way of increasing your aerobic capacity, HIIT has been shown in mice to modulate the immune system, decreasing inflammation and autoimmune activity more than HICT and not doing any exercise at all.

The protocol followed by the mice was as follows.

3 sessions per week of 5-7 intervals. Each intervals lasted for 1 minute, with a two minute rest period between each interval.

That’s it. That means that each training session lasted for between 15 and 21 minutes, three times per week. There’s no need to do more HIIT than that. In fact, doing more can be deleterious to immune function as it can lead to cortisol production. Mark Sisson has a fabulous, research-backed video on how to do HIIT here if you want to learn more about how to set up and execute your own HIIT workouts. I do my HIIT workout running, but you can use any aerobic activity as the basis for your HIIT workout, just keep the principles of a low number of reps with a short effort and adequate rest time constant across modality. Bike riding, rowing, burpees - these all work in the same way.

Of course, if you have a heart condition or any other condition that you believe HIIT may negatively impact your health, please check with your doctor first. For the rest of us, get your sneakers on and get out there!

In Conclusion

If you’ve read this far through this post, thank you. I hope it’s been, at the very least, informative. Beyond that, I hope it’s been helpful and piqued your interest in how you might be able to apply some of these strategies in your life to reduce inflammation or perhaps investigate some other that you might want to experiment with to improve your wellbeing and quality of life. If you have questions or comments, please let me know in the comments section below.

Lou

Lou Chalmer
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