medical training around the world and through the centuries, students have had to learn to recognise an inflammation the traditional way, which originates with the ancient Roman Celsus, who wrote great reference books about the body. Celsus’s favourite treatment was to simply open the veins and empty out the ‘extra blood’, a procedure he recommended for many types of health problems, as well as for people ‘with big heads’. Celsus also described the signs of inflammation in Latin: rubor, tumor, caldor, dolor. Redness, swelling, warmth, pain. Which is exactly what you feel in your throat when you have a sore throat. These signs of inflammation can in turn be counteracted by RICE, or rest, ice, compression, elevation. (Exactly what you do with a sprained ankle.)
The whole point, in short, is that inflammation works like a kind of fire department. It rushes out, attacks the enemies, cleans out and repairs. Then the system goes back to resting status.
This acute type of inflammation has a rhythm. There’s an ebb and flow, a clear beginning and an end, and the rhythm signals a healthy and active immune defence. It isn’t this type of inflammation that’s problematic but rather another one, which seems to be affected by food and contributes to illness. I wondered who might be able to tell me more about it.
I investigate some more, and after a while I find a new trail. There’s a researcher in the United States, Barry Sears, who has been on this track for a long time and founded an organisation for research in that area, the Inflammation Research Foundation. I’m not able to travel to meet him, but I don’t want to just send him an email, since there’s so much that I don’t understand. We need to actually talk.
I’m able to reach him by phone, and he gets right to the point.
‘This is a new area for most doctors. I’ve been working in the field for a while, but in general way too little research has been done.’
He mentions how many different kinds of diseases the low-grade systemic type of inflammation is linked to. We’re talking about heart disease, high cholesterol values, diabetes, joint problems and neurodegenerative disease, but also certain forms of cancer.
‘But what exactly does this low-grade systemic type of inflammation do?’ I wonder.
He begins to explain very fast, and it’s hard to follow him since the connection breaks several times during our call.
‘Okay, how about this: I’ll send you a scientific article,’ Dr Sears says.
He soon emails me an article from European Review of Medical and Pharmacological Sciences. I click it open.
‘The inflammatory response was developed over millions of years and allowed us to coexist with a number of microbes. The same inflammatory response also made it possible to repair physical damage . . .’
Okay, I think, acute inflammation is an ancient mechanism with benefits, millions of years old . . .
‘But there are also equally important anti-inflammatory mechanisms in the inflammation cycle that allow cell repair and renewal. Only when these two phases are continually balanced can the cells effectively repair the small damages that arise with inflammation.’
This is new to me. Does this mean there’s a need for balance inside the system itself – perhaps that just as there’s an inflammation yin, there also needs to be an inflammation yang?
‘But if the proinflammatory phase continues in a low but chronic level under the pain threshold, it can drive many chronic illnesses. In the end it can result in organ damage, loss of organ function and lead to severe illness, in spite of the fact that the initiating illness-causing events may have taken place decades earlier, triggered by an underlying and ongoing chronic inflammation process.’
So, low-grade inflammation arises from imbalance – from a steadily ongoing inflammation that doesn’t cause a ‘fire department’ type of acute inflammatory response but in the long run can act as a catalyst for small seeds of illness that have been germinating in the body for a long time.
Is this the type of inflammation that we bring about through an unhealthy lifestyle? In other words, might bad nutrition, stress, environmental toxins and other lifestyle factors give us inflammation, which in turn makes us sick? Perhaps that’s why the wrong food can lead to illness and not just to us ingesting too many calories.
And is it true that long before we actually become ill, the low-grade inflammation affects us so that we start to ‘lose steam’? When I went to the doctor complaining about my back pain, depression and listlessness and looked for explanations based on external things (‘the kids are moving away from home’), maybe it was actually a low-grade inflammation, an imbalance in my immune defence caused by a number of lifestyle choices, leading to my bad back, blue mood and bloated stomach. And maybe this is what I’ve ‘cured’ with my new lifestyle choices?
I go on looking to see if my symptoms, like back pain, fatigue and a ‘low’ feeling, could have been signs of low-grade inflammation. I find the following symptom list:
• The skin looks older, is drier, and has more wrinkles
• Lower energy
• Less stamina when exercising
• Swelling in the face
• Swelling around the belly
• Increased risk of either constipation or loose bowels
• Less ability to concentrate
• Fluctuating appetite
• Fluctuating blood sugar levels
• Weaker immune defence
• Joint pain
• More depressed mood
I can tick off several of the points but not all. So far, we’re just talking about what a doctor would call ‘everyday troubles’. But how does inflammation work in relation to serious illnesses?
I realise that I’ll have to become a detective in order to get to the bottom of this riddle. No single researcher seems to have the whole picture. I will have to solve a jigsaw puzzle.
A few years earlier, an editor in a publishing house gave me a book called Anticancer. I didn’t read it then, but one day it falls off the bookshelf as if some friendly soul in there wants to help me on my way. It turns out to be a good lead.
The book is by the French neurologist and Médecins Sans Frontières activist David Servan-Schreiber, who developed a brain tumour at the age of thirty and set out on a journey of knowledge to save himself. In the book, which became a bestseller in many countries, he reported on some of the leading research about the essence of cancer, as well as strategies for keeping up resistance. Servan-Schreiber eloquently describes how cancer and inflammation are intertwined and drive each other on in a kind of evil witch dance.
‘I realise that I’ll have to become a detective in order to get to the bottom of this riddle. No single researcher seems to have the whole picture. I will have to solve a jigsaw puzzle.’
A tumour is a number of cells that begin to grow wildly and unchecked. In the beginning, there’s enough nourishment for the tumour in its immediate surroundings, but after a while it outgrows its small neighbourhood. The tumour now begins to operate with a devilish intelligence, causing an inflammation around itself. Why? Fascinated, I continue reading. The tumour uses the inflammation to manipulate the immune defence and make it ‘attack’ the tumour from inside.
Once the immune defence has got into