Top 7 Causes of Inflammation and Proven Ways to Fight Them

Dr. Mike: Hey, Dr. Mike here. Dr. Crystal wants me to say if you have a burning desire to know more about inflammation and how to reduce it, stay tuned to find out.

Live Foreverish Introduction: You're listening to Live Foreverish, a show dedicated to helping you live just a little longer. Here are your hosts, Dr. Mike and Dr. Crystal Gossard.

Dr. Mike: All right. Welcome to Live Foreverish. You know, Dr. Crystal, you and I have talked about inflammation a lot. And we should, because if you want to Live Foreverish—a little longer and a lot stronger.

Dr. Crystal: So those of you, if you’re listening, Dr. Mike has a new tagline that he just came up with.

Dr. Mike: Living Foreverish: A little longer, a lot stronger.

Dr. Crystal: A lot stronger.

Dr. Mike: Come on guys, that is good.

Dr. Crystal: Okay, I'll get on the bandwagon.

Dr. Mike: All right. But it's true. Chronic inflammation—we have said so many times—is the common denominator of all age-related diseases.

How Do You Tell If You Have Inflammation in Your Body? 00:01:01

Dr. Mike: And so, having a strategy for keeping that inflammation in check is really important. But we have to back up, though, don't we? Because it is important to.

Dr. Crystal: Oh yes! It's how the body heals.

Inflammation is involved with bringing immune cells to the site. Of course, there is the redness, the heat and the swelling. Of course, the loss of impairment as well—the one that we don't like—and pain.

But there is a purpose for all of these aspects increasing blood flow to that area. And so, we need inflammation. And I know some people, they're just like, “I just want to wipe it out.” And I'm saying that, no, you need to heal.

And just a quick tangent. It's fast. We need the inflammation process to heal and to help us grow more muscles.

Dr. Mike: I love it. It's so true.

Dr. Crystal: When you're exercising, you’re breaking down…

Dr. Mike: Yeah, that's how you make muscle.

Dr. Crystal: …tearing apart that muscle. And you don't want to take too many anti-inflammatories after a big workout.

Dr. Mike: I'm gonna flip this. People are like, “I want to wipe out inflammation.” There are drugs for certain inflammatory conditions that do and guess what happens? They have an increased risk of deadly infections. You don't want to wipe out inflammation. It's so important.

Dr. Crystal: But we do live in a world where chronic inflammation is what's most prevalent in our population.

Can You Fix Chronic Inflammation? 00:02:43

Dr. Mike: Let's give a very simple, easy definition of chronic inflammation. How would you say that?

Dr. Crystal: Well, I think it's easy. I think it's really when you don't have a proper resolution [for] inflammation. We still have immune cells and inflammatory cells that are sticking around. It's a smoldering flame.

That's why I asked Dr. Mike to say: do you have a burning desire? You don't want to be burning, and you don't want the smoldering coals either.

Dr. Mike: Well, I told you that when inflammation was starting to get really big and stuff like that. That word “inflammaging.” [Do you] remember that?

TIME magazine [had] on their cover: “Is your body on fire?” That was their cover, and that was the world's first intro to this idea of chronic inflammation.

Dr. Crystal: You don't want the inside of your body to be a slow cooker.

Dr. Mike: Yeah, I like it smoldering. It's like some timbers are still burning in there.

Real acute information is a fire, and you need that. But your body also has things to pull it back, calm it down and wipe it out. Not totally, but just keep it controlled. And chronic inflammation, as we get older, we're losing that control.

Dr. Crystal: That's right.

Dr. Mike: All right…I like the way our team set this up for us. We're going to go through extrinsic and intrinsic issues. And what we've done is we've set it up where we're going to mention what the problem is and briefly discuss that and then quickly what the solution to that specific problem is.

What Is the Most Common Cause of Chronic Inflammation? 00:04:15

Dr. Mike: Now, if you're somebody who's interested in this—like I am, and I know Dr. Crystal is—I don't think of it as these things are happening in a vacuum. A lot of the stuff we're going to cover, they're happening to all of us all the time. So, it's not like you [have] to go, “Which one of those is me?” Most likely, it's a lot of these.

Dr. Crystal: Right. Many of these things you need to just keep in mind.

Dr. Mike: Yeah. So, extrinsic [causes are] outside things causing chronic inflammation. Number one, and I think this is the big one.

Dr. Crystal: I know it's the big one.

Dr. Mike: …imbalance in omega-6 to -3 fatty acids, or what is known as the omega-6 to omega-3 ratio. Really quickly…omega-6s tend to drive a little more inflammation, [while] omega-3s calm it down a little bit.

And a good ratio in the American diet is probably somewhere—people are going to argue [with] this—around 3 to 1 or 2 to 1—some people say 1 to 1 ratio. That's fine.

Dr. Crystal: The ideal ratio of 6 to 3.

Dr. Mike: It's definitely low. You know, like 3 to 1, let's say. But what's the average American’s?

Dr. Crystal: Oh! 17, 18 or 19 to 1. And when we say 19 to one [we mean that] if you look at the levels of these fats in your body—18 or 19 omega-6, which is pro-inflammatory, to 1 omega-3, which is anti-inflammatory. So, this is keeping us in a pro-inflammatory state.

The omega-6s [are] making these mediators of inflammation that are just super powerful, strong and good at doing their job. But of course, you have to balance that out.

Dr. Mike: That's all it is. It's a balance. And so, what's the solution coming from the Doctor of Clinical Nutrition?

What Is the Fastest Way to Reduce Inflammation in the Body? 00:06:20

Dr. Crystal: Well, the solution is to find ways to get more omega-3s into your body. That can be from fatty fish, salmon, sardines, anchovies or mackerel.

Dr. Mike: Love it. All of it. I'm getting hungry.

Dr. Crystal: Or nuts—like walnuts, flaxseed…

Dr. Mike: Pistachios.

Dr. Crystal: Mmm? I have to look that up. I don’t know, Dr. Mike.

Dr. Mike: I went too far. I'm not the nutritionist. I went too far.

Dr. Crystal: And then, maybe, adding in fish oil, krill or algae.

Dr. Mike: However, you want to get it, there [are] a lot of options out there.

It’s interesting [that it’s] the algae that actually makes the omega-3s, and then they get eaten by the fish and then we eat the fish—that's how we get it. I think at the end of the day, an omega-3 add-in is probably the easiest first step for people, but then also work on the diet. We like food first!

Dr. Crystal: We do. And so, with food first, just a reminder that the foods that are giving you the omega-6s are a lot of animal products. So, as you're upping the omega-3 intake, consider kind of decreasing the animal and the meats.

Dr. Mike: And again, we're not saying you have to eliminate it. It's just finding that better balance.

And you can actually test for this. You can know what your 6 to 3 ratio is. But right there, I just think for me, omega-3 add-on: two to four grams of omega-3 oils.

All right. Cause number two is food!

What Foods Contribute to Chronic Inflammation? 00:07:58

Dr. Crystal: And so, we already talked about the 6 to 3. But this section is really looking at high intakes of sugar, low fiber in your diet, processed foods and ultra-processed foods—there's a difference between the two.

Dr. Mike: There is, yes.

Dr. Crystal: We do have a show—if you want to go back and listen to a show—we talk about the different types of processed foods and the categories [that have] high intakes of fat. So, we’re talking about what most people eat: The Western diet.

Dr. Mike: Yeah. And so, a lot of it is pro-inflammatory. I know that one of the things you like to focus on in that kind of Western diet is the dysbiosis in the gut. That's simply a fancy way of saying [that] you don't have enough diversity of good, healthy gut bacteria in your gut.

Dr. Crystal: That’s right.

Dr. Mike: Yeah. And all of that can drive a more pro-inflammatory state. So, what's going to be our answer? I'm going to say Mediterranean diet!

Dr. Crystal: One of the best diets…I don't like calling it a diet.

Dr. Mike: It's a lifestyle of eating.

Dr. Crystal: It’s a lifestyle of eating. Because it's more than just the food that you eat, it’s really who you're eating it with—the family, the laughter, sitting around the table and sharing stories.

Dr. Mike: I miss that.

Dr. Crystal: That makes a difference.

Dr. Mike: Yeah. I think when you say the word “diet,” too, a lot of Americans automatically think [it’s] a weight loss thing. So, the Mediterranean lifestyle of eating and socializing at dinner…

Dr. Crystal: So, what does that mean? That means back to some fatty fish and some olive oil. That means eating local.

Dr. Mike: A lot of tomatoes and leafy greens.

Dr. Crystal: Right. Eating local and eating fresh food. It's real food.

Dr. Mike: I've said this before, and it surprises people. So, my mom's side is all Greek—I've told you this before—when my grandma would come and cook dinners, she [would] mostly put [vegetables on the plate]. I mean, there was some meat—we do like lamb.

We had some, but it wasn't it wasn't a big portion. It really wasn't. Because they didn't have anything! She was cooking [what] she knew how to cook. That woman got up every morning and made bread.

Dr. Crystal: Aww. Love it.

Dr. Mike: Every morning.

All right, moving on. So, the Mediterranean diet is a good way to go. Let's go to cause number three, [which] is the environment. What are we going to do here?

Environmental Factors 00:10:28

Dr. Crystal: There's so much that you can do.

Dr. Mike: Well, I don't know what to do!

Dr. Crystal: Look! Right in the other room, in our office, we have a huge hospital grade...

Dr. Mike: That loud, irritating hospital…

Dr. Crystal: …air purifier.

Dr. Mike: I can't concentrate when that thing is on.

Dr. Crystal: You have to be aware that the air in your surroundings needs to be cleaned. Remove the mold and dust.

Dr. Mike: Indoor air is worse than outdoor [air].

Dr. Crystal: With all of our buildings being sealed…But even the pollution outside…These pollutants get stored in our fat tissue.

Dr. Mike: That's a good point. We don't talk about that. Those chemicals [that] you don't want, they love to hang on to your body.

Dr. Crystal: They do. And then that causes inflammation.

Dr. Mike: Chronic inflammation. Right.

So, we [have] to do things to clean our environment. I mean, obviously, we can't control water and air or whatever, but you can inside. Filters—air and water—all that kind of stuff that you mentioned. I got to tell you too, carpets need to go.

Dr. Crystal: Ha.

Dr. Mike: What do you think?

Dr. Crystal: I'm a fan.

Dr. Mike: Of carpets?

Dr. Crystal: I am.

Dr. Mike: I know Blake [doesn't] like that. That's her husband.

Dr. Crystal: Oh, he hates it.

Dr. Mike: Just get a throw rug.

Dr. Crystal: I know.

Dr. Mike: Anyway. All right, so clean up inside.

Dr. Crystal: If you do have carpet, you need to make sure you vacuum weekly. [You should] have them steamed at least once or twice a year if you're going to live with carpet.

But yes, you're right. Absolutely right. But it's not just the carpet, it's the drapes. It's the curtains.

Dr. Mike: Wooden blinds.

Dr. Crystal: Oh, telling.

Dr. Mike: That’s what I do. I think maybe my insight is pretty good then.

Dr. Crystal: Maybe so.

Dr. Mike: All right. Let's talk then about what you can do internally.

We mentioned a lot of these chemicals you don't want [are] getting in your system. They drive up that chronic inflammation. So, a solution for the environmental thing is Boswellia. Well, a combination technically.

What Nutrients Help with Inflammatory Processes? 00:12:36

Dr. Crystal: Boswellia and Bael fruit.

Dr. Mike: I don't know if I know what bael fruit is.

Dr. Crystal: It's a shrub native to India [and] other parts of Asia. But there's research with Boswellia, which is Indian frankincense. I always like to say that.

[It’s] used in traditional Indian medicine [and shown] benefits for respiratory disorders. And there's research with these two nutrients combined in individuals who tend to be sensitive to air pollution, showing improvements in their respiratory function [and] lung capacity after six weeks.

Dr. Mike: There you go. So, try some Boswellia.

Dr. Crystal: I would like to say something else. When we talk about how these pollutants are stored in fat tissue, consider [using a] sauna, sweating or exercise—you are releasing those pollutants. And make sure you shower right after.

Dr. Mike: Hot yoga. We were talking about hot yoga. When were we talking about [it]? I don’t remember when that was.

Dr. Crystal: We were. Yesterday.

Dr. Mike: [You’re] never going to get me to do that. I sweat when it's cold.

Dr. Crystal: It’s fantastic.

Dr. Mike: Could you imagine me in a place like that?

Dr. Crystal: It's amazing.

Dr. Mike: I’d dehydrate and die.

Dr. Crystal: You wouldn't dehydrate. Well, you could. I mean, I would have to say, you need to work your way up...

Stress and Inflammation 00:14:02

Dr. Mike: All right. Let's go to cause number four: it's stress.

Now it's weird. Stress has a complicated relationship [with] inflammation. Well, you don't think it does, [but] I do!

Dr. Crystal: No, I agree. Before the show, we had this back and forth, and I'm like, “I don't understand because cortisol, which is our stress hormone, has an anti-inflammatory effect.” And Dr. Mike said, “Well, it's not that simple.”

Dr. Mike: It's not. We're talking about chronic inflammation, which means we're talking about chronic stress here. Again, stress and inflammation are very similar in that there's an acute aspect of both of them that you need. That fight or flight, which is driven by the cortisol system, keeps you alive if you need to slam on your brakes because a car or a kid jumped out.

I mean, it's an important thing, but it should calm down. But when it doesn't, you have excess cortisol levels that cause problems. It's the same thing with chronic inflammation. And here's what's interesting about it: excess cortisol actually can activate inflammatory pathways, not inhibit them.

It makes sense in the acute setting because, in that stressful thing, you don't need the immune system on. You don't need anything; you just need to run—you’ve got to run from that bear. So, your gut stops the inflammatory response, but chronically, it's a different story.

Dr. Crystal: Yeah. So, chronic inflammation or cortisol also impairs the gut microbiota, alters transit time, and leads to intestinal permeability, and all of that can lead to inflammation—just via the gut.

Dr. Mike: All right, so what are you going to do about stress? Obviously, we've talked about stress so much. There are stress modifications that you can be doing, ranging from sleep to self-care—all kinds of stuff—even some good nutrients.

Dr. Crystal: Even hot yoga.

Dr. Mike: I don't like hot, and I don't even like stretching. There's no way I'm doing that.

Dr. Crystal: Okay.

Dr. Mike: I'm going to that other place you wanted me to go to for stretching.

Dr. Crystal: Stretch Zone. Yeah, good.

Dr. Mike: So, I just lay there, and they do the work.

Dr. Crystal: It's better than nothing.

Dr. Mike: It's the only way I'm going to be able to [stretch].

Dr. Crystal: It’s better than nothing.

Dr. Mike: So, the answer to this: we chose magnesium. Why?

Dr. Crystal: We did, and not for the calming effect. Magnesium supports a healthy inflammatory response, most likely to do so based on this dietary inflammatory index. So, I say, “Oh, this is a win.” [It’s a] multimodal approach for magnesium.

Dr. Mike: I remember we were talking about how to do all this because there were so many things you could do here. And both of us almost at the same time went, “magnesium.”

Dr. Crystal: Yes. For sure.

Dr. Mike: All right…Those were the four extrinsic causes of chronic inflammation. Now we go to the intrinsic [causes]: number five.

Oxidative Stress and Inflammation 00:17:03

Dr. Mike: This is cause number five: intrinsic oxidative stress.

Dr. Crystal: I know. That could have gone at the top.

Dr. Mike: It could. But remember, it's at the top of the intrinsic [causes].

Dr. Crystal: Well, that's true. Okay.

Dr. Mike: So oxidative stress, I always refer to it as oxygen itself. Think about it: it's an active compound. I mean it's an active atom.

Dr. Crystal: Highly reactive.

Dr. Mike: Highly reactive. It creates a lot of electrons; we call them “crazy kids.” Remember that? Free radicals, crazy kids, they get all over the place.

And when they build up over time, that's oxidative stress. And it can come from metabolism, digesting food or the environment.

Dr. Crystal: Air pollution!

Dr. Mike: So, it all kind of comes into oxidative stress. And so, what are we going to do about this?

Dr. Crystal: Antioxidants.

Dr. Mike: Very simple solution.

Dr. Crystal: Neutralizing those free radicals, or as Dr. Mike mentioned, neutralizing the “crazy kids.”

Speaker 3: Yeah. So, foods: eat [colorfully].

Dr. Crystal: Yeah. Make your plate as colorful as you possibly can or just your day. Everything that you eat—try to get every color.

Dr. Mike: Yeah. I think it's just old school to say eat the rainbow…

Dr. Crystal: What else do you say? I mean, if you look at your plate, and it's all gray or brown.

Dr. Mike: Good ole American diet. Potato, bread and meat.

Dr. Crystal: 50 shades of brown are not the way. No way!

So, yes. You want purples, reds, oranges and greens—that's what you want. However, there are other nutrients you want [like] the golden yellow—curcumin or turmeric.

Dr. Mike: Love it. Absolutely. I take it every day [and cook with it].

Dr. Crystal: NAC: N-acetyl-L-cysteine.

Dr. Mike: NAC is good. Wonderful. Because NAC leads to…

Dr. Crystal: …glutathione.

Dr. Mike: That's the big one.

Dr. Crystal: Yes. Or you can just add in glutathione as well. So, antioxidant nutrients [are] going to target oxidative stress directly.

Dr. Mike: Cause number six is related to this because a lot of oxidative stress happens in a very specific part of the cell.

Mitochondrial Dysfunction 00:19:14

Dr. Mike: The mitochondria.

Dr. Crystal: Yeah. The powerhouse.

Dr. Mike: A lot of the sugar goes there; all of those crazy free radical electrons from oxygen go there. So, the mitochondria take a hit with oxidative stress. And so, we end up getting mitochondrial dysfunction.

Dr. Crystal: Unfortunately. And mitochondrial dysfunction is linked to the aging process in general.

It's linked to some neurological diseases—like Parkinson's disease. And you're even looking at some other chronic diseases. And so, we have to protect the mitochondria.

Dr. Mike: It can't protect itself, right? It doesn't have any defenses. It's interesting because it only has maternal DNA, [and] that DNA doesn't have a lot of those natural antioxidants that can form…So, it needs help.

Dr. Crystal: And the number one nutrient is CoQ10.

Dr. Mike: Say it! Yeah.

Dr. Crystal: Coenzyme Q10 resides primarily in the inner membranes of the mitochondria—a powerful free radical scavenger, picking up those free radicals.

Dr. Mike: Cleaning up those crazy kids.

Dr. Crystal: Reducing oxidative stress or oxidative damage.

Dr. Mike: Just again, I know there are two forms: ubiquinone and ubiquinol. Please go with the ubiquinol. It's better, I'm just going to say it.

Dr. Crystal doesn't like when I say things like that—when I say definitive things. And she's right, I shouldn't. But in this case, I am.

Dr. Crystal: I'm not saying a word.

Dr. Mike: Ubiquinol: It's the best form.

Dr. Crystal: Ubiquinol is the form that I would suggest for anyone to take. So, we do agree.

Speaker 3: Yeah. But if you still want ubiquinone. Fine.

Okay, let's go on then to cause number seven. This also happens a lot in the mitochondria: Glycation. So, you're going to go ahead and do your analogy because every time I do mine, you make fun of me.

Dr. Crystal: No. Your analogy is nice.

Dr. Mike: Even though my analogy is exactly your analogy—just a different way of doing it. So, go.

Dr. Crystal: Well, okay. So, my analogy…I'm going to switch up my analogy.

Understanding Glycation and Its Effects 00:21:29

Dr. Crystal: Pretend you have a coffee cup, and the coffee cup has a handle. The structure of that cup with the handle allows you to pick up the cup to drink it. So, if we can imagine that cup [is] proteins in your body.

All of your proteins have a unique structure that determines their function. And whenever you have glycation reactions—when sugar is in the body, when it's around proteins—it binds to those proteins and that protein loses its structure. So, it no longer has its function.

Dr. Mike: Like the cup without the handle.

Dr. Crystal: So, imagine the cup now, without the handle. You can't pick it up by the handle. And it just makes it awkward.

Dr. Mike: That works. Not as good as my hand analogy, but it works. Kind of the same thing really.

Dr. Crystal: Same idea.

Dr. Crystal: We see this in your everyday lab test: the hemoglobin A1C test.

Dr. Mike: Yep. You can measure it.

Dr. Crystal: We're looking at glycated hemoglobin. And there's no way to never have any glycated hemoglobin because there's always sugar in the bloodstream. There's always hemoglobin and sugar there.

Dr. Mike: So, an A1C that's considered optimal [is] somewhere [around the] upper 4s to like 5.6.

Dr. Crystal: I like 5.5.

Dr. Mike: 5.55 or something like that.

Dr. Crystal: It's hard to get it. If you're at 5.0, are you alive?

Dr. Mike: Mine was 5.4.

Dr. Crystal: Oh, that's nice. And so, that gives us an average amount of glucose that's in your blood over a three-month time period.

Dr. Mike: What it does is, it gives you a little more of a lasting look at how someone really is doing.

Dr. Crystal: Right. So, if you have lots of sugar in your bloodstream all the time…

Dr. Mike: …it's going to be higher.

Dr. Crystal: More of your hemoglobin will be glycated.

Speaker 3: Yep. For sure. And so, what are we going to do about glycation?

Managing Glycation with Thiamine 00:23:36

Dr. Mike: I'm a B vitamin fan for this specifically. There's one called benfotiamine. Have we decided how we're saying this? Because we never seem to say it the same way?

Dr. Crystal: No, I don't think we've decided.

Dr. Mike: You say it?

Dr. Crystal: I say benfotiamine.

Dr. Mike: I say benfotiamine, too. There we go.

Dr. Crystal: Oh. Calibrated.

Dr. Mike: This is a form of B1, right? A fat form of…wait.

Dr. Crystal: I thought it was B…

Dr. Mike: B4 or B5. Wait.

Dr. Crystal: B5.

Dr. Mike: You're making me look this up.

Dr. Crystal: Oh, my goodness. Thiamin is B1.

Dr. Mike: That's right. Benfotiamine.

Dr. Crystal: Do do do do. Dr. Mike’s looking it up.

Dr. Mike: It is a lab-made version of B1. I actually got one right.

Dr. Crystal: Wooo! So, it's a fat-soluble version of B1 that [can] be absorbed better and protect the tissue against blood sugar-related inflammation and tissue damage.

Dr. Mike: 300 to 600 mg a day for six weeks showed a pretty nice reduction in not just glycation overall, but even things associated with it like chronic inflammation. I'm surprised we forgot what [B vitamin it was].

Dr. Crystal: Brain fart.

Dr. Mike: Geez. How long [have] we been doing this? 20 years.

Anyway, okay. There are a bunch of different reasons—extrinsic and intrinsic—for chronic inflammation. Something that we got to keep at bay. You want to cool the body down; you don't want to have that burning desire.

I don't know, it’s what you wrote. And again, don't think of all of this as one thing. These are all occurring. So, in this country, the diet we eat, you’ve got to kind of consider all of this at the end of the day.

What's your favorite one we talked about here that drives chronic inflammation?

Dr. Crystal: Omega-3s. Yeah. That 6 to 3 ratio. So important.

Dr. Mike: Right. Because if you correct that it means you're eating better. You're probably more towards a plant-based Mediterranean [diet]. Now, your oxidative stress is going down a little bit, [and] glycation is going down a little bit. So, it kind of covers the shebang.

Dr. Crystal: I love it.

Dr. Mike: All right. There you go. For chronic inflammation.

Don't forget, you go to LiveForeverish.com and you're going to find a lot of episodes there. I don't know how many…Alex is here, our coordinator. How many now, Alex? He doesn't know. There are so many.

Download, like, share and subscribe, so you never miss a show. And then don't forget our sponsor, Life Extension. Go check them out at LifeExtension.com and use the discount code “PODCAST.” And they're going to get…

Dr. Crystal: 10% off $50 or more plus free shipping and handling.

Dr. Mike: I caught her off guard. She was starting to shut down. And yeah, that's with the discount code “PODCAST.”

I'm Dr. Mike, that's Dr. Crystal. Thanks for listening.