What Contributes to Inflammation?

In her weekly column, Bradford West Gwillimbury licensed nutritionist Nonie De Long shares a holistic approach for a reader with Lupus and arthritis.

Hi Nonie,

I consistently follow your articles in Bradford Today and I had a follow up question about a recent article.

You state “Systemic inflammation can almost always be traced back at least in good part to malnutrition or toxicity related to dietary imbalances.”  

Inflammation is an issue I deal with as I have Lupus, arthritis and sinusitis.  Could you elaborate further on areas of malnutrition that contribute to inflammation? Would you also be more specific in regards to toxicity?  What should I be looking for or doing to fix these two possible issues?  

And lastly, is there anywhere you can recommend to have a reliable food intolerance test?

Thanks, Confused

Dear Confused,

Thank you for your question, and for reading regularly! With your specific conditions - Lupus, arthritis (RA?), and sinusitis - you do need to address inflammation on a systemic level. Each of these conditions is inherently inflammatory in nature. Doing so will be the cornerstone to improving your health. 

Yours is a very complex health picture and obviously outside of the scope of my column to address fully, but holistic treatment should include addressing gut dysbiosis and permeability, which is certainly a factor in your inflammation. I’ll try to unpack this a bit, as it relates to toxins and malnutrition. But first I want to clarify the meaning of malnutrition. 

The root mal means disordered (Latin) or badly (le francais). We tend to take malnutrition to mean a lack of proper nutrition from not getting enough to eat. But it can also mean a lack of nutrition from not eating enough of the right things or from not getting adequate nutrients from the food one does eat. I will explain how this is relevant. 

Healthy intestines don’t just absorb nutrients and channel waste, their mucosa and structure also act as a barrier to pathogens and an informant to the immune system. When there’s permeability in this barrier (think of it as tiny holes or gaps in a tube shaped, tightly woven screen covered in little finger like projections) food, various toxins, and microorganisms we’ve been exposed to escape or leak into the bloodstream to circulate. This is not supposed to happen in a healthy body! In a healthy body, only beneficial, fully digested nutrients are given entry into the bloodstream by specific transport molecules via approved pathways to strategic sites where they are unloaded and used for specific manufacturing purposes. And all the dangerous things are locked inside the tube and swept along to be excreted. So foreign molecules (even nutrients) aren’t supposed to get into our bloodstream indiscriminately. 

But our bodies are wonderfully designed! Our immune systems are set up to tag antigens on the surface of all potentially harmful substances that get into our bloodstream, creating antibodies to them forevermore so once we have come into contact with an offender, we are more quickly able to identify and remove it in the future. Antibodies are a signal to obliterate: a sort of seek and destroy function, if you will. Toxins, viruses, fungi, bacteria, chemicals, drugs, foreign debris, and proteins all have surface antigens that identify them. 

So do many of our own cells, it turns out. But with an immune system that is functioning at normal levels, these are clearly recognized. 

In a healthy body the antigens are limited and of a specific duration under normal circumstances (a flu virus, for example), after which the body recuperates and the immune response dies down. But, in the case of a leaky gut, the invaders are continual - every time anything is passing through the gut there is a slow leak of antigens from various sources. The immune system goes to work tagging them all as a threat - even proteins we need for survival because they are escaping in an unrecognized form. Now they’re seen as offenders and a food reaction (sensitivity) is borne. Of course, the response is system-wide because the gaps allow these antigens directly into the bloodstream to circulate around. 

Now, the immune system response doesn’t stop there. It’s super sophisticated! It has a backup to that backup, called inflammation. When the body gets the memo that the seek and destroy mission isn’t doing the job and there are still circulating offenders getting in like gangbusters, it mounts an inflammatory response that is sort of like a system lock down. Inflammation can be localized - when a tissue is damaged, for example, and we get swelling, heat, redness, and pain as chemicals are released to bring blood to the area to facilitate healing and clean up. Or inflammation can be non-specific and systemic, depending on the perceived threat. 

Systemic inflammation looks like this:

“Seek and destroy botched it again.” “Not surprising. Snort. Okay, let’s get this done right. Initiate operation overkill.” Heat or fever - let’s torch these guys. Mucous - let’s trap these guys. Tissue swelling - let’s lock these guys in. Call in the Mr. T’s. (T-cells) - let’s attack these guys.  “Okay, but we’re running low on energy. “Right. Shut down the brain and draw all the energy reserves.”

For someone with Lupus, these symptoms will sound very familiar. 

The current medical paradigm is that systemic inflammation is a response in the body that doesn’t understand there is no threat - a spontaneously overactive or delusional immune system, if you will. In this paradigm it’s recognized that people with chronic systemic inflammation are more likely to develop autoimmune disease, although it’s not really understood how. It’s perceived that the body just randomly attacks its own tissues. And these people, in turn, develop multiple chemical and food sensitivities, by unknown mechanisms.

But what if the leaky gut sets all this in motion? When antigens are appearing several times a day the immune system naturally goes on high alert. This isn’t a dysfunctional immune system - it’s a smart one. And when it does this, it has to become hypervigilant in attacking antigens. Since the body’s cells have their own antigens, it’s easy to see how they could get accidentally tagged in sites where there is a perceived threat. When quality control in any factory is dealing with three or four x the normal maximum capacity, there are mistakes. And in this factory, tags are a forever thing. Any food with any protein component that escapes into the bloodstream via this mechanism would also be tagged and become something the body reacts to. Ditto chemicals. When this is happening daily, of course the backup inflammatory system is going to kick in to try to protect against the perceived invasion. 

BOOM! Continual systemic inflammation with multiple food and chemical intolerances and an immune system on overdrive that is now busy attacking not only outside offenders, but itself. This is a holistic understanding of “autoimmune” disease. And it all starts in the gut. 

And leaky gut is often linked to gluten intolerance. With your symptom set I feel safe saying it’s likely that you’re gluten intolerant, if not celiac. I would recommend testing for celiac immediately. If that does not return a positive test, I would recommend non-celiac gluten sensitivity testing. You can get antibody, saliva and blood testing, but they are not always accurate in the absence of symptomatology and a knowledgeable practitioner. It’s still new territory. I prefer my food intolerance test, antibody testing, and intestinal permeability testing, working collaboratively with your physician. In complex cases it’s always best to have a collaborative approach if you can.

Why do I feel you are gluten intolerant? Gluten, in particular, damages the gut lining in sensitive individuals. It burns the microvilli and causes gaps in the junctions of the intestinal lining. Remember, these gaps are how antigens ‘leak’ into the bloodstream to initiate and fuel the immune system mayhem. 

Undiagnosed non-celiac gluten sensitivity has been shown to masquerade as Lupus

As for toxins, mycotoxins (molds), parasites, candida, bacteria from root canals, heavy metals, synthetic fragrances, chemical cleaners, chemical body care products, and environmental toxins should all be considered and eliminated. These can precipitate the problem or just add to it. Remember, if there are regular antigens the immune system mayhem starts. Regular antigens can come from a food intolerance (gluten), from environmental toxins (mold), from endogenous toxins (bacterial imbalance or candida), or from any number of sources. So if you are gluten intolerant, that is also acting as a toxin. 

The person with an autoimmune disease will, as a result of all this, have an overburdened liver  - because it is trying to deal with all these toxins - and this means any subsequent toxin will have an exaggerated impact compared to the impact they would have on a healthy host. Something as benign as perfume can even trigger migraines or seizures in such people. Their livers just can’t handle any more! Discerning and eliminating these toxins can make a big impact on the burden of the body. Removing common toxins like sugar, alcohol, drugs, cigarettes, and processed foods are also imperative for managing symptoms and discomfort.

It may be helpful to think of toxicity as anything that adds to the burden of the body. It only makes sense that if the burden is increased chronically, the body is going to need copious nutrients to do that work. Unfortunately, when we are chronically ill the first thing to go is often our diet. We eat convenience food instead of quality, nutrient dense foods. These foods are full of toxic chemicals and additives. Too, many healthy molecules are mistakenly tagged as toxins (above). The body struggles in the presence of so many substances to protect itself from and is overwhelmed by the burden of it.  

But how does malnutrition play in? When the digestive system can’t contain nutrients in the lumen until they are properly broken down and delivered via appropriate pathways, deficiencies develop. At the same time, the body requires more nutrients than normal to sustain its protective detail. These deficiencies, in turn, make it difficult for tissues (like the damaged gut tissue) to self repair. This happens even when a person is eating well - because the food is not being absorbed properly. This is why I say malnutrition plays a large role. 

As such, I believe healing the gut and adding strategic supplements to a nutrient dense, easy to digest diet that identifies and avoids or rotates intolerances is essential in starting to address chronic inflammation and autoimmunity.

I hope this helps clarify the role of inflammation, toxicity, and deficiency, particular to your concerns, and of food intolerances. I hope it gives you some clear actions you can take to start to improve your health. If you want further guidance you can come see me in my clinic. I offer comprehensive testing for food intolerances and gut biome health, which would tell us a lot about the state of your digestive system to create a strategic plan. At the very least, I hope you are less confused!

As always, if readers have their own questions I encourage them to write to me at nonienutritionista@gmail.com. For more health news, recipes, and nutrition related events in the community, readers can go to my website at nonienutritonista.com and sign up for the newsletter. It’s nutritionist certified and 100% gluten and sugar free!

Namaste! Nonie Nutritionista

Nonie De Long is a registered orthomolecular nutritionist with a clinic in Bradford West Gwillimbury, where she offers holistic, integrative health care for physical and mental health issues. Check out her website here.

Do you have a question about health and wellness? Email nonienutritionista@gmail.com

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