In a wide-ranging speech on Aug. 23, 2004, in Phoenix, Ariz., Robert F. Kennedy Jr., then an independent candidate for President of the United States, made several comments about chronic disease, a topic typically addressed by doctors and, less often, by public health officials.

“Chronic disease is an issue that affects all of us far more directly and urgently than any culture war issue, as well as all the other issues that we obsess over that are tearing apart our country,” Kennedy said. “This is the most important issue. Therefore, it has the potential to bring us together.”

Chronic Inflammation News Graphic

Mr. Kennedy highlighted several data points that we were able to verify to illustrate the severity of the issue, including:

  • The United States spends more on healthcare than any other country, nearly twice as much as Europe. (source)
  • Two-thirds (66 percent) of American adults and children suffer from chronic health issues. (source)
  • About 18 percent of American teens have fatty liver disease. (source)
  • Seventy-four percent of Americans are overweight or obese. (source)
  • Cancers among young adults have increased by 79 percent. (source)

We appreciate Mr. Kennedy for bringing attention to the immense impact chronic disease has on both the U.S. economy and the health of our children and adults. As a Tampa, Florida-based medical practice dedicated to functional medicine and integrative healthcare, we have long been committed to diagnosing and treating the root causes of illness. Mr. Kennedy’s message, which you can read in its entirety here, echoes what we and our colleagues have been advocating in our clinics for years.

Inflammation – The Common Factor in Most Cases of Chronic Disease

One word that was noticeably absent from Mr. Kennedy’s remarks was “inflammation,” which those of us who have dedicated our lives to the medically-supervised care and motivation of others know is at the root of most chronic health conditions.

Virtually all chronic disease can be traced to chronic inflammation, and most chronic inflammation can be traced to preventable causes, including the following:

  • Unhealthy diet (high in sugar and other simple carbs, processed foods, and trans fats, and low in nutritional value)
  • Sedentary lifestyle (lack of exercise)
  • Undetected food allergies or sensitivities
  • Exposure to environmental toxins (including those in food and common household items and mold toxins)
  • Stress

In “Understanding and Managing Chronic Inflammation,” which we published here on the PROVOKE Blog in 2017, I explain how chronic inflammation — which had been reclassified at the time as “metaflammation” (metabolic inflammation) — wreaks havoc on the body. Diseases mediated by chronic inflammation include:

  • Allergies
  • Asthma
  • Arthritis
  • Metabolic disorders (including obesity and type 2 diabetes)
  • Cardiovascular diseases
  • Inflammatory bowel disease (IBD)
  • Chronic obstructive pulmonary disease (COPD)
  • Cancer

Since we published that blog post on chronic inflammation, research has progressed, giving us deeper insights into this silent, yet persistent condition. In this post, I highlight the key takeaways from the latest research, as well as what you or a loved one may do if you suspect that you’re living with chronic inflammation.

The Gut-Inflammation Connection

One of the most groundbreaking discoveries is the connection between the gut microbiome and inflammation. The gut microbiome is the ecosystem of bacteria, fungi, and viruses that inhabit the gut. As researchers point out in a study published in August of last year entitled, “Immunological mechanisms of inflammatory diseases caused by gut microbiota dysbiosis: A review”:

The gut microbiota is indispensable for maintaining host health by enhancing the host’s digestive capacity, safeguarding the intestinal epithelial barrier, and preventing pathogen invasion. Additionally, the gut microbiota exhibits a bidirectional interaction with the host immune system and promotes the immune system of the host to mature. When dysbiosis [imbalance of microorganisms in the gut] occurs due to various external factors, the normal physiological functions of the gut microbiota are lost, leading to pathological damage to the intestinal lining, metabolic disorders, and intestinal barrier damage. This, in turn, triggers immune system disorders and eventually causes inflammatory diseases in various systems.

What does all this mean? Simply put, what happens in the gut does not stay in the gut. and that’s not limited to digestion and elimination. An imbalance in the gut microbiome has far-reaching health implications. It can negatively impact every organ, tissue, and cell in the body. Gut health is an essential component of overall health.

Inflammation and Long COVID

Long COVID, characterized by symptoms lasting weeks or months after the infection has passed, affects about 10 percent of COVID patients, according to The New England Journal of Medicine. That should be no surprise given that inflammatory biomarkers, such as elevated levels of IL-6 and CRP, are common among those with long COVID, especially those suffering from persistent symptoms such as fatigue and brain fog.

The takeaways here are that Long Covid may be classified as an inflammatory disease, and that people suffering from Long Covid symptoms are likely to benefit from a treatment protocol for reducing inflammation and restoring healthy immune function.

Dementia and Inflammation

In “Neuroinflammation: A Potential Risk for Dementia,” a research team led by doctors Afroz Ahmad and Ozaifa Kareem describe how inflammatory responses in the brain may contribute to Alzheimer’s disease and other forms of dementia:

Microglia of the central nervous system (CNS) are the principal components of the brain’s immune defense system and can detect harmful or external pathogens. When stimulated, the cells trigger neuroinflammatory responses by releasing proinflammatory chemokines, cytokines, reactive oxygen species, and nitrogen species in order to preserve the cell’s microenvironment. These proinflammatory markers include cytokines such as IL-1, IL-6, and TNFα chemokines such as CCR3 and CCL2 and CCR5. Microglial cells may produce a prolonged inflammatory response that, in some circumstances, is indicated in the promotion of neurodegenerative diseases.

In “The Impact of Systemic Inflammation on Alzheimer’s Disease Pathology,” Junhua Xie, Lien Van Hoecke, and Roosmarijn Vandenbroucke conclude the following:

Increasing evidence indicates that systemic inflammation might drive the initiation and progression of AD. It is becoming increasingly clear that the brain cannot longer be viewed as an immune-privileged region and that CNS inflammation and systemic inflammation are connected to each other. Furthermore, this review strengthens the belief that peripheral inflammation worsens AD progression and this opens up a wide range of possible therapeutic strategies for AD via the modulation of peripheral inflammation.

What this means is inflammation plays a key role in Alzheimer’s disease and other forms of dementia, so treatments developed to reduce inflammation are likely to help. In fact, anti-inflammatory interventions, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) and natural compounds such as curcumin, are being explored to reduce inflammation and slow cognitive decline in dementia patients.

New Biomarkers for Early Detection

Being able to identify early signs of inflammation enables healthcare providers like those here at PROVOKE Health to diagnose inflammation-related illnesses earlier and provide more targeted interventions to halt their progression and perhaps reverse their course.

Until relatively recently, we have had to rely on biomarkers that provided a general indication of the presence (or absence) of inflammation, including the high-sensitivity C-reactive protein (hs-CRP) test and the erythrocyte sedimentation rate (ESR) test. Newer tests can measure the levels of specific cytokines (chemicals secreted by the immune system) and other inflammatory mediators. (Note that cytokines can both upregulate and downregulate the immune response.)

Healthcare providers now have more and better tools for diagnosing (or ruling out) inflammatory conditions in the body and making better treatment decisions. As researchers point out in “Cytokines in Inflammatory Disease,” “They [cytokines] can be used as biomarkers to indicate or monitor disease or its progress, and also may serve as clinically applicable parameters for therapies.”

Personalized Anti-Inflammatory Diets

While my 2017 blog post on understanding and managing chronic inflammation highlighted the importance of diet, new studies emphasize the need for personalized nutrition. For instance, some people may benefit more from a Mediterranean diet that is rich in omega-3 fatty acids, while others may find relief through a plant-based diet high in polyphenols (chemicals found in plants that are associated with a variety of health benefits).

The key takeaway here is that personalized nutrition plans, informed by genetic testing and microbiome analysis (to determine the composition of bacteria, fungi, and other microorganisms that inhabit the gut), are becoming an essential tool in combating chronic inflammation.

For details about a diet that is rich in omega-3 fatty acids, read “What Does Functional Medicine Say About the Mediterranean Diet?” here on the PROVOKE Health Blog.

Innovative Therapies: Beyond Pharmaceuticals for Treating Chronic Inflammation

Although conventional medicine often relies on pharmaceutical medications, interest is growing in other therapies such as the following:

  • Low-dose naltrexone (LDN)
  • Peptide replacement therapies, such as the potent anti-inflammatory BPC 157
  • IV therapies, including those with high doses of vitamins and added antioxidants, such as glutathione, to reduce inflammatory disease
  • Red-light therapy
  • Hyperbaric oxygen therapy

Innovative therapies include those that use little medication (such as LDN) to no medication (such as red-light therapy). Their purpose is to reduce inflammation without the side effects associated with pharmaceuticals and over-the-counter medications.

If you’re unfamiliar with LDN, please read “Low-Dose Naltrexone (LDN) and Healthy Immune Function,” here on the PROVOKE Health Blog.

Mind-Body Approaches: Stress and Inflammation

Many people don’t know this, but stress is a trigger for inflammation, and managing stress is known to be essential for living a healthy life. And according to “The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis,” engaging in meditation, yoga, and tai chi have been shown to lower inflammatory markers in the body. These mind-body approaches not only reduce stress but also enhance overall well-being, making them powerful tools in the battle against chronic inflammation.

Digging a little deeper, in the 2022 study “The role of yoga in inflammatory markers,” Dr. Carolina Estêvão concludes that “there is a growing body of evidence on the effects of yoga practices on the modulation of inflammatory markers, namely IL-1β, IL-6, TNF-α, INF-γ, CRP and hormones such as cortisol. . . . the most conclusive data points toward beneficial effects for IL-1β and IL-6 levels,” which have been implicated in autoimmune diseases such as rheumatoid arthritis and diabetes.

Help is Available for Chronic Inflammation

For a more foundational understanding of chronic inflammation and how it affects your health, revisit my earlier post, “Understanding and Managing Chronic Inflammation.” By combining these new insights with the basics, you can take proactive steps toward a healthier, inflammation-free life.

If you or a loved one suspects that inflammation is at the root of your health concerns, we’re here to help. You can schedule a free 10-minute consultation with myself or our Medical Director, Dr. Karalynne Blochberger, MD, here, or schedule an initial 60-minute appointment here.

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Disclaimer: The information in this blog post about chronic inflammation is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this blog post should be construed as medical advice from Dr. Matthew Lewis, Functional Healthcare Group, PLLC, or PROVOKE Health, nor is this blog post intended to be a substitute for medical counsel on any subject matter. No reader of this blog post should act or refrain from acting on the basis of any information included in, or accessible through, this blog post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP® specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing at PROVOKE Health in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), Dr. Lewis has learned how to restore his own health and vigor to prevent the onset of these and other illnesses, and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa and elsewhere.

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Dr. Matt
D.C., DACBN, CFMP®