4 Horsemen Series: Inflammation
Updated: Oct 30, 2020
The first topic in the 4 Horsemen Series will be on Inflammation. My mentor Dr. Kalish coined the term the 4 horsemen, which is a unique way of describing the major instigators of physiologic damage that happens to our bodies as we go through life.
"Inflammation is generally defined as a response to stimulation by invading pathogens or endogenous signals such as damaged cells that results in tissue repair or sometimes pathology, when the response goes unchecked."
- Nature Immunology 19 July 2017
Inflammation by definition should be good. It is the way your body defends itself against harmful viruses, bacteria, fungi. It is the way your body heals itself after injury. In the acute setting, under the right circumstances, inflammation is absolutely life saving and health promoting. When you fracture a bone, it generally takes 6-8 weeks for it to heal normally. During this time the inflammatory process ramps up and promotes the repair process. After that time, the mechanisms of inflammation cool down and turn off. That is how it is supposed to happen.
When we think of inflammation as a pathologic process or a process that causes harm or detriment to our bodies, we are referring to chronic, unchecked, continually ramped up inflammation that is not promoting healing and health. In fact, it leads to the opposite, chronic diseases in many forms. In medicine, when there is a chronic inflammatory component to an illness, we add the word "itis." Gastritis, colitis, enteritis, chondritis, arthritis, myositis, pleuritis, pneumonitis, and the list goes on and on.
Inflammation is clinically seen with classic signs described in latin as rubor, calor, dolor, and tumor, or in english redness, warmth, pain, and swelling. When you sprain your ankle, it swells up, becomes painful to touch and with movement. When you contract cellulitis or an inflammation of the skin generally caused by Staphylococcus or Streptococcus bacteria, you will note pain, redness, swelling, and warmth. This is acute inflammation in action.
However, contrast this with chronically painful and achy joints, depression, low energy levels, unexplained GI symptoms and weight gain more often seen in chronic inflammation. Sometimes there are no symptoms at all, and you just wake up one day with heart disease or cancer or an autoimmune condition.
In conventional medicine we are fairly good at diagnosing problems, and really good at naming them. We generally end up treating the symptoms of pain with NSAIDs such as ibuprofen, meloxicam, diclofenac. If there is an autoimmune component we may shut down totally or part of your immune system. If its cancer we may radiate the problem, cut it out, or try to eradicate it with chemotherapy. That being said, what do we offer in terms of finding the root cause of your Hashimoto's Thyroiditis, or Lupus, or cancer for that matter?
Not a whole lot.
When you were diagnosed with hypothyroidism, how many of you were told you likely had an autoimmune condition called Hashimoto's thyroiditis? How many of you were told about the concept of molecular mimicry? How many people had their diet's changed, their gut repaired? How many of you were put on levothyroxine or Synthroid and shown the door? And lets not forget about those who have a normal TSH and T4 levels yet still have the symptoms of hypothyroidism and are basically told sorry, live with it?