Chapter 7: Discussion and Summary

[Rebecca]

Chapter 7: Lyme and Inflammation

Discussion Questions:

1. Do you believe inflammation is a problem for you?

2. What steps are you taking to decrease your inflammation?

3. Have you seen any improvement if you are already following Dr. Horowitz's advice on limiting inflammation?

Summary:

• Inflammation is yet another reason why using the MSIDS approach for both diagnosis and treatment makes sense. The cause of chronic disease can be summed up by these three mechanisms; free radicals, oxidative stress, and inflammation. In fact, the number one biological mechanism that seems to underlie most chronic disease states is oxidative stress, which is caused by too many free radicals, and leads to inflammation.

• Chronic Inflammation is characterized by the simultaneous destruction and healing of various tissues in the body. Mononuclear cells produce cytokines (inflammatory chemicals) at the site of an injury. The problem happens when these cells don’t go away and inflammation can last for months or years leading to a laundry list of diseases.

• Persistent inflammation may also be caused by chronic bacteria, viral, parasitic, and fungal infections as well as other autoimmune reactions. When free radicals and inflammatory molecules are present in the cell they produce even more cytokines. This causes sickness syndrome, a protective mechanism that makes one feel ill so that they will rest and allow the body the resources and energy to heal. In Lyme-MISDS patients we see a dramatic increase in cytokine production where inflammation has “gone wild,” and can cause a Jarisch- Herxheimer reaction.

• Besides treating the underlying issues causing sickness syndrome, we also need to focus on decreasing free radicals and oxidant by-products of the nitric oxide biochemical cycle. Nitric oxide can act as free radicals and increase oxidative stress.

• To deal with the harmful effects of free radicals and oxidant by-products you need to target the infections, immune issues and inflammation. You must also support the detoxification pathways, balance hormones, address nutritional deficiencies, food allergies and sleep disorders, while also eliminating environmental toxins that may also increase inflammation.

• Inflammation in the brain is extremely important to treat when it comes to neurological symptoms. Neurotoxins are substances that can damage or kill off the brain’ neurons and are produced by inflammation. This can directly affect neurocognitive functioning. The key is to lower cytokine production and one will increase their overall cognition.

• “A 1994 study published in the journal Infection and Immunity, reported that Borrelia are so powerful that they can cause a much stronger inflammatory response than common bacteria that produce cytokines (like E. coli), one that is fifty to five hundred times stronger.” P. 191 Which explains the strong inflammatory response that some patients can have when exposed to Borrelia. It’s still important to address all causes of inflammation from the MSIDS perspective.

• Cytokine activity can occur in the central nervous system (neurological symptoms) or the peripheral nervous system (pain and inflammation in peripheral nerves).

• Lyme patients are generally poor sleepers and sleep deprivation causes, you guessed it, inflammation and the production of inflammatory cytokines!

• Heavy metal exposure, especially mercury, is extremely common in MSIDS patients. These metals increase oxidative stress and subsequent changes in cytokines. A 2006 study published in Critical Reviews in Toxicology, mercury was found to increase a patient’s susceptibility to infections. When removing heavy metals from the body, Dr. Horowitz found many of his chronic patients had many overall improvements.

• Cytokines can also mess with hormone production. More in Chapter 11.

[Rebecca]

This chapter was very difficult for me to follow and I found myself re-reading sections several times. Especially the section on brain inflammation and decreased cognition. I couldn't help but laugh and perhaps feel a little hopeful that this will pass.

I definitely think inflammation is a problem for me. I already have removed toxins from my home, eat a clean diet, have removed my allergy foods, detox often, sleep pretty well, and I believe I am balancing my hormones with my ND. So... hmmm... not sure I'm through the woods yet, but am well on my way.

[Vicki]

Ha, I am on my second reading of this chapter. It WAS hard to follow, but so important! I have various musculoskeletal ailments and fibro, so inflammation is a big one for me. The info in this chapter is a bit hard to retain--I understand it when I'm reading, but then I have to go back. And back again. Yup. Brain inflammmation!