In her book Inflammation, Christine Herbert discusses the complex networks which create chronic inflammation and the use of herbs and natural healing to strengthen them
There is an epidemic of chronic inflammatory diseases in the world, with incidences increasing all the time due mostly to our changing lifestyles. Instead of dying suddenly of acute infections, we now die more slowly of chronic inflammatory diseases.
Many factors interact with each other that determine chronic inflammatory disease. Our genes determine our individual strengths and weaknesses, but epigenetics determines how our genes express themselves and the way we live our lives will determine this. Variable factors include diet, the environment in which we live, the health of our gut microbiome, our digestive systems, and our immune system. Most of these variable factors are under our control and can be improved. We will find some of the methods of doing this here.
This article is about chronic inflammation – the inflammation that doesn’t have a useful or positive outcome in the body. Acute inflammation, redness, swelling and heat that follow injury are an important part of healing from an injury and need to be allowed to proceed. It is not holistic simply to stop an inflammatory response because inflammation is a result of and not a cause of disease. Inflammation is simply the body’s way of defending itself against attack. This is where we have to play detective and determine the cause of the inflammation; then, we can actually treat it. Anti-inflammatory medication may appear to help at first, but it then becomes part of the problem if used long term.
Inflammatory processes in the body
The health of the body and the presence or absence of inflammation is dependent on the health and proper functioning of all systems and organs. Just because a knee joint is swollen and sore doesn’t mean that the knee joint can be treated alone. Any malfunctioning body systems or organs will also need to be treated and returned to health to treat the knee. This is always more obvious when there is inflammation throughout the body, such as in fibromyalgia or rheumatoid arthritis, but it applies to almost all chronic inflammatory processes.
The immune system is the key to inflammation, but it doesn’t work alone; it requires all body systems to play their role well in a complex interconnecting dance that will maintain a harmony of health when it functions as it should. A strong immune system will maintain a healthy body. The gut plays a vital part in immune system homeostasis, as most immune cells are in the gut. If the gut is not healthy, the immune system won’t be healthy, and there will be chronic inflammation to one extent or another. This is something that the older traditional medicine systems knew, and those who practise herbal medicine today also know. The health of the body begins in the gut (1).
In most cases of chronic inflammation, the initial problem begins in the gut, generally with the diet. Either too many inflammatory foods such as sugar, trans fats or refined grains are present, or foods are eaten to which there is an intolerance, most commonly dairy or wheat.
The immune system can be seen as the housekeeping system of the body. It protects us from pathogenic organisms and removes or isolates dead or malignant body cells and foreign bodies.
Innate or non-specific immunity is the immunity we were born with and refers to the general protective function of the immune system. It includes the barrier functions of the skin and internal mucous membranes in the mouth, digestive system, lungs and urinary system. It also includes tears in the eye and ear wax. Macrophages are also part of the innate immune system, and they can eat or phagocytose foreign particles to render them harmless. Fever is an innate immune response that creates a hostile environment for an invading microorganism and stimulates the immune response.
Adaptive or specific immunity develops over time in response to exposure to various antigens. It involves lymphocytes B cells and T cells – which produce specific antibodies against the invader (B lymphocytes) and has various cytotoxic mechanisms (T lymphocytes) to clear up dead or compromised tissue cells. These cells also have an ability to remember earlier invasions which means that future attacks are more efficiently dealt with.
A healthy immune system will recognise which cells it needs to attack and recognise healthy self-tissue. But if it is under too much pressure, for example, chronic inflammation, this is when the immune system can turn on the host body, attacking self cells and creating autoimmune disease.
Removal of dysfunctional, dead and dying tissue cells is also part of autophagy (literally, self-eating). This process can be seen as a spring clean of the body and may be important in protection from cancer (2) and also involves both specific and non-specific immunity and can be made more efficient by exercise and fasting with the overall effect of cell regeneration and recycling cellular nutrients (3).
The process of autophagy has been shown to be optimised by a diet low in refined starch and sugar and high in omega-3 fatty acids (4,5).
How to improve the immune system’s health
Herbs and nutrition directly affect the immune system, but all body systems are vital here, so any attempt to improve the health of the immune system must also look at the whole. Emotional health also affects the immune system, hence the field of psychoneuroimmunology. Stress or social isolation will weaken immune function, whereas a relaxed nervous system creates a strong immune system. This connection has been demonstrated many times in studies (6,7,8).
Lack of sleep is strongly linked with a weak immune system and a much-increased risk of cancer. A study involving sleep restriction in healthy young men where sleep was only allowed between ten in the evening and three in the morning resulted in a seventy per cent reduction of natural killer cells plus reduced cellular immune response – both vital in a normal immune system which amongst other things also protects us from cancer. After one night of recovery sleep, only part of the immune system returned to normal – the conclusion was that even a modest disturbance of sleep reduces the natural immune response (9).
A good and varied diet is important for a healthy immune system. Particularly important vitamins and minerals include vitamins D and C and zinc and selenium. Good sources of vitamin C include most fresh fruit and vegetables; vitamin D is best obtained from sunlight exposure or a supplement. Food sources of vitamin D include oily fish, mushrooms and eggs. Zinc is found in red meat, shellfish, legumes, nuts and seeds. Selenium is found in brazil nuts, fish, poultry and sunflower seeds.
The gut microbiome needs to be healthy for a strong immune system, so fermented foods such as sauerkraut or kefir are helpful. These must be unpasteurized so that the beneficial bacteria are still present.
Short term fasting will have a stimulant effect on the immune system, just as will raising the body’s temperature in a sauna or steam room. This type of stimulation is useful when an immediate effect is needed for an acute situation.
Herbs that affect the immune system can be subdivided into immune modulators or tonics – these are slower acting and can be used long term to improve immune function in those with chronic infection, autoimmune disease or lowered immunity; and herbal antimicrobials that practically attack and kill invading microorganisms.
Immune modulating herbs include echinacea (Echinacea purpurea and E. angustifolia), astragalus (Astragalus membranaceus), marigold (Calendula officinalis), wild indigo (Baptisia tinctoria), Siberian ginseng (Eleutherococcus senticosus), ginseng (Panax ginseng), ashwagandha (Withania somnifera), and all the medicinal fungi including (Trametes versicolour) and reishi (Ganoderma lucidum). Many immune-modulating herbs are also adaptogens, so they will support the endocrine and nervous systems, supporting immunity.
A herb that strengthens connective tissue, hence reinforcing the immune system’s barrier function, is horsetail (Equisetum arvense); this plant contains very high amounts of silicic acid or silica, which is water-soluble and required by all connective tissue (10).
Lymphatic herbs may also have a role to play in promoting autophagy. These might include cleavers (Galium aparine), heartsease (Viola tricolour), and figwort (Scrophularia nodosa).
Herbal antimicrobials include garlic (Allium sativum), thyme (Thymus spp), oregano (Origanum majorana), sage (Salvia officinalis) and walnut (Juglans nigra).
Liver health and immunity
The digestive tract’s general health depends on the health of the gut, its microbiome, and the liver. Any treatment of inflammation anywhere in the body requires that the gut and the liver are healthy and functioning well.
There is a three-way interaction between the microbiome present in the digestive system, bile acids produced by the liver, and the immune system, which results in an inflammatory response, healthy or otherwise.
Bile acids are the main component of bile, produced by the liver and secreted into the small intestine via the gallbladder, where its main function is to digest fats and oils from the diet. However, they also have an important role in the inflammatory process. After bile acids have processed fats, they travel down the digestive tract, where they are modified into immune regulating molecules by gut bacteria. One type of immune regulating molecule will activate effector helper T cells (Th17) which are pro-inflammatory. For example, when an infection needs dealing with, another type activates regulatory T cells (Tregs) that are anti-inflammatory and necessary when the infecting pathogen has been killed. These should balance each other out to maintain good intestinal health.
Low levels of Tregs have been seen in those with inflammatory bowel disease and are linked with low bile acids (11).
Cholestasis is where there is a decrease in bile flow and is associated with impaired immunity and ability to fight infection and increased inflammation. (12)
Improving the liver’s health will improve bile acid function, and most people will benefit from improving liver health.
How to improve liver health
Remove anything causing harm to the liver, such as alcohol or toxic chemicals. Medication may also be causing a problem, and if it cannot be removed, then work with diet to ameliorate the problem as much as possible.
Diet should be organically grown foods as much as possible in order to ensure minimal chemical residues. The Pesticide Action Network UK’s website an idea of how many pesticides and herbicides are used on many types of fruit and vegetables; therefore, it is possible to decide which foods should be bought as organic.
Some foods are good at supporting the liver; these include lemon and lime; bitter salad leaves such as dandelion, chicory and endive; dark green leafy vegetables, particularly the brassica family; olive oil and olives. Coffee is also a useful liver herb, if not overindulged. The hepatic herbs for the liver need to be chosen carefully to support whatever is going on. If someone has an overactive, hot liver and is given liver stimulant herbs, they will become hot, flushed and emotional. These people need calming and cooling liver tonics such as agrimony (Agrimonia eupatoria), burdock (Arctium lappa), chamomile (Matricaria chamomilla), dandelion (Taraxacum officinale), vervain (Verbena officinalis) or yarrow (Achillea millefolium). And those with a cold, stagnant liver need the more stimulating liver herbs such as angelica (Angelica archangelica), artichoke (Cynara scolymus), barberry (Berberis vulgaris), marigold (Calendula officinalis), milk thistle (Silybum marianum), or yellow dock (Rumex crispus).
The health of the gut
The gut wall lining from mouth to anus is made up of many layers. The inner layer is the mucosa, in which there are mucous secreting cells and epithelial cells. This lining is permeable but very selectively, allowing only a few small molecules to pass through once digested and made safe to enter the bloodstream. The body secretes a protein called zonulin which increases intestinal permeability because sometimes this is required, but this is a controlled and immediately reversible permeability. But zonulin is also secreted when there is inflammation in the gut from food sensitivities, diet, infections, etc.
When this wall is subjected to prolonged inflammatory damage, the tight junctions between cells can widen, allowing larger molecules to pass through, creating more inflammation due to the activation of the immune system and more food sensitivities. So food sensitivities are a cause of, and a result of, increased intestinal permeability.
The increased intestinal permeability is termed leaky gut and is a major player in chronic inflammation and may also be a key process in the development of autoimmune diseases (13).
When the gut lining becomes less efficient and the digestive secretions of the stomach decrease due to poor health or ageing, the ability of the digestive tract to digest food and obtain nutrients will decrease. In this case, symptoms such as bloating, reflux, gas and feelings of fullness will appear, and food intolerances start to increase. These symptoms may also be due to eating the wrong foods. Still, they often indicate that digestive capability has been compromised, which, in turn, will impact the microbiome, the liver, and nutrient availability for the immune system. All of these have an impact on overall inflammation in the body.
Bacterial endotoxin is a lipopolysaccharide LPS found in the cell walls of gram-negative bacteria, which are found in large numbers in the gut, the gums, and other tissue when there is bacterial infection or dysbiosis. When they remain in the intestines, they don’t cause a problem, but when the bacteria die off and there is a degree of gut leakiness, then the released LPS can move through the intestinal wall and into the bloodstream, where they will initiate inflammation. Evidence shows that this process is important in the development of inflammation linked with obesity and diabetes and may be a major cause overall of chronic inflammation (14) and of brain microglial activation, which promotes neurodegeneration of the brain (15).
A diet high in trans fats or constant snacking can also cause a dysbiosis that increases LPS production (16), and a diet high in fructose causes LPS-induced inflammation (17).17 It has been shown that celery (Apium graveolens) contains aglycones which show potent inhibitory activity against LPS-induced nitric oxide production in macrophages.
Cardamom significantly decreases the secretion of inflammatory mediators secreted by lipopolysaccharide-stimulated macrophages.
How to improve gut health
Leaky gut and digestive ability are closely linked; once the correct diet for the individual has been found, the rest will follow. Healing a leaky gut must commence with a good diet with no inflammatory foods.
Removing processed foods and replacing them with healthy food can turn around an inflamed digestive system within a couple of months. Bone broths, when long-cooked, release collagen peptides that support the repair of the intestinal wall. Gum acacia is another supplement that appears to be able to heal damaged tissue, possibly by supporting that part of the microbiome that improves tight junctions in the intestinal lining (20). Herbs can help repair the gut wall, and those containing mucilaginous polysaccharides such as Aloe vera (Aloe barbadensis), marshmallow root (Althaea officinalis), and slippery elm (Ulmus fulva), and also many seaweeds are often used to improve mucosal health.
These herbs are easiest to take as powders in tablespoonful doses and can be mixed with stewed apples (peel and all), which contain large amounts of pectin, which is also a good gut healer.
Marigold (Calendula officinalis) and plantain (Plantago spp.) are both inflammation-mediating herbs excellent at wound healing. Simmering the dried or fresh herbs for 20–30 minutes makes a strong decoction. Ideally, this would be drunk on an empty stomach after at least a 12 hour fast. Make it the night before and drink the next morning. A dose of a handful of the dried herb in about 250ml of water daily would be fine.
Improving digestive function requires the involvement of bitter herbs and aromatic digestive herbs. These should be chosen to suit the person, making distinctions between warming and cooling bitters (see liver herbs above).
Most culinary herbs and spices such as black pepper, mustard, ginger, coriander and cumin will help digestion and can be taken before eating, with food or afterwards if needed.
If these are not enough, bitter herbs can be used, ideally before a meal but also useful afterwards. I have a formula for a digestive bitters tonic, which has been the most popular formula I have ever made, and hundreds of people have found it useful. The mix contains warming and cooling bitter herbs and aromatic herbs, which together really help digestion:
- 3 parts artichoke (Cynara scolymus)
- 2 parts (Angelica archangelica)
- 2 parts blessed thistle (Carbenia benedicta)
- 1 part fennel seed (Foeniculum vulgare)
- 1 part gentian (Gentiana lutea)
- 1 part bitter orange peel (Citrus aurantium fr.)
- 1 part ginger (Zingiber officinale)
- 1 part centaury (Centaurium erythraea)
Take anything from twenty drops to a teaspoonful of tincture in a bit of water as needed.
The combination works best as a tincture as it becomes quite unpleasant as tea. As a tincture, it is pleasant to take if a little bitter to those who are not used to bitter tastes. Everyone gets used to it after a few days.
The health of the microbiome
The human body is an ecosystem, part of which includes a vast number of different microbial organisms which play a vital role in the proper function of our bodies. The role of the gut microbiome is well recognised in the inflammatory process, and the inflammatory process has been shown to have deleterious effects on the microbiome (21).
It has also been well recognised that pre-industrial peoples have a similar microbiome wherever they live in the world. Those living in industrialised areas have a very different, less healthy microbiome due to three main reasons: the presence of antibiotics, a diet of processed food, and a much more sanitised environment. However, there is no such thing as a “normal” microbiome; it is always individual, so testing to determine a microbiome to see if it is “healthy” is not that useful. A microbiome will contain not only bacteria but also viruses, fungi and parasites, and its makeup will be affected by everything from conception onwards. It is considered that the most influence comes from the first one thousand days of life, including time in utero. However, it can be improved and repaired at all stages of life.
One hundred years ago, the killer diseases worldwide were pneumonia, tuberculosis and infectious gut diseases. Nowadays, these have been supplanted in the richer, western world by the killer inflammatory diseases – cardiovascular disease, cancer and diabetes. So as a population, we have learned how to manage bacteria but overmanaged them so that we killed all micro-organisms, beneficial and pathogenic, without the understanding that we actually needed the beneficial ones
For example, a study has shown that the presence of a bacterium Blautia obeum in the gut can protect against cholera by a number of different mechanisms, including its interaction with bile salts. The study found that B. obeum was prevalent in the microbiome of people studied in Bangladesh. Those from Bangladesh had a much more diverse microbiome than a similar number of people from the USA (22). The functions of these beneficial microbiotas are numerous and very important to our health. Our understanding of the functions and health of the microbiota has only really developed in recent years, and more and more connections have been drawn between this new industrial microbiota and chronic inflammatory diseases. We still don’t know the full story yet, but it is developing (23).
There is evidence that dysbiosis weakens the immune defences “thereby predisposing to more severe SARSCoV-2 infection and contributing to ‘long COVID.’” (24).
The factor with the most effect on the microbiome is diet, and we need a good variety of foods to feed a large variety of microorganisms. The average modern western diet contains a tiny variety of different plant foods, in some cases less than ten. In contrast, the diet of older generations may well have contained at least one hundred different plant foods.
It is now understood that if we eat at least thirty different plant foods in a week, we will have a much healthier microbiome than if we only ate ten different ones. It’s actually not that difficult to eat such a variety, as plant foods include all grains, nuts, seeds, fruit and vegetables.
One important change in diet from the less developed to the developed world was the reduction of both soluble and insoluble plant fibre based complex carbohydrates found in plants such as legumes, whole grains and vegetables. These were replaced by simple carbohydrates, the refined and processed grains and sugar that make up the modern diet, which is much less useful to the microbiome and shown to have altered its structure and function, resulting in dysbiosis (defined as unnatural changes in the composition of the microbiome) and leading to chronic inflammatory disease. Stress can also have a significant impact on the microbiome this can be physical or mental stress and can include overworking, sleep deprivation, pollution, local climate change and lack of exercise. Social interaction and physical activity also have an impact on gut and body health (25).
How to improve microbiome health
There are several ways to improve the microbiome, but it is most important first to improve the gut’s health, i.e. improve the terrain. If there is a leaky gut, then this needs dealing with first.
The bacteria in the gut microbiome need prebiotics to feed on for their health. The breakdown products of this digestion are short-chain fatty acids released into the blood circulation, which have beneficial effects on the whole body (26).
They are a particular kind of dietary fibre that the gut microbiota selectively uses and are vital to the microbiome’s health. Good prebiotic fibre containing foods include Jerusalem artichokes, apples, bananas, asparagus, leeks, onions, oats, barley, and linseeds. Acacia gum and slippery elm (Ulmus fulva) are also excellent prebiotic sources.
Probiotics, the bacteria that can support the microbiome and be ingested in capsules or drinks, are useful but are only temporary residents of the gut and only serve a purpose while they are being taken. In order to encourage the microbiome to flourish, the terrain needs to be right, so prebiotics, a healthy diet and a healthy gut wall are most important. Garlic (Allium sativum) is useful as it is a prebiotic and antimicrobial to pathogenic microorganisms. Fermented foods and drinks such as sauerkraut, kimchi, kombucha and kefir are most useful here too, and as they are food and drink can be taken daily at a much lower cost than probiotic supplements. However, if these are purchased rather than homemade, it is important that they are unpasteurized so that the beneficial bacteria are still present. Eating avocados also seems to support healthy gut flora.
The nervous system and inflammation
The nervous system comprises two main parts, the central nervous system, which includes the brain and spinal cord, and the peripheral nervous system, which includes nerves branching off from the spinal cord and extending to all parts of the body.
These nerves carry messages or information in their nerve cells or neurons between the brain and the body, which control every action.
There is a strong bi-directional connection between the brain and the gut via the cranial and the vagus nerves and the entire peripheral nervous system. So anything that affects the gut will affect the brain and vice versa. When there is an inflammatory state in the gut, it will affect the brain – this is apparent in patients with inflammatory bowel diseases such as coeliac disease, where there is also a high incidence of brain inflammation visible on an MRI scan (27).
Or, if the gut is on fire, then the brain will also be on fire.
The action of the vagus nerve is very linked with inflammatory states in the body. The vagus nerve, so-called because it wanders through the body like a vagabond – originates in the brain, travels down the neck, through the chest, to the abdomen creating an interconnected network between the brain, digestive system, lungs, heart, liver and kidneys. Its principal function is to send messages to the brain from the organs, so the brain is aware of how they are functioning. The vagus is also able to assess immune function too.
The vagus nerve controls the parasympathetic nervous system – so it is vital in winding down from any sympathetic nervous system activity. The sympathetic nervous system is activated by increased cortisol in the fight or flight response created by a stressful situation. Keeping this balance between parasympathetic and sympathetic is vital for health. It was a matter of life or death to have that sympathetic response when we were out hunting or being hunted back in the stone age. Still, those who don’t deal well with stress and anxiety find themselves in the sympathetic mode more or less constantly and unable to revert to relax mode, which is parasympathetic dominance. The sympathetic response releases hormones such as adrenalin and cortisol, resulting in a raised heart rate, tense muscles (ready to run), sweating, slowed digestion and a feeling of increased energy due to gluconeogenesis (the generation of new glucose by the liver). It also releases the hormone renin from the kidneys, increasing blood pressure and metabolism. Understanding the stress response is simple if we consider the domestic cat – they are masters of relaxation (parasympathetic dominance). Still, when necessary, they can spring into fast action to hunt or to run from a dog (sympathetic dominance) and then straight back to sleep again afterwards as though nothing had happened.
Generally, the parasympathetic response is anti-inflammatory, and the sympathetic response is pro-inflammatory, especially if out of control. So chronic stress is a major cause of inflammation.
Stress results in the release of inflammatory cytokines through the effect on sympathetic and parasympathetic nervous system pathways. These cytokines have been found to interact with neurotransmitter metabolism and neuroendocrine function. Poor sleep results in lowered vagal tone, increased inflammation, and inflammation results in poor sleep. Pro-inflammatory cytokines IL-6 and TNF alpha daytime secretion are increased in insomniacs which causes more inflammation and contributes to the chronic inflammatory diseases so common today – type two diabetes, cancer, osteoarthritis and cardiovascular disease.
How to improve nervous system health
Improving vagal tone will help the body to relax better after any stress. There are several methods of improving the tone, and the results will reduce inflammation. These need doing long term and daily for several weeks to get results:
- Cold exposure will activate the vagus nerve, and regular cold exposure can lower the sympathetic response and increase parasympathetic activity via the vagus nerve: cold showers, or at least cold face wash.
- Deep and slow breathing activates the vagus nerve, reduces anxiety and increases parasympathetic response. Aim at six breaths a minute as diaphragmatic breathing with the expansion of the stomach.
- Singing, humming, chanting, and gargling activate the throat muscles and stimulate the vagus nerve.
- Probiotics – healthy gut bacteria improve brain function by affecting the vagus nerve.
- Meditation – can increase vagal tone.
- Eye exercises – without moving the head facing forward, look to the right for one minute, then to the centre, then left for one minute, breathing slowly as you do it. This exercise can be done sitting or lying down (28).
- Omega-3 fatty acids – increase vagal tone and vagal activity. For example, oily fish, flaxseed oil, and walnuts.
- Exercise – stimulates the vagus nerve.
- Massage can stimulate the vagus nerve – also reflexology and the Bowen technique.
- Socialising and laughing stimulate the vagus – and stimulating the vagus often causes laughter.
Anything that causes inflammation in the gut will affect the brain, so in order to protect the brain and nervous system, it is vital to follow an anti-inflammatory diet. There are suggestions that non-coeliac gluten sensitivity may be of prime importance here, but all pro-inflammatory foods should be avoided (29).
Plastics, in particular the plasticisers bisphenol A BPA, and bisphenol S BPS, are also implicated in causing inflammatory damage to nerve cells, so avoiding all plastic wraps and bottles is a good move (30).
Herbs to improve nervous system health will be nervine tonics, nervine relaxants and adaptogens. Many of these double up as inflammation mediating herbs, and notable herbs which do this are chamomile (Matricaria recutita), lemon balm (Melissa officinalis), linden flower (Tilia europaea), St John’s wort (Hypericum perforatum), skullcap (Scutellaria lateriflora), ashwagandha (Withania somnifera), rose root (Rhodiola rosea) and schisandra (Schisandra chinensis).
Endothelial cell health
Endothelial cell health is another important factor in the inflammatory process.
Endothelial cells form the lining of all blood and lymph vessels in the body. They are there to act as a barrier between blood and lymph and the rest of the body tissues. They are also selectively permeable to some chemicals to move into body tissues and permeable to carbon dioxide to move into the bloodstream from tissues. This permeability is a very important function that, among many other things, maintains the blood-brain barrier, which protects the brain from toxic chemicals.
Another main function of endothelial cells is maintaining the elasticity of blood vessels to allow them to constrict and dilate – vasoconstriction and vasodilation in order to control blood flow and blood pressure. Endothelial cells synthesise nitric oxide (NO), which acts as a vasodilator, and also catecholamines which act as vasoconstrictors. Reduced NO production and/or bioavailability is considered the central mechanism responsible for endothelial dysfunction (31). NO also acts as an anticoagulant to prevent anything from sticking to the endothelial cell wall.
The endothelium also has a role to play in wound healing – controlling platelet aggregation and a clotting factor to prevent further bleeding, but also they are involved in fibrinolysis, which dissolves clots and prevents thrombosis.
If there is a chronic inflammatory process, then damage to the endothelium will result in a loss of elasticity, resulting in poor vasodilation, which results in hypertension; it also results in increased coagulation incidences as it tries to heal itself. This process results in thrombosis, heart and kidney disease, neurological disease and pulmonary disease. Insulin resistance and diabetes are inflammatory and will also damage the endothelium, hence the link between diabetes and cardiovascular disease. With age, diabetes, hypertension, smoking, and inactivity, endothelial cells lose function. A recent study looking at mRNA COVID vaccines concluded that the mRNA vaccines dramatically increase inflammation on the endothelium and T cell infiltration of cardiac muscle and may account for the observations of increased thrombosis, cardiomyopathy, and other vascular events following vaccination (31).
How to improve the health of the endothelium
- Avoid smoking, inactivity, obesity, sugar and refined carbohydrates.
- Eat more plants, especially whole grains, nuts and seeds, herb teas, green tea, cocoa, and dark chocolate, which all increase endothelial nitric oxide, one of the most helpful ways of supporting the endothelium.
- Spices improve endothelial function – turmeric, ginger, cinnamon and black pepper. Foods to improve microcirculation: chocolate, berries, garlic, beetroot and green tea.
Often the heroic methods of modern medicine – the surgery and medications – are required when heart disease becomes severe, but in the earlier stages, or when things are stabilised, there are plenty of herbal interventions that can help. The main mechanisms of action of the most commonly used hypertension medications are calcium channel blockade, beta-adrenergic blockade and angiotensin-converting enzyme inhibition. Herbs have been shown to act by all of these mechanisms as well.
Herbs that will support endothelial function include ginkgo (Ginkgo biloba), hawthorn (Crataegus oxyacantha), red sage (Salvia miltiorrhiza), rose hips (Rosa canina), reishi (Ganoderma lucidum), ginger (Zingiber officinale). Gentian (Gentiana lutea) has been shown to prevent endothelial inflammation (32).
References
- G.Vighi et al. “Allergy and the gastrointestinal system.” Clinical and experimental immunology vol. 153 Suppl
- Suppl 1 (2008): 3-6. 2L.Galluzzi et al. “Autophagy in malignant transformation and cancer progression.” The EMBO journal vol. 34,7 (2015): 856-80.
- P.Kuballa et al.Autophagy and the immune system. Annu Rev Immunol. 2012;30:611-46.
- L.Shen et al. “Dietary PUFAs attenuate NLRP3 inflammasome activation via enhancing macrophage autophagy.” Journal of lipid research vol. 58,9 (2017): 1808-1821.
- J. Bland The long haul of COVID-19 recovery: immune rejuvenation versus immune support. IHCAN April 21
- Abdurachman,et al. “The role of psychological well-being in boosting immune response: an optimal effort for tackling infection.” African journal of infectious diseases vol. 12,1 Suppl 54-61. 7 Mar. 2018
- Y. Barak The Immune system and happiness Autoimmunity reviews Vol 5, 8, Oct 2006 pp 523–527.
- S. Brod et al ‘As above, so below’ examining the interplay between emotion and the immune system Immunology. June 2014.
- M. Irwin et al. Partial night sleep deprivation reduces natural killer and cellular immune responses in humans. FASEB J. 1996 Apr;10(5):643–53.
- L.M. Jurkić, et al. Biological and therapeutic effects of ortho-silicic acid and some ortho-silicic acid-releasing compounds: New perspectives for therapy. Nutr Metab (Lond) 10, 2 (2013).
- Harvard Medical School. “Bile acids may help regulate gut immunity and inflammation.” ScienceDaily. www.sciencedaily.com/ releases/2020/01/200103141047.htm accessed 3/12/20.
- M.Wammers et al. “Reprogramming of proinflammatory human macrophages to an antiinflammatory phenotype by bile acids.” Scientific reports vol. 8,1 255. 10 Jan. 2018
- Q.Mu et al. Leaky Gut As a Danger Signal for Autoimmune Diseases. Front Immunol. 2017 May 23;8:598.
- P.D.Cani, et al Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 2007 Jul;56(7):1761-72.
- G.C. Brown The endotoxin hypothesis of neurodegeneration. J Neuroinflammation 16, 180 (2019).
- C. Franceschi, et al. Inflammaging: a new immune–metabolic viewpoint for age-related diseases. Nat Rev Endocrinol 14, 576–590 (2018).
- N.Jones et al. Fructose reprogrammes glutamine-dependent oxidative metabolism to support LPS-induced inflammation. Nat Commun 12, 1209 (2021).
- L H Zhu et al, Constituents from Apium graveolens and their anti-inflammatory effects. J Asian Nat Prod Res. 2017 Nov;19(11):1079-1086.
- M.Souissi et al. Antibacterial and anti-inflammatory activities of cardamom (Elettaria cardamomum) extracts: Potential therapeutic benefits for periodontal infections. Anaerobe. 2020 Feb;61:102089.
- J.C.Clemente et al. The role of the gut microbiome in systemic inflammatory disease. BMJ 2018;360:j5145.
- S.Alavi, et al. Interpersonal Gut Microbiome Variation Drives Susceptibility and Resistance to Cholera 22)
- Infection. Cell. 2020. 22Vulnerability of the industrialised microbiota https://science.sciencemag.org/content/366/6464/eaaw9255/tab-pdf.
- Gut Microbiota May Influence COVID-19 Severity, Immune Response – Medscape – Jan 11, 2021.
- Stefani Lobionda, et al. “The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors.” Microorganisms vol. 7,8 271. 19 Aug. 2019
- Davani-Davari, Dorna et al. “Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications.” Foods (Basel, Switzerland) vol. 8,3 92. 9 Mar. 2019.
- I.D. Croall et al. Cognitive Deficit and White Matter Changes in Persons With Celiac Disease: A Population-Based Study, Gastroenterology, Volume 158, Issue 8, 2020, Pages 2112-2122.
- Rosenberg, Stanley (2017) Accessing the Healing Power of the Vagus Nerve.
- Vasefi, Maryam et al. “Diet Associated with Inflammation and Alzheimer’s Disease.” Journal of Alzheimer’s disease reports vol. 3,1 299-309. 16 Nov. 2019
- E. Schirmer,et al. Bisphenols exert detrimental effects on neuronal signaling in mature vertebrate brains. Commun Biol 4, 465 (2021).
- Endothelium and cardiovascular diseases: vascular biology and clinical syndromes. Editors Protasio L. et al 2018.
- Steven R Gundry, Correction to: Abstract 10712: Mrna COVID Vaccines Dramatically Increase Endothelial Inflammatory Markers and ACS Risk as Measured by the PULS Cardiac Test: a Warning, Circulation, 8 Nov 2021 2021;144:A10712
- R.Kesavan et al.Gentiana lutea exerts antiatherosclerotic effects by preventing endothelial inflammation and smooth muscle cell migration. Nutr Metab Cardiovasc Dis. 2016 Apr;26(4):293-301.
