Chronic Inflammation and Adrenal Fatigue Part 1

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

Understand how chronic Inflammation worksChronic inflammation and Adrenal Fatigue are quite closely associated: inflammation contributes to and triggers common, but very subtle, symptoms of Adrenal Fatigue such as brain fog, gastric bloating, pain of unknown origin, depression, anxiety, and reactive hypoglycemia. Let us start by trying to understand a little bit more about inflammation itself.

Chronic Inflammation Basics

Inflammation is a process started by your own body as part of its response to stress, whether physical or emotional. An example of physical stress would be an ankle strain. Emotional stress can arise from a heated argument or relationship difficulties. Inflammation involves a complex biological cascade of molecular and cellular signals that alter physiological responses, ultimately resulting in the familiar clinical symptoms of pain, swelling, heat, and redness. These four classic symptoms of inflammation were first described in the first century AD by the Roman medical writer Celsus: rubor, meaning redness; tumor, meaning swelling; calor, meaning heat; and dolor, meaning pain. In Latin, the original root of the word inflammation is inflammatio, which means “setting on fire.”

So why does your body become inflamed, causing you pain and discomfort? It turns out that this is absolutely necessary for your body’s normal repair processes to occur. Inflammation is the process by which your body fights off and expunges whatever is causing it harm or stress. The discomfort we feel is simply collateral damage of this process.

Inflammation begins when your body rallies to defend itself from toxins or pathogenic invaders or to heal damage. Blood capillaries dilate and the vessel walls become porous, allowing white blood cells to move out of the vessel and to the site of damage or infection. This infusion of blood and fluid into a region of your body causes the characteristic swelling, which often puts pressure on nearby nerves, creating discomfort and pain. The inflammatory molecules may also trigger the activation of pain signals, intensifying the discomfort. The feeling of heat in the inflamed tissue is a result of the increased blood flow to that area.

In general, then, the inflammatory response of your body is a natural biological phenomenon that your body engages in to keep itself healthy and functional. But problems can occur when inflammation begins to run rampant without a proper controlling influence to oppose it, leading to chronic inflammation.

Chronic Inflammation – Friend or Foe?

While both physical and emotional stress can trigger inflammation, the intensity of an emotionally triggered inflammatory response tends to be less than a physically triggered one. Remember that inflammation is a body’s automatic response to any form of injury, whether real or perceived. Although the acute inflammatory responses that cause short term pain (due to swelling) benefit your body in the long term, the modern epidemic of chronic, low-grade inflammation due to emotional stress slowly destroys your body’s balance. With the continuous, low-grade inflammation that is typical of emotional stress, your body’s systems experience a constant inflammatory response, putting them in an unbalanced state, and you become more susceptible to the effects of aging and disease. In fact, it is this subclinical chronic inflammation that, in the end, causes many of the symptoms that are actually perceptible to an individual. This subclinical inflammatory state often festers for years before it becomes apparent or clinically significant. The length of time this inflammatory state has been aggravated is often directly linked to the severity of the resulting condition, as well as its prognosis In fact, the effect of the body’s inflammatory response is the cause behind many chronic diseases.

Chronic Inflammation can lead to symptoms of pain.The acute signs of inflammation are familiar and recognizable, as already mentioned: swelling, redness, heat, and pain. However, signs of chronic inflammation are often more subtle. These include frequent infections, irritable bowel, bloating, food sensitivities, dizziness, pain of unknown origin, brain fog, anxiety, and depression.

In a healthy body, the fire of acute inflammation is tightly controlled: it turns on at the right time to battle invaders and start the repair process, and just as critically, it turns off so that the body can get back to its normal functions. The turning off process is controlled by cortisol, our body’s anti-stress hormone. While inflammation itself is an unpleasant process, your body is designed to tolerate some inflammation and to control it. Research has revealed, however, that low-level chronic inflammation can simmer quietly and insidiously in the body, in the absence of overt trauma or infection, and have profound effects on our physical and mental health.

In cases where inflammation is tied to a specific chronic condition, the inflammation is generally local: in the arteries for those with heart disease, in the brain for those with Alzheimer’s, or in the pancreas for those with diabetes. Certain foods and environmental toxins also give rise to inflammation throughout the body, involving disparate areas, including the brain. This can affect your health, mental acuity, and even lifespan.

Other illnesses with a strong component of inflammation include psoriasis, stroke, fibromyalgia, gastroesophageal reflux disease (GERD), Hashimoto’s thyroiditis, lupus, asthma, allergies, autism, celiac disease, and Crohn’s Disease.

Other conditions that involve inflammation include:

  • Visible signs of aging like wrinkles
  • Susceptibility to bacterial, fungal, and viral infections
  • Acid reflux
  • Cancer
  • Skin conditions like psoriasis and acne
  • Arthritis
  • Bronchitis
  • Chronic pain
  • Diabetes
  • High blood pressure
  • Osteoporosis
  • Heart disease
  • Candidiasis
  • Urinary tract infections

Anti-Inflammatory Medications

Unfortunately, the weapons for fighting inflammation are extremely imprecise. Analgesic and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are tools of temporary benefit; they only act to suppress inflammation, not the underlying condition. They reduce pain, alleviate the swelling, and make us feel better in the short term, but they do not address the root of the problem.

Steroids, however, are like indiscriminate weapons of mass destruction that slow down the whole immune system. They are great tools for fighting inflammation, but they also raise the risk of infection, erode the bones, predispose the patient to diabetes, and cause mood swings. Steroids have also been found to affect blood vessel walls, possibly increasing the risk of blood clots.

Statins are another important category of drugs. They are widely used to combat high cholesterol in your body, but they also have anti-inflammatory properties. Statins can lower your chance of having a heart attack, but there are mounting concerns about the possible side effects, including muscle pains and an increased risk of diabetes.

The decision regarding what type of drug to use to control your inflammation is further complicated by the grade and severity of your inflammation, where and how the inflammation is localized, as well as the suspected root cause of the inflammation (if known).

Common causes of chronic inflammation include:

  • Chronic Inflammation can be brought on by over consumption of alergy causing foods.Mild but chronic allergies or sensitivities to food that may have only subtle symptoms.
  • A disruption in the population or composition of the normal microbes in your gut, also called dysbiosis. This imbalance causes your immune system to react aggressively to the microbial population of your gut and may or may not have noticeable symptoms.
  • Environmental toxins such as smog, preservatives in food, water additives, and toxic metals. These are linked to various diseases including cancer and fibromyalgia.
  • Dietary and lifestyle factors; the modern lifestyle is far more sedentary than that of our ancestors, and the modern diet contains a high concentration of processed foods packed with sugar and fat. This imbalanced, unhealthy state is a major contributor to inflammation and the development of cardiovascular disease and diabetes.
  • Stress! Chronic stress, whether psychological or physiological, drives up cortisol production in the adrenal glands and creates inflammation. One of the most commonly overlooked conditions that triggers chronic systemic inflammation is Adrenal Fatigue.

Read Part 2 | Part 3
© Copyright 2016 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Yes. It can be due to chemical sensitivities. This can become very problematic.

Pain can be caused by chronic inflammation


  • Indira says:

    It’s amazing how inflammation plays a huge role on health and how so many different factors can cause inflammation. Thank you for sharing this insight!

  • Mark says:

    Is fish oil the best option for inflammation? Are there any factors that would make this a poor choice, other that allergies, obviously?

    • Dr.Lam says:

      If you are on a blood thinner or have bleeding issues, you need to be careful.

      Dr. Lam

  • Claudy says:

    Is it helpful to alternate applying a hot and cold pack on an inflamed area?

    • Dr.Lam says:

      That can be helpful but it may actually make things worse if your body cannot handle the inflammation.

      Dr. Lam

  • Alex says:

    What is the best way to deal with low-level chronic inflammation?

  • Tracey says:

    How many anti-inflammatory can I take in a week that wouldn’t be harmful to my liver?

  • Tammy says:

    Can this type of AF triggered inflammation make carpal tunnel syndrome worse?

  • Clarence says:

    Can drugs like Meloxicam help with the swelling of adrenal fatigue.

  • Julie says:

    Can food sensitivities cause perceived arthritis? Can changing my diet eventually lead to me getting off prescribe arthritis medications?

  • Amanda says:

    Can chemical sensitivities cause inflammation in the body?

  • Mary says:

    What is the difference between edema and inflammation?

    • Dr.Lam says:

      Simplistically, Edema is accumulation of fluid, regardless of source. Inflammation is the body’s response to injury and can lead to excessive fluid.

      Dr Lam

  • Cruz says:

    Could chronic inflammation in a particular location lead to calluses of the area?

  • Karen Rae Steele says:

    Is there anyway to see if you have adrenal fatigue? I swell up so much I cannot wear shoes!!

  • Paul says:

    Hello Dr. Lam. I use cold packs sometimes for control inflammation, but I almost feel like using them causes more discomfort than it helps. I try to avoid using things like ibuprofen, but need to sometimes. What other methods can I use to control swelling?

    • Dr.Lam says:

      For acute cases, cold is best. Also elevation may be helpful. For chronic inflammmation, there are many natural tools ranging from fish oil to tumeric. The key is dosage and delivery system.

      Dr Lam

  • Rosalind Scovill says:

    Very informative! I do have some of the symptoms, esp. psoriasis. I have found a lotion which does well at controlling the external symptoms, but of course that does not address what is going on inside. I am using progesterone cream and wonder what impact this has. Will also read your section on glandulars and herbs as I use many supplements, herbs. Thank you, Dr. Lam

  • Carla says:

    Fascinating. I have been trying for years to get off prednisone but without a naturopath’s support, and supplements, this hasn’t happened yet. I recently started iodine (tri-iodine caps, 2/day for 25mg total) based on Dr. Tenpenny’s guidelines. What I wonder is if the thyroid and adrenals are so interdependent, doesn’t that mean we must address its needs/deficiencies concurrently? Otherwise adrenal function may not recover as hoped, if low iodine/elevated bromine/chlorine, etc are zapping thyroid function?

    • Dr.Lam says:

      They are interconnected and very much associated with each other. Concurrent approaches are best, but there is often a prioritization needed to match the body’s state of affairs for maximum healing.

      Dr Lam

  • Victoria Raines says:

    Thank you for your wonderfully informative articles on chronic inflammation and stress. I’m in Dr. Amy Yasko’s genetic program and was, as I say, ‘poisoned’ by second hand smoke many years ago. I’m disabled with asthma, chronic fatigue, pain, etc. Now, ALL petrochemical fumes from exhaust to perfume cause inflammatory reactions in many areas of the body. Your articles help me understand some of the really complex aspects of this process. Thank you, so much, for explaining these things in a detailed and thoughtful way. 🙂

  • Sheila says:

    I am abiding by so much of your wonderful information. Having had big doses of steroids for asthma, it has definitely affected my whole endocrine system. I am down to 3 and a half mg each day, but my body is still not recovering. I just don’t know what else I can do.just keep hoping that my good food and rest might eventually heal my poor body. Has been over 2 years now, do you think I will recover?

    • Dr.Lam says:

      The body has tremendous self healing power. Supporting the adrenals where cortisol is regulated can be very helpful in your long term dealing with steroid if you do it right and stay away from glandulars and herbs.
      Click Adrenal Fatigue Glandular & Herbal Therapy for more information.

      Dr Lam

    • Carla says:

      Dr. Bob DeMaria, NMD, stated that we *must* abstain from ALL sugars, while trying to recover adrenal function. And caffeine, of course, since adrenals get stressed processing it for elimination. (he answers general questions on FB)

  • mal says:

    Dear Dr Lam,
    Great article! Thank you.
    2 years ago I had a prostate biopsy that led to an infection of the testicles and epididymis. It was the 2 months of Cipro that triggered an adrenal collapse that I have been struggling with ever since. Chinese herbs have been the greatest help and I feel fairly good most of the time. However I notice that whenever I get under stress I tend to experience pain in the testicles again. Could this be an example of what you are talking about in the article above?

    • Dr.Lam says:

      Yes it can, and also it could be an underlying sign that your healing has not been complete and some underlying dysfunction remains.

      Dr Lam

  • Ilias says:

    What about joint inflammation that keeps returning? I have a knee injury and when I stand on it for a long period of time I have noticed that some minor swelling and pain develops by the end of the day. Is this considered chronic inflammation?