Things like systemic inflammation and leaky gut have started to become popular topics in the last few years, but I think it’s still very confusing for a lot of people.
What I hope to do is to give you a better understanding of what these processes are, how they occur, and what impact they may have on your persistent and / or confusing physical (and even mental) symptoms.
We don’t always think about how lifestyle factors can play a role in the process of chronic inlflammation and leaky gut. It’s easier to understand how something like smoking, just for example, can cause inflammation in the lungs and in the body. What’s harder to understand is how things like the foods that we are eating, stress levels, or poor quality sleep play a role as well. You can’t always choose what things are going on, and that is a scary place to be, especially when it comes to your health. However, what you can choose is the way you respond and your habits and behaviors. This puts you back in a place of having some control over what is going on and a sense of empowerment surrounding the process, even if it takes time to overcome.
After giving you a more clear picture of what is going on within the body—and hopefully a better understanding of how chronic inflammation occurs—I am going to give you some practical tips and next steps so that you have options for ways you can do something about them. It is a physical, emotional, and mental journey, but healing is worth the investment!
I realize there is a spectrum of commitment level involved with some of these changes based on how much they interfere with your preferences or disrupt your lifestyle. Regardless of your commitment level to making changes, there will be something you can apply starting today!
Also, before we jump in, I do think it is important for you to know that I am a medical provider and I have personal experience with these issues as related to my battles with hypothyroid and SIBO (small intestinal bacterial overgrowth). I don’t claim to know everything, but have done (and continue to do) a lot of research in these areas. Many of my clients deal with these issues on some level, even if it is not full blown. I would be happy to assist you in any way I can if this is an area you need to tackle! You can contact me here. If I don’t know how to help, I’ll point you to someone who does! I currently work with clients online via email, via phone consults, and via the Voxer app.
What is inflammation?
Inflammation is the body’s natural way of healing itself. There are different molecules responsible for the inflammatory response. Some mark the “foreign invaders” then others come in and attack. Usually when we think about inflammation, we think about an acute illness, an injury, or possibly a chronic problem like arthritis. We tend to think of it from a physical standpoint. We think about things like redness, swelling, and pain.
What is systemic inflammation?
If you have a sore throat or sprain your ankle, you might have inflammation of the tonsils or your ankle. That’s localized inflammation. Systemic simply means that the inflammatory response can cause problems anywhere.
Something like a fever which indicates infection is not specific to one body system. Meaning the issue could be anywhere or everywhere. A fever is an example of what we call a systemic symptom.
That picture / process can be helpful to think about in order to understand systemic inflammation and other symptoms.
Again, systemic simply means that the inflammatory response can cause problems anywhere. Systemic inflammation looks different depending on the location it manifests.
A few examples:
- Musculoskeletal system: joint damage / stiffness / pain muscle soreness
- Blood vessels and Cardiovascular system: cardiovascular disease, hypertension, heart disease
- Gastrointestinal system: leaky gut, fatty liver disease, Irritable Bowel Syndrome
- Neurological system: brain fog, mood disorders, Alzheimer’s / dementia
- Pulmonary system: Asthma, bronchitis
- Dermatologic: rashes, hives, eczema, dryness, damaged hair / nails
What causes systemic inflammation?
In a situation where there is an underlying issue already present and then something else happens above and beyond what the body can handle, things can start going wrong with the immune system. Basically, the body is already on “high alert,” then there is an additional trigger.
I mentioned before about the different molecules responsible for the inflammatory response. Some mark the “foreign invaders” and then others come in and attack them based on those tag. If the process is efficient, all goes right, but the body can only handle so many things at once.
When the body overwhelmed by all the things going on, it’s like someone running around trying to tag the “problems” but they don’t have time to really look closely and so they can end up marking normal things by accident. The body can end up marking its own tissues that look very similar to the actual invader or other things that look like problems, but actually aren’t. Many of these things are proteins that are complex and have pieces that look very similar. That is why dietary things can be such heavy hitters.
This overwhelm of compounding things can be caused by things outside of our control—thing like illness, injury, exposure to harmful substances in our environment, genetic predisposition, autoimmune conditions, but systemic inflammation can be caused by things which are under our control as well.
What we’re learning is that even chronic illnesses, genetic problems, and autoimmune disorders are associated with, and impacted by, things which are under control. Our lifestyle and behaviors have an influence. There can be a feedback loop that develops where things go around and around in a negative cycle.
What do I mean by lifestyle and behavioral choices having influence?
When I say this, I mean things like:
- The foods you eat
- How much sleep you get and the quality of it
- Physical activity
- Stress management
- Personal Relationships
- Substance use (tobacco/alcohol/medications)
You might not have complete control over some of these things, but you certainly have some control over most, and you have control over how you manage them appropriately. Even just the knowledge that you have control can help with your perception of the situation.
Even your thoughts can be toxic or empowering. The power of life and death is in the tongue. Thoughts can nourish you or be destructive. What you think about what is going on matters.
What are the red flags for systemic inflammation?
Too many to list them all, but can include:
- Pain, fibromyalgia
- Brain fog, chronic fatigue
- Cardiovascular disease and high blood pressure
- Metabolic syndrome and Diabetes
- Abnormal cholesterol
- Weight gain, especially around the midsection
- Mood changes; depression, anxiety, ADD/ADHD
- Gastrointestinal symptoms; bloating, heartburn, constipation, diarrhea, etc.
- Skin symptoms like hives, rashes, eczema, rosacea
- Allergy symptoms; congestion, cough
- Hormone imbalances, PCOS (polycystic ovarian syndrome), thyroid disorder
- Autoimmune disorders like Lupus, RA, Hashimoto’s, psoriasis, etc.
What is leaky gut?
Your gastrointestinal system is more than just a means of getting nutrition into the body. Is part of the immune system and it is also part of the neurological system. You’ve probably heard of it referred to as the “second brain” before. That is because it helps to communicate with the body on a chemical level much like the brain and in conjunction with the nervous system. As part of the immune system, it is a barrier of entry.
Under normal conditions the junction of the lining of the intestine allows only specific things to get through. Chronic inflammation of the absorptive surface of the inside of the intestines leads to “gaps” that are bigger than usual. See this post for great info and helpful photos. This allows things to pass through which usually aren’t able to, such as harmful chemicals or large protein molecules which are fully broken down. This sets up a state for “high alert” like I talked about earlier.
How is leaky gut related to systemic inflammation?
This is really a chicken or the egg scenario. Either can cause the other. To make matters worse, once it gets going, it can be a vicious cycle of a negative feedback loop.
A trigger (or inflammation itself) can weaken the gut lining, resulting in larger things to pass through which aren’t normally able to, which then sets off (or perpetuates) the “high alert” situation I mentioned earlier. The systemic inflammation then further weakens the gut lining, causing more leaky gut, and around and around it continues.
What causes leaky gut?
Essentially, anything that causes inflammation and irritation to the gut lining.
A few examples:
- Infections: bacterial, yeast, mold, parasites
- Medications: things that directly affect motility like pain medications, or ones which change the environment like acid reflux medications, or antibiotics which impact good bacteria, just to name a few.
- Foods: More on that shortly
- Toxins: heavy metals, ingredients in plastics, pesticides
- Stress: Physical, emotional, even good stress all adds up. Stress can deplete neurochemicals in the brain.
- Allergens: Environment, foods, etc.
How does food play a role?
Food communicates as much as it nourishes. We do not give enough credit to how this impacts our gut.
A few ways it plays a role:
- Food choices are not just feeding you. They are feeding gut bacteria which can influence diseases, hormones, mood, and the neurological system
- Direct irritation like additives, preservatives, contaminants
- Allergic response
What are the big dietary triggers?
Often things which have complex proteins:
- Dairy: including whey and casein (in food and in protein powder)
- Soy: including protein powders and other soy-based products; soy sauce, condiments, cooking spray, meat alternatives, soy milk, etc.
- Eggs: whites, yolk, or both depending on the person
- Legumes: beans, chickpeas, lentils, peanuts (for some people tree nuts as well, but less likely)
What other foods can cause an issue besides the high-trigger foods?
These are the foods that are more irritants than they are allergens, or instead of being related to the protein molecule mistake tagging, they cause inflammation in other ways.
- Carbs: All are not bad; it’s refined carbs that cause the majority of problems.
- Fats: All fats aren’t bad; it’s certain types of fats that cause problems; trans-fat, saturated fat*, vegetable oils, incorrect omega 3 to 6 ratio.
- Alcohol: It may be shown to have some benefits, but it is a toxin first and foremost, and for someone dealing with chronic inflammation the benefits don’t outweigh the problems.
- Caffeine: Might not be a problem for everyone, but for anyone dealing with cortisol issues it can be a major issue (you will know if this is you if you are “tired but wired”).
- Coffee: It is very heavily contaminated with pesticides (if not organic), and again the caffeine may apply as a concern for some.
- Low quality meats: Processed meat which has additives and preservatives, meat that’s fed poor quality diet (you are what you eat eats), meat grown with antibiotics and hormones which are irritants.
*(A note on saturated fat. I am more concerned about poor quality vegetable oils than I am saturated fat or even cholesterol. Unless you have a familial or genetic problem with cholesterol, it might not be necessary to worry as much about them as we have in years past. The clogged artery model in textbook was actually from a study on hydrogenated vegetable oils, not animal sources of fat. But in high inflammatory state, can be a potential problem, so moderation is always best).
How does sugar play a role?
Most has to do with elevated blood sugar, spikes in insulin, and eventually insulin resistance which is the precursor to and cause of diabetes.
When your blood sugar rises:
- There is an increase in inflammatory response.
- There is an increase in destructive byproducts which are formed in the presence of sugar.
- There is an increase chance for insulin resistance and weight gain, specifically around the mid-section which also increases inflammatory chemicals (and further perpetuates insulin resistance in a vicious cycle).
What can you do?
This will vary based on your “rediness to change” and your commitment level. Do what you can; something is better than nothing.
Small steps—gather information and try to identify problems:
- Keep a food journal to log symptoms and identify triggers.
- Have MD do labs (in some cases).
- Read labels to gain awareness.
- Keep track of times throughout your day where you experience high stress and times which you experience a sense of calm. This is just data collection. Do not attach judgment to it. It will give you an idea of where to make changes later on. Keep track of these things by writing them down or logging them in a note on your phone. Don’t skip this thinking that you won’t forget because you will.
Medium steps—adding things in which reduce inflammation:
- Leisure walking (not powerwalking!) which helps with lowering stress hormones and boosts mood.
- Prioritize (good quality protein) and eat it first to help stabilize blood sugar and hormones (more on this here).
- Sleep more and improve quality of sleep (some tips here; some additional info here and here).
- Be mindful to slow down when you eat and chew thoroughly .
- Spend time in activities which recharge and energize you (hobbies, rest, relaxation). Ideally, they should be things which are not tied to productivity. Unfortunately, most of us allow our self-worth to be tied to our work. This is about adding things that are enjoyable in and of themselves, not a means to an end. Hobbies and relaxation are different for everyone. For some it may be social events, for others is may be alone time. For me it is things like listening to podcasts, introspective time, walks with my husband with uninterrupted time talking. For others it may be gardening, a sport, or writing.
- Practice preventative self-care. This is similar to rest, relaxation, and recharging activities, but are practiced in advance of becoming drained to help offset the load of life. A lot like preventative medicine and screenings. You do these as an ongoing practice instead of waiting until you’re stressed. Again, these things will look different for everyone. For me they are things like gratitude journaling, Bible study and prayer, exercise, my morning routine, etc. For others, it may be meditation, playing music, creating something etc.
- Eat more whole, natural, nutrient dense foods more often. (i.e. eat more lean protein, use more healthy fats, choose naturally sweetened whenever possible).
- Eat without distractions.
- Don’t eat in a stressed out state; do 2 minutes of slow deep breathing to get into a calm state if you are stressed.
- Practice gratitude.
- Drink more water.
- Spend time with people who build you up and encourage you.
- Put the principles of your faith into practice (if you are a person of faith); acting in alignment with your values is empowering and therapeutic.
Bigger steps—avoid the things which cause inflammation:
- Try an elimination dietary protocol and strategic reintroduction (dairy, gluten, soy, alcohol, legumes, peanuts, caffeine, etc.).
- Switch refined sugars for natural ones that don’t impact blood sugar (stevia, erythritol, monk fruit).
- Remove artificial ingredients and processed foods.
- Remove sources of stress (relationships, unnecessary commitments).
- Set boundaries and give yourself more margin (say no, use a schedule).
- Remove things from your schedule and create open space on your calendar.
What elimination and other protocols are there?
Please note, while some use these for weight loss /management, none of these are intended here for purposes of weight loss / management, but rather healing.
Diets and protocols include:
- Whole 30 (this is my go-to for those who want to do an elimination as it is likely the most clear cut and easy to implement on your own, at this time, once you do the background reading. See here for my thoughts and follow the link to the site to learn more about how to do it).
- Low FODMAP (Can be very confusing to do alone without medical or coaching assistance).
- Paleo (This is getting easier to do with convenience options and such).
- AIP see also here (Very similar to plaeo, but more strict).
- Intermittent Fasting (This can be used in conjunction with other protocols or alone and is very helpful if the gut needs some rest time. There are different ways to do it; see link).
- Keto (Definetly extreme/requires a lot of dedication and effort, but may have a place).
- Carnivore Diet (This is very extreme in my opinion; while has a place, I do not think it is necessery in most cases).
- Elemental diet (Should be done under medical supervision).
The right process will look different for everyone. My preference is to use the least restrictive method possible to get results. Said another way, we want to be as inclusive as possible, both from a mindset standpoint and nutritional variety standpoint. We don’t want to create fear around this process. Fear itself is a stressor and will make things worse. We also don’t want an unnecessary disruption of life by following a protocol. I also recommend using these for as long as needed, but then resuming as close to what “normal healthy eating “looks like for you. Sustain only what limitations keep you feeling and functioning at your best, no more, no less.
You should discuss these options with a qualified medical provider and/or RD. In some cases, labs may need to be monitored.
Final thoughts to consider:
- For some people this will be a temporary process, others will need to avoid certain things on an ongoing basis.
- You don’t know how bad you feel until you know how good you can feel. It is worth trying for a length of time.
- You can always go back to the old way. Give it a fair shot.
- Something is better than nothing—little steps add up. Gives you a sense of victory and confidence.
- Get support—don’t try to do it alone!
- For those who have hit dead ends and wall after wall: Be your own advocate! Don’t give up! You can find relief and improvement!