Inflammation: The Basics
Inflammation is one of the most common reasons for someone to come see me in my clinical practice. Almost everyone suffers from some sort of inflammation at one point or another, and most people have no idea how or why this is happening. Inflammation can be caused by a wide variety of issues from acute pain caused by a cut or bruise or more chronic causes. They can all be dealt with by relatively the same solutions.
Inflammation by definition is “a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection.” This can occur almost anywhere in the body.
Inflammation hinders the liver’s ability to detoxify and clear toxins that exist in the body. It can also hinder the absorption of nutrients in the gut (this is done primarily by the duodenum and small intestine). Excess inflammation is one of the root causes of almost all diseases.
For the sake of time, effort, (and to not get overly nerdy!) I will use a few of the most common manifestations of inflammation, and some nutritional ways to help correct an overly inflammatory picture.
How Diet Affects Your Inflammation Picture:
To understand how inflammation occurs we need to look at where it comes from in our diet. Essential fatty acids or EFA’s are the building blocks of everything that we are as humans and they come directly from our foods! Essential fatty acid balance plays a key role in what your inflammation picture looks like.
There are 3 basic components: arachidonic acid (AA), Omega 6's, and Omega 3's. These three building blocks are found mainly in the fatty parts of meat/fish. The highest concentration of all three is found in wild salmon.
Omega 6 Fatty Acids:
Omega 6’s, or linoleic acid, is the most common in average American diets. They can be found in all veggie oils, especially canola, corn, safflower, and sunflower oils. Omega 6's are also present in processed foods and tend to be much more inflammatory. Processed meats and other quick meals are high in trans fats, and the oils they use to make them are of a low quality. Omega 6's are also found in cured meats as well as chicken. It is important to note that Omega 6's and Omega 3's fight for the same pathways in the body. When you have an excess of Omega 6's they win the fight and cause more of an “inflammatory response”.
Omega 3 Fatty Acids:
Omega 3's consist of alpha linoleic acid, EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid). They are generally considered “anti-inflammatory”. This means that they, in balance with omega 6's, elicit more of an anti-inflammatory response. Omega 3's are much less common in average diets, thus it takes more of an effort to get enough through diet alone. Some foods that are high in Omega 3's are fish (especially salmon & sardines), flax seeds, chia seeds, hemp seeds, raspberries, blackberries, blueberries, most legumes, and many different types of nuts. Making a smoothie for breakfast with berries, nuts, and seeds is a great way to get them daily.
Balancing Your Fatty Acid Intake:
All three of the above-mentioned fatty acids (arachidonic acid, Omega 6's & Omega 3's) are necessary for optimal health. The balance of these is what mainly determines the balance of pro-inflammatory and anti-inflammatory eicosanoids.
For people who have an adequate balance of Omega 6's and Omega 3's in their diets, increased consumption of arachidonic acid is unlikely to increase the inflammatory picture throughout the body. However, diets that are consistently high in arachidonic acid without a good balance of the Omegas can exacerbate chronic inflammation - esp. in IBD (Irritable bowel disease) pictures. We want to stress that arachidonic acid is a necessary part of a healthy diet as it is necessary for muscle growth/repair of muscle tissue. Do not try to eliminate it from your diet! Seek balance with the Omegas. Everything is about balance in a thriving body.
Too much AA and/or Omega 6's, along with too little Omega 3's is pro-inflammatory
Most Americans get plenty AA and Omega 6's but not enough Omega 3's
Ideally, you want a 2-4:1 ratio of 6's to 3's meaning, 8-16 grams of Omega 6's and 4 grams of Omega 3's.
Do not eliminate AA from your diet
Inflammation and NSAIDs vs. Supplements
Eicosanoids are potent chemical communications molecules that adjust cellular processes in the body. Prostaglandins are a type of eicosanoid that act like hormones. This becomes relevant during a discussion about inflammation when we bring NSAIDs into the mix.
NSAIDs (non-steroidal anti-inflammatory drugs) are designed to interfere with prostaglandins. Taking NSAIDS inhibits/suppresses inflammatory action because of this interference. We all have taken, and will take, NSAIDs at various times. They bring a welcomed quick release of pain when we really need it. I'm not here to stand on my soapbox and tell you to not take ibuprofen when you have menstrual cramps. However, NSAIDs are not a long-term solution. We want to correct the inflammation at its source. You don’t want to stop the processes with inhibitors, you want to modulate the activity with supplements and with the goal of resolving, rather than suppressing the inflammation.
A recent study of 250 patients with cervical and lumbar disc disease who were taking NSAIDs revealed that 59% could successfully substitute fish oil supplements as a natural anti-inflammatory agent instead of the NSAIDs.
Supplementing with a high-quality fish oil is highly recommended. Nordic Naturals brand is my personal favorite. They use very high-quality fish and oils. The reason you get that “fishy” flavor from a fish oil supplement is because the oil inside is rancid and has gone bad. Making sure to purchase a high-quality supplement (find it in the refrigerated section!) will help you avoid rancid oils, which can also have an inflammatory effect on the body. Fish oils are a great way to balance AA from animal fats and Omega 6s from plant oils. Using Vitamin D3 in combination with fish oil is a powerful dietary anti-inflammatory combination. Please note that if you're vegan there are some wonderful algae supplements that are a fantastic substitute for fish oil.
Some other natural inflammation modulators include:
(these have a steady, slower anti-inflammatory action rather than an instant one)
- Vitamin D3 (calcitriol)
- High-quality EPA/DHA (fish oil, marine algae oil)
- ALA (alpha-linoleic acid): seeds or seed oils of flax, chia, with a lower concentration in hemp
- GLA (gamma-linolenic acid, a healthy way to get Omega 6s): seed oils of borage, evening primrose, black currant
- Turmeric (curcuminoids are phytoconstituents that are anti-inflammatory. It is better to eat the rhizome of turmeric rather than an extract of curcumin. Plants have a synergy and eating the whole plant is far more anti-inflammatory than an extract of one constituent.)
- Ginger (gingerols, shogaols & synergistic compounds)
- Green tea extract (EGCG & synergistic compounds)
- Rosemary (contains antioxidant and anti-inflammatory action)
- Sage (Salvia spp.) – similar to Rosemar
- St. John’s Wort (hyperforin & synergistic compounds)
- Licorice (numerous active constituents)
- Plantain (flavonoids, tannins, iridoids)
- Self-Heal (Prunella vulgaris) – numerous constituents - more rosmarinic acid (antioxidant) than rosemary. Used extensively in traditional Chinese medicine.
- Indian Frankincense (Boswellia serrata) - (triterpene acids)
- Feverfew (sesquiterpene lactones & synergists)
- Salicylate-rich herbs (meadowsweet, wintergreen, willow bark, poplar species buds, etc. These are the same plants that were the origins of Aspirin)
- Phytochemicals: quercetin, kaempferol (flavonols); resveratrol
- Zyflamend® formula – Made by New Chapter vitamin company. The herbal ingredients are Rosmarinus, Curcuma, Zingiber, Ocimum, Camellia, Polygonum cuspidatum, Coptis, Berberis, Origanum, Scutellaria baicalensis – all are COX-2 modulators, some are also COX-1 and 5-LOX modulators. Zyflamend is a wonderful supplement that has shown to have a tremendous effect on arthritic pain.
Herbal Medicine for Inflammation:
Althaea off: (Marshmallow, leaf, root, and flower)
Uses: Soothing and protecting the mucous membranes, can help to alleviate symptoms of peptic ulcers, and gastritis. Marshmallow can be beneficial for intestinal problems such as colitis, diverticulitis, and IBS. It can be used as a mouthwash/gargle for inflammation of mouth and throat.
As a demulcent, or mucilaginous herb, it brings relief to inflammatory conditions of the upper respiratory tract such as dry coughs, bronchial asthma, bronchitis, laryngitis, pharyngitis, tracheitis, and pleurisy. The whole plant can be utilized for all of these ailments and more, the flowers, leaf and root are all commonly used.
Clinical Actions: Demulcent - super moistening, anti-inflammatory, mildly immune-enhancing, nervine: calming to nervous system, vulnerary, alterative.
Cautions & Contraindications: May impair the absorption of some drugs, so Althaea should be taken at least 1 hour apart from taking medications.
Tilia spp: (Linden tree flower, and leaf)
Uses: The flowers are good for colds and flus, reducing nasal congestion and soothing fever. Linden can also be used to aid inflammations of the upper respiratory tract, as well as inflammations of the gastrointestinal and genitourinary tracts.
Clinical actions: Antispasmodic, diaphoretic, demulcent, anti-inflammatory, expectorant, astringent, antimicrobial
No dosage warnings or contraindications
Glycyrrhiza glabra: (Licorice root)
Uses: Licorice produces a thick, protective lining to the stomach, making it useful for inflammatory stomach conditions. It is a powerful anti-inflammatory for digestive issues such as canker sores, gastritis, peptic ulcers, and heartburn. Licorice is soothing to all mucous membranes; it is also good for sore or dry throat and bronchitis, arthritis or inflamed joints, and some skin problems such as atopic eczema.
Clinical actions: Demulcent, anti-inflammatory, adaptogen (in large doses), expectorant, vital stimulant, immunomodulator.
Dosage: Don’t take in large doses, if using daily, no more than 6 weeks at a time, with 2 weeks off before starting again.
Cautions & Contraindications: High blood pressure, heart failure, kidney disease, cholestatic liver disorders and liver cirrhosis, in edematous states, and where potassium balance is critical.
Calendula officinalis: (Calendula, pot marigold flower)
Uses: Calendula is an antiseptic herb; it has a wide variety of uses internally as well as topically. It is commonly used as a wound-healing, astringent for cuts, wounds, bruises, mild burns, varicose veins, as well as many other skin afflictions. It is helpful for infants for diaper rash, cradle cap, and it helps sooth the nipples of nursing mothers. Calendula may be used internally for digestive problems. If taken as an infusion its anti-inflammatory action helps gastritis, peptic ulcers, and colitis.
Clinical Actions: Vulnerary, mild antispasmodic, mild diaphoretic, anti-inflammatory, astringent, antiseptic, detoxifying, mildly estrogenic, antiedematous, antimicrobial, immunomodulant, mild liver stimulant.
Cautions & Contraindications: It is important to note that it should not be used on open/oozing wounds, it may close a skin affliction before it has had time to properly heal and seal an infection under the skin.
Rosmarinus officinalis: (Rosemary)
Uses: Rosemary is a beautiful anti-inflammatory herb. It contains phytoconstituents that are extremely antioxidant and helpful for the detoxification processes through the liver. Rosemary is a circulatory stimulant and cerebral stimulant improving memory, cognition, and aids in nervous system repair. Rosemary is said to be so uplifting that it can bring hope to those who “fail to thrive” and has antidepressant action. Rosemary is helpful for long term stress and can help alleviate headaches.
Clinical Actions: carminative, emmenagogue, brain tonic, restoring, aromatic, tonic, stimulant, astringent, nervine, anti-inflammatory, antioxidant, mild expectorant
Cautions and Contraindications: There are no reports of contraindications or side effects when used properly. Correct usage includes NOT ingesting the essential oil at any time.
Avena sativa: (Oatstraw, Milky oats)
Uses: Oatstraw or milky oat tops are very soothing and anti-inflammatory to many systems of the body. Milky oats are said to help repair nerve endings and nervous disorders. Oatstraw helps calm and soothe anxiety and tension held in the body. Oats are moistening to the tissues, for painful gut inflammation. It has been used in treatment for addictive habits to aid in their recovery. Externally it is soothing to minor wounds and skin inflammations.
Clinical Actions: nutritive, demulcent, emollient, mild immunomodulation, tonic, mild sedative, mild diuretic, anti-inflammatory
Cautions & Contraindications: Oat grains may need to be avoided by a person suffering from a gluten intolerance of any kind
Inflammation is Manageable!
To summarize, to decrease the amount of inflammation you experience on a daily basis it's important to eat a well-balanced diet and include some vitamin/nutritional supplements for an added synergistic bonus. Adding some herbs is extremely supportive for an inflammatory picture no matter where it is manifesting in the body.
Formula for Topical Relief of Inflammation
Wildcrafted Topical Pain Oil:
Arnica spp: Arnica is a beautiful yellow, flowering plant with heart-shaped leaves. Its smell is a wonderful surprise when you find it in the wild. One of the best topical pain relievers, it instantly decreases inflammation locally at the site where needed. You can apply it topically in oil, make a salve with beeswax, or fresh as a poultice. Not for internal use!
Humulus lupulus: Wild hops are antispasmodic to the muscles and tissues when applied topically. Hops are a sedative plant and do relatively the same thing externally as internally. They are anti-inflammatory to the skin and are soothing as well.
Populus spp.: Harvested in early spring, Cottonwood buds are one of my favorites for topical pain relief. They are fantastic at reducing localized swelling and helping to heal irritating skin conditions. The buds smell so wonderful and they provide immediate anti-inflammatory action.
For a simple medicated anti-inflammatory oil, use equal parts of all three infused oils.
- Carrie Calvin, Licensed Clinical Herbalist & Nutritionist