Can you believe it’s October already??? I can’t!! The year has gone by in the blink of an eye and to tell you the truth, I’m tired!! After a very busy spring and summer, I was looking forward to a quieter fall, but that’s not really happening either.
If you suffer from eczema then you know what a struggle it can be to find the right topical support for relief. I say “support” instead of “remedy” because when we’re treating our skin topically, it’s going to be supportive rather than curative, which remedy implies.
So, where do you even begin??
With the enormous amount of treatments out there, it can be daunting to find the one that’s right for you. You almost have to treat it like a process of elimination to see what works with your particular brand of eczema.
For the most part, I’m a middle of the road person when it comes to medications, natural remedies, and OTC’s. I don’t believe there’s one best way or best system. If you’ve got asthma, you’re probably going to need an inhaler until you actually get the underlying inflammatory process under control.
There’s nothing worse than when you’re in the middle of an eczema flare. Your skin is an itchy oozy mess, you feel horrible, and all you need is something to help calm it down.
So let’s talk about what you can put on your skin to help tame the flame and itch!
Steroids.Topical steroids are very common when it comes to treating an eczema flare. They work by reducing inflammation which calms the itch and gives your skin a chance to heal. Like over-the-counter (OTC) cortisone, prescription steroids work similarly to the anti-inflammatory hormone cortisol made in your body, but they’re much stronger.
As a general rule of thumb, it’s best to start with a lower potency in short bursts and then stop once the flare settles.
While I think steroids can be helpful in the short-term, I’m not in favor of long-term use. They can have detrimental effects such as thinning of the skin, acne or stretch marks. It basically decreases the integrity of the skin which is the exact opposite of what we’re trying to achieve when treating with eczema.
In some rare cases, steroids can induce other skin conditions like rosacea. The last thing we want to do is add another inflammatory skin issue to the one we’re already dealing with.
In addition to these side effects, there’s also a skin condition associated with excessive topical steroid use called Topical Steroid Withdrawal (TSW). The symptoms are actually similar to eczema– dry, itchy, red, burning skin in mild cases and oozing, bleeding skin in the its more severe form.
Eucrisa. Similar to steroids, Eucrisa alters the body’s natural inflammatory process that triggers eczema symptoms. The main ingredient, crisaborole, is combined with an emollient-rich ointment that helps keep the skin moisturized.
But like most prescription medications, you run into possible side effects. The more common ones include burning or stinging when the medicine is applied.
Here’s the thing with prescription medications– they’re often designed to shut down biochemical pathways by blocking enzymes, so they basically turn off your natural processes. This alters your biochemistry causing shifts in the inflammatory processes and the immune system.
In the case of Eucrisa, it blocks the enzyme PDE4 (phosphodiesterase-4) which shuts off certain inflammatory signals, effectively decreasing or stopping the process.
The goal is to give the skin more support and heal it, rather than shut off biochemical pathways. Not to mentioned the many underlying causes that aren’t addressed when the inflammatory process (read: body’s danger signal) is artificially blocked.
Like I said, I’m a middle-of-the-roader when it comes to prescription topicals. I think they have their place, but not when it comes to finding a long-term solution. It’s important to get to the root cause of why you have certain things going on in your body.
Most practitioners can’t speak with insider knowledge of the over-the-counter lotions and potions- but I can because one of my first jobs out of undergrad was in the formulation department for a very well-known personal care and paper products company (yes, it was a long and winding road for me to get here!!).
My job was on the microbiology and chemistry side, so I got to experience firsthand what types of chemicals were used and the effects they can have. This was one of the many things that actually drove me to wanting to go more natural!
Even though I’ve seen the negative side of OTC’s, I do think they have their place when it comes to finding immediate relief.
Hydrocortisone cream. Cortisone creams relieve eczema bouts the same way most prescription topicals do. Synthetic cortisone mimics the actions of cortisol, your main anti-inflammatory hormone, but is more pronounced. It works by suppressing the inflammatory signals that get triggered and block the symptoms caused by inflammation.
Helpful in the short term? Possibly, yes.
Long term solution? NO.
Benadryl cream. Antihistamines such as Benadryl (diphenhydramine) cream are very common when it comes to soothing the itch that comes with eczema. They’re generally used to treat allergies by blocking the effects of histamine– an immune system protein and signaling chemical. The body can mistake things like pollen as a harmful substance in the body and then releases histamine to fight it off. This is what causes the itchy eyes and runny nose. Even though eczema isn’t an allergy, antihistamines do have a sedating and anti-inflammatory response that helps relieve itching.
The downside to OTC medications is that they just work as a band-aid instead of solving the actual problem. They’re very accessible and inexpensive so it’s easy to become reliant on them rather than find a solution to the root cause.
Eucerin. This is a well known brand that creates creams and lotions specifically for dry skin and eczema. Eucerin contains emollients which promote moisture and increases the skin’s capacity to hold onto water. Keeping the skin moisturized can provide some itching relief and give it a chance to heal.
Cetaphil. Cetaphil is another brand that has a line of lotions made primarily to help treat eczema. Their eczema specific moisturizer has an active ingredient called filaggrin which is an essential protein for skin hydration and barrier function. Many people with eczema have mutations in the filaggrin gene which is why they are prone to eczema, rashes and general skin irritation.
Petroleum jelly/Vaseline. Petroleum jelly is a topical that dermatologists recommend frequently because people with sensitive skin can generally tolerate it. It locks in moisture and protects against outside allergens. It’s a highly process petrochemical that many sensitive people react to, not to mention the environmental impact.
Most conventional topicals are going to provide some support and dampening of the inflammatory feeling on the skin. The downside is that most of them contain synthetic ingredients like sodium dodecyl sulfate (SLS), isopropyl palmitate, parabens, and preservatives to name a few. These chemicals are known toxins or irritants so it’s important to remember that anything you put on the skin will get absorbed into the body.
Some of these chemicals are also endocrine disruptors which is something you don’t want to mess with. They are stored in fat cells and alter normal hormone biochemistry, especially estrogens and estrogen hormone pathways.
The last area I wanted to touch on are the natural remedies. And as always, you have to find what works for you.
I’ve tried so many over the years I’ve lost count. We hear the same thing from our patients as well.
I always kid around when we have the, “what have you tried?” conversation because most of us have a lotions and potions graveyard. You know… the drawer where all of your partially used topicals go to die!!
Herbal Treatments. Moon Valley Organics has EczaCalm and Herbal Heal. I use both of these depending upon my needs. I’ve been using Herbal Heal over EczaCalm because lately I feel like that’s been working really well for me. Both of these have about 12 different ingredients made with organic carrier and essential oils, as well as many herbs that are anti-inflammatory.
They both contain calendula which is known in the herbal world to be very nourishing to the skin. It’s a pretty awesome ingredient because there are no known side effects, it’s incredibly healing, and it can be used across all age ranges. You’ll see it in some of the more natural baby diaper creams— Bottom Balms, for example. It really can be used in a wide array of applications.
You can also make up your own. I talk about it more in this post.
Essential Oils. Lavender, frankincense, myrrh (we’re getting a little Christmas-y)—and tea tree oil are all very soothing for eczema.
The beauty of using EO’s is that they have multiple avenues of how they’re helping. Some of the most common mechanisms of action are antimicrobial, anti-inflammatory, calming, analgesic (pain eliminating), and skin supporting. You’re going to get a little more bang for your buck with the cross-functional types of support they provide.
Frankincense, also known as boswellia, is my FAVORITE! It’s a potent anti-inflammatory that has lots of research behind it. It’s also a great immune booster, stress reducer, and healing to the skin. It’s steroid-like structure is thought to be one of the reasons it’s so effective. I use it topically, aerosolized in a diffuser, and internally for treating all types of inflammatory conditions, not just eczema. Frankincense is literally the Swiss Army knife of the anti-inflammatory world!
Lavender is calming, sedating, and has some inflammation relieving properties. It’s also well tolerated by most people, including children and babies. A little at bath time (for kids and adults) helps soothe the skin and the mind.
Myrrh is another cross-functional heavy hitter like Frankincense. It has all of the “anti’s”… antioxidant, anti-inflammatory, and antimicrobial to bacteria, parasites, and fungi (like Candida). A bonus is that it has anti-cancer properties as well. Historically it has been used to heal wounds and cracked/chapped skin.
Tea tree oil, like Frankincense and Myrrh, has many beneficial properties, but it’s broad spectrum antimicrobial actions are what make it famous. It’s active against a wide array of microorganisms (bacteria, yeast, other fungi, parasites, and viruses) making it a very useful tool. Staphylococcus aureus and yeast based infections such as Candida, jock itch or ringworm (yes, it’s a fungus- not a worm) are sometimes implicated in eczema, and research shows tea tree oil to be effective against them.
Please note that sometimes, especially when used in excess, essential oils can be irritating to the skin. I always tell people to be very careful when they’re first starting to work with them. If you’re making a batch of something yourself or adding them to a bath, start off with just a couple of drops to see how your skin responds.
Organic Healing Balm. Dr. Bronner’s has an Baby Unscented Organic Magic Balm. I use this on my kids for everything. I sometimes use it on my eczema- it just depends on the severity of the itch.
A lot of people with eczema like Bronner’s, but some people find it a little bit irritating. I’d say stay away from the peppermint one and stick with the unscented balm.
All Good’s Goop is another good option. It has lots of herbs, olive oil, and coconut oil to soothe the skin.
Cleansing Oil. Another company that I really like is FatCo. I use their products myself and have heard from a lot of my clients that they love their facial cleansing oil. I’m an advocate of using oils because they don’t strip the skin like detergents found in other products.
They also have this myrrhaculous face cream. It has myrrh and tallow which are the main components in their lotions and creams. It’s highly supportive and nutritive to the skin. Speaking subjectively from my own experience (and the experience of a lot of the people that I work with that have used this), it’s just really supporting and nourishing to the skin.
Sea Salt Spray. This is something you can easily make yourself with some water and some sea salt at home. A lot of people who have eczema benefit from going into the ocean and salt water. Dead sea salt works really well because it’s packed with minerals that help balance the pH in your skin.
Kamedis. Kamedis has a complete eczema line from washes to lotions. I learned about this from patients that raved about it. They have created plant-based treatments for eczema that combine botanical extracts with OTC ingredients.
Theramu. Theramu is another one of my favorites. They’re also all-natural and use a combination of CBD and emu oil which provides bioavailability so it works where your skin needs it most. Both the CBD oil and emu oil are soothing so it’s one of the go-to’s in our clinic as a first line therapy to try out.
With a condition that is so highly individualized, you have to play around and find what works for you. Some topicals will work better than others and some will work for a short period of time.
While that can be frustrating, the great news is that true healing can be accomplished and you can banish the topicals forever!
The goal is to always get to the root cause of what’s going on, but if you’re in a really bad state, topicals can be the way to go to find immediate relief. And that’s okay! You can always transition and switch off of them as you work on your underlying causes.
Which topicals have worked for you? We’d love to hear!
Finding Relief From The Outside-In
If you’ve ever suffered from an eczema flare, then you’re probably familiar with the burning, itching, crawling sensation on your skin. And, you know how horrible it is!!
Your immediate instinct is to calm what’s happening on the outside… you just want to stop the scratching and bleeding and oozing.
In functional medicine, the goal is always to address the root causes and heal from the inside-out.
But when it comes to eczema… I know you need to have some relief on the outside first so that you can focus on the actual underlying causes— not just the symptoms.
What I’ve seen with skin issues, especially eczema, is that there’s no one-size-fits-all remedy.
Something that really irks me is when you go to message boards and people are like, “Oh, (insert favorite remedy) is my miracle cure….” or “I use dead sea salt baths” or “I use coconut oil” or “I use apple cider vinegar.” Don’t get me wrong, these things are all helpful, but everybody is so highly individualized that it’s hard to say any one thing will work across the board.
Eczema is more specific to the individual than any other condition we treat in our clinic, so we encourage people not to get caught up in other people’s hype. Do the work to heal inside, but in the meantime you can find ways to help soothe the rash.
9 Healing Bath Options
Something I’ve used myself, and have gotten back feedback from patients and colleagues alike is on the benefit of a healing bath. There are lots of different things you can put into a bath, but these are my top 9:
- Magnesium sulfate/Epsom salt. These minerals can be very soothing for an eczema flare for a couple of reasons. Epsom salt helps decrease inflammation which can reduce the swelling of lesions and calm itching. It also has antimicrobial properties keeping your skin free of bacteria.
- Dead Sea Salts. I’ve gotten a lot of positive feedback about this one which is in the mineral category. Dead Sea Salts aid in hydrating dry skin and can provide some itching relief with it’s anti-inflammatory properties. And more than Epsom salt, it’s packed with lots of minerals that help balance pH.
I like to add dead sea salts with baking soda or Epsom salt with baking soda to my bath— usually a cup of each if the itch is bad. You can buy them at any natural food store or on Amazon.
- Borax/Boron. You might be familiar with Borax (sodium tetraborate) as a cleaning agent, but it can also be very soothing for an eczema flare. It helps lower inflammation and can be used to treat infection.
You’re probably starting to see a pattern that most of these have an anti-inflammatory response which helps decrease itching (but it’s all about finding out which ones work best for YOU).
Read here for further information on the many benefits of Borax, because like many of these remedies you can use it for many application.
- Essential Oils. Essential oils (EOs) have a variety of healing benefits, but you have to be very careful because for some people they can incite more of a flare. Even if they’re used in small, diluted quantities in the bath, they still can be a little caustic to the skin.
I tell people to use them very sparingly if you’re going to use them. Tea tree oil or lavender oil are the two that I tend to use most frequently and recommend starting out with.
Of all the EOs, tea tree oil is one of the best for treating eczema symptoms. It has antibacterial components that help fight infection and stop it from spreading. It also has antifungal and anti-inflammatory properties that reduce itching.
Lavender oil can be calming for both your mental and physical state. It helps restore and balance healthy nutrients in the skin which reduces irritation. Bonus- lavender also minimizes the stress that goes along with an eczema flare.
- Sitz Baths, Herbal Blends, and Chamomile Tea bags. If you’ve ever given birth, sitz baths are commonly recommended for their healing properties. I used them after both of my births and they significantly helped with the soothing and healing my skin.
I had an “A-ha” moment with my second baby last year because I’d had an eczema flare because of the hormones during pregnancy. I thought to myself, “Hey, I can probably use this for the eczema too,” so I tried it.
I actually bought Earth Mama Angel Baby (which just recently changed its name just to Earth Mama) since they make pre-made sitz bath pouches. I bought those because, quite frankly, who has the time to make them when you’ve got a new baby or kids or just have a busy life?
I also augmented it with dried chamomile that I got from a natural food store that I put that in cheesecloth or a sock if you don’t have cheesecloth. Soaking with those for about 20 minutes really soothes my skin (and my mind). Chamomile tea bags also work instead of preparing the dried herbs.
Bonus tip— sitz herbs are also recommended for hemorrhoids and diaper rash!
- Colloidal Oats. I put a big asterisk by this one because of the *gluten issue*, but some of my patients have experienced healing benefits from colloidal oats or oatmeal so I didn’t want to exclude it.
Many people with skin and gut issues tend to have problems with gluten internally and sometimes externally. Those with Celiac can get a skin manifestation called dermatitis herpetiformis. I’ve seen people who have not been diagnosed with Celiac, but do have the dermatitis herpetiformis and it’s misdiagnosed as eczema.
Now, the cool thing is, really, it doesn’t matter what you label something on the skin. You’re going to end up treating it essentially the same especially because these are all in the autoimmune realm.
Like I said, I’m really careful when it comes to recommending anything that is grain-based, but this is where bio individuality comes into play. One person’s poison can be another’s medicine. If you’re going to do this, make sure it’s gluten-free. If gluten is an issue for you, and you don’t know it yet, you want to make sure you’re not adding fuel to the fire.
You can read more about the uses and benefits of colloidal oats here.
- Hydrogen Peroxide. Most of us have this under our bathroom sink to clean out cuts or as a natural cleaner. When added to a bath, it helps disinfect eczema sores and promotes new cell growth.
Be sure to use a food grade hydrogen peroxide and add no more than one cup to your bath. I recommend starting off a little slower with maybe ½ cup to see how you tolerate it.
- Baking Soda. This is another household item that has many uses. I buy a giant bag at Costco because of the quantities I use and it’s way more economical. I add this to almost every bath for myself and kids even when I don’t have a flare because of its other benefits.
As I mentioned in #1, combined with Epsom salt it makes for a great detox bath.
- Apple Cider Vinegar. Similar to the previous point, apple cider vinegar is also multifunctional. It has compounds like riboflavin, vitamins, enzymes, and mineral salts which can improve the quality of your skin.
It acts as an astringent and helps remove surface bacteria that shows up when the skin is compromised from a flare.
Experiment with the quantities that work for you, but I would start by adding ½ – 1 cup to your bath.
Many of these are items you likely already have in your home for other reasons, or you’ve built yourself a “natural medicine cabinet.” Start with one ingredient at a time. Go slowly by using ¼- ½ cup with of the powdered ingredients or single drops of essential oils initially, then work up to the full dose you need from there.
If something completely doesn’t work for you, try something else from the list. Remember that it may take some time to see what works for you and dial in your recipe. You can always tweak it once you see what works for you.
Most people will get some type of relief from something on the list, even if it’s only a small amount.
Resist the urge to go hog wild with any of the ingredients because you could end up stoking the flames and adding fuel to the fire. It’s so easy to go overboard when you finally find a remedy that provides some relief. But heed my words… don’t do it!! (I know from personal experience and it was a disaster!)
There’s no one blanket approach to calm an eczema flare which is why I like to suggest a variety of options. All of these are going to provide different healing properties. Some are going to balance the pH while others will have antimicrobial effects, but they’re all going to be anti-inflammatory to some extent.
Have you experimented with any of these healing baths? Let us know in the comments section!
I frequently get asked to do talks on summits, podcasts, and master classes. I often speak about eczema, gut and skin health, and preventing autoimmunity in children. But aside from those, one of the most common topics I’m asked about is how to find an experienced functional medicine practitioner (we covered this a bit on this podcast).
And, I totally get it!!!
Finding a new practitioner can be difficult itself- let alone a well vetted functional medicine practitioner.
This space has blown up in the past three to five years, and it seems a little like the wild west.
Trying to decipher credentials, training, and experience can make your head spin.
I’m fortunate that I know many practitioners, so that if I need help for myself, a family member, or a patient that needs referral, I have a solid base to choose from. However, I’m in the dark as much as the next person when I don’t have a word-of-mouth recommendation or a person to refer to.
Truth be told, I kind of dread it.
Having a checklist of wants and needs can inform the process and make it much less daunting. Hopefully this information will guide you in your process 😊.
What To Look For
- What is their focus/specialty. If you have specific needs such as skin issues, gut issues, or cancer, you probably want to see a specialist rather than a generalist. They typically have experience treating a great number of patients with your concerns and needs which is important.
For example, our practice specializes in eczema and autoimmunity, but at the core of those issues are gut, hormone, and immune system imbalances. Every practitioner within the practice has extensive experience treating all of these areas.
We’re definitely not cancer specialists and would refer you to an appropriate practitioner if that was the reason you reached out to us. We know our strengths and focus on them!
2. Formal Education/Degree. The practitioner’s base education may vary depending upon your needs. If you are first beginning your healing journey and would like assistance with lifestyle coaching or tweaking your diet, then a health coach would likely suit you well. They are trained in walking people through those processes step-by-step.
Sometimes health coaches work alone or as part of a team. We have a few that we work with when we feel somebody needs a little extra help dialing in their diet or lifestyle.
When you have something more significant going on, like eczema, an autoimmune condition or IBS, you’ll likely want to work with a higher-level practitioner that has an advanced degree (preferably one where they’ve learned in physiology, biochemistry, pathology, differential diagnosis, etc.) plus Functional Medicine training. Doctoral, advanced nursing degrees, and physician assistants (MD, DO, DC, ND, DOM, DPT, DNP, APRN, PA etc.) will have the most extensive education with regard to being trained as a healthcare provider.
3. Functional Medicine Training. There are several organizations that train functional medicine providers as certifications or training programs.
These three have been around the longest and offer comprehensive training in Functional Medicine:
- Institute for Functional Medicine
- Functional Medicine University
These organizations teach specific versions of Functional Medicine
- Kalish Institute
- Kresser Institute
Many other organizations offer specialty training in hormones, immune function, environmental medicine, autism, etc. This is all great too! It means your practitioner cares enough to keep pursuing more knowledge to help people heal.
- Bonus Experience. Here is where a little extra digging might help you out. You never know what experiences someone might have that would make them and even better practitioner. Teaching, research, counseling, or even having rescued themselves from the corporate world might be to your benefit. There are many life experiences or jobs that might make a practitioner more well-rounded. One-on-one mentorships with experts are also a bonus.
5. Years Practicing Functional Medicine. This one is pretty obvious :). Experience is important. Ask the practitioner how long they’ve been practicing functional medicine. Really, FIND out how long they’ve been practicing!!! I’ve been burned by referring clients to new practitioners that really didn’t know what they were doing but their website made it seem otherwise.
In our practice, Dr. Tammy and I have over 30 combined years of clinical practice, and over 20 combined years of Functional Medicine practice. We’ve trained with the IFM, Kalish Mentorship, Seeking Health Educational Institute, and 1000’s of hours of continuing education courses and seminars on topics from gut health and autoimmunity, to hormone balancing and environmental toxins. Dr. Tammy also did a hormone mentorship program for several years.
1. Personality. Above all else, and almost as important as experience and training is personality. If the functional medicine practitioner you choose doesn’t resonate with your personality…RUN. You’ll serve yourself best if you find somebody you jive with. Your communications and outcomes will typically be better.
Think about it, would you marry someone you didn’t get along with?? This is an important relationship, much like a marriage.
2. Exploratory Call or Free Consult. This is your golden opportunity to learn more about the practitioners and the practice! You can find answers to the questions laid out above, as well as many other details that important to you. If you call or email a practice and they aren’t willing to give you any information, that might be a red flag. They should be willing to share some information with you.
Many practitioners do anywhere from 10 to 20 minute consults now so that you can see if they are a good fit or you, and likewise, you for them. An honest practitioner will tell you if they can’t help you or if your case doesn’t fit their practice.
We offer free 15-minute consults for this reason (click here if you’re interested).
Pro Tip: Write your list of questions out before you contact any providers you’re interviewing so you can compare all of their answers and find who is best for you.
Wishing you the best of luck on your journey!
There is one thing that eczema, infertility, and miscarriages have in common…
All three can make you feel very alone and very tortured physically and mentally. I’m sharing my story with you because I think it’s SUPER important to change attitudes on child loss AND, inform people about the link between inflammation, autoimmunity, and infertility.
Bear with me first though- some confessions.
First, you’ll note as you read through this that I started writing it in December. I started but couldn’t bring myself to finish it, let alone publish it. I was afraid and still broken.
Second, because of the inspiration of some of my superwoman friends and colleagues in the health space, I’ve been able to process my traumas and gather the courage to share this with you all. THANK YOU to Anna Cabeca, Brie Wieselman, Christine Faler, Jaime Ward, Jenn Fugo, Jessica Drummond, Jolene Brighten, Keesha Ewers, Sheri Fox, and Steph Gaudreau.
You ladies all inspire me. EVERY. SINGLE. DAY.
I have so much gratitude for having you all in my life. We don’t tell people often enough how much they matter to us, so I want to let you all know.
Third, there are some very raw and vulnerable moments, so you might cry reading it as I have writing and editing it.
Miscarriages SUCK and are still taboo in our culture. This is really unfortunate because those of us who have suffered in the dark know what a lonely, hellish place they can be. NO ONE should have to suffer in silence when they’re dying inside. And sadly, no one can really relate unless they’ve ever suffered the loss of a child. It leaves you with a hole inside that never goes away.
[Initial thoughts from December] I’m doing something I never do right now. I’m attempting to write this in the throes of many emotions. On one hand I’m extremely happy because my little sister just gave birth to a healthy baby boy. It’s a pretty exciting time for our family this year since I had my little girl almost 5 months ago.
On the other hand, I’m feeling very sad. Alone. Gnawing pain.
Because today is the anniversary of my first miscarriage. That was one of the hardest days of my entire life.
Worst day ever.
Looking back, it taught me many lessons about life, autoimmunity, and eczema. But that doesn’t make it hurt less.
On Christmas day two years ago I was trying to act like it was a normal day. I should have been extremely happy to watch my almost three year old open his presents and have family over. I was in the kitchen prepping Christmas dinner, but deep down inside I knew something was very wrong.
I was wearing a shirt that said “joy” and I couldn’t have felt further from that. I knew deep down that I was probably having a miscarriage. I went through the day thinking, “things like this happen… women have spotting and cramping and they still have healthy babies.” I was in complete denial.
I made it through dinner and went to bed, but I couldn’t sleep. I had a sense of impending doom that would not leave. And like many women, I tend to labor in the middle of the night. The cramps got worse and then my worst nightmare was realized. I was definitely having a miscarriage.
If you’re far enough along it proceeds exactly like a labor. I’ll spare you the details because it was HORRENDOUS as I’m sure you can imagine.
The experience is seared into my brain. I wish it was a foggy memory but I can’t forget. I remember sitting on the bathroom floor just sobbing and feeling so alone. My husband was there but I don’t think he knew what to do. I just sat there for what seemed like an eternity.
Eventually, I laid back in my bed next to my husband, but I felt like I was the only person in the world.
I couldn’t go to sleep so I went downstairs to our couch, laid in the fetal position and cried for 4 hours. Literally to the point I was nauseous and had no tears left.
The next several days were a blur.
I was largely catatonic. My sister was one of the few people I told and she came over and brought me flowers which I really appreciated but it still felt unbearable. I’ve had a few low moments in my life but I don’t think I’ve ever truly felt depressed.
I was quite depressed after this. I was numb. Thankfully, I had my son because if I didn’t I really don’t know what would have happened.
I got pregnant again in March and was cautiously optimistic. Things seemed to be progressing fine. I made it past the 8 week mark and was breathing a minor sigh of relief since that is when I had my first miscarriage. But then at 12.5 weeks, I had another one.
This one was different. Still agonizing, but I felt like I knew what to expect and went through the motions.
Almost like an out of body experience.
Again, I’ll spare you the details. And again, I really only told my sister and super close friends.
I suffered in silence.
I don’t want that for you.
It’s the worst feeling in the world.
And, it’s the opposite of what you should do.
For mamas that’ve experienced any loss, you know your world will never be the same. There will always be a hole in your heart for your little angel. As time goes on it hurts a little less but it will creep up on you when you least expect it and that empty, hollow feeling can return.
Mother’s Day will never be the same, even if you have children. The two Mother’s Days since I’ve had my miscarriages have been filled with both love and sadness. Last year when I was pregnant was particularly hard. I was sad and silently hoping that everything turned out fine because I didn’t know if I can handle another even more dramatic loss. I cried A LOT on Mother’s Day in a mix of hormones, fear, and grief.
Thankfully, my story had a happy ending. My amazing and beautiful rainbow baby was born in August of 2018. She’s such an amazing little girl. She’s been so sweet and so happy from day one. People comment on how smiley and what a good demeanor she has.
I don’t take for granted how incredibly blessed and lucky I am because I know that there are women out there that won’t get that chance.
Women’s health, fertility, pregnancy, and birth are sacred. We need to support each other through the good and the bad. We need to make a long-term commitment to each other not just in the days and weeks after a birth or a loss, but in the months and years that follow. Because these moments become the fabric of Who We Are and intertwine us all together. They form the blanket of support that we need to give one another.
So, I want you to know, I am here for you.
And those ladies I thanked above- they’re in your corner too. They are all in the health and functional medicine space too- many are women’s health specialists- but all are darn awesome women.
A few of them (you know who you are) are probably why I was able to get pregnant and keep the baby to term.
Together, we ran a bunch of tests on me. My hormones were low across the board (thyroid, adrenals, estrogen, progesterone and testosterone. I had dysbiosis from stress and previous birth control pill use (that’s another long and horrible story).
The likely culprit for my losses began as STRESS. Long term stress. That stress depleted my hormones, damaged my gut, and caused food sensitivities, nutrient depletions, and my eczema.
You need progesterone to maintain your pregnancy and I couldn’t make enough. Had enough to get pregnant, but not enough to stay pregnant. This is a big problem for women today. We’re all depleted from the stress and abuse we put our body’s through.
So, I got to work.
Since my hormones were a mess I got on compounded, bioidentical DHEA and progesterone. I also upped my dose of compounded T3/T4. I knew I needed to get my hormones going in the right direction quickly and this was the best way for me, especially since I’ve had reactions to other types of hormone support in the past.
I went on an AIP rotation diet to calm my system down and start to heal my gut. Then I did 8 weeks on a dysbiosis protocol for pseudomonas and staphylococcus (using herbal blends, monolaurin, and rotated probiotics) with liver support. I followed that up with 3 months of gut terrain rebuilding and immune support. I also did some work on resolving past traumas too.
In all, this process took me 8 months, but then….
I missed a period and found out I was pregnant even though I wasn’t actively trying.
Again, mixed emotions.
I was so happy, but so scared. I went through 75% of the pregnancy scared. Loss traumatizes you in ways you can’t imagine. I was super paranoid and had been before.
I took progesterone for the first 20 weeks of my pregnancy- 4 weeks longer than was recommended because I was that worried. It worked…and you know the rest of the story.
I had my beautiful rainbow baby.
But that doesn’t mean there aren’t scars and wounds that surface from time to time.
So, I need my tribe, which now includes you.
I’m here if you need me, because I want to help mamas be healthy, clear eczema, get rid of autoimmunity, and have healthy babies.
That is my mission.
And, we have to support each other. As women we need to have a voice and not stay in the dark.
It took me a couple of years to come out and share this, but I’m so happy I did. Because if I help even just one mama get through her dark time or resolve her root causes to have a healthy baby, I’ve accomplished my goal.
I hope you had a wonderful Mother’s Day 2018 no matter your circumstance. Earth babies and angel babies all count!! It’s okay to feel both happy and sad too. Don’t let anyone tell you otherwise.
If you know anyone that could use support, please share this with them. I really wish I had reached out for more help or someone gave me a little nudge to get more support. If they aren’t ready, just be there for them through the process and step up when called upon.
Many people wonder if you can do an elimination diet while breastfeeding (and working, mommying, friending, and wifing… that’s wife-ing not wifi-ing)???
The answer is YES.
If you’re on our email list, you know that I decided to give myself the gift of health this year. The only thing I asked for as a gift was new sneakers (thanks hubby!). At this point in life, experiences with family and friends and my health matter much more than material objects.
I felt like my health needed to be more of a priority since the longer I nurse my 8 month old, the more some of my deficiencies and imbalances seem to becoming apparent.
I have news for all of the pregnant and nursing mamas out there, regardless of how perfect your diet, supplementation, and lifestyle are it’s super difficult not to become depleted in some way after you have a baby and are nursing. This is a very metabolically (and MENTALLY) demanding time in a woman’s life, so we need to support ourselves accordingly.
And like we always tell our clients, you can’t take care of your family or be present in your life if you’re not taking care of yourself. So…. What was I waiting for??
Questions and plain old procrastination!!!
Contrary to what people probably think- I often have the same initial questions as you all do even though I’m a trained practitioner. I was concerned about my milk supply and if any treatments impact the baby or my milk content.
Yes, it is true (I’m being 100% honest).
For the same reason we as practitioners don’t recommend treating ourselves. It’s really hard to view yourself objectively. It’s easy to second guess, dismiss, or blow things off when you’re the only one analyzing yourself.
That’s how I got to my elimination diet.
I planned on doing all of this after I weaned my sweet, little babe. But all of my practitioner friends said a resounding, “HECK, NO.”
Truthfully, my immune system has been challenged since the baby was about 4 months old. I’ve had several viruses in that time. I usually get that many viruses in a year… not 3 months.
I also had a little eczema patch develop on my eyelid a couple months ago that I haven’t been able to completely clear.
Time to look inside (hello root causes)!!
On the advice of my observant and smart friends (read: persistent!), I ran some basic serum labs and things looked a little off. According to my CBC (complete blood panel), my immune system seemed overwhelmed and my thyroid was less than optimal even though I take a compounded T3/T4. My immunoglobulin levels were also off.
What are immunoglobulins you ask??
When you hear people talk about IgG, IgE, IgM, and IgA, these are your immunoglobulins. These are antibodies produced by your white blood cells that help you fight foreign invaders like bacteria, viruses, and parasites (or foods if you have a leaky gut!!). In Functional Medicine these are important because they give us an idea of what is going on regarding infections and autoimmunity.
My IgM was high which generally signifies acute infection. This wasn’t surprising since I’ve literally had viruses piggy-backing each other. Ugh.
IgG is the most abundant and typically higher when you’ve been sick, especially as time goes on, but mine was low. Not a good sign.
The low IgG is telling me a couple of things…
My body has been fighting a battle against respiratory pathogens (and possibly foods, my own tissues, and/or some gut stuff). IgG is the immunoglobulin that can enter tissues making it important to fighting battles in your body. It binds pathogens and toxins directly. Mine being so low means that my ability to fight off infections and handle toxins is impaired. No Bueno ☹.
The writing was on the wall.
This was all the motivation I needed to get myself into action.
I knew if I didn’t do anything I’d keep getting sick, have potential eczema flares, and not have enough energy to be a good mommy/wife/worker/friend.
The Action Plan
- AIP Elimination Diet. I knew I need to clean up my diet. For me, this means going the Autoimmune Paleo (AIP) route since we tend to follow a Paleo-ish diet in our home. Normally my diet looks something like this:
– No gluten.
-Occasional dairy outside of regular use of butter and full fat cream in coffee.
– Rice, quinoa, or corn only 1-2x per month.
– Occasional legumes.
– Otherwise, we mostly eat meat, fish, fowl, veggies, fruit, nuts, seeds, and eggs.
AIP is a good place to start on an elimination diet, especially now that there are studies showing the benefit for autoimmunity. It also naturally takes out highly reactive foods.
I wanted to make it easy on myself (unlike my previous autoimmune rotation diet) because I’m spread pretty thin these days with an active little one.
I’m eliminating nightshades, nuts, seeds, coffee, all dairy, all grains, and eggs for 4 weeks. Simple enough. There are so many resources out there on the internet now, but I really like Whole 30 and Against All Grain since they have modifications for AIP. I’m adding them back in one at a time over a 3 day period and watching for any reactions.
- Ramping up anti-inflammatory and immune supporting supplements. I’m taking a super concentrated fish oil at 4x dosing (I take 2 caps at breakfast and dinner). I’m using a variety of probiotics specific to my past needs since I haven’t tested my gut yet****. Notice I said YET. I’m also using a mushroom blend that has reishi, maitake, coriolus, and shitake. Lastly, an immunoglobulin product.
Immunoglobulin products such IgG (usually dairy based) or IgY (usually egg based) help support the gut and immune system. Many people get nervous when they find this out, especially when they’re doing an elimination diet because of the dairy or egg source. The truth is that most people can tolerate these, except those with an IgE allergy or a severe sensitivity. I’m using this twice daily.
- Adding in LDN. LDN, or low dose naltrexone, was recommended to me a couple of times in the past when colleague friends analyzed my labs. I always put it on the back burner trying to fix other things first. This time I decided to listen since my immune system needs some real help. LDN works by increasing your body’s internal opioids (think endorphins) and supporting the immune system.
The diet has been easy to follow because I’m not over complicating it. I make batches of meat in the slow cooker (beef, chicken, pork, or buffalo) to have throughout the day or my husband will grill meat or fish. I always have big containers of greens for salads and use Primal Kitchen salad dressing so I don’t have to make it (good for marinade’s too). Last, there are always roasted veggies, plantains, yams, and sweet potatoes on hand. I’ll have berries or pears as a treat.
I’m 3 weeks in and feel good. I have more energy and my sleep seems to be more regulated outside of the baby waking me. I had been waking myself or unable to fall asleep. No new viruses.
My milk supply has remained consist too!!! YAY!!!!
My patch of eyelid eczema is almost gone too. I noticed the eczema fade after 1.5 weeks and I attribute that to both the LDN and diet because I had started the supplementation before and that was helping but didn’t have the same effect. (Note: NOTHING topical was helping it ☹). It’s mostly dry skin and a few tiny bumps which is encouraging.
I’m so encouraged that I’m going to do another experiment that I’ll let you all know about next month. This one will be exciting (and scary for me). But you know my philosophy- I’d never ask a patient do to anything I couldn’t or wouldn’t do.
Stay tuned!! And, reply in the comments about your experiences with elimination diets.
Don’t let the Easter Bunny bring you eczema for Easter!!
The topic of stress is tossed around so much these days that it seems we’ve become desensitized and brush it off. But the fact remains that stress is indeed one of the most notorious triggers for eczema and autoimmunity.
And, the holidays are often stressful times for most of us. On the surface, Easter seems pretty easy and benign, right??
Well, not really.
Granted, it isn’t the long, drawn-out process that Christmas has become now that the “holidays” start the day after Halloween (not to mention cost in money, time, and sanity). But, it definitely shares a few key components of the other major holidays that might cause an eczema flare.
Stress Related Triggers
Travel. Preparing for travel and the act itself are bigger stressors than you may think. It burdens your mind with all of the things you need to do before you leave, even if it’s only for a day or two. Packing and prep are hard enough, but add kids and pets and the stress is magnified (parents of kids and fur babies know what I’m talking about!!). Then there’s coming home to laundry, no food, and maybe even work since technology can be a ball-and-chain that way.
Family. It depends on your family dynamics and for many this isn’t so bad, but the larger the gathering, the bigger opportunity for issues to arise. Often family members feel free to let their opinions fly, disregard others’ feelings, or like to “stir the pot.” Every family has one (or more!). In my family we give out the Blueberry Muffin Award at the end of events for the person that causes the biggest problem. (I’ve only received it once- about 20 years ago when I was in college).
It can also be difficult if you make healthier (“different”) lifestyle choices, and this is very real possibility if you have eczema. For years I’ve been teased about my diet and lifestyle choices. I’ve learned to ignore them because I’m WAY healthier than the people teasing me. Usually when people give you a hard time it’s because they’re feeling insecure or inadequate about themselves. Psychologically, it makes them feel better to go after you because you’re doing something they can’t or won’t do. That doesn’t make it okay, but you can take the high road.
Gawkers. Perhaps one of the most difficult things to deal with when you have eczema is people staring. As if you’re not self-conscious enough!?!?! If it’s family or close friends, these are usually the same people who have some smart-ass comment too. Being in a public setting with strangers can be rough too because that’s like an open invitation to stare because of the mob mentality.
Don’t Let Stress Get You Down
Having a strategy going into the holidays is key to not succumbing to the stress monster and ending up with an eczema flare. Take some time to think of possible stressors you’ll encounter and figure out how you’ll handle them before they even happen. Here are some helpful tips :
- Planning will help you take some of the stress out of travel. Make a list of what you need to bring and getting things ready during the week prior to your trip helps avoid chaos right before you leave. Gas your car up a day or two earlier if you’re driving (this usually saves time and money). Get healthy food ready for your journey and make sure it’s easily accessible. Even if your only traveling down the street, preparing food the day before will help things go smoothly.
- Bring food if you have special dietary needs and there won’t be options for you to enjoy the occasion. Ask ahead what will be served and let them know your situation. Often people are accommodating and understanding, especially if you’ve been down the eczema road for a while. If they aren’t helpful, control your own destiny and bring your own food. Upsetting your host’s feelings is not your problem when you’re skin is on fire (or could flare back up).
- Don’t let the emotional bullies and energy vampires ruin your holiday! If people tease you for your choices, make snarky comments, or stare too long, you’ve got options on handling this. 1- Laugh it off and know that they lash out at others from their own place of hurting or insecurity. 2- Ask them when they got their medical or health care education when they give you unsolicited advice (since their comments are almost always rooted in opinion). 3- Bring an awesome dish that follows your dietary needs or restrictions, but don’t tell anyone it’s any different until they taste it and love it. Prove to them that their misconceptions on diet are exactly that. There are soooo many gluten, dairy, soy, corn, histamine, or _______ (insert any food here) free recipes that rock, so show them!
- Attitude is everything when dealing with stress. If you go into the event with a positive attitude, chances are things will go well. This is where self fulfilling prophecy comes into play.
- Breathing can also help get you through rough times. On many occasions I have chosen to take a few deep breaths and move on instead of engaging someone that’s trying to make me feel bad. I try to remember that it’s a them issue and not a me issue. They are just projecting onto me. It still sucks and can hurt, but I consciously know it’s not me and that’s huge.
- This point may be controversial, but when we’re talking stress and health it’s completely valid- skip the holiday events if you think they’ll be too much for you. If you’re in the middle of a horrible eczema flare or have had lots of stressors in your life recently, this may be the best option for you. If you know going to Easter brunch or dinner will be a battle and will put you in a worse place then politely decline. Tell everyone you’ll see them at the next event. You don’t owe anyone an explanation even though family often feels entitled to one. If you do say something tell them the truth and be authentic because that will serve you better.
Make the holidays enjoyable and as stress free as possible to avoid the Easter Bunny leaving eczema in your basket! If you have any tips or suggestions for stress free holidays, please share in the comments below.
Understanding an eczema outbreak is really complex. And like a child learning language, you have to understand the alphabet and sounds first before you can talk. Same goes for eczema.
To really understand an eczema outbreak, you have to first understand the difference between the way functional medicine and conventional medicine views it.
Why Functional Medicine?
Functional medicine (FM) is a “systems” way of thinking. And when we say “systems,” it’s not like conventional medicine that views the body as a group of isolated systems where you have a cardiologist for the heart, an endocrinologist for hormones, etc. In FM, we view the systems, or areas of the body, as operating as a whole response to the environment (kind of like the operating system of a computer).
It makes perfect sense because each area influences the others.
A good analogy to help you understand functional medicine versus conventional medicine is to think about a tree. Visualize the entire tree with its roots, trunk, branches, and leaves. Conventional medicine looks at one branch, whereas functional medicine views all of the branches, trunk, and roots. It’s going to look at the leaves and even further in-depth because we really want to understand what’s going on in the entire person.
When we do this, we take a really detailed history and look for root causes. It’s interesting that we look for root causes and use the tree analogy, because the goal is to find out what is foundationally disrupted in your body to figure out what’s causing the eczema flare.
Conventional medicine really tends to see eczema as something that doesn’t truly have a cause yet. When I was told that I had eczema the doctor said, “You’ve got eczema. There’s no known cure. See you later.” However, in functional medicine—and now even in the medical literature (check it out here)—they’re starting to talk about it as an autoimmune condition and starting to identify some causes of it. And that’s what we’re going to get into here a little bit later.
This is why taking a FM approach to looking at eczema really can help you get down to why things are happening.
The ATM Model
One of the foundational principles of understanding functional medicine is the concept of antecedents, triggers and mediators. We call it the ATM model. These are how a functional medicine practitioner frames an understanding of your entire life history and contributing factors to your condition. We’re looking at all of that to figure out how you got to where you are today.
Let’s start off with the antecedents, which are the predisposing factors. Those are things like genetics and family history, lifestyle, past illness, and exposures (occupational, home, or environmental), and are the underlying or precipitating cause of illness.
A key point regarding genetics and family history is that they aren’t life sentences. A lot of people think, “Oh, there’s cancer in my family. I’m going to get cancer.” That’s not necessarily the case. There are so many modifiable factors here that can prevent you from actually having that illness even though you might be very prone to having it. Great news!!
To recap: Genetics are largely modifiable. NOT your destiny. **Note, in a future post I’ll address genetic concerns such as the filaggrin protein and common SNPs (single nucleotide polymorphisms) that matter to eczema suffers.
Triggers are what provoke the signs and symptoms of illness. Those are along the lines of infections, allergens, toxins, radiation, surgery, social conditions, and things of that nature. They’re going to combine with the antecedents to actually cause more signs and symptoms.
Last, the mediators perpetuate the illness. You can think about these on a biochemical or psychosocial level. Biochemically speaking, the hormones, neurotransmitters, metabolites, free radicals, and inflammatory chemicals are what perpetuate what’s going on. Once you have that genetic factors, plus the triggers, these mediators keep that cycle going. In the case of eczema, it’s going to cause the flare to continue.
The psychosocial factors—stress, thoughts, beliefs, community- are extraordinarily important in this model, but also in eczema. Stress is often the primary trigger and tipping point for most people (***remember stress can be emotional or physiological like trauma or infection…regardless of the source, it causes systemic biochemical changes that are bad if they continue for a prolonged period of time).
Genetics, family history, lifestyle, past illness, and environmental exposures are key antecedents for everyone. For example, if you have certain historical factors like a family history of autoimmunity or allergies, asthma, and eczema (the allergic triad) you’re much more likely to get eczema than the rest of the population.
The most common triggers I see in practice are infections, allergens, toxins, diet, and dysbiosis (an imbalance in the microorganisms in your body—not just in your gut, but all over your body). In eczema, skin dysbiosis can be an important piece of the puzzle too.
The primary mediators of eczema are (without getting too crazy science-y):
- Hormone imbalances (especially from stress and sex hormones). Cortisol, DHEA, estrogen, progesterone, and testosterone imbalances can perpetuate inflammation and make eczema flares worse.
- Depleted Nutrients. In practice it’s usually omega 3 fatty acids, vitamin D, antioxidants such as vitamin C and selenium, and minerals such as zinc and magnesium. Protein malabsorption can be an issue too since you need the amino acids to make collagen and skin tissue.
- Inflammatory chemicals. Histamine, cytokines, and free radicals are major contributors here, though there’s a long list of players in this biochemical pool.
- Impaired liver function. If you’re liver can’t function optimally, you can’t clear metabolic waste, toxins or hormones efficiently which are essential for a healthy gut and skin. This is often one of the key places we address first.
- Leaky gut. This occurs when many of the above factors cause increased intestinal permeability allowing things into the bloodstream (like bacteria, toxins, proteins, etc.) that shouldn’t be there. This causes inflammation and immune system activation driving the eczema cycle.
I find for most of the clients we see in our virtual clinic is that stress is often the most significant factor, either as a trigger or as something that’s perpetuating, or both. We work on addressing it in its many forms, in many different ways.
To recap- if you’re having an eczema flare or a flare-up of any autoimmune condition- you’re looking at: antecedents + the triggers + the mediators= cause of flare.
It’s a cyclical process that self-perpetuates until you identify the triggers and the root causes to stop this cycle. You must eliminate the root cause imbalances such as infections, hormone and nutrient imbalances, allergens, foods, etc., to get this cycle to stop. Then you actually need to take the proper steps to heal it (replacing nutrients, healing leaky gut, balancing hormones, improving liver function, etc.).
Real Life Eczema Example
I’m going to use myself as an example. I’m not necessarily proud of this, but we’re all human 😉
I was driving home from my sister’s this past Halloween. I had just thought to myself that I was so excited because I didn’t have any Halloween candy…. but then I did.
About an hour later, it triggered a flare. And for me, the area where my eczema always, always, always starts is my left wrist and my left hand. They started itching like mad. I was scratching for four hours.
Immediately, I went downstairs and took some anti-inflammatory nutrients because I knew I had to get at that flare before it became a full-blown outbreak. Yes, it is possible to dampen the effect of a flare once you have your eczema under control.
But for me, I had a major flare. My last major flare was 1.5- 2 years ago. I hadn’t had anything go on since then until I was pregnant recently and had a few minor flares (due to hormones) that went away quickly.
Let’s also review my ATM’s.
My major antecedent is the allergic triad in myself and family members. As I mentioned above, the allergic triad is allergies, asthma and eczema. Most of that manifests in childhood, but not always. I only had allergies in childhood. Eczema started in my 30’s! If you have any of those, you’re also going to be more prone to autoimmunity as an adult.
And, eczema often accompanies other autoimmune conditions, not just in and of itself.
So I have 2 of the allergic triad, and a family history of autoimmunity and inflammation conditions. There’s lots of cardiovascular disease and diabetes in my family. Historically, I was bottle fed and was around smokers growing up which are also key antecedents in developing eczema.
My main trigger for this flare was hormone imbalance and dysbiosis that developed during pregnancy. In the gut, when your hormones such as progesterone are high, it slows things down in pregnancy. It sets the stage for things like leaky gut and dysbiosis to occur. This was something that I had experienced quite a bit of during my pregnancy (even though I tried my hardest to prevent it since I know what I know!!).
Diet was also a key trigger (especially the candy). I kept a clean, organic diet for the most part. However, after the birth, my diet has not been quite as tight. I’m gluten-free and try to be in the realm of Paleo/Autoimmune Paleo. But sometimes I have corn or dairy or beans. And those things have crept into my diet more frequently now that I’ve had the baby.
The candy just happened to be the breaking point for me… that little bit put me over the edge!
My primary mediators were hormone and nutrient imbalances from pregnancy and breastfeeding, leaky gut, and STRESS.
I’m going to reiterate stress here… I’ve got a new baby. I’ve got a 5 year old. I’ve got work. I’ve got life. Everybody’s got stress. But I currently feel like I have a lot on my plate. That’s the main mediator perpetuating the cycle for me.
And for me, stress is probably the number one factor that contributes to my flares every single time. When my stress levels get high, I can get a flare super easily. And I know that’s true for many of the people we work with in the clinic as well.
Another less obvious mediator is lack of sleep. Lack of sleep is a major contributor to manifesting any autoimmune condition, especially something like eczema. We heal and regenerate when we sleep. If you’re not sleeping well, it’s not happening.
Lastly, there’s the issue of support and community, or a lack thereof. When you first have a baby, everyone comes and sees you for the first couple of weeks. And then it’s suddenly, it’s gone. This can leave you with a sense of feeling like you’re lacking community or lacking support. I won’t say that I feel that tremendously, but I feel it a little bit.
All of these things added up and resulted in my eczema flare.
If you’re looking for more support in healing your eczema and understanding your root causes, you can always book a free 15-minute consult with our clinic: http://drstephaniedavis.com/consultation/.
Do you know you’re root causes or ATM’s? Leave a comment below if you do!
This article originally appeared on Healevate.
Leaky gut, as you might be imagining it in your head, is layman terminology for intestines that have increased permeability.
This can be due to a variety of reasons, which we’ll dive into shortly, but first let’s provide a basic understanding of how the GI tract works.
The gut is a tube that is about 20-25 feet long, covers 3000 square feet (the size of a tennis court) of surface area and is only one cell layer thick, according to Dr. Mark Hyman.7
There are spaces between this single layer of intestinal cells that open and close to allow only specific, very small molecules to pass. These spaces are controlled by tight junctions.
What Exactly is Leaky Gut or Intestinal Hyper-Permeability?
The primary purpose of the GI tract is to provide barrier function, as well as to allow the selective passage of substances it deems beneficial, all the while keeping foreign invaders out.
Every second of every day, your intestinal cells, along with the immune, neurological and hormonal components within them, screen your environment in an effort to keep you healthy.
Leaky gut occurs when there is a breakdown in this barrier function allowing substances to enter the bloodstream that normally wouldn’t be there, resulting in immune system activation and inflammation.
Dr. Alessio Fasano lays it out nicely, saying that “The intestinal mucosa is the battlefield on which friends and foes need to be recognized and properly managed to find the balance between TOLERANCE and the immune response.”2,3,4
How Does Leaky Gut Occur?
The tight junctions in a healthy gut operate like a club bouncer, selecting what to allow past the “velvet rope” and into the bloodstream. Simply put, they keep bad things out and allow good things through.
In a Leaky Gut however, the tight junctions leave the “velvet rope” unattended, allowing everything to pass through. This can result in serious problems.
Technically speaking, Leaky Gut, also commonly referred to as intestinal hyper-permeability, occurs when inflammation leads to the breakdown of the mechanism that controls the tight junctions between the intestinal cells, allowing them to become looser. This allows the “leaking” of either larger and/or foreign particles through to your bloodstream.
Modern lifestyles place a lot of stress on the gut in the form of poor diet, medications, alcohol, infections and environmental toxins, leading to chronic irritation, inflammation and ultimately the breakdown of the intestinal barrier.
This delicate layer that should be selective and tightly regulated, now has tiny pin-prick like holes in it that allow foreign substances such as undigested foods, bacteria, yeast and toxins to cause an immune response.
As this scenario progresses over time, a variety of conditions can arise, including acne, allergies, asthma, fatigue and joint pain, or even more serious ones such as Hashimoto’s, Graves’ Disease, Psoriasis and other autoimmune conditions.
Triggers of Leaky Gut
The most common triggers of Leaky Gut are:
Stress is a significant trigger and mediator in the development of Leaky Gut. According to Chris Kresser, LAc, “The biochemical changes that occur in times of stress have significant and immediate impact on gut function.”1
Once your body perceives a stressor, whether it’s work, infection, exercise, food or toxin, it mounts a biochemical response that results in increased gut permeability, mediation of inflammation, increased sensitivity to pain, altered gut motility and changes to the gut microflora. Over time this can lead to significant changes in GI function.
Kresser states that “Experimental studies have shown that psychological stress slows normal small intestinal transit time, encourages overgrowth of bacteria, and even compromises the intestinal barrier.”1
These changes provide the gateway for other triggers to wreak havoc, as larger food particles, toxins, and pathogens enter the bloodstream through the gut, and thus the immune response occurs.
While the stresses of work and family are of noteworthy significance, the food that you eat is actually the biggest daily stressor, as perceived by your body, according to Dr. Robert Rountree.5
Common gut-damaging foods include:
Gluten: A protein that has been hybridized (changed from its original form) to the point that your body sees it as foreign and reacts to it.9,10
Sugar and Refined Carbohydrates: Support yeast overgrowth and promote bad bacteria over good bacteria.
Alcohol: Alcohol and its by-products are direct toxins and irritants to the GI mucosa. It’s also linked to yeast and SIBO infections.
Processed Foods: Contain additives and preservatives that your body sees as irritants or toxins.
GMO’s: Genetically modified foods that your body can’t identify. The largest GMO crops are Corn, Canola, Soy, Sugar Beets, Zucchini, Yellow Squash and Papaya.8
Food Sensitivities and Allergies: Gluten, Dairy, Corn, Soy, Yeast, Eggs, and Nuts are the most common offenders. With Leaky Gut, larger food particles enter your blood and the immune system responds. Since you’re likely eating very frequently, the result can be a continuous cycle of inflammation and immune upregulation.
Lectins and Phytates: Nutrient blockers that are produced by plants for survival that cause mineral malabsorption and alter the gut lining leading to immune activation. These are widespread in grains, legumes, and nuts.9,10
Conventional Dairy: The protein A1 Casein damages the gut lining, and according to Dr. Josh Axe, pasteurization causes degradation of enzymes that are critical to digestion of lactose.11
GI infections such as Candida (yeast), parasites, H. pylori, and SIBO (small intestinal bacterial overgrowth) release toxic metabolic products that cause inflammation to the gut lining, as well as the breakdown of its physical barrier.
This toxic process also makes the intestines more hospitable to other pathogens, leaving you vulnerable to additional infections.
The presence of these GI infections also contributes to dysbiosis, or the imbalance of the bad gut flora over the good flora, essentially wiping away another level of defense against invaders and allowing the toxic environment to flourish.
Infections such as Lyme Disease and other tick borne illnesses, as well as certain viruses, can also play a role in the development of Leaky Gut, by contributing to processes that alter normal digestion and elimination, as well as perpetuate inflammation.16
Infections can also further complicate the situation through molecular mimicry.
Molecular mimicry occurs when the body mistakes a self-molecule for a foreign molecule and in error mounts an immune attack on its own tissue.14
A classic example is the bacteria Klebsiella attacking the joints, resulting in Ankylosing Spondylitis.15
Due to molecular mimicry, bacteria and parasites are often found to be root causes in the development of various autoimmune conditions.14, 15
In addition to the toxins produced from bacteria, yeast, and parasites, your body is exposed to an excessive amount of daily contaminants.
According to the EPA there are over 70,000 chemicals in U.S. commerce today.12 Some common ones include:
- Heavy metals such as mercury, lead, cadmium, and arsenic.
- Pesticides such as Glyphosate and Bt toxin.
- Mold mycotoxins.
- Chemicals such as BPA, BPS, PCBs, dioxins, phthalates, chlorine, fluorine, xylene and toluene.
Toxins can damage intestinal cells, alter the gut nervous and immune systems, or even kill beneficial bacteria. The worst effect however, may be that these toxins are being reabsorbed and recirculated rather than eliminated from your body.
Even the hormones in your body can act as toxins because they can be re-absorbed into circulation if the flora is imbalanced and the gut is permeable.
Anti-inflammatories, antibiotics and acid blocking drugs are the main medication-type contributors to Leaky Gut.
NSAIDs actually block the production of prostaglandins, which are substances that can mediate pain, but that are also critical to rebuilding the lining of the intestines.
According to Dr. Leo Galland, NSAIDs can further cause damage by sensitizing bacteria and altering the GI flora.13 He states, “If you use a full therapeutic dose of NSAIDs for 2 weeks there is a 75% chance you will develop a leaky gut that will not go away when you stop taking the drug.”13
Along with killing pathogens, antibiotics also kill the good bacteria, creating the potential for yeast overgrowth, which directly causes and perpetuates Leaky Gut.
Acid blockers decrease the amount of stomach acid produced. This results in suppressed and incomplete digestion of food, which allows large particles through the intestines and into the bloodstream. This increases the likelihood of immune system reaction. Further, decreased stomach acid leaves you vulnerable to pathogens, as there isn’t enough acid to kill them.
Symptoms of Leaky Gut
GI: Gas, bloating, belching, stomach pain, constipation, diarrhea, undigested food particles or fat in stool, gurgling in stomach, acid reflux, and food sensitivities or allergies.
Immune: Allergies, asthma, chronic sinus infections, frequent infections such as respiratory or urinary tract infections, candida overgrowth, and autoimmune conditions.
Liver: Poor detoxification, pain under the lower right ribs.
Skin: Acne, rosacea, rashes, eczema, psoriasis, and dermatitis.
Musculoskeletal: Joint pain, muscle pain, and fibromyalgia.
Brain and Mood: Headache, fatigue, brain fog, inability to focus, irritability, anxiety, depression, ADD/ADHD, lack of coordination or balance and poor memory.
Hormone: Fatigue, poor temperature control, weight gain or weight loss, poor sleep quality, food cravings, poor blood sugar regulation and hormone imbalances.
If you’re experiencing symptoms that lead you to suspect Leaky Gut, you should address them quickly.
According to Dr. Tom Sult, “As the condition of the gut degrades, the health implications can become serious.”6
Minor Symptoms tend to be largely limited to the gut early on in the condition, where as a more progressive case will have symptoms outside of the gut.6
The more symptoms that you have, the higher the correlation to an increased immune system response and the subsequent possibility to develop more serious conditions that can be difficult to reverse, such as autoimmune conditions.
Every single autoimmune condition is thought to have the same root cause: Leaky Gut. Dr. Alessio Fasano’s research has been integral in identifying this linkage. In his 2012 paper titled “Leaky Gut and Autoimmune Disease,” he states, “In addition to the genetic predisposition and exposure to triggering non-self antigens, the loss of protective function of the mucosal barriers that interact with the environment (mainly through the GI and lung mucosa) is necessary for autoimmunity to develop.”2,4
In The Paleo Approach, Dr. Sarah Ballantyne, PhD writes, “A leaky gut is present in every autoimmune disease that has been tested, including Ankylosing Spondylitis, IBDs (Crohn’s and ulcerative colitis), Celiac Disease, Multiple Sclerosis, and Type 1 Diabetes.”15
Lab Testing For Leaky Gut
There are several testing options to determine whether you’re suffering from increased intestinal permeability, or Leaky Gut.
Some labs label it the Intestinal Permeability Test, while more generic labels include the Lactulose-Mannitol Test or Hydrogen Breath Test.
Since there are many contributing factors to the development of Leaky Gut, other important tests to consider are:
- Food sensitivity and allergy testing
- Dysbiosis testing through organic acids, stool cultures, and SIBO breath testing
- Toxin testing through urine or hair analysis
- Liver function testing through a blood test or an organic acids test
Treatment of Leaky Gut
Dr. Leo Galland explains that even though you have a leaky gut, the cells of the intestinal lining replace themselves every 3-6 days.13
This means that once you eliminate the contributing triggers and root causes of Leaky Gut you can repair the intestines fairly quickly. The hard part can be identifying all of the causes and eliminating them.
Functional Medicine’s approach to the treatment of Leaky Gut is the 5R Program:
- Remove the sources of irritation and inflammation:
Eliminate foods that contribute to leaky gut. Completing an elimination diet for 3-4 weeks is a good place to start.
Using a food diary is a great tool to identify food sensitivities when you add them back in. If you add them back in and have any type of reaction, you should keep them out until your gut is fully healed.
An anti-inflammatory, whole foods based diet is best.
Try to eliminate the use of medications known to contribute to leaky gut, if you can.
Reduce toxin exposure by eating organic when possible, using cleaner personal care and home products, and filtering your home air and water. Many green plants provide natural toxin filtration.
Remove all sources of parasitic, fungal, and bacterial infections in the gut. If you take care of these without resolution of symptoms, look into viruses and other infections such as tick borne illnesses.
- Replace the nutrients that your body needs to heal:
Using digestive enzymes and betaine hydrochloride to allow for proper breakdown and absorption of nutrients.
Taking a good multivitamin can help restore nutrients while your body is still not completely digesting and absorbing food.
Glutamine is an amino acid that is the primary source of fuel for intestinal cells. Supplementing with glutamine at 5-10g twice daily can help heal the gut lining faster.
Omega-3 fatty acids found in fish oils can help decrease inflammation taken at a dose of 2-4 g per day.
Supplements that contain Slippery Elm, Marshmallow Root, Aloe, DGL, and Zinc Carnosine are soothing to the gut mucosa. Use these cautiously as some of them can cause GI distress in people with certain dietary restrictions and autoimmune conditions.15
- Reinoculate with good bacteria to restore the flora:
Using a high quality probiotic with at least 50 billion CFU twice daily will help restore the gut flora. Lactobacillus and Bifidobacter species are best.
Fermented foods such as sauerkraut, kimchi and kombucha, as well as kefir and yogurt (you can use dairy or non-dairy based) contain live, active cultures that will help the good bacteria stick around.
Prebiotic fibers and resistant starches provide the nutrients that support the healthy flora and maintain intestinal health.
- Repair the gut lining and normal physiological functions.
Taking many of the supplements described in #2 and #3 will help repair and rebuild the gut lining.
In addition, it’s important to also repair the normal physiological processes of digestion, or you risk developing a leaky gut again. This includes using betaine HCl to increase stomach acid, digestive enzymes to assist the pancreas, intestines and liver until they produce adequate levels on their own, and sometimes ox bile to assist the liver in the digestion of fats.
Additionally, motility, or the ability to keep waste and toxins moving through the GI tract, often needs to be repaired and restored.
Ginger and d-limonene are good agents to stimulate GI motility. Exercise and movement are also great ways to keep the bowels moving.
- Rebalance your body to heal faster and maintain vibrant health moving forward.
Decreasing stress through journaling, deep breathing techniques, meditation, yoga, exercising, or getting out into nature are great ways to achieve this.
Finally, one of the most imperative measures you can take is to get at least eight hours uninterrupted sleep as this is when the body heals.
There’s no smoking gun for overcoming leaky gut, but what you’ve just read is the blueprint used by top functional medicine practitioners the world over. And it works.
Like everything else in life that’s worth it, you must put in the work. If you can commit to these changes, you could be well on your way to healing your gut in short order.
This article originally appeared on Healevate.
Chronic inflammation = disease. This is a profound statement that has broad ramifications for health and disease management everywhere.
If you look at the root causes of almost every single disease and death, you’ll notice that chronic inflammation is a player in the process.
Some inflammation is good—in fact, it’s a normal, healthy biological process. It’s only when inflammation goes unchecked for extended periods of time that it becomes a big problem.
Think of inflammation as a smoldering ember. If you have a few embers in one room of a 10-story building, it’s a small problem that’s contained. But if you have embers in every room on every floor of that 10-story building, now there’s a problem. Just a little puff of air might rekindle these embers into an actual fire again. Eventually, the heat from this small fire could grow, and the whole building could go up in flames.
This is similar to what happens in the body. A minor infection might cause a fire that turns into smoldering embers, and these embers die out when the infection is gone (if you have a healthy immune response).
If you’re stressed out, not exercising or sleeping well, or have poor nutrition, imbalanced hormones, and GI problems, there’s a good chance you have smoldering embers burning throughout your body, creating a low-level systemic fire.
If you don’t identify the causes of these small fires, they’ll wreak havoc on your body and cause full-blown diseases like diabetes, heart disease, cancer, Alzheimer’s, Parkinson’s, dementia, stroke, autoimmune conditions, or hundreds of other major diseases.
The good news is that the power to change this is in your hands, because every action you take each day either contributes to health or causes disease.
What Exactly is Inflammation?
Inflammation is a big buzzword in the world of health now, and rightfully so. The word inflammation comes from the latin word “inflammare,” meaning “to ignite,” and it’s your body’s response to danger signals.
Classically, inflammation describes the body’s immune response and biochemical processes to remove harmful stimuli, such as pathogens, toxins, irritants, or even damaged cells in an attempt to preserve itself and heal. Then we have the physical manifestations of inflammation: calor (heat), rubor (redness), dolor (pain), tumor (swelling), and loss of function.
This process is apparent when you have a cut on your arm, a bad sunburn, or a pimple. It’s less obvious when you have a viral or bacterial infection, since you can’t see the signs. What we’ve described here is acute inflammation. Acute inflammation is a normal process necessary for life; it allows you to survive scrapes and infections. It has a beginning and an end.
Conversely, chronic inflammation persists without end in response to hidden infections, toxins, chemicals, and/or foods or from lack of counter-regulatory mechanisms (chemical “off” switches) in the immune system that should turn inflammation off.2 Persistent cellular stress or dysfunction caused by a high calorie, low nutrient diet, oxidative stress, and hormone imbalances perpetuates this process.
Chronic inflammation is never a good thing. The major danger with chronic inflammation is that it’s silent, causing destruction for years or decades before it’s noticed (usually as the first signs of a disease), leaving significant damage in its wake.1 It could be raging inside you at this very moment without you even noticing. This kind of inflammation is what underlies almost every chronic illness and disease known to man.
Acute and chronic inflammation share a common origin, although they end with two very different products. The main differences between the two processes are:5
- Elimination or isolation of the stressor (infection, toxin, chemical, etc.)
- Usually a local response (anaphylaxis is the exception)
- Usually adaptive with an appropriate response that begins and ends
- Usually short in duration
- Maladaptive (the normal mechanisms that quench inflammation aren’t working)
- Disrupts normal balance (homeostasis) in the body
- Alters normal cellular function
- Destroys cells and tissue over time (like the degeneration of joints in arthritis)
- Long duration (months to years)
- Often unnoticeable or hidden
How Does Inflammation Occur?
The inflammatory process is a complex symphony of the response of the immune system and its interaction with many different types of cells and biochemical signals.
There are two main branches—the innate immune response, which occurs quickly and is more simple and nonspecific, and the acquired immune response, which occurs more slowly, as it’s more specific and has memory (so when you encounter the same trigger, such as a virus, your body is prepared for the attack).
Triggers, such as infection or injury, induce a series of biochemical events. Numerous substances are released simultaneously by the injured tissues, causing changes to the surrounding tissues.6
Remember our 10-story burning building? You can think of your injured tissue doing this just like you would turn on the sprinklers to dampen the fire and alert the fire department.
There are many chemical messengers that function in this process; however, the important ones to note are histamine, serotonin, bradykinin, lipid (fatty acid) derived mediators, cytokines, and acute phase reactants.
These chemicals are the “fire department,” with their many tools to put out the fire. They’re responsible for actions such as swelling (increased leakiness of the blood vessels), relaxation (dilation) or tightening (constriction) of the blood vessels, airways, and intestinal smooth muscle, and sending out chemical messages that turn on genes, recruit more helpers to the scene, or produce substances involved in the inflammatory process itself.
Histamine: Most people are aware that histamine is involved in the inflammatory response given the significant notoriety of antihistamines with allergies.
What many people are unaware of is that it also functions as an excitatory (stimulating) brain neurotransmitter producing wakefulness and anxiety, which is why many people with severe allergies, hives, or GI infections don’t sleep well.5,6 Its highest concentrations are in the gut, skin, lungs, and central nervous system (CNS), where many of the symptoms are felt.
Serotonin: This substance is best known as a brain neurotransmitter responsible for keeping you happy, calm, and well-rested. It’s also known for its role in the gut, affecting motility (how food and waste move through) and secretion of digestive chemicals. 95% is produced in the gut, and it can be significant in inflammatory GI disorders. You know that feeling when you get butterflies in your stomach, then have anxiety and maybe diarrhea? That’s serotonin. Together, histamine and serotonin are some of the first responders in the inflammatory movement.3,5
Bradykinin: This protein isn’t well-known by name; however, you’ve felt its effects many times before, since it’s a significant chemical in the inflammatory process. Bradykinin causes many of the actions of the inflammatory process (swelling, pain, blood vessel dilation, etc.) itself, or it signals other cells to participate and release their chemicals. It can also increase histamine release, making a response more intense.4 Bradykinin is most often released from tissue damage or exercise.4
Lipid Derived Inflammatory Mediators: This is a fancy term for chemicals derived from the oxidation (the loss of electrons from molecules—think rust) of the omega-6 fatty acid, arachidonic acid (AA), and omega-3 fatty acids’ eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Like histamine, you may have heard of some members of this group of chemicals before, since prostaglandins and leukotrienes are called out in the inflammatory process in advertisements.
They’re short-lived, signaling molecules found in most cells that modulate all aspects of the inflammatory process, including the resolution of inflammation, and they have system-wide influence on nerve transmission, mood, and hormone secretion.5,7,8
Cytokines: These are the primary chemical switches that turn the immune response on and off. They activate and recruit other cells to the immune response and assist in antibody production. Cytokines are responsible for fever production and participate in the allergic response, as well as antimicrobial and antiviral activity.5,7,8
Tumor necrosis factor alpha (TNFɑ) is one of the most important cytokines involved in systemic inflammation; it regulates other cells of the immune response. It has antiviral and anti-tumor activity, and dysregulation is implicated in obesity, Alzheimer’s, cancers, depression, and IBD.5,7,8
Acute Phase Reactants (APR): APRs are a category of proteins produced in the liver that increase or decrease in response to inflammation. Some of the most notable are C-reactive protein (CRP), ferritin, and fibrinogen.
CRP increases rapidly with inflammation and marks damaged cells, making them easier to identify for elimination. Once it rises, it’s cleared rapidly from the system.11,12
Ferritin, an iron carrier protein, increases in response to most infections, except a few bacterial strains.11,12 Fibrinogen is a coagulation factor promoting clot formation that increases with inflammation. ESR (erythrocyte sedimentation rate), also considered to be an APR, describes the rate at which red blood cells fall in a one-hour period and correlates to fibrinogen levels.11,12
Other aspects of the inflammatory response involve the formation of antibodies to specific antigens and the blood clotting system. Antigens are proteins found on all cell surfaces, and when the immune system identifies them as foreign, it forms a corresponding antibody to it. Antibodies either neutralize the foreign invader or prepare it for phagocytosis (engulfing of a foreign particle for elimination).9
The process of blood clotting (coagulation) involves a group of proteins that convert clotting factors (such as prothrombin, thrombin, and fibrinogen) to a fibrin clot. The pathway is linked to inflammation since the clotting process, which occurs outside of a cell, can trigger the inflammatory signaling inside of a cell.
These processes operate in a feedback loop that promotes one another, and when left uncontrolled, this loop can be a problem in chronic inflammation—especially cardiovascular disease, clotting disorders, and hormone imbalances.10
All of these chemicals signal in various ways to elicit the response that produces redness, swelling, heat, immobility, and pain—as they should—but the body is smart and knows that the inflammation must end.
Dr. Robert Rountree, MD, states, “Simultaneously, the body activates biochemical counter-regulatory pathways (off switches) that produce anti-inflammatory mediators such as lipoxins, protectins, and resolvins. These are lipid mediators that are made on demand from the omega-6 fatty acid, arachidonic acid (AA), and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) specifically for the purpose of turning off the inflammatory response.”2
This pro- and anti-inflammatory balance is the adaptive immune process, and it’s what should happen after an acute injury where the body identifies and responds to the insult or invasion, then repairs the injury and the process ends.
This process becomes a problem in two scenarios. First, when this response is exaggerated, producing a severe allergy or anaphylaxis. Second, when the cause of acute inflammation persists without end or the counter-regulatory mechanisms (anti-inflammatories) are compromised, producing chronic inflammation. Acute inflammation from a wound, infection, or a food allergy will cause systemic, chronic inflammation if not identified and treated.
Additionally, when the normal mechanisms that quench inflammation are decreased (or pro-inflammatory processes are increased), chronic inflammation will ensue. Inflammation begets inflammation, so it’s important to identify the triggers to stop perpetuating the cycle.
Functional medicine cardiologist Dr. Mark Houston says it best: “The body has a limited number of options to deal with an unlimited number of insults.”
Triggers of Inflammation
There are many triggers of inflammation, and often several are operating in concert together, propelling the cycle forward.
What these triggers have in common is that they generate free radicals or reactive species from oxidative stress and/or the inflammatory chemicals discussed previously.
Free radicals and other reactive species are produced as a product of oxidation, which involves the removal of one electron from an atom, rendering it unstable or reactive.
Your body obtains energy by combining fuel from the foods we eat with the oxygen we breathe in a controlled metabolic process that yields potentially dangerous oxidative byproducts that damage DNA, mitochondria, proteins, and cell membranes if we don’t have the appropriate antioxidant and anti-inflammatory mechanisms in place.
Oxidative stress isn’t only generated when you eat, but also during exercise, detoxification, and when the immune system is activated in the inflammatory response.
The good news is that many of these triggers are modifiable lifestyle factors or conditions that can be tested for, identified, and reversed. Dr. Mark Hyman, MD explains the importance of identifying the causes, explaining, “My job is to find those inflammatory factors unique to each person—to see how various lifestyle, environment, and infectious factors spin the immune system out of control, leading to a host of chronic illnesses.”16
The most common triggers are:
- Hormone imbalance
Diet, for most people, is the single most important lifestyle change that can significantly impact chronic inflammation.
The food you eat sends chemical messages to your genes, which will either turn up or turn down inflammation. The following are pro-inflammatory foods (so you should think about avoiding them):
Gluten: A protein that has been hybridized (changed from its original form through breeding, not genetic modification) to the point that your body sees it as foreign and reacts to it. This reaction upregulates the immune system and will continue until the gluten is removed.
Food Sensitivities and Allergies: Gluten, dairy, corn, soy, yeast, eggs, and nuts are the most common offenders. When your body is constantly bombarded by these irritants, leaky gut, or increased intestinal permeability occurs, allowing larger food particles to enter your blood, and the immune system responds. Since you eat several times a day, the result can be a continuous cycle of inflammation and immune upregulation until the source is eliminated.
GMOs: Genetically modified foods that your body can’t identify can trigger an immune response similar to a food sensitivity. The largest GMO crops are corn, canola, soy, sugar beets, zucchini, yellow squash, and papaya, many of which are pro-inflammatory to begin with.
According to Dr. Tom O’Bryan, BT (botulinum toxin) in GMO foods has been shown to cause severe intestinal permeability in insects.23 Dr. O’Bryan also warns that BT toxins have been found in maternal and fetal blood, so we know they’re getting absorbed when we consume them.23
Sugar and Refined Carbohydrates: Your body is only designed to handle small amounts of natural sugar, and there are several issues with exceeding this amount.
First, refined sugar and carbs are genetically unfamiliar, which is a problem.11 Second, when you consume sugar or carbs, especially in large amounts frequently, it causes a rapid rise in blood sugar. If you need fuel, your body will use it; otherwise, it gets stored in muscles as glycogen or in fat cells.
If you have decreased insulin sensitivity or diabetes, this storage process is inefficient, leaving sugars in circulation, which spells trouble because it leads to the formation of free radicals from increased oxidation. Too much insulin release is pro-inflammatory as well.11 Excess sugar also promotes yeast overgrowth and dysbiosis (higher amounts of bad bacteria versus good bacteria), which further encourage inflammation.
Conventional Dairy and Meats: Meat and dairy raised in a conventional manner (grain-fed versus grass-fed) have the same health problems humans do, since they weren’t meant to eat grain.
Consuming all of these grains leads to a higher production of pro-inflammatory omega-6s and fewer omega-3s in these animals. When you eat them, you’re increasing your levels of pro-inflammatory fats as well. Some of the proteins (especially A1 casein) found in dairy are known to promote inflammation according to Dr. Kelly Brogan.13
Bad Fats: Most Americans have a dietary (and bodily) imbalance in their omega-6/omega-3 ratio, which causes your body to be in a pro-inflammatory state. Corn, safflower, sunflower, soy, and peanut oil are all omega-6s. Also, healthy fats such as olive oil, nuts, and nut oils are degraded (oxidized) when used in cooking at high heats or when storing them improperly, leaving them vulnerable to oxidation due to air exposure.
Consuming these now rancid (oxidized) fats is inflammatory. Chemically altered trans fats (hydrogenated oils, margarine) in processed foods are potent drivers of inflammation as well.
Processed Foods: These foods contain additives, colorings, dyes, and preservatives that your body sees as irritants or toxins. Because these foods are foreign to your body, they may induce an immune response.
Alcohol: It’s well-documented in literature that alcohol consumption decreases immune function.14 Alcohol and its by-products are direct toxins and irritants to the body, especially the gut, liver, and brain.
Advanced Glycation End-Products (AGEs): AGEs are produced as a result of a glycation reaction, when a sugar reacts with a protein or fat. AGEs form stable molecules that embed in tissues, causing oxidative damage, and are difficult for the body to get rid of. In food, they occur by cooking at high heat as with grilling, barbecuing, deep frying, broiling, and searing—basically anything that gives color or texture. The higher the heat, the more AGEs that form.
Meats, sugary foods, and processed foods are particularly high in AGEs. They also occur naturally in your body, and the higher your blood sugar, the more these will form, so limiting sugars and maintaining blood sugar is important. Fructose is particularly reactive, so limiting daily intake to 25 g or less is best.15
Low Phytonutrient and Antioxidant Consumption: A diet low in a broad array of plant-based nutrients is associated with increased levels of inflammation, even if you’re eating “the right things.” Decreased intake of fruits and vegetables is associated with developing inflammation that preceded metabolic syndrome and heart disease, among others.16
Stress as a trigger for inflammation is just as important as diet is. It could be argued that stress is more so, actually, since stress comes in so many different forms that all add up when combined in our hectic modern lives.
Physical Stress: Trauma/injury, surgery, and exercise (too much or too little)
Chemical Stress: Toxins, metabolic waste and oxidation, infections, allergens, chronic illness, autoimmunity, medications, hormone imbalances, food, and drink.
Emotional Stress: Work, finances, relationships, job change, marital change, death of a loved one, birth of a child, etc. This is what people commonly refer to as “stress” in their lives. These stressors are often the hardest to control and can have a profound impact on healing.
It’s important to note that the body doesn’t discern between different types of stresses. Similarly, it can’t perceive the difference between good stress (birth of a baby or a new job) and bad stress (loss of job, divorce) and will react the same.
Anything that disrupts homeostasis will be perceived by the body as a stressor, and it will act accordingly in an effort to keep you alive.
Stress, like inflammation, is good when the response is appropriate and controlled. It initiates the ‘fight or flight’ response meant to keep you alive when danger is present (like when you encounter a bear and need to escape), like blood rushing to your brain to keep you focused. Simultaneously, non-essential functions like digestion and reproduction are decreased.
Just like with inflammation, counter-regulatory off switches exist so that the stress response ends. This was great in paleolithic times; however, in modern life, we have an overabundance of stress that doesn’t seem to stop.
Our stress response never ends, disrupting the mechanisms that should bring us back in balance. This causes several physiological changes that potentiate inflammation.
Chronic stress causes the sympathetic nervous system to be upregulated and increases levels of the stress hormone cortisol.
Over time, constant cortisol elevation leads to cortisol resistance, where the body must pump out even more to meet the same metabolic demands.
When this occurs for extended periods of time, cortisol levels become chronically low and adrenal fatigue develops. Cells of the immune system become insensitive to cortisol’s regulatory effect and don’t respond, which promotes inflammation.17
Not only does stress promote inflammation, but it also lowers immunity. A 2012 study by Dr. Sheldon Cohen revealed that prolonged exposure to a stressful event was associated with the inability of immune cells to respond to hormonal signals that normally regulate inflammation.
In turn, those with the inability to regulate the inflammatory response were more likely to develop colds when exposed to the virus. “The immune system’s ability to regulate inflammation predicts who will develop a cold, but more importantly it provides an explanation of how stress can promote disease,” Cohen said. “When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. Because inflammation plays a role in many diseases such as cardiovascular, asthma, and autoimmune disorders, this model suggests why stress impacts them as well.”17
Prolonged stress upregulates (turns up) pro-inflammatory genes, resulting in increased susceptibility to infection, slower wound healing and resolution of illness, and increased risk of serious illness and premature aging from the effects of cell damage.
Dysbiosis occurs when there’s an imbalance between the beneficial and harmful organisms in you body, especially the gut.
Normally, you have helpful bacteria and even some yeast that help you digest food, produce nutrients, and protect you from harmful organisms as well as inflammation.
Dysbiosis arises when there’s a general imbalance between the good and bad flora, or when there’s a pathogen or infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), or a parasite.
Research shows that a decrease in certain gram-positive bacterial species is associated with inflammation, since they’re responsible for producing short-chain fatty acids (SCFA), which act to decrease some of the inflammatory signaling molecules and enhance the immune response.18
Additionally, an increase of certain gram-negative bacterial species promotes inflammation because most of them contain lipopolysaccharide (LPS) in their outer cell membrane. This is an endotoxin—as the name suggests, that’s bad because it promotes inflammation by eliciting a strong immune response and contributing to leaky gut (increased intestinal permeability).
SIBO arises when there are more bacteria in the small intestines than there should be. Normally, there are much fewer bacteria in the small intestines than the colon since the small intestines function more in digestion and absorption of nutrients. SIBO infections can promote inflammation through the imbalance of bacteria, leaky gut, nutrient malabsorption, and the imbalance of histamine and serotonin.
Candida (yeast) is a fungus that aids in digestion and nutrient absorption. It’s opportunistic, becoming pathogenic and increasing in numbers if your immune system is compromised from stress or illness, or if your diet is high in sugar and carbohydrates.
Research shows that Candida infection delays healing, and the inflammation from the infection promotes further colonization of yeast, creating a vicious cycle of low-level inflammation and infection.19
Parasites are literally everywhere. Giardia (sometimes called beaver fever) and Cryptosporidium are some of the parasites that make the headlines occasionally, even though there are a plethora that exist. Acute parasitic illness manifests with the typical symptoms of diarrhea, vomiting, stomach pain, bloating, fever, and malaise. Most resolve with the normal immune response.
Chronic infections, however, can range from asymptomatic to severe, with blood and mucus-filled stools, profuse diarrhea, and malnutrition. These infections contribute to inflammation through decreased nutrient absorption, constant immune system attack, and interrupted sleep patterns.
Infections other than typical GI infections are also a common source of inflammation; they often go undetected for long periods of time, allowing them to wreak havoc on the body and the immune system.
Some more obvious infectious agents are mold (fungal infection), Lyme and other tick-borne illnesses, and chronic viral infections like the Epstein-Barr virus (EBV). Less obvious and often hidden infections that can go undetected for years are abscesses from trauma or surgery, but especially dental procedures.
Mold: Describes a group of fungi that are ubiquitous. Their spores are often airborne and deposit everywhere, which is why you find white or green fuzzy patches on your produce or bread. It can be associated with dysbiosis or systemic infection.
The toxins (mycotoxins) that come from mold are very harmful, producing symptoms ranging from mild to severe fatigue, sore throats, nosebleeds, headaches, diarrhea, brain fog, food sensitivities, and memory loss. These symptoms often mimic other conditions, which delays diagnosis and allows inflammation to proliferate.
Tick-Borne Illness: Tick-borne illnesses are becoming more prevalent and are often hard to diagnose. Lyme disease, an infection acquired through the bite of a tick infected with the bacteria Borrelia burgdorferi, is the most well-known of this type of infection. Babesia, Rickettsia (Rocky Mountain Spotted Fever), Ehrlichia, and Bartonella are also frequently identified infectious bacteria from tick bites. These infections not only take a toll only the immune system itself, but also the gut, contributing to decreased GI motility and dysbiosis.
Chronic Viral Infection: A common but not often talked about cause of systemic inflammation. The problem with viruses is that they can remain latent (inactive) for extended periods of time and don’t reactivate until there’s a trigger.
Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are two herpes family viruses that can remain latent after initial infection and only become active again under stress or immunosuppression. EBV, the infectious agent in mononucleosis, is also associated with the development of several types of cancer and autoimmune conditions. Chronic activation of the immune system produces inflammation with undetected viruses.
Abscesses: Can occur after any type of tissue injury such as trauma, surgery, infection, or dental procedures (especially a root canal). They form when incomplete healing takes place, either from a physical barrier or because the body can’t mount an appropriate immune response to kill off the bacteria.
The constant activation of the immune system produces chronic inflammation, and many systemic symptoms can go on for years—this is one of the most difficult causes to detect, since most people forget about a procedure or discount an injury.
Trigger: Hormone Imbalances
Hormones need to be maintained in a delicate balance for proper function. When any hormone is too high or too low, many of the other hormones shift as well, causing imbalances throughout the system.
Cortisol, DHEA, insulin, estrogen, progesterone, and testosterone all have effects on each other, as well as other hormones, which all impact inflammation.
Generally, androgens (testosterone and DHEA) have a suppressive effect on the immune response and inflammation while estrogens increase the immune response. Research suggests:
“Low levels of androgens as well as lower androgen/estrogen ratios have been detected in body fluids (blood, synovial fluid, saliva) of both male and female rheumatoid arthritis patients, supporting the possibility of a pathogenic role for the decreased levels of the immune-suppressive androgens.
“Several physiological, pathological, and therapeutic conditions may change the sex hormone milieu and/or peripheral conversion, including the menstrual cycle, pregnancy, the postpartum period, menopause, chronic stress, and inflammatory cytokines, as well as use of corticosteroids, oral contraceptives, and steroid hormonal replacements, inducing altered androgen/estrogen ratios and related effects. Therefore, sex hormone balance is still a crucial factor in the regulation of immune and inflammatory responses.”
Adrenal fatigue with lowered cortisol and DHEA, estrogen dominance in women (with a relative low progesterone level), and low testosterone in men (with a relative elevation in estrogen) all create an imbalance that skews the body to a pro-inflammatory state. This state can be further exacerbated by poor blood sugar regulation.
Proper blood sugar regulation is critical in maintaining hormone and inflammatory balance. Excessive insulin is pro-inflammatory, as is the activity of the enzyme aromatase, which is increased by insulin.
Aromatase is the enzyme that converts androgens to estrogens, and it has a great deal of influence on the production and balance of sex hormones. Many cell types have aromatase activity, but adipocytes (fat cells) are of particular interest because the more you have, the more active aromatase is.
If you’re insulin-resistant, diabetic, or overweight, the enzyme aromatase will become upregulated, promoting inflammation. Insulin resistance (high insulin levels) and excess body fat increase estrogens, which increase aromatase and inflammation in a vicious cycle.
In addition, elevated blood sugar levels from insulin resistance create more inflammatory compounds, worsening the situation. This is why poor blood sugar regulation combined with excess body fat creates the perfect inflammatory storm and provides a base for many chronic illnesses.
Toxins are virtually all around us in modern life, from pollutants in the air we breathe, the water we drink and bathe in, and the foods we consume to the products we use to clean ourselves, our homes, and our possessions. They can also be produced in the cooking process and in our guts.
The process by which toxins cause inflammation is multifactorial. According to Chris Kresser, LAc, MS, “Environmental toxins interfere with glucose and cholesterol metabolism and induce insulin resistance; disrupt mitochondrial function; cause oxidative stress; promote inflammation; alter thyroid metabolism; and impair appetite regulation.”
The thyroid is particularly sensitive to chemicals and oxidative stress. With increased exposure, thyroid function decreases, producing a hypothyroid state that triggers weight gain and supports inflammation.
Toxins you’ll want to minimize exposure to include heavy metals (mercury, lead, aluminum, arsenic, cadmium, etc), tobacco smoke, air pollution outside and in the home, pesticides (organophosphates), herbicides, plastics (BPA, BPF, BPS, phthalates, polystyrene, PVC, etc.), chemicals (toluene, xylene), and preservative and chemical-laden personal care products and foods. This list is a good place to start, but it’s not exhaustive.
Toxins can also come from cooking at high heat. When food darkens in color, it not only produces AGEs but also heterocyclic amines (HCAs), especially in meats. Consumption of HCAs is linked to many types of cancer since it alters genes (mutation) and promotes inflammation.21 And if your detoxification systems are impaired, the effects can be magnified because of the free radicals and oxidative stress generated. Dr. Robert Rountree says, “Eating a burnt burger is really no different than smoking a cigarette.”24
Symptoms of Inflammation
Anything that ends in ‘itis’ means that it’s inflamed. Appendicitis literally translates to “inflammation of the appendix.” Other than the obvious ‘itis’ conditions, here are other symptoms associated with chronic inflammation:
Immune: Allergies, asthma, autoimmune disorders, chronic or recurrent infections that won’t resolve (such as sinusitis or UTIs)
Skin: Dermatitis, eczema, acne, rashes, hives, redness, pruritis (itchiness), petechiae (broken blood vessels)
Gastrointestinal: Food sensitivities, food allergies, GERD (acid reflux), IBS, IBD, and infection or dysbiosis that can produce gas, bloating, diarrhea, or constipation
Brain and Mood: Headaches, brain fog, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia
Nerves: Tingling, pins and needles, paresthesia
Hormonal: Poor blood sugar regulation (especially high blood sugar), weight gain or loss, imbalanced female and male hormone systems, poor sleep quality, thyroid imbalances, adrenal imbalances
Cardiovascular: Hypertension (high blood pressure), high cholesterol, anemia
Musculoskeletal: Joint and muscle pain, fibromyalgia
Liver: Poor detoxification, elevated liver enzymes
Chronic inflammation affects literally every cell in your body. Virtually all significant diseases and conditions are related to chronic inflammation.
If the above symptoms are ignored, they can become a full-blown condition like a heart attack, congestive heart failure, diabetes, cancer, Parkinson’s, Alzheimer’s, ulcerative colitis, Crohn’s, Celiac, Hashimoto’s (autoimmune hypothyroid), Grave’s (autoimmune hyperthyroid), stroke, Lupus, multiple sclerosis, rheumatoid arthritis, osteoarthritis, psoriasis, scleroderma, hepatitis, pancreatitis, autism, ADD/ADHD…the list goes on.
Lab Testing for Inflammation
Testing for inflammation can be exhaustive. This is a good list to start with to investigate general inflammation.
Root cause testing, including allergens, food sensitivities/allergies, heavy metal and toxin exposure, mycotoxicity, GI infections and dysbiosis, hidden infections, autoimmune conditions, and hormone testing may also be necessary.
- High sensitivity C-reactive protein (hsCRP)
- Erythrocyte sedimentation rate (ESR)
- Lipoprotein a (Lp(a))
- Apolipoprotein A1 and B (Apo A1 and B)
- Complete blood count
- Vertical Auto Profile (VAP) cholesterol test or lipoparticle protein testing (LPP)
- Salivary cortisol testing with DHEA
Blood Sugar Regulation:
- Blood glucose (blood sugar)
- Fasting insulin
- Hemoglobin A1C
- Telomere testing
- 8-hydroxy-2-deoxyguanosine (8-OHdG)
- Lipid peroxides
Treatment of Inflammation
The treatment of inflammation can seem daunting since there are so many different causes.
The easiest approach is to clean up the diet, add in nutrients and make lifestyle modifications.
If you’re not getting the desired results, do some further investigating into root causes such as food allergies, autoimmunity, GI infections, impaired detoxification, toxic exposures (mycotoxins, heavy metals, chemicals), hidden infections such as Lyme or EBV, and proper hormone balance.
Diet: Dr. Mark Hyman, MD suggests, “Eat an organic, whole foods, high fiber, plant-based diet, which is inherently anti-inflammatory. That means unprocessed, unrefined, real food high in powerful anti-inflammatory plant chemicals called phytonutrients.”27
As Dr. Josh Axe notes, “Antioxidants are self-sacrificing soldiers that donate an electron to neutralize free radicals and are consumed in the process.” He suggests eating brightly-colored vegetables and fruits, cocoa, and green or white tea.25
Dr. Hyman also recommends getting an oil change. “Eat healthy fats from olive oil, nuts, avocados, and omega-3 fats from small fish like sardines, herring, sable, and wild salmon.”27 These fats are anti-inflammatory and promote a healthy omega 3:6 ratio.
An elimination diet may help you find out if there are foods contributing to your inflammation. Eliminate these foods for at least 30 days and note how they make you feel when you add them back in.
Cooking your foods at a lower heat will help them retain nutrients and avoid forming harmful substances. Author Mark Sisson recommends poaching, boiling, steaming, braising, baking, or using a pressure cooker or crock pot.28 If you really want to grill or cook at high heat, marinating with olive oil, citrus, and herbs or spices will reduce toxin formation.
Nutrients and Supplements: There are many anti-inflammatory nutrients found in fruits, vegetables, teas, coffee, herbs, and spices. Here are some that can be helpful if you experience inflammation:
Magnesium and vitamin D exert anti-inflammatory action by decreasing cytokine production and prostaglandins, respectively.1,31
Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.
Curcumin blocks activation of a key protein that triggers the immune response and decreases cytokine activity according to research out of Ohio State University.29
Ginger is a root that has uses in many ancient traditional medicine systems. Ginger is an anti-inflammatory and a blood thinner.30
Boswellia (frankincense) is an Ayurvedic herb that, when taken orally or topically, provides anti-inflammatory properties through inhibiting pro-inflammatory enzymes.30
Alpha lipoic acid (ALA) functions as an antioxidant and supports healthy mitochondrial function.31
Essential fatty acids (EPA and DHA) from fish oil or krill oil is important since humans don’t efficiently synthesize it themselves. They modulate the inflammatory response and maintain balanced fatty acid ratios.1
Probiotics (“good bacteria”) increase the levels of healthy bacteria in your gut, which reduces inflammation.
According to neurologist Dr. David Perlmutter, turmeric (curcumin), green tea extract, pterostilbene (from resveratrol), glucoraphanin (from broccoli), and coffee activate an important anti-inflammatory pathway (Nrf2), and taking these nutrients as supplements can be far more effective at increasing antioxidant production than typical antioxidants.26
Lifestyle Modifications: These are some of these easiest and most effective ways to reduce inflammation. Incorporating them into your life as habits will help promote long-term inflammation management.
Exercise: This is one of the most effective ways to decrease inflammation, since it has so many benefits—improved insulin sensitivity and body composition, decreased stress (when you don’t overdo it), and decreased signaling of inflammatory chemicals.32
Stress reduction: Stress is one of the biggest contributors to chronic inflammation, and managing it essential to lifelong health. Identifying stressors is the first step. Once you’ve done this, create boundaries, say “no” when you have to, and make sure your feelings are heard and understood.
Relaxation: Learn to actively relax to engage your vagus nerve, the powerful nerve that relaxes your whole body and lowers inflammation, by doing yoga, meditation, deep breathing, or even taking a hot bath.27
Sleep: Getting adequate sleep is essential to healing. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.
Unplug: Being constantly tuned in to your phone, computer, iPad, tablet, or TV exposes you to radiation and can also alter your sleep cycle due to blue light stimulation.
Detox your personal care products: If you won’t eat it, don’t put it on your body. Opt for natural or organic lotions and creams, shampoo, conditioner, toothpaste, deodorant, and fragrance. You can make many for low cost at home from coconut oil, essential oils, and other common household items.
Detox your home: Look for natural and organic products here too to avoid toxic chemicals. Many cleaners are now being made from enzymes and plant soaps. You can also make homemade ones from vinegar, lemon juice, baking soda, essential oils, and more. Keeping lots of green plants in the home helps detox the indoor air as well. Look for rubber plants, aloe, peace lilies, areca palm, golden pothos, and English ivy.
With a little detective work and some requisite effort, you could be well on your way to putting out the fire from within your own body that’s robbing you of your health. Learn to listen to your body and to notice the obvious signs. Your body is an incredible machine that’s designed to want to heal. All it asks of you is to provide it with an environment that’s conducive to this objective.