Taming Chronic Inflammation Should Be Your #1 Health Goal. Here's Why.
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I lay on the exam table, trying not to look as my doctor inserted a long needle into my warm, softball-sized left knee. When he was finished injecting the steroid medication and aspirating the knee joint, he held up the syringe to show me all the yellow-orange synovial fluid he’d collected. I admit it made me a bit queasy. But I was also a little hopeful—maybe the inflammation and pain would stay away for a while?
This same procedure was repeated every three or four months during a period in my twenties when my rheumatoid arthritis (RA) was not well-controlled. Not only did the RA wreak havoc on my left knee, the autoimmune disease was also causing inflammation and pain in my hands, wrists, feet, and elbows. The persistent inflammation resulted in permanent joint damage, which led to three surgeries in five years.
During bad flare-ups, body aches and fever made it feel like I had the flu on top of all the joint pain. And then there was the severe fatigue and depressed mood, symptoms that I had never experienced before RA and chronic inflammation entered my life.
All of this made it very clear to me that out-of-control inflammation was seriously bad news.
Years later, when I went back to school for my master’s in nutrition, I studied the role inflammation plays in so many other chronic diseases—from heart disease and type 2 diabetes, to cancer and depression. You might say that I came to see chronic inflammation as the root of all evil. Well, maybe not quite.
But more and more evidence is piling up that chronic inflammation is at the root of most chronic illness. And now it seems that it may also have something to do with why some people are more vulnerable than others to severe illness from COVID-19.
In this post I’ll take a look at the connection between chronic inflammation and chronic disease, the impact of inflammation on our mood, and the urgency of addressing chronic inflammation during the pandemic. If you have a chronic health condition of some kind, chances are good that chronic inflammation is playing a role in it. So let’s get started!
Acute vs. Chronic Inflammation
First, it’s important to note: not all inflammation is bad! Acute inflammation, which is what happens when we get a cut or twist an ankle, is a beneficial process: the body’s immune system sends inflammatory cells to the site of injury or infection, and these cells carry out the functions necessary for healing. Acute inflammation doesn’t last that long, so any collateral damage to healthy tissues is minimal.
In chronic systemic inflammation, one or more factors can cause an immune response that persists for a prolonged period of time. Because the inflammatory cells stay around for too long, they cause ongoing damage to the body’s own tissues and organs, which can then also trigger further inflammation. If you think this sounds like a recipe for poor health, you’re right.
Inflammation and Chronic Disease
Chronic systemic inflammation is thought to play a role in most common chronic health conditions, including:
type 2 diabetes
high blood pressure
cardiovascular disease
non-alcoholic fatty liver disease
chronic kidney disease
cancer
autoimmune disease
neurodegenerative disease
depression
osteoporosis.[1]
That’s a pretty comprehensive list of the diseases causing the most suffering and death in the industrialized world!
The link between chronic inflammation and chronic diseases is supported by this simple fact: people with autoimmune diseases that involve systemic inflammation are more likely to also have type 2 diabetes, cardiovascular disease, and metabolic syndrome. And the more severe the inflammation is, the higher the risk is of developing one of these chronic diseases.[2]
Even more telling is the research showing that drugs known as biologics that reduce systemic inflammation also have two additional benefits: (1) they improve insulin sensitivity—which decreases the risk of type 2 diabetes, and (2) they lower rates of heart attacks and strokes.[1]
Finally, higher levels of inflammatory biomarkers in the blood—which indicate higher levels of systemic inflammation—have been shown to be predictive, not only of death from heart disease and stroke, but also of death from cancer, and of death from any cause![3] Let that sink in for a moment.
Maybe now you’re the one seeing chronic inflammation as the root of all evil?
Inflammation and Your Mood
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People living with a chronic illness—who, as we know, are likely to have chronic inflammation—are more likely to suffer from depression.[4] Could inflammation be to blame for this increased risk?
As I alluded to above, the times in my life when I’ve experienced depressive symptoms were the times when my RA was not well-controlled and my levels of inflammation were high. So it has always made a lot of sense to me that inflammation contributes to depression.
It turns out there’s scientific support for this link. Tryptophan, an amino acid that is needed to produce serotonin—one of the “feel good” chemicals in the body—is broken down at a higher rate when the immune system is activated and inflammation is high. Less tryptophan available means less serotonin, which contributes to lower moods.[5]
The relationship between inflammation and depression is complex, but there’s substantial evidence that inflammation can lead to symptoms of depression.[4] And eating an anti-inflammatory diet is associated with a lower risk of depression.[6] All good reasons to make taming inflammation a top priority for protecting and improving our mental health.
Chronic Inflammation & COVID-19
So far we’ve been focusing on the link between inflammation and non-communicable chronic diseases. COVID-19, caused by the SARS-CoV-2 virus, is an acute and highly contagious communicable disease. So what does COVID-19 have to do with inflammation?
In a study in the New York City area, the three most common conditions seen in patients hospitalized with COVID-19 were high blood pressure, obesity, and diabetes.[7] We also know that the risk of serious illness from COVID-19 increases with age. What do these conditions, as well as advancing age, have in common? You guessed it: they’re all associated with chronic systemic inflammation.[1]
Photo by Graham Ruttan on Unsplash
The potential link between COVID-19’s worst outcomes and chronic inflammation was explained this way by Dr. Mark Hyman and Dr. Dariush Mozaffarian in The Boston Globe:
When COVID-19 lands in a pre-inflamed person, it is like putting gasoline on a fire. The inflammatory explosion, known as the “cytokine storm” (when the body attacks its own tissues and cells) is a major driver of the need for hospitalization, admission to ICUs, ventilator use, and death. It is not the virus itself that kills us, but the overwhelming inflammation that results from an immune system already on high alert.[8]
In addition, obesity and metabolic syndrome—both of which cause inflammation—are associated with a weakened immune response, further increasing the risk of severe illness from COVID-19 for people who are metabolically unhealthy.[8] It’s still just a hypothesis at this point, but the potential role of chronic inflammation in the development of severe illness from COVID-19 is beginning to be explored.[9]
It’s crucial that we all do our best to avoid getting infected (or infecting others) with the novel coronavirus by social distancing, wearing a mask in public, and washing our hands. But perhaps our efforts to protect against COVID-19 should also include steps to reduce any underlying chronic inflammation. That way, if we do become infected, we have the best possible chance of avoiding the disease’s worst consequences.
Bottom Line
Chronic inflammation is something most of us with a chronic illness have in common. When it’s not well controlled, it leaves us vulnerable to additional chronic disease, depression, and the potential for suffering the worst consequences of COVID-19.
The good news is that we can minimize chronic inflammation through diet and lifestyle changes, and thereby dramatically increase our chances of living longer, healthier, and happier lives.
Are you ready to start taming your inflammation? If you’re ready to make changes in your diet and/or lifestyle to maximize your health and happiness, I’d love to help! Learn more about how integrative health coaching can help you achieve your health goals, and set up a free 15 minute consultation with me to get started!
Written by Linda Oechsle, MS, CDN, NBC-HWC