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Series Code: MH
Program Code: MH230005S
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00:01 Whether it's eczema, arthritis, cancer, heart disease,
00:05 digestive problems, diabetes, asthma, even Alzheimer's, 00:09 they all have something in common. 00:11 And that something is inflammation. 00:14 Inflammation is at the root of these conditions. 00:17 I'm Rise, and today we're going to be looking at answers 00:19 to some of the questions I've had for a while, like, 00:22 what is inflammation? 00:23 What is it doing to my body? 00:24 And how can we put it out? 00:26 That's what we want to know. 00:28 Why are we so fired up? 00:47 We live in an era of abbreviations. 00:49 Social media and texting is full of them, 00:51 and medical talk is not much different. 00:53 We're going to hear some crazy abbreviations like, 00:55 CRP, IL-6, TNF-A. 00:58 If you haven't heard of those before, no worries. 01:01 Dr. Sherzai refers to them as markers of inflammation. 01:05 Some of these are from a family of molecules called cytokines. 01:07 And you're going to hear that word again. 01:10 Think of cytokines as a language of the immune system. 01:12 They're chemical messengers that your immune system 01:15 uses to communicate. 01:16 They have their place, but they can get stuck on replay 01:19 with the command to keep the fire of inflammation hot. 01:23 We have specialized cells in our body and in the brain 01:26 that are responsible for the defense system. 01:30 And they get activated when they realize that there's 01:33 something going on. 01:34 Now they could be erroneously activated by, 01:37 you know, certain products that have been 01:41 injected or have been introduced into that otherwise 01:45 relatively healthy environment. 01:47 And they just go haywire and awry, and they start attacking 01:50 not only the foreign objects, the inciting element, 01:56 but they start damaging the healthier 01:58 parts of the brain as well. 02:00 And so there is this crazy cascade that starts. 02:03 And so it's the cells trying to get rid of even healthy cells, 02:06 and they start increasing the secretion of certain chemicals; 02:10 interleukin-1, 6; there's different names for all these 02:14 inflammatory markers. 02:15 And this incredible process starts where it's a downward 02:21 spiral of cells damaging cells, 02:24 and a result of that breakdown products of cells, 02:26 the chemicals that are secreted damage other cells. 02:29 And so it just continues until one figures out what was 02:34 the inciting event and a plan is instituted 02:37 to stop that cycle. 02:39 While most people think of acute inflammation 02:41 in terms like a sprained ankle, it swells up, 02:43 it gets red, and it's oftentimes very painful. 02:46 But in health, oftentimes we're talking about chronic 02:50 low-grade inflammation. 02:51 It's really, it's systemic; it's throughout the whole body. 02:55 And most of the time there's not really a lot of 02:57 indicators for that. 02:59 Now you can do testing for it. 03:00 You can do a sed rate, erythrocyte sedimentation rate, 03:05 which is a very common test in medicine to look at 03:08 if there's inflammation in the blood, which means 03:10 everywhere, right? 03:12 You can also do what's called a high-sensitivity CRP, 03:17 or cardiac C-reactive protein test 03:21 that measures a different type of inflammation. 03:24 You can have a lot of one inflammation 03:26 and none of another type of inflammation. 03:28 So sometimes you have to test broadly. 03:31 You can do interleukin-6, 03:32 you can do tumor necrosis factor-alpha. 03:35 All these are different types of inflammation. 03:38 Sometimes only one of them is present, 03:40 and that means there's a problem. 03:42 That there's this chronic irritation to your entire body 03:46 that has to be addressed. 03:48 Because that means your brain is potentially being inflamed 03:50 through the blood-brain barrier, your heart is being inflamed. 03:53 In fact, inflammation is a much bigger risk factor to the heart 03:58 and cardiovascular disease than is high cholesterol. 04:01 In fact, having a high cardiac CRP is at least twice 04:06 as predictive of a problem or a risk factor 04:10 as a high cholesterol. 04:12 So we need to make sure that we're addressing the underlying 04:18 issues that are driving this irritant, inflammatory 04:22 process throughout the body. 04:24 We look at something called the C-reactive protein, CRP. 04:28 It's one of the better markers for inflammation. 04:30 And I will do this on a person that, I do it rather routinely 04:35 because I want to know is their problem just related to 04:39 a hearing loss, or dizziness, or one of those thing, 04:42 or do we have an underlying inflammatory response 04:45 going on in the body? 04:47 Inflammation is disease. 04:49 And so you need to look at that to see. 04:51 If you catch it early, you can turn things around. 04:55 If it's end stage, then you've got a diagnosis. 04:58 That's the importance of inflammation. 05:01 Inflammation is a condition that can manifest in various ways, 05:04 including heart disease. 05:06 Dr. Wes Youngberg touched upon this topic, 05:08 and now Dr. Facemire will discuss inflammation 05:10 in relation to heart disease. 05:11 Heart disease is the number one killer of Americans. 05:15 Every 34 seconds someone has a heart attack. 05:19 And according to the American Heart Association 05:21 one in three people suffer from some sort of 05:24 cardiovascular disease. 05:26 And while heart disease is the number one killer for men, 05:31 one in three women have heart disease. 05:37 And so we are very aware as women with breast cancer, 05:41 but only one in every thirty-one women die of breast cancer 05:47 instead of one in three of heart disease. 05:49 So when you focus only on cholesterol, 05:52 you have a huge problem. 05:55 And thankfully, I think that research is catching up. 05:58 Because we know that it's not just one risk factor 06:01 or one problem. 06:03 50% of men and 64% of women have a heart attack 06:09 without having any prior symptoms. 06:12 And this is causing the U.S. $109 billion annually. 06:18 So cholesterol is not just the issue. 06:21 It's really relevant at this time to understand 06:27 that there is something called inflammation 06:31 that is coming to the front line as one of the main problems 06:38 in our heart disease world. 06:42 And it starts in a cell that I have a picture for it, 06:46 which is called the endothelial cell. 06:49 And this endothelial cell, as you see, is just beautiful. 06:52 I have magnified it. 06:54 You can see inside the blood flow and the red blood cells, 06:57 but the endothelial cell has this 06:59 fine, tiny, one-layer lining. 07:03 And the endothelial cells actually have tremendous 07:08 impact on how cardiovascular disease develops. 07:12 So it's not just cholesterol. 07:13 Lipids are only a very tiny window 07:17 to what is actually happening. 07:18 We've been talking about inflammation, 07:20 we've been talking about mitochondrial dysfunction, 07:22 endothelial dysfunction, 07:24 and the inflammation that happens in the arteries. 07:26 So those tests are very limited. 07:32 What I try to do is I try to do what's called a more extended 07:38 and advanced lipid panel. 07:40 Because they actually can give you categories of each molecule. 07:45 You know, for example, HDL, some patients have a 90 HDL. 07:50 "Oh my HDL is so good." 07:52 And when I do the advanced lipid, I see that the HDL 07:55 that they have is the less beneficial. 07:58 So not all HDL is equal; we have three or four types. 08:02 And you know, there is a lipidology actually. 08:06 A specialty. 08:07 So I cannot really go into detail with this because it's 08:10 just a vast subject. 08:12 But I have to say that just knowing the amount 08:17 of cholesterol, you have, maybe the size of your molecules, 08:21 and the type is not enough. 08:25 So thankfully we have other markers of inflammation. 08:31 And there is, I have requested these labs to my patients 08:37 that are really trying to prevent a heart attack. 08:40 It's a really good way of looking at inflammation 08:44 into a cellular level. 08:47 And there is a lab called the Cleveland Heart Lab 08:51 that offers certain testing that actually can measure 08:57 your TMAO, it can measure some byproducts 09:02 of endothelial dysfunction, it can measure apo-B 09:06 which is actually more important than LDL actually, 09:12 which is another lipoprotein, and CRP. 09:16 So what I do for patients that have a lot of risks, 09:19 I do more in detail testing. 09:22 But CPR, just high sensitivity CPR is a very simple 09:27 and very helpful marker. 09:29 Because it can tell you how inflamed your arteries are. 09:33 There are urine tests that can show you inflammation. 09:37 So we talk about the leaky endothelium, remember? 09:42 And this endothelium, when it leaks, it leaks proteins. 09:47 And it leaks one of the proteins in the bloodstream: albumin. 09:51 And we measure micro-albumin in the urine. 09:54 And if it's high, we know, uh-ho, this endothelium 09:57 is not working well. 09:59 We really need to focus on repairing the endothelium. 10:02 You get inflammation, what is causing it? 10:05 So don't think, "Oh, I'm going to take these ten supplements." 10:08 You know, "All these vitamins are going to help, 10:10 these antioxidants." 10:11 There are many companies that promote so many products. 10:14 My patients come with different kinds of, 10:16 offering, you know, life-saving results. 10:22 But honestly, if we keep eating the same foods, 10:26 and not going to bed on time, and being on the internet 10:30 until midnight, not exposing ourselves to the sun, 10:33 not drinking enough water, no rest, 10:36 I mean, things are not going to change 10:39 no matter how many supplements you take. 10:41 Cardiovascular disease is now an inflammatory disease. 10:45 Yes, you can have plaque. 10:47 Remember I talked about fire, right? 10:50 For the fire you need gas and you need the wood. 10:53 So you can have wood, you can have cholesterol. 10:56 And maybe no wood, right, no wood, just very little. 11:01 But if you have the gas and you have the spark, 11:05 you create a fire. 11:07 So this is so important. 11:08 Heart disease is not just about cholesterol. 11:11 The lining of the blood vessels is composed of cells, 11:13 endothelial cells. 11:15 The health of these cells are crucial. 11:17 When the cells experience inflammation, 11:19 the wall of the blood vessels can actually become leaky. 11:22 That's what Dr. Facemire was referring to when she 11:25 talked about leaky endothelium. 11:27 I asked Dr. Facemire about her approach with her patients. 11:30 Well, I have a picture in mind when I approach my patients. 11:37 And it's a big iceberg. 11:40 And when I see a patient, I see the little tip 11:46 when I have my first encounter. 11:49 And I know that the complaints or the symptoms 11:55 they are experiencing, they're only the surface 11:59 of what is under. 12:01 So I like to go to the root. 12:04 That's my approach. 12:05 And the other approach that I have, 12:08 which I have a picture for it too, 12:10 is this thumb being clamped with a wrench. 12:15 And I remember going to a conference and giving this 12:19 presentation, and I told the audience, I said, 12:22 I have this patient with his thumb that is 12:26 clamped with a wrench. 12:28 And he comes to you and tells you, 12:30 "Doctor, I've been suffering pain, terrible pain, 12:35 and redness in my thumb." 12:37 And you tell him, "Okay, take ibuprofen three times a day, 12:42 and come in a week." 12:44 And he goes home and takes ibuprofen comes back, and says, 12:49 "It's not helping." 12:50 Now it's not just red, it's starting to become blue. 12:54 And you say, "Oh, maybe it's infected. 12:56 Go and take some antibiotics." 12:58 And another week passes and he comes back and he says, 13:01 "It's not getting better." 13:03 And I keep telling them the story about this poor man 13:08 that he's going to lose his thumb. 13:10 And then finally the doctor says, "You need surgery. 13:13 You need bypass surgery because your thumb has no circulation. 13:17 So we need to put a bypass for some circulation there." 13:20 I asked them, and I said, "What should you do?" 13:25 And they all laughed, of course, and said 13:28 the patient didn't need antibiotics, 13:30 the patient didn't need anti-inflammatory, 13:33 the patient didn't need a bypass surgery. 13:35 We just need to get rid of the wrench and unclamp the thumb. 13:40 So that's my approach. 13:41 I'm trying to find out if there is something that I can do 13:46 as I talk to my patients about how to get rid of the 13:51 cause rather than just address the symptoms with drugs. 13:56 So what I hear her saying is that inflammation at the lining 14:00 of our blood vessels is what we need to focus more on. 14:03 To explain it better, these endothelial cells have a 14:07 compound called nitric oxide. 14:10 They produce and interact with this compound. 14:13 And nitric oxide actually decreases oxidative stress, 14:18 decreases the inflammation of smooth cells. 14:21 You know, because a smooth cell is one that when it's inflamed 14:24 is like a scar, you know, when you go and cut yourself. 14:27 All of these inflammatory cells come to the rescue 14:30 and then decrease the inflammation, 14:32 but then they leave something there, which is a scar. 14:35 And that happens over and over again 14:38 every time we light up a cigarette, 14:39 every time we have fried food, every time we're under stress 14:44 and our cortisone level is high, 14:46 every time that we have a viral illness that comes. 14:49 All this inflammation takes place and the body 14:52 keep repairing, but when we repair, 14:55 we actually scar the artery. 14:57 So this nitric oxide is vital and dilates the arteries. 15:01 So the health of the endothelial cell is key 15:06 in preventing heart disease. 15:09 One of the ways we can support healthy nitric oxide 15:11 production in the blood vessels are by eating 15:13 green leafy vegetables. 15:15 You know, chronic inflammation has always seemed 15:17 a bit nebulous to me. 15:19 A little bit hard to put a finger on. 15:20 And I think maybe that's because it's an important 15:22 part of our design, so it's necessary. 15:25 We need inflammation when we're fighting an infection. 15:28 We need some inflammation which is designed to kill 15:31 the infecting bacteria or virus. 15:36 We need inflammation when we've been injured. 15:38 Let's say we've smashed our finger or sustained a cut. 15:41 There's some inflammation that's necessary to bring 15:43 blood flow to that wound. 15:46 In fact, it helps the skin to regrow and heal up. 15:50 So inflammation is part of that and necessary. 15:54 Yeah, inflammation is so crucial to life. 15:56 Inflammation, when we have an insult or injury, 16:01 the body calls in all the troops to come in and repair 16:04 tissue or repair the damage, 16:06 or repair something that's happened. 16:08 So from that perspective, inflammation is crucial to life. 16:12 Inflammation has a very important role 16:15 in brain health in general as it pertains to the development 16:20 of neurodegenerative conditions. 16:22 So inflammation is a condition where certain cells 16:26 and neurochemicals are produced by cells 16:29 in the supporting structures to get rid of 16:32 any offensive material, whether it's an infection, 16:36 bacteria, fungus, or a foreign body. 16:40 The body has the capacity to start attacking it 16:43 and allow for the body to slowly and gradually heal itself. 16:46 So we need inflammation for life and for sustenance of 16:50 our functions. 16:52 However, with the kind of lives that we are leading, 16:55 we are exposed to way too much inflammation. 16:57 And it's not even bouts of inflammatory reactions, 17:02 but there is constant inflammation. 17:04 We need inflammation in performing sensitive 17:07 operations and missions. 17:08 But as we heard, when it becomes chronic, it's damaging. 17:12 So we know four mechanisms that actually damage the brain. 17:15 Inflammation, oxidation, lipid dysregulation, 17:19 and glucose dysregulation. 17:20 What does that mean? 17:22 Glucose dysregulation means that you have insulin resistance 17:24 or diabetes that's not taken care of or treated. 17:27 Or even elevated sugar levels on a repeated basis 17:32 has been shown to damage the brain. 17:34 We did a study, one of the large studies, 17:36 NHANES, a large database, looking at insulin resistance 17:39 and cognitive decline in younger people, 50's. 17:43 And we excluded diabetics. 17:45 So people who have insulin resistance 17:47 which usually doesn't get treated. 17:49 And they had lower cognitive state. 17:50 So glucose dysregulation is a pathway. 17:53 Inflammation is a big pathway. 17:55 People who have traumatic brain injury, 17:57 people who have infections repeatedly, 17:59 even gingival disease on a chronic basis. 18:01 ~ That's oral health. 18:03 Oral health, we don't even think about that. 18:04 But it does. That creates inflammation. 18:07 And also inflammation is always usually a later pathway 18:10 for the other pathways. 18:12 So being aware of inflammation and what causes inflammation, 18:15 and eliminating that. 18:16 Then we have lipid dysregulation, 18:18 which we think is a big driver. 18:20 We're talking about fat. 18:21 Especially saturated fat. 18:23 Study after study after study shows that people who have 18:26 high cholesterol have a 57% increase risk 18:31 of dementia and Alzheimer's. 18:32 Even borderline increased cholesterol, 18:35 which usually people don't treat, 18:36 have a 35% greater risk of dementia and Alzheimer's. 18:39 So lipid dysregulation is a critical component. 18:42 In fact, one of the main genes associated with Alzheimer's, 18:45 APOE e4, its function is lipid transport. 18:49 But it does it poorly, so the risk goes up four times 18:52 if you get one gene from one parent, 18:54 twelve times if you get one gene from each parent. 18:57 But it has to do with lipids, and fats. 19:00 So pour into the mixing bowl inflammation, ROS, 19:04 glucose dysregulation from insulin resistance, 19:06 poor oral health, we've not only got increased risk of 19:09 heart disease, but brain disease as well. 19:13 Inflammation is present in all chronic conditions 19:17 and all chronic diseases such as cardiovascular disease, 19:21 and diabetes, and obesity. 19:24 There is so so-called subclinical inflammation going on, 19:28 which means that our immune system is just producing some 19:33 cytokines that increase inflammation. 19:37 For example, in the arteries that would be atherosclerosis, 19:42 but also in other parts of the body. 19:45 In the adipose tissue which happens in obesity. 19:50 In the adipose tissue, or in the fat that's stored ectopically 19:55 in the liver, and in the muscle, and in the pancreas 19:58 that would be in type 2 diabetes. 20:01 And why does it even matter when our body produces too much, 20:07 too many cytokines that promote inflammation? 20:11 It turns out that it's really disruptive for our immune system 20:16 which is turned down. 20:18 It deploys some of the immune cells in the places 20:25 where they're not needed as much. 20:27 For example, when cancer starts developing somewhere else, 20:32 there's like not enough power to pay attention 20:38 to what's happening somewhere else. 20:40 So it's really important not to exhaust our immune system 20:46 on subclinical inflammation in our arteries 20:49 and in the adipose tissue. 20:52 It's just better to save all those forces for serious 20:58 events, like for example, cancer, or when we fight 21:01 a virus, or bacteria so that our immune system 21:05 can be strong. 21:07 When the immune cells start producing the cytokines, 21:12 it's like sending messages. 21:14 And the messages can be really powerful. 21:16 They're directed to specific cells in the body 21:20 and tell them some specific instructions what to do, 21:24 how to fight the danger. 21:26 Now if we start producing these messages, 21:30 these cytokines, in response to no danger, 21:34 obviously, we're just exhausting the immune system 21:38 and other cells of the body. 21:41 Think about it, what if headquarters kept giving 21:44 the Navy Seals wrong commands or the same command 21:46 over and over and over? 21:49 Producing too many messages can be confusing 21:53 for the body. 21:55 And there may be some discoordination. 22:01 However, it's the slow burn, the uncontrolled chronic 22:08 low inflammation that then sets us up for just about 22:12 every chronic disease that there is out there. 22:15 When you think about all the chronic diseases; 22:17 heart disease, diabetes, hypertension, 22:20 autoimmune disease, cancer, even obesity, 22:25 inflammation, chronic Low-burn inflammation is 22:28 sort of at the base as a cause for all of those. 22:33 And so we have to think about, well what's creating that 22:36 low slow burn, and how do we manage that? 22:39 Because inflammation is crucial, right? 22:42 And so when I think about that chronic inflammation, 22:47 it's basically we have some sort of ongoing trauma 22:51 that we're doing to the body that's causing it to constantly 22:54 have a little bit of reaction, little bit of reaction causing. 22:58 That inflammation that's constantly there, 23:00 that little bit of reaction that's constantly there 23:03 can make you fatigued. 23:05 Your body is constantly in a little bit of a battle 23:08 trying to control whatever those insults were. 23:10 And those insults can be in multiple things. 23:12 Environmental toxins, it can be the food that you're eating, 23:15 it can be the stress, it can be the lack of sleep. 23:18 All of these things, again, can be the cause of 23:22 this low-grade inflammation. 23:24 Inflammatory diseases reflects the fact that 23:29 in certain situations, particularly coming from 23:33 lifestyle factors, inflammation can become something that 23:36 doesn't turn itself off, isn't turned off properly 23:39 when it should have been. 23:40 So we need inflammation to be turned on at the right times. 23:43 We need it to turn off when the damage has been resolved, 23:47 when the infection is gone. 23:49 When inflammation stays turned on or functions in an 23:52 out of control way, then it causes damage to 23:57 a lot of systems in the body and puts us at risk for various 24:00 diseases that have inflammation sort of at their core. 24:03 Inflammation is an important factor in the diseases I treat. 24:08 So probably the most common disease 24:10 I treat is type 2 diabetes. 24:12 And it makes up probably at least half 24:13 of my visits every day. 24:17 And inflammation is a key component of type 2 diabetes, 24:21 both in how it begins and how it's sort of 24:23 propagated or made worse. 24:25 And inflammation is an important process that makes 24:29 diabetes hard to treat and hard to reverse, 24:32 although that's all possible. 24:34 When we're talking about chronic inflammatory diseases, 24:37 we mentioned type 2 diabetes, heart disease and stroke 24:41 both are diseases involving inflammation of blood vessels. 24:45 Obesity is a disease of chronic inflammation. 24:47 So is Alzheimer's disease. 24:49 And cancers have an important factor of inflammation 24:53 that feeds them or promotes the possibility of cancer growing. 24:57 So yet again, maybe perhaps all of the top killers, 25:00 of people in the western world anyway, 25:03 are closely tied to inflammation. 25:06 Next, we're going to hear from psychiatrist Dr. Binus. 25:09 I asked him if inflammation is an underlying problem 25:11 in the conditions he treats. 25:13 There are a lot of studies that actually 25:16 point in that direction. 25:17 But I think we need to be a little bit careful 25:20 because not all psychiatric disorders are, 25:23 maybe put it this way, not all people that have depression, 25:26 for example, are over-inflamed. 25:30 There's actually, so what they have shown is that when you do 25:35 research and you give people more inflammation, 25:38 that it can definitely increase the likelihood 25:41 that they develop depression, anxiety disorders, 25:44 and other mental health problems. 25:46 However, not everybody that has a lot of inflammation 25:51 has mental health disorders. 25:53 And there are people that have serious mental health disorders, 25:57 like really bad schizophrenia or very bad bipolar, 26:00 and their levels of inflammation are actually quite low. 26:03 So what we see is that it seems like there is a subset 26:08 of people that are more sensitive to the inflammation, 26:13 and then that can really trigger more mental health problems 26:17 and trigger depression, or bipolar or whatever it might be. 26:20 But there's other people it seems like they have 26:23 a bit more resilience, and it doesn't affect them as much. 26:26 Now that being said, inflammation, I believe, 26:29 is always important and we want to regulate that, 26:31 because even though it might not right away push someone 26:34 over the edge into a mental health problem, 26:37 it can be part of the triggers. 26:41 And eventually, if you keep getting hit with one problem 26:45 after another, it will eventually push anyone over the edge, 26:48 and then they'll develop a mental illness. 26:50 And inflammation can certainly be one of those factors. 26:53 Very interesting. 26:54 I also asked neurologist Dr. Sherzai about the impact 26:57 of physical trauma to the brain, as it's unfortunately 27:00 a fairly common cause of brain inflammation. 27:03 Yes, when people have a traumatic brain injury, 27:06 depending on the extent of the injury, 27:08 it could be a physical injury where you actually see 27:10 physical damage to the brain, 27:13 to the neurons and their connections, 27:15 or it could be subtle enough that it only causes axonal 27:19 damage and injury and constant inflammation. 27:23 There have been studies that have looked at specific 27:26 types of neuroimaging in the brain where inflammation 27:29 was the most prominent byproduct or activity 27:33 after traumatic brain injury. 27:34 And you know, chronic traumatic encephalopathy 27:37 is being studied in people who have had multiple head injuries, 27:40 and it seems that predominantly it's inflammation that causes 27:44 most of the damage. 27:45 Inflammation is a common denominator to many diagnoses. 27:49 And it's not what you were made for. 27:51 No, you were made for health. |
Revised 2025-06-17