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Inflammation 101

Page Two of a Three-Part Article.

The first thing I learned from Dr. West is that inflammation is the body's initial response to all tissue damage. In other words, any time you damage a cell in any way, an inflammatory process is initiated. There are two basic types of tissue damage: mechanical damage and chemical damage.

Inflamed Shoulder.jpegChemical damage comes from toxins and toxins derive from three main sources. First, there are poisons which can be introduced into the body. These could be plant toxins (poison ivy, death cap mushrooms, etc.) or animal venoms (bee stings, spider bites, etc.) or chemicals (heavy metals, gasoline, solvents, etc.). Second, there are metabolic toxins (waste products of our own metabolism. And third, there are metabolic toxins released by microorganisms and parasites (such as yeast, bacteria, intestinal worms, etc.).

However, no matter what the source of the toxin is, the response of the body is always the same. So, while the body can be traumatized and injured in many different ways, the manner in which the body responds is consistent. This is what makes the simple techniques of natural healing so effective.

When cells are damaged, their membranes rupture. This allows chemicals which were inside the cell to be released into the surrounding fluids. Among these chemicals are histamine, bradykinin and serotonin. These chemicals initiate the inflammatory process, by dilating the pores in the nearby blood capillaries. This allows the plasma proteins (albumin, globulin and fibrinogen) to move out of the blood stream and into the tissue spaces in large quantities. Since these proteins hold onto water in the blood stream (maintaining osmotic pressure), they carry this water with them into the tissue spaces. This causes the first characteristic of inflammation: swelling or localized edema.

This slows down the microcirculation at the site of injury. Normally, the fluid between the cells is moving very rapidly (changing 80 times per second according to Dr. Guyton). Now, the fluid pools around the cells creating a localized stagnation. This is one of the body's protective mechanisms.  If the damage is due to some toxin, this slows the movement of the toxin so it can't spread rapidly through the body. If the protective layers of skin or membranes have been damaged, it also prevents microbes that may have entered through these breaches from moving rapidly through the system.

However, in spite of the protective nature of this pooling of fluid, it also creates two negative effects. One is that the oxygen and nutrient supply to the cells is diminished. The other is that wastes are not removed efficiently. Thus, cells suffer oxygen and nutrient deprivation and the localized environment becomes increasingly toxic, the longer the fluid remains in place.

Dr. West believed that the other classic symptoms of inflammation—pain, heat and redness—are caused by this accumulation of fluid. He believed that the lack of oxygen causes the pain and that the heat and redness are caused by a shutting down of the sodium potassium pump which creates electrical energy for the cell. He felt that the electrical energy was being converted to mechanical energy. I was never convinced that his explanation was correct, so I've never taught it.

In all fairness to Dr. West, however, the only chemicals he knew to be involved in the inflammatory process were histamine and bradykinin. I have the advantage of 20 additional years of research to aid my understanding.

My New Insights on Inflammation

For instance, when I first learned about free radicals and oxidative stress, I thought, now there's a more reasonable explanation for the “heat” part of inflammation. There must be a lot of free radical activity at the inflammatory site. Now, I know that white blood cells are drawn to inflammatory sites where they release oxygen radicals to destroy microorganisms and “burn up” cellular debris. So, this definitely helps account for the heat at the inflammatory site.

More recently, I've been learning about the chemical messengers cells use to “talk” to each other. These chemicals are very basic types of hormones—autocrine hormones—and are collectively known as eicosonoids. They include prostaglandins, leukotrienes, cytokines, lipoxins and resolvins. Currently, there's a lot of research being done on these chemical messengers and their role in inflammation. These messengers help create the other classic symptoms of inflammation.

Forgive my cynicism, but I believe that the reason the researchers are focused on these chemical messengers is because they are trying to develop new designer drugs to manipulate them. The COX-2 inhibitors (viox and celebrex) were drugs developed from studying how to manipulate these chemical messengers to relieve pain. My attitude is that we're overlooking some very obvious and simple answers here because they're too easy and don't lead to patented chemicals (drugs) that make pharmaceutical companies rich.

In order to understand what some of those obvious and simple answers are, we first need to delve a little deeper into our understanding of what is happening. So far, the book that has been the most helpful in developing my understanding of the chemicals mediating the inflammatory process has been The Anti-Inflammation Zone by Barry Sears. He talks about four phases of inflammation. So, let me explain each of these phases of inflammation, what is happening, and how we can help the body in each phase.

Initial Phase of Inflammation

We've already introduced the first stage of inflammation by explaining that tissue damage causes cell membranes to rupture. This results in the release of histamine, which is followed by a release of bradykinin, serotonin and other chemical messengers. These messenger chemicals dilate the capillary pores allowing fluid and protein to rush into the damaged tissues creating swelling, which initiates the inflammatory process.

Wrist Inflammation.jpgAt this stage, inflammation is actually quite easy to reverse. If one can keep the fluid moving out of the tissues and into the lymphatic system, then the cells never suffer oxygen and nutrient deprivation or a localized build up of toxins. This allows repair to take place very rapidly. All one has to do is keep the lymphatics moving, which can be done by applying pressure to the injury, lightly rubbing or massaging the injured area or even applying energy to the area of injury.

This technique works extremely well for smashed fingers, bumps, abrasions, burns and other minor injuries. I can't begin to count the number of times I've been able to take the pain out of minor injuries like these (either on myself or others). The process generally takes 5-20 minutes. (One of the things I learned from Dr. West and have subsequently verified to be true is that the maximum time it takes to reverse these minor injuries is 20 minutes.) As long as you keep the fluid from building up in the tissues, the pain will go away and the damage will be reversed within that period of time.

Of course, you can't use these techniques for chemical injuries like a bee sting or spider bite. That's because keeping the lymph moving would spread the toxin more rapidly through the system, something we don't want to do. So, you have to do something that will neutralize the toxin first, like applying an herbal poultice.

Second Phase of Inflammation

In the second phase of inflammation, eicosonoids (leukotrienes) are released to further dilate the blood vessels. This allows white blood cells to exit the blood stream and enter the damaged area. The white blood cells can get rid of toxins and debris from damaged cells. This also causes further swelling.

Histamine and leukotrienes also cause bronchial constriction and increase the production of mucus on mucous membranes. This helps flush irritants from the respiratory tissues (which is what happens in a cold). There are also eicosonoids that sensitize pain receptors in the nerves, to increase pain signals to the brain.

One point that I learned from Dr. West that seems to be missing from the literature on inflammation (so I can't substantiate it from the research, only from personal experience) is the issue of the proteins clotting in the tissue spaces. I believe this happens during the second phase of inflammation, and here's my take on it:

It appears that active cells produce tiny electrical fields and that these fields keep the proteins in suspension so they don't clump together. With the fluid accumulation in the tissue spaces causing reduced oxygen and nutrient supply, the electrical fields diminish, and this is what causes the proteins to clump together or clot. Once they clump together, they won't move into the lymphatics and the fluid remains stuck in the tissues. I believe that this problem creates the second phase of disease, the subacute or stagnant phase, where a chronic congestion develops in the localized tissue and lymphatics.

The reason I know that there is an electrical connection between the proteins and the fluids is because of my experiences in noting how electromagnetic fields affect injured tissues. The application of energy alone (either in the form of “hands on” healing, electrical stimulation from actual electrical devices or magnets, or high energy remedies such as essential oils) consistently breaks up this localized stagnation and moves the stuck fluid and protein into the lymphatic system to be drained away.

The fact that I've seen applications of energy alone take down the localized edema is enough to convince me that this second phase of inflammation is characterized by a loss of energy production in the cells and a further stagnating of fluids. However, as I've already stated, none of the literature I've read on inflammation talks about this.

Third Phase of Inflammation

In the third phase of inflammation, more eicosonoids (cytokines) signal white blood cells (macrophages and neutrophils) to enter the area for further clean-up. These cells use oxygen radicals to destroy microbes and cellular debris. This is where the oxidative stress of inflammation comes in. Healthy cells have antioxidants to protect themselves from oxidative stress. If the cells are deficient in antioxidants, then the oxidative process taking place at the site of inflammation can damage more cells.

It's like a forest fire which starts because there's a lot of dead, dry wood in the forest. When the fire gets going, and it's hot enough, even green trees will burn. Antioxidants make cells that are like well-watered trees. They're hard to burn. This contains the inflammation and keeps it from spreading.

Fourth Phase of Inflammation

This is the final or healing phase in the normal inflammatory process. The cleaning crews (white blood cells) have been busy “burning up” debris and clearing the area. Now, cortisol from the adrenal glands is secreted. This shuts down the production of eicosonoids and halts the inflammatory process. It's like hosing down the entire area to put out the fires and prepare for reconstruction. Macrophages clean up the remaining debris, while a new group of eicosonoids (lipoxins and resolvins) signal cells that it's time to begin the process of rebuilding.

There are several obvious things that inhibit the healing phase. One is exhausted adrenals. This is something I see in autoimmune disorders. I've never seen anyone with an autoimmune disorder who doesn't have exhausted adrenals. I've also never seen anyone who has an autoimmune disorder who wasn't low in antioxidants.

Therefore, my personal theory about autoimmune disorders is that they aren't caused by the immune system turning on the body. I think they are caused by some kind of toxicity which has created a chronic inflammation in part of the body. Like the forest fire, the inflammatory process is running out of control because the adrenals aren't strong enough to produce enough cortisol to keep the fire in check, and healthy cells are being damaged by the lack of antioxidants.

Another reason why the healing phase isn't initiating in chronic inflammation is because it takes omega-3 essential fatty acids to create the eicosonoids needed to signal the repair and rebuilding phase. Because just about everyone in our society is getting too many omega-6 essential fatty acids and not enough omega-3 essential fatty acids, the body is unable to initiate the healing phase. High levels of insulin also interfere with the production of the eicosonoids that keep inflammation in check and promote healing, so our high carb diets are also contributing to the problem.

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