WHAT HAPPENS IN VAGUS…
We’re bombarded with well-meaning health advice every day. Wouldn’t it be nice if we could take a simpler, more unified approach to health, and could the key to this lie in the levels of inflammation in our bodies?
All about INFLAMMATION: Chronic inflammation is Public (health) Enemy No 1, and a trigger of disease
A SINGLE PATHWAY TO WELLBEING?
Eating well, exercising, drinking lots of water, a good night’s sleep, maintaining a healthy body weight, meditation, yoga – what’s the common health thread? The answer is inflammation.
All of this advice has been linked to lowering the levels of inflammation in the body.
Some health experts believe tackling this key issue could be the single most critical step we can take to protect our health. This is because inflammation is associated with a range of health conditions – from anxiety, depression and cancer to heart disease, back and joint pain, difficult menopausal changes and even problems with our teeth and skin.
WHAT IS INFLAMMATION?
Inflammation is the body’s natural response to injury or illness. It is directed at repairing tissues and cells, and removing harmful bacteria, viruses or chemicals in the body in order to restore us back to health.
So imagine you’ve cut your finger on a piece of broken glass. Right away, the immune system jumps into action, with white blood cells rushing to the site of the injury to do battle against the hostile bacteria that were on the glass and to deal with the physical trauma of the resulting cut itself.
From the outside, this battle manifests itself in some, or all, of the five classic signs of inflammation: pain, heat, redness, swelling and loss of function – and this is no bad thing at all.
The aim of your body is to repair your cut finger and restore it back to full health. The pain and discomfort you feel is, in a sense, actually necessary and even beneficial – it’s a sign of a healthy immune system fighting back against injury.
Immunity is often compared to a war in the body, with white blood cells making up a highly trained army, swallowing up bacterial, viral or parasitic invaders, showering them with toxic chemical bombs, punching holes in cells in handto-hand combat and dissolving them wholesale.
THE KEY PLAYERS
• MACROPHAGES (literally ‘big eaters’) are large white blood cells that have been described as the troops of our immune system. They gobble up bacteria and dead cells, and produce cytokines, which are inflammatory hormones.
• LYMPHOCYTES are other white blood cells that have been described as the generals of the immune system.
• B CELL LYMPHOCYTES produce antibodies to help the troops (the macrophages) fight infection.
• T CELL LYMPHOCYTES are programmed to recognise and deal with invaders – foreign substances called antigens in the body.
• GRANULOCYTES are short-lived white blood cells that can dissolve foreign substances such as bacteria, viruses or parasites.
It’s a brutal battle, but acute inflammation is designed to be a short-term assault to ensure that collateral damage to healthy tissue is minimal.
At some point, in a healthy individual, once an injury or infection is healed, the generals of the immune system should decide that the enemy is on the run. They call off the troops, inflammation drops off, the body goes back to normal, and all is well again.
THE DARK SIDE OF INFLAMMATION
The trouble is that inflammation in the body can be a double-edged sword. It’s an important biological process we want to see switched on in times of illness or injury. But sometimes the switch fails to turn off in good time, and inflammation becomes chronic. Increasingly, scientists are suggesting that chronic inflammation may be the common factor in many diseases.
In a piece by Harvard Medical School, inflammation was proposed as ‘a unifying theory of disease’, and even ‘a common underlying cause of major degenerative diseases’, with a tongue-in-cheek
reference to ‘a one-stop approach to health’.
The authors wrote: ‘The four horsemen of the medical apocalypse – coronary artery disease, diabetes, cancer and Alzheimer’s – may be riding the same steed: inflammation.’ And there is research evidence to back up these claims.
HEART DISEASE: Studies have shown that people who were in the top third for levels of C-reactive protein (CRP), a biomarker for inflammation, were twice as likely to have a heart attack than those in the lowest third.
DIABETES: People who develop diabetes have high levels of inflammatory molecules. According to the Harvard medics, ‘Inflammation not only sets the stage for insulin resistance but accelerates as insulin resistance sets in, which may further hasten the onset of diabetes.’
CANCER: Evidence suggests that cancerous tumours are often formed at the sites of chronic inflammation. Carcinogenic substances such as cigarette smoke and asbestos are known to contain inflammatory substances. The Harvard health experts have suggested that ‘malignant tissues seem to commandeer many of the inflammatory weapons sent out to vanquish them’. ALZHEIMER’S DISEASE: At one point doctors were certain that the brain was protected and kept separate from the immune system by the blood-brain barrier (BBB), which screened out inflammatory cells and molecules, preventing them from entering the brain. However, scientists now believe that inflammatory cytokines are able to get across the BBB, and this has been linked to nerve damage and the incidence of Alzheimer’s.
DEPRESSION & ANXIETY – A NEW IMMUNE-BASED APPROACH
The four diseases mentioned are by no means the only ones linked to inflammation. In his fascinating book The Inflamed Mind, University of Cambridge psychiatrist and professor Edward Bullmore says, ‘I would dare to suggest that none of us will live our lives untouched by depression, directly or indirectly.’
This, he says, is based on figures that suggest that about one in four people – so probably ‘at least one member of all the families on the planet’ – will suffer from depression over the course of
their lifetimes. Despite the fact that depression is on track to become the single biggest cause of disability in the world by 2030, he also notes the suggested treatments – psychotherapy and selective serotonin reuptake inhibitors (SSRIs) – haven’t changed much since the 1990s.
Professor Bullmore’s book sets out the evidence for a breakthrough in the understanding of depression and anxiety, arguing that these illnesses could have their roots in the immune system, and specifically in levels of inflammation in the body and brain. Taking an integrated view, he also looks at how often depression-like symptoms coincide with certain physical illnesses such as arthritis and joint pain, chronic fatigue (which he points out, ‘can follow glandular fever, a viral infection of lymphocytes in adolescence’) and the menopausal transition, which he notes ‘is associated with a high rate of depression and antidepressant drug use among midlife women’.
He considers a new way of thinking about his patient, Mrs P, who had rheumatoid arthritis and was depressed: ‘She was depressed not just because she knew she was inflamed but, more simply, because she was inflamed.’
Hopefully, Professor Bullmore’s approach will usher in a truly holistic era in health where the brain-body connection is taken as a given and depression is never dismissed as being ‘all in the mind’.
This sort of shift could mean that in the future, depression and anxiety could be treated with psychotherapy and SSRIs alongside anti-inflammatory approaches, with much more emphasis on ‘lifestyle’ aspects such as diet, exercise, sleep habits, meditation and so on (see the fuller list of tips overleaf).
Treatments could see patients being offered new anti-inflammatory drugs or supplements, but also non-drug therapies such as electrical devices positioned in the outer ear to stimulate the vagus nerve with the aim of reducing inflammation levels as measured by blood cytokine levels.
Turn over to see what happens in vagus...