Image by Emilian Robert Vicol from Pixabay

There has been a trend for some time in the natural health space vilifying inflammation. Many point out that it is present in nearly every chronic Western disease, from heart disease to cancer to autoimmunity. 

This is true; inflammation is a hallmark of all of these diagnoses, and many more. But correlation is not the same as causation. 

Let me explain. Imagine that someone were to do a study demonstrating that, in a statistically significant percentage of criminal activities, the police are present at the scene of the crime. What if the conclusion of the researchers, in this fictional scenario, is, “Cops cause crime! Let’s do away with all the cops!” 

The real situation, of course, is exactly the other way around. The cops show up to fight the crime, once it has occurred. There is a correlation between cops and crime, but cops are not the cause of the crime; rather, the crime is what draws the cops to the scene. 

Inflammation works in exactly the same way. 

Inflammation Is An Adaptive Response, In Its Place

When you get injured, or your body encounters a foreign substance, bacteria, virus, fungus, or parasite, the inflammatory process begins as part of the non-specific phase of your immune response.

In other words, inflammation means healing has commenced.

Here’s what happens during the non-specific immune response:

  • White blood cells in the area (including mast cells) release chemicals like histamine, bradykinin, and eicosanoids.
  • These chemicals cause the arterioles (tiny arteries that supply blood to the injured area) to dilate, bringing more blood flow to the area. They also increase the arterioles’ permeability, allowing more white blood cells to enter the fray (including neutrophils, basophils, eosinophils, macrophages, and monocytes). These help to break down microorganisms.
  • The result: the area turns red, swells up, and hurts (because the chemicals released can irritate the nerves).

Typically this should only last for a few days. After that, if the immune system wins and the injury is healed or pathogen is dead, the next stage is called suppuration (formation of pus). Pus is the carnage after the confrontation is over: it contains dead white blood cells, and debris from the fallen bacteria. The body generally gets rid of pus on its own, followed by granulation, or formation of healthy tissue in the area of injury.

But sometimes, the immune system loses. That’s when the trouble starts.

Chronic Inflammation

Chronic inflammation occurs when 1) the immune system fails to overcome the causative agent in acute inflammation, 2) if an irritant persists or is continually re-introduced into the body, or 3) if the immune system gets confused and turns on itself (autoimmunity).

Now, the body’s tissue is either under direct attack, as in autoimmunity, or it bears collateral damage as the immune system contends with the irritant or invader. Ultimately this leads to fibrosis (thick and scarred connective tissue), and tissue destruction.

Even so, the problem in these cases isn’t the inflammation itself. The problem is the trigger that set off the inflammation in the first place. Even in the case of autoimmunity, there’s always some external trigger, at least at the onset. 

Anti-Inflammatory Supplements

This is why, even though there are many great supplements out there that help to suppress inflammation, I don’t like using them for that purpose long-term. 

A few supplements I see a lot of people on for anti-inflammatory purposes include turmeric, and various combinations of enzymes away from meals, usually including bromelain as part of the formulation. I’m not against these by any means — they have other benefits besides being anti-inflammatory, and decreasing inflammation in the short term can offer both relief of symptoms, and can protect from tissue damage, while we’re treating the root cause. The only time I think they’re a reasonable long term choice is if for some reason, we can’t find the root cause. 

There is one semi-exception to this, and that is when the original insult is gone, but the body hasn’t yet gotten the message. If inflammation continues when the trigger is gone, the immune response needs a ‘reset.’ This is a good time for an immune modulator, not an immune suppressant—something like Low Dose Naltrexone, for instance. 

Another semi-exception to this is the case of adrenal fatigue. Cortisol is your body’s natural anti-inflammatory hormone. If you have plenty of it, you can keep inflammatory insults in check, such that they cause you no symptoms and no problems. But if your cortisol production tanks secondary to some source of either physical or emotional stress, now an inflammatory trigger that was always there but minding its own business before (like a food sensitivity or a chronic infection) can become unmasked. In that case, the real treatment is more to restore adrenal function than necessarily to address the previously innocuous agent (though sometimes that can help too). 

The body doesn’t just break for no reason. There’s always a trigger. You just have to find it. 

The Upshot

Inflammation is not your enemy. Inflammation is trying to heal you. 

If it lost the fight and your body has found a “new normal,” complete with chronic but impotent inflammation, the root problem is still not the inflammation. 

Anti-inflammatory treatments (natural and otherwise) have their place, and can be very helpful in the short-term. But healing will require addressing the reason for the inflammation in the first place.