What Causes Inflammation And How Can You Treat It?

Mark Hyman, MD

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Narrator: Coming up on this episode of The Doctor's Pharmacy. Dr. Mark Hyman: Inflammation isn't just there randomly, it's there because there's something causing it. So what are the causes and drivers of inflammation? Well, basically, number one, two, and three is diet. And guess what? The number one, two and three in diet thing is sugar, sugar, sugar. Hi everyone, it's Dr. Mark Hyman. Welcome to The Doctor's Pharmacy, a place for conversations that matter. And today I'm bringing you a new feature of the doctor's pharmacy called Health Bites, little nuggets of health information to improve your health by taking small steps daily to lead to significant changes over time. And today we're talking about one of my favorite subjects, inflammation and how it's linked to everything from obesity to all the chronic disease of aging. And I'm going to share with you the key to solving and unlocking good health through dealing with inflammation. All right, so what is inflammation? What's the big deal? Why has it become so dangerous? Well, inflammation is a natural part of your body's function. It's essential. Yes, you cut yourself. What happens? The white blood cells gather, they come to the site to rescue, they create swelling, they bring all kinds of healing factors and what you see is redness and swelling and pain and heat. That is the classic sign of inflammation in the body. We used to call that in medical school rubor, dolor, calor and tumor. Tumor just means swelling, not tumor. It's anyway Latin, whatever. But the key is that it's this normal process that happens as a result of dealing with problems that go wrong. But here's the rump. In the past, most of what we had to deal with was acute things that caused inflammation like a cut or an infection. But today, our modern lifestyle is driving so much hidden inflammation, systemic chronic inflammation, silent inflammation, it's a silent killer, and it turns out that it's not the kind of inflammation that we are familiar with, like a sprained ankle or a sore throat or something that's an obvious kind of inflammation, the kind that's good. The kind that's we're talking about is the kind that's bad and that leads to almost every known disease of aging, heart disease, cancer, diabetes, Alzheimer's, not to mention things like ADD, depression, obviously autoimmune disease, obviously allergies, asthma, all sorts of gut issues. All these problems are caused by inflammation. Of course, then the question is what causes inflammation? We're going to get to that. From a functional medicine perspective, I don't care that you're inflamed, I care about why you're inflamed. I don't want to give you an immune suppressant, an antiinflammatory drug, a pile of aspirin, I want to find out what the cause is and get rid of it. In functional medicine, there's a simple rule and it's this, it's called the tack rule. If you're standing on a tack, it takes a lot of aspirin to make it feel better. Take out the tack. And if you're standing on two tacks, taking one out doesn't make you 50% better, so get rid of both of them and all of them, maybe there's five or ten tacks. And that's the secret of functional medicine. It's a method of investigating the body as a system looking for root causes and getting the body back in balance. All right, so what is the deal with this inflammation? I mean, I think when I was in medical school, heart disease was a plumbing problem. It was clogged arteries. We now know that it's in inflammation problem, that the reason your cholesterol becomes an issue is because it gets inflamed and white blood cells sop up the cholesterol and stick it in the arteries causing plaque. Same thing happens in the brain. Alzheimer's is inflammation in the brain. All those plaques in the brain come from inflammation. So cancer also is a disease of inflammation and when you, for example, look at various studies, even with cholesterol, if your inflammation level's high, but your cholesterol is also high, you're at high risk. But if your cholesterol's normal and your inflammation's normal, you're no risk. But if your cholesterol's high and your inflammation's not high, you're really a not great risk. And the worst is if you have obviously both. So inflammation's a real big issue. They did a study of an elderly population. They found that if their CRP was high, which was a blood test for inflammation and interleukin six and other cytokine tests for inflammation, they had a 260% more likely chance of dying in the next four years. So this is no joke. So you might feel fine. I had a patient say to me, "I don't know what's wrong, I feel fine. Well I saw my blood tests, I don't really care. I feel fine. Why should I change what I'm doing?" I'm like, "Well, if you don't change what you're doing, it might not go well for you." Now there's no guarantees that's true, but it's likely true. So the real concern isn't our response to an injury or an acute infection or something like that, but this chronic smoldering inflammation that solely destroys our organs and our ability to function and leads to rapid aging.In fact, I just finished my book on aging called Young Forever and they talk about the hallmarks of aging. One of the key hallmarks is inflammation, or they call it aging itself inflammaging. And what happens with aging is there's this runaway inflammation that just degrades your whole body. So understanding what inflammation is, how to diagnose it and how to deal with it and get rid of it is so essential if you want to be healthy. Now what's the problem with the treatments we use? Why not just take Advil or aspirin or take a steroid like prednisone? Well, they're fine for acute problems, but when things are in this slow smoldering state, they really don't work. In fact, the new data on aspirin was pretty scary about heart disease, "Oh, it's going to help you and stabilize your blood and blah blah blah and prevent clotting," but it turns out that the recommendations for aspirin were over-enthusiastic and that there are certain patients who should be on aspirin, but very few compared to the universal statement that everybody should take an aspirin to prevent heart disease. No, because it causes strokes and it causes bleeding, which is not good, like GI bleeding. So if you look at those drugs like aspirin or Advil or Aleve, they're not benign. I mean they're really helpful when you need them, but they can cause terrible gut issues. I had gastritis, for example, after taking them for broken arm and many, many people die. In fact, as many people die from taking those drugs as from asthma or leukemia. So imagine if we literally eliminated those drugs, we'd be basically be essentially... It'd be the equivalent of curing leukemia or asthma. So it's not a joke. So statins for example, even cholesterol drugs like statins, like Lipitor, they may not have their main effect by lowering cholesterol. In fact, it may be because they actually lower inflammation. That's what they do. It's a "side effect" of the statin, but actually may be their main effect. So how do you know if you have inflammation? Is there a way to test for it? Is there a blood test? Well, there are and there are more and more coming. So the most common one that people do is called C-reactive protein, it's high sensitivity C-reactive protein and it's something your doctor can order. It's on any lab panel you can get. Now if it's super high, it could be infection, but if it's in the sort of one to 10 range, that's usually the hidden inflammation. Ideally it should be less than one, any higher than that means you're on your way. Now there are other blood tests you can check, cytokine, Sed rate and so forth, may not be as helpful. But there's a new test developed by a professor at Stanford called iAge, I-A-G-E, meaning immune age. And it really looks at your immuno, which are 50 different cytokines, many of which you've never heard of, they're molecules that are regulating immunity and inflammation, that he was able to correlate by using artificial intelligence with disease. So he found really there were about four that highly correlated with your risk of heart attack, cancer, diabetes, Alzheimer's and so forth. What's so amazing is this test is really not that expensive, it's easy to get and you can track it over time. And then the good news is you can change things and change your inflammation. Inflammation isn't just there randomly, it's there because there's something causing it. So what are the causes and drivers of inflammation? Well, basically number one, two, and three is diet. And guess what? The number one, two, and three in diet thing is sugar, sugar, sugar, or the equivalent of sugar starch, starch, starch. So anything that's sugar and starch drives inflammation, particularly high fructose corn syrup. So, that should not be a staple in your diet, and unfortunately it is, it's about 60% of our calories in America. Soda is the number one source of calories in America, which is terrifying to me, and the average American eats 152 pounds of sugar and 133 pounds of flour every year. That's enough to kill most of us pretty quickly, and it does, which is why we see we're the sickest population in the world and so many people die from diet related diseases. So it's in sugar, it's in high fructose corn syrup, it's in processed flours and foods. Also inflammatory fats may be a factor, so lots of refined oils, [inaudible 00:09:24] , trans fat, which have been ruled not safe to eat by the government, but they're still everywhere in food. I don't know how that works to be honest with you, I guess there's little loopholes that the food industry gets to give them maybe years or decades. But this was 2005, seven years ago they said, "Hey guys, trans fat kills you. Not safe to eat, don't use it." But if you go to the grocery store, you can find it everywhere, which is terrifying. I mean, more and more companies are removing it, but it's still there. Also, what else can cause low grade inflammation? Sitting on your butt, not exercising. Exercise is a powerful anti-inflammatory. Not over-exercising, not running a marathon, but doing a modern amount of exercise every day really helps to lower inflammation. Stress, another big cause of inflammation. So nothing we can do about stress, it's out there, bad things happen, reading the news... I try to stay away from the news by the way. It's so stressful. I figure if something really bad's happening, I'll hear about it. But the key is to find habits and behaviors that reduce your stress response, meditation, yoga, hot and cold therapies, massage, breath work, whatever works for you, try it. But it's got to be a daily practice. I do it every day. Today I worked out, I did a sauna and a ice bath and that really helped me calm my nervous system. Also deal with toxins. Toxins are also inflammatory. They're called immuno toxins, low levels of pesticides, chemicals, petrochemicals, heavy metals. I encourage you to go to the Environmental Working Group's website, EWG, and find out how to reduce your exposure through food, including fruits and vegetables, animal products, fish, household cleaning products and even skincare products. I mean, did you know that lead is in a lot of lipsticks? That a lot of skincare products have petrochemicals that get absorbed through your skin and get in your body and cause harm? Yeah, don't be doing that. So also another source sometimes is latent infections we might not know we have it, like a virus or tick infection or mold we're exposed to. So those all can drive inflammation. And of course our microbiome is probably one of the biggest sources of inflammation in us. We all have an imbalanced microbiome, mostly from our poor diet, lack of fiber, processed food. So we want to cultivate our inner garden. I've written a lot about this. We've created a new product called gut food that helps people actually heal their gut and it's like a multivitamin for the gut. So I encourage you to check it out gutfood.com. So really tending your inner garden is so important because there's actually a phenomena called metabolic endotoxemia. This is a phenomena that is resulting from bad bugs that produce these toxic compounds called endotoxins that get absorbed through your gut lining into your bloodstream and then activate your immune system, like for example, these lipopolysaccharieds, which are these little endotoxins, and then your immune system gets activated, triggers inflammation and there's all the downstream consequences of that. For example, high levels of TNF alpha, one of the inflammatory molecules, it triggers insulin resistance. So literally, not even by changing your diet, you can become pre-diabetic just by the toxic bacteria in your gut. That's why they call it metabolic endotoxemia. Anyway, enough with that. So the reason we really don't track this is because doctors just kind of are not thinking about the root causes of disease. They're like, "Okay, what's your symptom? What are you suffering from? Okay, let me find the drug that best matches that. If you have a strep throat and I can give you a penicillin grade, I'll get a cure. But most of them, I'm just managing symptoms or I'm giving you an immune suppressant." And that's not the answer unfortunately. Okay, so let's say you've identified the causes, you've figured out you have inflammation, how do you live an anti-inflammatory lifestyle? It's the same old stuff, I hate to say it, but it's eat real food, lots of phytochemicals, all those colorful plant compounds are anti-inflammatory. All the phytochemicals in food are so powerful for reducing inflammation. Also, just real whole unrefined, unprocessed foods. Not lots of sugar and starch, no trans fats, no refined oils and get lots of those phytonutrients. Good fats are really important too. Avocados, olive oil, extra virgin olive oil, ideally omega-3 fats, things like sardines, herring, sable, wild salmon, they're all really rich in omega-3 fats and they're very healthy for you. Exercise. Lots of research on exercise can reduce inflammation. It helps supports your immune system, it strengthens your heart, it corrects insulin resistance and improves your mood, it helps reduce stress. I mean, it's one of those miracle therapies that can really do so much for you at so many levels. Practice active relaxation, which sounds like a contradiction or an oxymoron, but no, you have to actively relax. It's not... I don't mean sitting, watching TV, drinking a beer. I mean meditating, doing yoga, deep breathing, getting a massage, doing something where your body just kind of hits down into the parasympathetic state and calms your nervous system. Hot bath, I love that. Last night I was a little... had a very busy day, lots going on and I just took a hot bath with Epsom salt, and I just kind of floated away. It was great. Also, food sensitivities are another big factor. You might not know this, but a lot of hidden inflammation can come from, not allergies, but food sensitivities. Things like gluten, dairy and certain things that people react to that they may not know they react to. So I often recommend an elimination diet, like the 10 day detox diet that I've created, to help people reduce their overall level of inflammation and then you can add back foods and see what's really the problem. So maybe you eliminate a lot of things and then you just add back one at a time. And for example, dairy I know causes inflammation. If I have dairy, I get pimples, my skin's weird, I get congestion, so I don't need dairy, although I do manage to tolerate goat and sheep okay. Healing your gut, doing a gut repair program. That's why we created gut food that's so important and I think many people would benefit from actually a focused gut repair program because a lot of their imbalance bacteria are causing inflammation. And lastly, take the right supplements. A multivitamin, fish oil, vitamin D, all help drop inflammation. So that's really it for today's Health Bite on inflammation. It's a lot of information, a lot of information on inflammation, so I hope you enjoyed it. That's it for today. If you want to share with your friends and family, please do. We'd love to you have them here for you and we'll see you next time on The Doctor's Pharmacy. Narrator: Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health. x