Chronic inflammation is now recognised as a significant factor in the onset of common diseases such as obesity, cancer, heart disease and depression. It’s even been implicated in degenerative conditions such as Alzheimer’s and Parkinson’s disease. Our goal in optimising the health of all that cross our path (that includes you reading this article) is to reduce even low levels of inflammation and in doing so, significantly reduce your risk for many of today’s biggest killers.
In clinic we draw on a range of tests to most accurately identify level of risk for inflammatory related conditions, but without those on hand there are also signs of underlying inflammation that you can look to. In this article we’ll cover it all. For background please refer to our recent article ‘What the Heck is Inflammation?’
What are the top 8 Signs of Inflammation?
For a long time, depression has been classified as a disease of chemical imbalance, but there is plenty of emerging evidence to suggest that it could be related to inflammation. Research is showing that inflammatory cytokines have the ability to cross the blood brain barrier and impact neurotransmitter and hormone function. Let’s look at serotonin as just one example – the down regulation of this (our ‘happy hormone’) will lead to the usual signs and signals of chronic low mood – decreased social activity, learning issues and low libido.
You’ve probably experienced signs of acute inflammation due to minor tissue damage that takes place during exercise – redness, swelling and aching. This is actually a normal and healthy physical response to exercise and is your body’s way of encouraging you to rest when needed. When you fail to read the signs and take the time to recover from acute inflammation, or if there are other forms of physical or psychological stress competing for the immune system’s attention, this is when acute inflammation has the potential to become chronic in nature. It’s in this state that you become far more susceptible to reoccurring or multiple injuries. This is why, as an athlete, taking care of your gut health and avoiding inflammatory foods is key to managing and avoiding injury.
What do we classify as diarrhoea? It’s lose, watery stools and it’s a sign of inflammation triggered as a result of trauma caused by food poisoning, food intolerances and/or pathogens. You can also think about it this way, it’s a fast track for elimination of the ‘bad guy’. Chronic diarrhoea however could be symptomatic of chronic inflammation in the gut brought about by regular exposure to toxins (such as pollution and pesticides), trigger foods (some of the most common being gluten and fructose containing foods), dysbiosis in the gut, pathogens and even autoimmune conditions like Inflammatory Bowel Disease (IBD) and Coeliac Disease. If you’re experiencing diarrhoea regularly then it’s crucial to work with a professional to identify the underlying cause.
This can go both ways – nutrient deficiencies can contribute to inflammation and identified nutrient deficiencies like iron, magnesium and B12 could be symptomatic of inflammation, specifically in the gut. Up to 80% of your immune system lies in your gut. It forms a huge line of defence between the outside world (the food you eat) and the inside world (your blood stream, organs and other tissues). Chronic inflammation in the gut can affect the quality and integrity of your gut lining, leading to intestinal permeability or, as it’s often referred to, leaky gut. This creates space for undigested proteins, pathogens and bacteria to enter the blood stream and similarly, essential nutrients and minerals to be “leaked”.
So, if you’re eating plenty of the right foods or even supplementing and not noticing a shift in nutrient status, it could be a symptom of underlying inflammation in your gut.
If we think of energy as a currency and consider that fatigue therefore occurs when energy output is greater than energy production, then inflammation can contribute on both sides of the equation to cause fatigue. On one side, the energy required to support an immune system on chronic high alert will result in currency being drained. On the other, if inflammation is present leading to downregulation in mitochondrial function (mitochondria being the home of energy production) then energy production will struggle to meet demand, leading to fatigue.
Of course, there are many other causes of fatigue. If you’re addressing the basics by getting 7-8 hours of good quality sleep each night and you’re well hydrated but still waking up with zero energy, then it’s likely inflammation is present.
That’s right, chronic skin conditions such as hives, eczema, rosacea and psoriasis are actually a sign of chronic inflammation. Symptoms occur when skin is exposed to a stimulus that triggers an immune response. Triggers range from physical stimuli like irritation and friction on the skin as well as exposure to the likes of trigger foods, chemicals and dysbiosis in the gut.
As your skin is your largest organ, it can often speak loudly to the level of dysbiosis and therefore levels of inflammation in your gut. If you’re suffering chronic and unexplained skin conditions, then consider looking to the cause of the inflammatory response. Hint: there’s a good chance it’ll be somewhere between your stomach and your large intestine.
If you’re working to overcome gut dysbiosis through the use of probiotics or antimicrobials, then die off of pathogenic overgrowths can also manifest in skin conditions. Of course, other common examples include bloating and changes in bowel habits. The goal in improving your microbial diversity and balance is to avoid these reactions, but sometimes you’ll get worse before you get better. If this does occur, you can support the clearance of toxins through the use of supplements like diatomaceous earth and activated charcoal. It’s best to work with a professional when using these for the first time.
It’s key to note that we need histamine in some levels – it plays a primary role in immune response. Therefore, a histamine intolerance is not an intolerance to histamine itself but rather a sign of excessive levels due to over exposure, excess production or inadequate clearance. Can you guess what leads to an excess of histamines? You got it, an immune response and most likely a chronic immune response brought on by trigger foods or environmental factors such as pollen. Excess can also be compounded by histamine producing bacteria such as Klebsiella and Ecoli. A lack of clearance will be exacerbated by diamine oxidase (DAO) enzyme deficiency which often occurs as a result of GI disorders. This includes intestinal permeability or conditions that are autoimmune in nature, like IBD.
Some simple things you can do to avoid excess histamine is to prioritise fresh meals over leftovers, avoid fermented foods in excess and minimise the common triggers like alcohol and excessive amounts of cacao. If you suspect your tolerance to histamine is low, then explore what’s triggering the immune response and start to address it.
Brain fog relates to poor memory, inability to find the right words, a general slowing of cognition and an inability to focus. All of these are very likely signs of inflammation in the brain or the gut – given the constant communication between the two, it’s likely to be a combination of both. We know intestinal permeability can lead to systemic inflammation, so too can conditions where toxins are able to cross the blood brain barrier. It’s this that sees the immune system being over worked and inflammation occurring.
To start to overcome brain fog, firstly eliminate some of the obvious contributors – lack of sleep, hormone imbalance and dehydration. If this doesn’t address your symptoms, then look to other likely causes. This includes exposure to environmental toxins or low-grade infections that may be draining your immune system elsewhere, like in the gut.
What’s the common link?
When you consider that up to 80% of your immune system’s tissues are housed in the GI tract, it’s no surprise that inflammation in the gut has implications for many of these symptoms. As Hippocrates said, “all disease begins in the gut” and this means your approach to managing these signs and symptoms of inflammation should also come back to the gut.
Where to from here?
Beyond these symptoms, to truly identify your levels of inflammation and therefore disease risk there are blood tests you can request. Enquire with your doctor about the following:
- TC: HDL: optimal <3.5, where <5.0 is good
- Triglycerides: ideal <1.0 mmol/L
- C-reactive protein (CRP): ideal <1 mg/L
- Homocysteine: ideal 7.0-7.5 umol/L
- MTHFR genetic variations
- ESR: references vary according to age and gender
Take home messages:
- Acute inflammation is a normal and vital element of immune function.
- Chronic inflammation has implications for many of today’s biggest killers.
- Signs of inflammation are obvious when you get in tune with your body so please don’t ignore them.
- Stay in touch with your markers of inflammation through regular blood tests.
- Diet and lifestyle plays a huge role in managing low grade inflammation – avoid inflammatory foods and common triggers, avoid exposure to chemicals in the environment and toxins brought about through chronic stress and bacterial infections.
- Spend your time and energy understanding the state of your gut, address ill health there and notice how your signs and markers of inflammation begin to change for the better.
My hope is that this article prompts you to look within to treat the underlying cause of inflammation with the long-term goal of avoiding topical solutions and medications. If you have questions or need assistance in addressing any of the above, then we’d love to hear from you. Please leave a comment below or get in touch with us firstname.lastname@example.org
Miller et al. 2009. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biological Psychiatry, 65, 9, 732–741.