angelita b. frando, md board certified in family medicine board certified, medical acupuncture

INFLAMMATION and YOUR HEALTH

Angelita B. Frando, MDBoard Certified in Family Medicine

Board Certified , Medical Acupuncture

Definition:

complex biological response to harmful stimuli (pathogens, damaged cells or irritants)

Protective attempt to remove the injurious stimuli and initiate the healing process

Important for survivalCauses wounds and infections to heal (acute)Chronic = progressive destruction of tissue

=>disease and degenerative changes

Manifestations (Signs):Calor (Heat)Rubor (Redness)Tumore (Swelling)Dolor (Pain)Functio laesa (loss of function)

Causes:BurnsChemical irritantsFrostbiteToxins Infection by pathogensPhysical injury, blunt or penetrating Immune reactions due to hypersensitivity Ionizing radiationForeign bodies (ie., splinters, dirt and debris)StressTraumaAlcohol

Types: Acute & ChronicNames Based on body systems / organs involved: ( “-itis”)

AppendicitisArthritisBursitisColitisCystitisDermatitisMyositisMeningitisTendonitisTonsillitisVasculitis

Acute vs ChronicCausative agent:Bacteria, injured tissues

Immediate onsetDuration: Few daysOutcome:

Resolution, abscess, or chronic inflammation

Persistent acute inflammation, viruses, persistent foreign bodies, autoimmune reactions

Delayed OnsetUp to many months or

yearsOutcome:

Tissue destruction, fibrosis, necrosis

Process of Acute Inflammation:

Injury/pathogen => cells activated to release inflammatory mediators:Vasodilatation => Increased blood flow =>

redness and heatIncreased blood vessel permeability =>

leakage of plasma proteins and fluid into tissues (swelling)

Some mediators increase sensitivity to pain

Other biochemical reactions occur (complement system, coagulation and fibrinolysis systems, etc.)

Cell derived mediators:

Lysosome granulesHistamineInterferon (cytokines)IL-8 (Interleukin 8)Leukotriene B4Nitric oxideProstaglandinsTNF-alphaand IL-1

Inflammatory Markers:CRP (C-reactive protein)

Increased levels associated with increased risk of heart attacks, strokes, high blood pressure, muscle weakness and fragility

ESR (erythrocyte sedimentation rate)Homocysteine levelsTumor necrosis factor –alpha (TNF-@)Interleukin 6, 8, 18 (IL-6, IL-8, IL18)Blood glucose, insulin and leptin (especially

for obese)

Disorders associated with Inflammation: Acne vulgaris Allergies Asthma Atherosclerosis Autoimmune disease Cancer Celiac disease Chronic prostatitis Degenerative arthritis, Hypersensitivities Interstitial cystitis Inflammatory bowel / Digestive tract disordes (Pancreatitis, Crohn’s disease, Regional enteritis,

Enteropathies, Hepatitis, etc.) Kidney diseases (Diabetic Nephropathy, Glomerulonephritis, etc) Myopathies Obesity Osteoporosis Pelvic inflammatory disease Reperfusion injury Rheumatoid arthritis , Lupus, and other connective tissue disorders Skin: Psoriasis, Dermatitis Sarcoidosis Transplant rejection Vasculitis

Medications vs InflammationAspirin

Works on prostaglandins Watch for gastrointestinal ulcers and bleeding

NSAIDS May cause gastric/duodenal ulcers May damage kidneys with prolonged use

Cox-2 inhibitorsSteroids:

Problems with prolonged use Weight gain, metabolic syndrome, gastric ulcers,

blunts adrenal function, etc.

Supplements vs InflammationArthritis:

OPC3Omega 3Glucosatrin (Boswellia with Cox-2 inhibition)

Supplements vs InflammationAcne vulgaris:

PrevadermDigestive enzymes

Supplements vs InflammationAsthma/ Allergies:

OPC3AloeORAC

Supplements vs InflammationAtherosclerosis

OPC3Heart HealthOmega 3Activated Vitamin BResveratrol

Supplements vs InflammationAutoimmune diseases:

OPC3Omega 3Resveratrol (do not give with Coumadin or

breast cancer)Co-Q-10Vitamin BMultivitamins/Minerals

Supplements vs InflammationCancer

During remissions Breast Cancer

B complex Vitamin D3 Calcium CoQ-10 OPC3 Multivitamins/multiminerals

Supplements vs InflammationCancer

During remissions (not during treatment) Colon Cancer

Resveratrol Fiber powder B complex CoQ-10 OPC3 Multivitamins/multiminerals

Supplements vs InflammationCeliac disease

Digestive enzymesAloe

Supplements vs InflammationDegenerative arthritis:

Omega 3OPC3Glucosatrin

Supplements vs InflammationInflammatory GI/bowel disorders, etc.

Crohn’s disease – OPC3, Digestive enzymes, Aloe

Irritable Bowel Syndrome – OPC3, Aloe, Digestive enzymes

Diverticulitis – (after bowel rest and antibiotics) Aloe, Digestive enzymes, fiber powder (for diverticulosis), OPC3

Pancreatitis – Digestive enzymesGastric / Duodenal Ulcer – Aloe, Digestive

enzymesHepatitis – Digestive enzymes, Hepatocleanse

Supplements vs InflammationKidney disease due to diabetes:

OPC3

Interstitial cystitisOPC3

Supplements vs InflammationOsteoporosis:

Calcium plusVitamin D3 with K2 (IF Vitamin D deficient)

D3 levels should be optimally placed at around 40-60 nmol/l

Monitor blood levels to avoid toxicity

Supplements vs InflammationOBESITY:

Associated with chronic inflammation Waist circumference correlates to inflammatory

response

OPC3ResveratrolOmega 3Transitions

Supplements vs Inflammation

Reperfusion Injury (Heart and Brain):Post- Myocardial infarction and Post-StrokeOPC3ResveratrolOmega 3

Psoriasis:OPC3

Keep Inflammation in moderation