Well over 100 diseases are as a result of inflammation in the connective tissues or degeneration of these tissues, such as:

• alzheimer's
• ankylosing spondylitis
• arthritis - rheumatoid arthritis, psoriatic arthritis, osteoarthritis
• asthma
• chron’s disease
• colitis
• dermatitis
• diverticulitis
• hepatitis
• irritable bowel syndrome (IBS)
• lupus erythematous
• nephritis
• parkinson’s disease
• ulcerative colitis

Inflammation is the end result of ongoing oxidative stress caused by:

• emotional or physical trauma
• nutritional or environmental pollutants

It can be caused by a combination of everything.

Atherosclerosis, heart attacks and strokes are increased in rheumatoid arthritis (RA), all of which are caused by oxidative stress. What is oxidative stress

As always, our diet plays a major part and sugar is the main culprit as it causes glycation. The following foods should be avoided as much as possible:

• potatoes – sweet potatoes are fine funnily enough
• legumes
• sweet fruit or root veg
• sodas
• sauces
• tinned foods containing sugar
• all grains such as bread, cakes, biscuits, pasta etc

These convert to glycation. Glycation takes place when a glucose molecule binds to a protein or lipid molecule without the control of an enzyme. With the molecule now impaired, leads to advanced glycation endproducts (AGEs) which then results in inflammatory diseases.

Physical or mental stress can also cause oxidation. Markers for inflammatory diseases are:

• low reduced glutathione (GSH) levels
• low Vitamin D3 and other anti-oxidants
• high oxidised glutathione (GSSH) levels
• high malondialdehyde (a market for oxidative stress, formed when fats are oxidised)
• increased lipid peroxidation
• high homocysteine
• high CRP
• high fructosamine

Markers need to be tested for all of these.

 

Factors causing Inflammation

 

  • oxidative stress, due to decreased levels of anti-oxidants, particularly Vitamin D3, glutathione and superoxide dismutase. Increased sugar intake in foods which convert to glucose, decreased zinc and selenium levels. Estrogen suppresses zinc levels, progesterone on the other hand raises them
  • omega 3 deficiency
  • decreased levels of vitamins B2, C and E and beta-carotene
  • high levels of matrix metalloproteinases (MMPs) which break down protein causing a pathological reaction as inflammation
  • high levels of estrogen which stimulates matrix metalloproteinases, it also accelerates the aging of collagen
  • progesterone deficiency which is always low in inflammatory diseases. Progesterone suppresses MMPs
  • predominance of inflammatory Th1 cytokines over the anti-inflammatory Th2 cytokines. Progesterone stimulates the Th2 response so too does Vitamin D3
  • emotional stress, progesterone is known as the calming hormone, which will activate the GABA receptor sites. GABA is one of our most calming neurotransmitters
  • allergies to certain foods. Estrogen increases the response to allergens. Progesterone suppresses mast cells responsible for the increase in histamine
  • high levels of advanced glycation endoproducts (AGEs)
  • environmental toxins
  • high level of tumour necrosis factor-alph. Progesterone suppresses TNF-alpha
  • high level of prolactin. Progesterone suppresses prolactin, so does the amino acid tyrosine
  • increased levels of fructosamine, a sign of insulin resistance
  • increased levels of homocysteine
  • increased copper levels. Copper suppresses both progesterone and zinc, supplementing with both will suppress the excess copper
  • high level of pro-inflammatory HDLs, leading to increased lipid peroxidation. Progesterone protects against lipid peroxidation

Rheumatoid arthritis affects about 1% of the world’s population, mainly found in women who have 3 times the likelihood of getting it than men. It usually occurs between the ages of 20 – 60, but it can also occur at any age.

Peri-Menopause usually brings on the onset, between the ages of 40 – 50. With it the typical estrogen excess symptoms occur:

• general aches and stiffness
• painful joints
• fatigue and difficulty sleeping

There is a predominance of the inflammatory Th1 cytokines over the anti-inflammatory Th2 cytokines in arthritis. Progesterone stimulates the Th2 cytokines, so pregnancy improves symptoms in 75% of cases. This is because progesterone levels rise greatly during pregnancy, particularly in the 3rd trimester which is when symptoms in lupus patients stop. The remaining 25% have low progesterone levels. It has been proven that 90% of cases relapse within 6 months after giving birth, and highest within the first 3 months. Progesterone levels fall sharply after birth.

Prolactin, the hormone controlling milk production, rises after birth. Prolactin stimulates the immune response and is elevated in both male and female RA patients. Progesterone suppresses prolactin production.

Studies have found that there is a progesterone deficiency in females with thyroid and ovarian autoimmune diseases. Studies also found that both progesterone and androgens were significantly lower during the luteal phase in RA patients. A rare case of systemic lupus erythematosus (SLE) occurred in a transgender man who was given estrogen (feminising hormones).

 

Natural Treatment

 

It is so important to address inflammation as soon as it has been detected before it causes long term damage. High amounts of anti-oxidants are needed as well as progesterone which is excellent for inflammation. Food containing sugar should be avoided.

Progesterone is neuroprotective; it helps to prevent lipid peroxidation and confers vascular protection. The endogenous steroid cortisol and the commonly prescribed glucocorticoid prednisolone, will increase cholesteryl ester (CE) formation which leads to atherosclerosis, progesterone will block the increase. Estradiol (E2) proved to be ineffective. Progesterone being an excellent anti-inflammatory reduced the response of natural killer cells, the TH1 response, as well as other known initiators of inflammation. Progesterone suppresses estrogen, which is an excitatory hormone which is known to cause inflammation. It stimulates the production of IL-4 and IL-10, anti-inflammatory agents. Tumour necrosis factor-alph is an inflammatory cytokine involved in the acute phase reaction in arthritis. Progesterone decreases both intracellular and secreted TNF-alpha. Estrogen has no effect.

Oxidative Stress is behind all types of inflammation due to low levels of anti-oxidants which should be increased. Vitamin D3 and the amino acid N-acetyl cysteine (NAC) are most important. NAC chelates any excess copper and other environment toxins. Selenium is also very important as it is part of the glutathione molecule. The other two important amino acid precursors are glycine and glutamine which are both found in our food, NAC is not. If stressed, glutamine becomes a conditionally essential amino acid and supplementing is important.

Progesterone is excellent for any kind of emotional stress as it is a calming hormone and activates the GABA receptor sites. GABA can be difficult to use as too much will cause symptoms to return. Therefore supplementing with progesterone is far easier.

Taurine is another calming neurotransmitters, it is a powerful sulphur amino acid like cysteine (NAC) and is vital for the immune system. Without Taurine, fats will accumulate in the blood.

One should also test for Insulin Resistance, if present, it should be addressed.

If a high homocysteine level is found the following vitamins should be taken:

• B2
• B6
• B12
• Folic acid
• Tri-methyl glycine
• Zinc

As you know, Vitamin D3 is essential for better health, it is connected to every single functioning cells in our body. Testing should be done for 25-hydroxyvitamin D, also called calcidiol. 30-50% of people have a deficiency, particularly those living in:

• climates with little sun
• living above 32 degrees north or south of the equator
• work in doors, therefore spending very little time in the sun

A deficiency is less than 25ng/L or 62.4nmol/L. Please read the Vitamin D3 page for more information.

 

Additional Information

 

The amount of progesterone to be used depends on the individual and how severe the problem is. Woman should use between 100-200mg daily and men should use between 10-100mg daily. If symptoms are severe, more maybe needed. Rubbing progesterone cream on the affect areas brings great relief to many sufferers.

Please remember to read the How to use Progesterone Cream and Estrogen Dominance pages.

The following plants contain powerful anti-oxidants:

• green tea (catechins)
• raspberries
• strawberries
• blackberries
• cranberries
• walnuts
• pecan nuts

They all contain ellagic acid, raspberries providing the greatest amount.

Broccoli, cabbage, watercress etc should be eaten in moderation and avoid eating them raw as they are goitrogens and contain an enzyme that suppresses the thyroid gland. Turmeric contains curcumin which has been found to stop pre-cancerous changes in the DNA.

Many plants contain flavonoids, particularly berries and buckwheat, which remove metal toxins and also protect the anti-oxidant vitamins.

Fermented Foods are excellent for inflammation.   They are potent chelators (detoxifiers) and contain much higher levels of probiotics than probiotic supplements, making them ideal for optimizing your gut flora. OTC probiotics simply do NOT compare. In addition to helping break down and eliminate heavy metals and other toxins from your body, beneficial gut bacteria, they perform a number of surprising functions.

 

Tests Required for Inflammation

 

  1. Vitamin D3 (low) (essential test) – the test should be done for 25-hydroxyvitamin D (calcidiol). Vitamin D Council.
  2. CRP (increased levels) (essential test) – the level of CRP rises when there is inflammation throughout the body, normally none should be found. Levels if found vary from <1.0mg/L to >3.0mg/L. Medline CRP.
  3. Homocysteine (possibly increased levels) – 0.54-2.3mg/L (4-17 micromoles per litre mcmol/L). WebMD.
  4. Malondialdehyde (increased) – standard range: 1.0 – 4.0mM. Northwest Life Science Specialties Baylor Research Institute.
  5. Progesterone (generally low) – serum 10ng/ml, saliva 0.2ng/ml. Medline Progesterone.
  6. Estradiol (possibly high) – serum 30 – 400pg/mL, saliva 2pg/ml. Medline Estradiol.
  7. Insulin Resistance (sometimes observed) – there is no single test for IR, but the following are often tested: Medline Insulin Resistance, Lab Tests Online-Understanding Insulin Resistance.

• Blood pressure equal to or higher than 130/85mmHg
• Fasting blood sugar (glucose) equal to or higher than 100mg/dL
• Elevated insulin levels
• Elevated CRP (a marker for inflammation)
• Large waist circumference – 35 inches (87.5cm) or more
• Low HDL cholesterol – under 50mg/dL
• Triglycerides equal to or higher than 150mg/dL

 

Other References - adverse side effects

 

Prednisolone
Sulfasalazine
Methotrexate
Hydroxychloroquine
Etanercept
Infliximab
Adalimumab
Contraceptives

 

References

 

Vitamin D deficiency may be the most common medical problem in the world

Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004

Vitamin D deficiency in undifferentiated connective tissue disease

The complex role of vitamin D in autoimmune diseases

Osteoarthritis

Hypovitaminosis D among rheumatology outpatients in clinical practice

Gender specific effect of progesterone on myocardial ischemia/reperfusion injury in rats

Glucosamine prevents in vitro collagen degradation in chondrocytes by inhibiting advanced lipoxidation reactions and protein oxidation

New Onset Systemic Lupus Erythematosus in a Transgender Man: Possible Role of Feminizing Sex Hormones

Protective effect of silymarin on oxidative stress in rat brain

Increased fructosamine in non-diabetic rheumatoid arthritis patients: role of lipid peroxides and glutathione

Sex hormones influence on the immune system: basic and clinical aspects in autoimmunity

Plasma lipid peroxidation and antioxidant levels in patients with rheumatoid arthritis

Steroid hormones and disease activity during pregnancy in systemic lupus erythematosus

T1/T2 cell balance in rheumatoid arthritis

Plasma malondialdehyde as biomarker for oxidative stress: reference interval and effects of life-style factors

Hormonal pattern in women affected by rheumatoid arthritis

Intraarticular progesterone: effects of a local treatment for rheumatoid arthritis