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What Inflammation Really Is

By: Michael Lam, MD, MPH; Carrie Lam, MD; Jeremy Lam, MD

Video summarized in article below. 

Dr. Michael: Okay. So, let’s start with understanding what inflammation really is. Now, it’s quite interesting that up to 30 years ago the concept of inflammation as being something that is bad for our body has never been really explored. We know that inflammation is part of a normal physiological response.

Let’s say you sprain your ankle. It’s going to turn red. It’s going to swell up. It’s going to be hot. You’re going to have pain, and you’re going to have a loss of function. This is all part of the body’s inflammation response, and we know it is a good thing.

Now, the problem really comes when the body’s inflammation response—and we will go into that—becomes kind of haywire. So, let’s start out first… Dr. Jeremy, tell us more about inflammation.

Dr. Jeremy: So, inflammation is classically characterized by, like you said Dr. Lam, redness, heat, swelling, pain, and loss of function. So, again, inflammation is a normal part of your body’s defenses. For example, your body has a fever when it comes into contact with a virus or a foreign pathogen because it’s trying to get rid of that foreign pathogen, and it’s harder for viruses and bacteria to survive at higher temperatures. The fever also helps activate the body’s immune system, which is one important part of the Inflammation circuit. So, again, inflammation is not a bad thing, but if it becomes chronic, then long-term problems can start to arise.

Now, before we talk about the Inflammation circuit Dr. Lam, why don’t you just tell us about the whole NeuroEndoMetabolic stress response in relation to the Inflammation circuit.

The Big Picture: The NeuroEndoMetabolic Stress Response

Dr. Michael: Okay. Now, our body is designed and has evolved through all these years to adapt to the environment whenever there’s stress. Now, stress can be physical or emotional. In the old days, stress meant that you had to face a tiger that was running after you and trying to eat you up. In modern days, stress is really about more emotional than physical stress. However, the body doesn’t understand that.

The body’s reaction to stress is the same, and it actually has three components. One is the neurological system that kicks in. One is the endocrine system that kicks in. And one is the metabolic system that kicks in. I say those words loosely, but each of these components is actually multi-compartmentalized.

When you combine these three things together, you get what we call the NeuroEndoMetabolic stress response. It’s like an orchestra with the winds section, the strings section, and the percussions. So, when you have all these three work together, they orchestrate an overwhelming, well-designed, perfect response to any stress when it comes. So, this stress response—which we call NeuroEndoMetabolic stress response or the NEM stress response—has six different circuits. Each circuit is responsible for a certain part of the response and is activated at a certain time and sequence to help the body deal with stress.

They are the Inflammation circuit, the Detoxification circuit, the Hormonal circuit, the Bioenergetic circuit, the Cardionomic circuit, and the Neuroaffect circuit. Now, today we’re going to focus more on the Inflammation circuit.

So, the body combines these circuits, and they activate it at certain times in perfect sequence. Sometimes it’s the Inflammation circuit. Sometimes the Cardionomic circuit. Sometimes it is the Detoxification circuit. Collectively, they form a wonderful symphony with a design to prevent the body from being overcome by stress.

If the stresses however become too big, then these circuits can therefore become compromised. They become dysregulated, or they can be damaged or broken. That’s when the signs and symptoms happen. Dr. Carrie let’s talk about specifically the Inflammation circuit.

How the Inflammation Circuit Works

Dr. Carrie: Right. The Inflammation circuit is regulated by three main organ systems. The first is the immune system, the second is the GI tract, and the third is the microbiome. These three systems are the Inflammation circuit of the NeuroEndoMetabolic stress response, because inflammation like we talked about, is a normal defense mechanism of the body. It can be designed to protect you, but like Dr. Lam said, if it goes on for too long, you’re in the fight or flight stage, and you’re just starving. Or having too much chronic stress, it can lead to stressing the body and the adrenal glands. So, Dr. Jeremy why don’t you tell us about each organ system in more detail.

The Immune System and Inflammation

Dr. Jeremy: Okay. So, the first organ is actually the immune system. Inflammation at its heart is really the immune response in the body. When your body is under attack, the immune system will release these inflammatory compounds, which will help deal with an invasion and foreign pathogens.

Now, after the attack, your inflammation comes down and things go back to normal. This is a normal response.

However, if your body and your immune system is constantly being stressed, constantly being attacked, then the inflammation can become chronic, and this could lead to problems.

Now, the immune system over time can be put into overdrive leading to some immune-related issues such as autoimmune conditions, getting sick often, and constantly feeling under the weather. These are some of the types of issues that can happen when your immune system is just put on overdrive.

Dr. Carrie: So, long-term inflammation from the immune system will actually result in symptoms as well, like migrating aches and pains, itchiness, fatigue. All right?

Your GI Tract and Inflammation

The second system that could really get affected would be the GI tract. The GI tract is very important in your body’s defense mechanism to prevent inflammatory compounds from entering your system.

But if your gut is not doing well, it can add to this inflammation, and actually make things more inflammatory in nature.

Some foods are more suspect than others. These include sugars, refined grains, alcohol, processed meats, and dairy. So these are definitely foods you want to avoid.

Dr. Michael: So, the concepts that we’ve talked about so far, the immune system and the GI tract, both form the cornerstone of the inflammation response. So, the GI tract is such an important system in the inflammation response of our body. Dr. Carrie, let us know what problems happen when the GI tract becomes inflamed.

Dr. Carrie: You could have a lot of conditions and symptoms that can arise due to GI tract imbalance. These include leaky gut, getting a lot of diarrhea or gas or bloating, food sensitivities, fatigue after eating like a food coma, changes in your mood, and even anxiousness.

Dr. Michael: Yes. Most people don’t really associate these things with the inflammation response, but if you look globally, it’s almost like the body is on fire. There’s a simmering discontent within. It’s this ongoing displeasure that drains the system. It’s almost like someone is hitting you constantly, 24/7, even though you’re sleeping, and sooner or later your body wears out. That’s why these symptoms occur.

Dr. Jeremy let’s go on to the third part of the inflammation circuit. We talked about the immune system. We talked about the GI tract. What is the third part?

The Microbiome and Inflammation

Dr. Jeremy: Okay, so the third and final system of the inflammation circuit is the microbiome. The microbiome is a combination of microorganisms that help us stay alive. They protect us against germs. They help break down our food. They produce vitamins for our bodies, and they also help control our immune system.

So we have many microbiomes in many locations, such as our stomach, our intestines, on our skin. Even on the vagina and in our nasal passages we have microbiomes.

Dr. Michael: Of course, one of the most important microbiomes is actually lining the gut. It is the imbalance of this microbiome that leads to what we call “gut dysbiosis.” So symptoms can be like feeling gassy, bloating, leaky gut, weight gain, or imbalanced blood sugar.

Chronic Inflammation Is What Drains You

Most people think of inflammation as just a redness which is true, but there’s a chronic subclinical inflammation that goes on that you don’t see. It’s this that drains you. No matter what you do, you just don’t seem to have your full vitality. This is what inflammation imbalance can lead to.

 
© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

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