Normal Gut Flora, Inflammatory Markers, and Chronic Illness – Part 1

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM


inflammatory markers and the gutThe current epidemic of chronic illness not only in the U.S. but around the world has spurred considerable research into the role of normal gut flora and inflammatory markers in the development of these chronic illnesses. Much valuable information has been generated regarding inflammation as the apparent foundation of many of these conditions.

Disruptors of Metabolism Come from Lack of Normal Gut Flora

A typical source of inflammation comes from metabolism and the lack of normal gut flora. Normal gut flora consists of the good bacteria and other microorganisms that work to digest the nutrients ingested. This process of metabolism is the body process that dictates inflammation. Metabolism is the sum total of all chemical reactions in the body that drives it toward either health or disease.

When metabolism is disrupted, inflammation results. It is this inflammation that leads to chronic illness.

Understanding the disruptors of metabolism will give healthcare professionals the information they need to develop effective strategies for dealing with chronic illnesses. There are multiple inflammatory markers that can be assessed to determine even low levels of inflammation that signals the presence of conditions ripe for the development of chronic illness.

These inflammatory markers typically result from a leaky gut barrier and/or leaky brain barrier. Both of these conditions are themselves the result of disrupted metabolism and are indicators of abnormal gut flora.

Inflammatory Markers of Disrupted Metabolism

In order for a healthcare professional to determine the presence of underlying chronic inflammation, he or she must have information regarding those biochemical markers that signal that presence. Conventionally trained healthcare professionals rely mainly on the standard blood serum tests to determine the source of symptoms and illness. Serum C reactive protein (CRP) is an inflammatory marker that has historically been used as a general non-specific marker of systemic inflammation. Unfortunately, results are not very specific. Multiple conditions including acute trauma can lead to false positives.

Practitioners need to have a more comprehensive viewpoint about health and illness in order to appreciate the importance of these inflammatory markers. The NeuroEndoMetabolic (NEM) model of this stress response is that comprehensive viewpoint. This approach looks at the interaction of six organ systems in the body when stress is present. Rather than the typical approach of looking only at individual organs or symptoms, the NEM model allows practitioners to get to the root cause of symptoms. These six organ systems relate to metabolism, neuroaffective, hormonal, cardionomic, inflammatory, and detoxification processes in the body. Assessing these systems allows tracing of the cause of sometimes vague symptoms.

The vague symptoms often are related to Adrenal Fatigue Syndrome (AFS). In the normal process of responding to stress, the body ultimately stimulates the adrenal glands to secrete cortisol, the stress-fighting hormone. As stress continues, adrenal exhaustion ultimately results. At that time, the adrenals can no longer secrete cortisol. Symptoms of AFS begin. Inflammation is one of those symptoms that can start at a low level and continue there for a long time. All the time it is present, it’s causing additional problems. If stress continues, these symptoms become more serious. Ultimately, symptoms of AFS can lead a sufferer to become bed-ridden.

Assessing and dealing with the inflammatory markers of metabolic disruption allows successful remediation and a return to normal metabolism and normal gut flora.

Normal Gut Flora

How inflammatory markers and normal gut flora relateMuch current research has been conducted that shows the importance of normal gut flora in providing energy and nutrition for the body through metabolism. The gut has been shown to be responsible for the overall health of the individual. If metabolism is disrupted, illness results.

Gut flora, normal and abnormal, have been linked to a multitude of significant illnesses. Ordinarily, the thousands of microorganisms in the gut live in a symbiotic relationship that aids in metabolism.

At times of increased stress, the balance of the organisms in the gut gets interrupted, a condition called dysbiosis. This can allow food particles, viruses, and bacteria to enter the bloodstream, triggering an immune response and inflammation.

Chronic stress leads to chronic inflammation beginning in a gut with abnormal flora. Chronic inflammation leads to chronic illness conditions. Fortunately, this chronic inflammation and its relationship with disrupted metabolism can be measured using inflammatory markers.

Markers of Inflammation

IL-6 and Inflammation

Interleukin-6 is an vital inflammatory marker that can be tested via salivary tests. Produced at the site of inflammation, interleukin-6 (IL-6) is a major player in the acute phase of inflammation through the production of acute phase proteins. Combined with a soluble receptor sIL-6R alpha, IL-6 controls the change from acute to chronic inflammation by changing leucocyte infiltration from polymorphonuclear neutrophils to monocytes or macrophages. Chronic inflammation is also stimulated by the effects of IL-6 on T and B cells.

Acute inflammation is beneficial due to its efforts to destroy the organisms that cause infection in the body. Chronic inflammation is the kind that damages tissue and cells. Acute inflammation is predominantly made up of neutrophils initially, but this changes in a day or two to mostly monocytic cells. Chronic inflammation, on the other hand, is associated with mononuclear cells like macrophages and lymphocytes.The inflammatory marker IL-6 is involved in this change from acute to chronic inflammation, but the process is not well known.

The antibody produced for the IL-6 receptor has been used with some success in alleviating some autoimmune disorders.

VEGF and Inflammation

Vascular Epithelial Growth Factor (VEGF) is a signal protein that enables restoration of oxygen supply to tissue when blood circulation isn’t adequate due to insufficient oxygen or other reasons. VEGF allows the body to flood specific areas with blood flow and bring the immune cells such as leukocytes or macrophages to the area much quicker than normally possible. This can lead to swelling and inflammation in the area.

When cells are not getting enough oxygen, such as in conditions of disrupted metabolism, they produce “hypoxia inducible factor” stimulating the release of VEGF. This prompts the growth of more blood vessels, bringing more oxygen to the cells. Histamine can also bring on the release of VEGF.

Another way VEGF helps immune function is by building more lymph vessels. These vessels are the way immune cells move through the body searching for bacteria, fungi, and viruses.

inflammatory markers and VEGFAnother important function of VEGF is its ability to improve neuron function and viability, thus preventing brain impairments. It can also help in preventing memory loss related to diabetes. Animal models have shown VEGF to aid in the prevention of neurodegeneration and ALS through increasing blood flow.

There are some negative aspects of VEGF, as well. It can lead to increased inflammation in the body. It does this by activating microglia, which can trigger inflammation. VEGF also takes away molecules that help blood vessels stick together, thus making them more likely to leak. This can cause more inflammation and worsen the symptoms of conditions like rheumatoid arthritis.

VEGF can also increase the permeability of the blood brain barrier, increasing the likelihood of neurotoxins accessing the brain.

As VEGF builds new blood vessels, it doesn’t differentiate where it builds these vessels, sometimes increasing the blood supply to cancers. This makes it easier for cancers to grow and makes it harder to kill them.


Part 2 Coming Soon! Available on January 12th, 2018.

© Copyright 2018 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Question

Even with normal gut flora, metabolism can be disrupted and develop markers to show this disruption. Some of those markers include VEGF, histamines, MPO, and TGF-beta. These markers are not always recognized by conventionally trained healthcare providers as indicators of underlying inflammation.


inflammatory markers