Inflammation

Inflammation can be triggered by microbes, foods, trauma, or toxins, but when the immune system is well-supported, the result is tolerance rather than over-reactivity.

Supporting Resolution

Ginger and Boswellia can help with inflammation. Dietary fiber (50 grams/day) can help to move toxins out of the body and reduce the amount of toxins that are reabsorbed because of deconjugation by beta-glucuronidase. Watch out for high fat meals that can increase LPS translocation.

NRF2 drives the body’s endogenous antioxidant production, including glutathione. Support NRF2 with brassicas for their sulforaphane, curcumin, green tea, CoQ10, and quercetin.

A meta-analysis by Farsi and colleagues (2019) found that CoQ10 supplementation at doses over 150 mg/day reduced TNF-α and IL-6. Chronic stress and chronic disease can suppress the body’s CoQ10 production, which in turn feeds inflammation. The researchers also noted CoQ10 was less effective at BMIs over 26, suggesting greater CoQ10 demand in obesity.

Sleep is a core piece of any anti-inflammatory plan. A systematic review by Irwin et al. (2016) found sleep disturbances associated with elevated CRP and IL-6. Sleep brings down activation of the sympathetic nervous system. The NF-κB pathways produce inflammatory cytokines when β-adrenergic receptors are kept activated by the sympathetic nervous system.

Accessible Assessment

The neutrophil-to-lymphocyte ratio (NLR) can be calculated from a standard complete blood count that almost any client will already have on hand. A ratio above 3.5 is generally considered a red flag for inflammation.

Low homocysteine can be an indicator of low glutathione.

Omega-3 index; supplement with EPA/DHA if low.

Histamine intolerance and gut health

A study by Schink et al. (2018) connected histamine intolerance to dysbiosis and intestinal permeability. The enzyme DAO normally breaks down dietary histamine. DAO is produced by enterocytes and stored in the intestinal epithelium, but if the gut lining is inflamed or damaged, DAO drops and histamine symptoms can follow. If you have histamine intolerance, avoiding high histamine foods such as leftovers, aged cheese, processed meat, wine and sauerkraut can help. Preservatives, dyes and sulfites can also contribute to histamine load.

Glutathione

A study by Sinha et al. (2018) found that oral liposomal glutathione measurably raised glutathione status in 12 healthy adults, with the biggest gains in people who started with the lowest baseline levels. Interestingly, the researchers noted that glutathione levels can dip during fasting, since cysteine is rate-limiting in glutathione production. Staying consistent with daily protein intake helps keep glutathione levels stable. Acetaminophen can also deplete glutathione.

The Takeaway

Inflammation deserves a look in nearly every case — regardless of the presenting complaint. Diet, sleep, stress, environmental exposures, and gut health are all places to intervene, whether that means removing a trigger or supporting the body’s resolution process. Understanding inflammation can reinforce the rationale behind these interventions.

References

Farsi, F., Heshmati, J., Keshtkar, A., Irandoost, P., Alamdari, N. M., Akbari, A., Janani, L., Morshedzadeh, N., & Vafa, M. (2019). Can coenzyme Q10 supplementation effectively reduce human tumor necrosis factor-α and interleukin-6 levels in chronic inflammatory diseases? A systematic review and meta-analysis of randomized controlled trials. Pharmacological Research, 148, Article 104290.

Irwin, M. R., Olmstead, R., & Carroll, J. E. (2016). Sleep disturbance, sleep duration, and inflammation: A systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biological Psychiatry, 80(1), 40–52.

Schink, M., Konturek, P. C., Tietz, E., Dieterich, W., Pinzer, T. C., Wirtz, S., Neurath, M. F., & Zopf, Y. (2018). Microbial patterns in patients with histamine intolerance. Journal of Physiology and Pharmacology, 69(4).

Sinha, R., Sinha, I., Calcagnotto, A., Trushin, N., Haley, J. S., Schell, T. D., & Richie, J. P., Jr. (2018). Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function. European Journal of Clinical Nutrition, 72(1), 105–111.