Key to the Inner Kingdom

With the beginning of each year, most of us look at what we would like to change in our lives. Better health and more energy is often part of what we hope to achieve. Many of us need a rest after the holidays…a real vacation, since we tend to spend the holidays eating lots of sugar and stressing out. Holiday food is generally the kind of food that candida, a kind of yeast, thrives on. Due to stress and sugar, many of us are a bit worn out after the holidays, and the candida weakens our immune systems just enough to make it easier for colds and the flu to pop into our lives.

In order to develop a winning strategy for anything, it is priceless to understand as much as possible about each goal. When it comes to health, the more we understand about how the body works, how it gets sick, and how we become stronger, the better we become at taking intelligent steps toward gaining the vitality we all seek. I've made it my job to do everything possible to understand countless aspects about human beings, including the complex question, “Why do people get sick?” This is the first time I've written about the role that inflammation plays in illness.


Over the past half year, I have spoken with both doctors and lay people who talked about inflammation as if they really understood it. But they didn't. I spent months researching the subject, something that I initially studied in medical school. Inflammation is very complicated. I will try to make'“some” sense out of it for you, but will not promise to provide all of the answers. I consult with some of the healthcare”“gurus” when I am researching something very complex, and I did so on this subject. What I found was that, even national experts, did not understand the whole picture . . . and they did not know that they did not know.

Every illness that ends with “itis” is an inflammation, or an illness caused by inflammation. Here is a short list of “itises:” appendicitis, arthritis, bursitis, bronchitis, conjunctivitis, dermatitis, gastroenteritis, gastritis, tendonitis, encephalitis (brain), meningitis (lining of the brain), neuritis (nerves), endocarditis (lining of the heart), vasculitis (blood vessels), myositis (muscles), phlebitis, tonsillitis, ulcerative colitis, and gingivitis (gums).

There are numerous illnesses caused by inflammation, or in which inflammation plays a major role, but which do not end in “itis.” These include fibromyalgia, chronic fatigue syndrome, sepsis (widespread infection of the blood), obesity, irritable bowel syndrome, Cohn's disease, and diabetes.

We all have a sense about inflammation, but none of us fully understands it. We will begin by looking at acute inflammation, and then later on we'll examine chronic inflammation. Here is a simple example (and exercise) that illustrates acute inflammation. If you scratch yourself or simply take a fingernail and firmly run it across your skin, a red line will form. That redness is the first sign of inflammation.

The 4 Signs of Acute Inflammation

The 4 cardinal signs of acute inflammation are: 1) redness, 2) heat, 3) swelling, and 4) pain. When inflammation becomes chronic, a 5 th sign develops, and that is “loss of function.” Here is what happens when you get a scratch of any severity. This is the mechanism of” all acute inflammation:

1. There is increased blood flow to the affected area, which occurs due to 2 things. First, the capillaries at one end of the inflamed area dilate, bringing in more blood. Second, the capillaries at the other end of the inflamed area constrict.

2. The blood vessels begin to leak, pouring white blood cells and fluid outside of the blood vessels. The fluid contains proteins such as fibrin (involved in the production of fibrous tissue) and antibodies (that attack infectious agents and foreign bodies). Water also leaks out, which leads to swelling.

3. The white blood cells do several things.

A) Some of the white blood cells, like those called “macrophages,” engulf and destroy foreign objects (like splinters), and infectious agents (like bacteria). They also pick up cellular debris.

B) White blood cells wall off the affected area, and

C) Release chemicals called “cytokines,” which are involved in all aspects of wound healing. There are quite a number of different kinds of cytokines.

D) A kind of white blood cell, the mast cell, releases histamine. Histamine increases blood flow to the area, and facilitates leakage of fluid and proteins from the blood into the tissue space. Histamine is especially involved in allergic inflammation.

E) Other chemicals are released by white blood cells to help rid the body of any foreign substance. Some of these chemicals are toxins, which are intended to kill invading agents. Unfortunately, these toxins may also damage our own tissues.

4. Cytokines

Cytokines deserve additional explanation. In acute inflammation, cytokines attach to foreign bodies and infectious agents to help destroy them. They help guide the activities of a variety of white blood cells, including the white blood cells that created them. Cytokines attract white blood cells to the site of infection, are involved in the release of histamine, and play an important role in how blood vessels function. Cytokines make blood vessels more “leaky,” so that inflammatory cells and chemicals can pour into the site of inflammation. In the process, they also damage blood vessels. This family of compounds, cytokines, has multiple components. Some are anti-inflammatory and others are pro-inflammatory. In the total, long-term picture of inflammation, both pro-and anti-inflammatory cytokines are involved. Pay attention to cytokines, for they are the bridge between acute and chronic inflammation.

Acute inflammation is caused by: trauma, toxins (snake bite and toxic spider bites), irritants (like that thorn you're having trouble removing or your contact lens), infection, and extremes of hot and cold, including burns. Many of the'“itises” listed above, like bronchitis, encephalitis, and meningitis, are caused by bacteria or viruses. They start as infections, and one of the main ways the body responds to infections is with the inflammatory process. Wherever there is infection, there is inflammation. Given what you've already read, it becomes clear that inflammation plays a major role in so many problems that we all face. But, before rushing out to your doctor for steroids or NSAIDS (non-steroidal anti-inflammatory drugs) . . . or to the health store for natural anti-inflammatory compounds, like aloe vera, remember one thing. Inflammation is a complex process. In the simple example of a skin scratch, you can see how many different processes are at work in the total process called'“inflammation.”

The inflammatory reaction is like the stress response in that both are crucial for survival. It is not surprising that cytokines, one of the major mediators of inflammation, is in the same class of compounds as neurotransmitters and hormones.

Outcome of Acute Inflammation

1. Most of the time, that skin scratch is going to totally resolve, and you will never know anything ever happened. That is one outcome of inflammation, in which the inflammatory response was entirely successful.

2. Part of the healing process involves walling off the affected area with fibrous tissue. If healing is not complete, a scar will form. The inflammatory process causes tissue damage as part of the overall process of healing and repair. Scar formation is part of the tissue damage phase.

3. In the case of some bacteria, an abscess may form to wall off the infection.

4. The acute inflammatory response may not succeed, and as a result, chronic inflammation sets in. In chronic inflammation, there is almost always tissue destruction.

What you've read is fairly complicated and it is what happens when you scratch your skin, step on a thorn, get bitten by a spider, or get a little skin infection. To re-cap: acute inflammation makes an area: red, warm, swollen, and painful. That's what happens on the surface of your body. You need to understand this simple picture of acute inflammation before you can begin to understand what is going on inside your body with chronic inflammation . . . with conditions like gastritis, bronchitis, or hepatitis. The basic 4 parts of inflammation are present in chronic inflammation, but, unless your “itis” is dermatitis, you can't see the inflammation, although you may feel the pain and heat.

Chronic Inflammation

By providing you a clear picture about a simple, acute inflammation (an inflamed scratch), my intention is to provide you with an image to help you understand chronic inflammation, most of which you cannot see. Much of what takes place in acute inflammation also takes place in chronic inflammation. Whether you have tendonitis, gastritis, or bronchitis, you are still dealing with redness, heat, pain, and swelling. That is part of what is going on with every “itis.”

Science has not yet adequately explained everything that takes place between a brief, acute inflammation, and a chronic inflammation that may last for decades. The activity of cytokines is present in all different kinds of inflammation, whether acute or chronic.

We develop chronic inflammation for several reasons:

1. The injurious agent or toxin continues to affect us. Either acute inflammation was not able to remove that agent or toxin, or we continue to be exposed to that agent over and over again.

2. The inflammatory process is not able to contain a toxin or infection, and so both of those grow larger or spill into our bloodstream. If you have a bacterial infection that is not contained by your body's first attempt at healing through inflammation, bacteria will spread through your body. Everywhere that bacteria spread, the inflammatory process will be chasing it, trying to control and stop it.

3. Since acute inflammation failed to stop an initial problem, in chronic inflammation many more factors come into play as the body works harder to solve the problem. The over-production of antibodies against a local infection or toxin can backfire. Those antibodies can pour into the blood, and turn against other parts of the body, creating an autoimmune reaction. In some cases, chronic inflammation involves a particular organ or tissue, such as appendicitis, tendonitis, or bronchitis. You may have a chronically inflamed tennis elbow, but the rest of your body is not affected at all. In other cases like cardiovascular disease, inflammation becomes a total body process.

Oxidative Stress and Inflammation

The relationship between oxidative stress and inflammation is so close that many people confuse the two. Oxidative stress is caused by free radicals, which are compounds or chemicals that are missing an electron. As a free radical courses through your blood vessels, it steals an electron from the artery wall. Over the years, free radicals create tears or rips (internal scratches) in artery walls. The body responds to these tears as it would with any injury, namely with inflammation. Living, as we do, in a polluted world, we eat and breathe free radicals, so that at any particular moment, you might have billions of free radicals attacking your blood vessels and the rest of your body. The attack or injury may be very small at first, as it is with free radical damage, but it does not matter. The inflammatory process will appear virtually everywhere to deal with any kind of injury or infection . . . large or small. Atherosclerosis and cardiovascular disease are largely caused by oxidative stress, which in turn causes inflammation. Picture that skin scratch, and then imagine tiny scratches throughout your blood vessels, each “scratch” producing an inflammatory reaction. Wherever you find inflammation, you will find elevated levels of cytokines, for they are part of all inflammation.

Inflammation that is widespread throughout the body is associated with most chronic illness, and from the pictures and images you've already read about, you can see how important this process is. Now, let me explain a bit more about some other inflammations. In anemia, cytokines attack the production of red blood cells. In arthritis, cytokines destroy joint cartilage. In kidney failure, cytokines restrict circulation and directly damage the kidney.

I've written about cytokines as if they are all pretty much the same. But they are not. As previously stated, some cytokines increase inflammation and others decrease inflammation. Other cytokines are not involved in inflammation at all. With inflammation, the two opposing kinds of cytokines are designed to create balance. Illness and inflammation occur, when we lose a healthy balance of inflammatory cytokines.

The next time you cut yourself, you'll have a better understanding of what's going on. Likewise, when you visit the doctor because of a bad sore throat and he says, “Your throat is really red, and swollen,” you'll know why it's red and swollen. When you bump your elbow, and a few days later it feels warm and painful, you'll know that your elbow is inflamed.

In the next issue, we will look at various treatments for inflammation. For now, I want you to understand the basic processes of acute and chronic inflammation, and to appreciate the complexity. Inflammation is not as simple as a bacterial infection, where the task is to find an agent to kill the bacteria. There are multiple phases of inflammation, multiple parts of the immune system involved, a great number of inflammatory cells as well as inflammatory compounds like cytokines. Like the stress response (fight, flight, or freeze), the inflammatory response is the body's earliest response to a threat to survival. Once we see how complex it is, we will be more knowledgeable in how we diagnose and treat it.

Now that you know that chronic inflammation plays a major role in health and disease, it is important to know about a few lab tests that measure inflammation. They include: C-reactive protein, the sedimentation rate (sed rate), and IgE (immunoglobulins type E). These are just a few, of which C-reactive protein should be ordered by every doctor as part of a standard blood panel, as it is a reliable gauge of total body inflammation. With this information, I hope you proceed into the New Year with more knowledge to help you gain greater health and vitality.

David Gersten, M.D. practices Nutritional Medicine, Integrative Psychiatry, and Interactive Guided Imagery out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at


Dear Louise

Dear Louise,

I've been reading your column for a while now, and I feel that you could help me with my problem. I don't know where to start. I have thinning hair as well as body hair, which is all I think about all day—it's preventing me from living a normal life or having a relationship.

I've been to the doctor and been diagnosed with PCOS (polycystic ovary syndrome)—doctors say it has to do with insulin resistance. I'd like to know if this condition is something I caused by the way I view myself, or is it just a heredity condition (my Dad's family has a history of diabetes, and my grandmother and aunt had severe hair thinning/loss). If you could shed a little light on my condition/situation, I'd be forever grateful.

P.D., New York

Dear P.D.,

First of all, stop thinking about it all the time. Obsessive thinking just makes the pattern stronger. The only thing preventing you from having a normal life or a relationship is your own thinking. The way you choose to view yourself has a lot to do with how much you're suffering.

A history of diabetes in the family means that the whole family has poor eating habits. Extreme hair loss is often aggravated by a diet of excessive salt and sugar with too little protein. More fish and green vegetables could balance your whole system.

When we're tense and afraid, we often create those bands of steel that originate in the shoulder muscles and come up over the top of the head. Tell your scalp to relax right now. If you notice that your scalp visibly relaxes, then I suggest that you relax your scalp often. A good scalp massage morning and evening will stimulate circulation.

Your lesson is to love yourself exactly as you are right now. Think of this condition as temporary. In your mind, allow it to go back to the nothingness from whence it came. You're not your family, nor do you need to think or eat the way they do. Go to a good nutritionist and learn healthier eating habits. There's so much you can do for yourself. Don't waste your thoughts bemoaning your fate. Affirm: I can heal myself and I will!

(You might also want to get the book The PCOS Protection Plan, published by Hay House.)


Dear Louise,

Recently my mother died at the age of 50 leaving me (a 22-year-old male) and my sister(16) behind. My sister is now going to live with my aunt and uncle, and I will live on my own. I've experienced her death differently when I look at my family. I feel loss, but am not depressed, angry, or sad. I know that my mother wants me to be happy. I'm sometimes scared, though, also, when it comes to relationships. I have a desire to live with a girlfriend, but my fear is that I'll do that out of fear of being alone and less about love. I don't know what's right anymore in this regard. I experience great feelings of autonomy and independence, and now I feel this even stronger. It's like a clash. I want to live with someone I love; yet I also value my own life very much. What would you advise?

A.D., the Netherlands

Dear A.D.,

For the time being, I suggest you do nothing. Allow yourself to go through the grieving period in your own way. Know and affirm that Life loves you and has your best interest in mind. Yes, your mother wants you to be happy, so talk to her and ask her to help you with your decisions.


Dear Louise,

I want to be a successful writer like you. How do I begin? Where do I start?

A.G., Los Angeles

Dear A.G.,

What are you passionate about? What kind of books do you want to write? Who do you see as your audience? Are you thinking of writing self-help books? Are you a public speaker? There are so many questions to ask you. To begin, you must start to write. After you've written something, you can then look for a publisher. Go to a library or bookstore and get a book called The Writer's Market. It will tell you which publishers would be interested in the sort of material you've written, and which require an agent.

For my own story, I was teaching classes and wanted to reach more people, so I put my workshop on paper in form of a book. I didn't go to a publisher because I didn't believe they would allow me to tell my story in my own way. So I printed my own book and then just sold them to my various students. It was a very slow beginning. Then Life decided that the book needed a wider audience. Good luck to you!


Dear Louise,

A while ago I read someone's interpretation of A Course in Miracles saying that sex is for procreation purposes only. Is that a common concept? If so, I don't want to be that enlightened!

­—J.F., New Hampshire

Dear J.F.,

I've never heard of that concept with regard to A Course in Miracles! It sounds like that remark is coming from an asexual person (someone who has no desire for sex at all). Denying natural bodily functions is not being enlightened—it's just adding another rule about how we're supposed to live.

My advice is love who you are, forget the past, and forgive everyone and yourself. Enjoy your body . . . enjoy your life. Stay in the present moment, and choose to be happy!


Dear Louise,

I've always been fascinated by the thought of growing and changing my attitude and personality. In other words, I want to become a better person.

My big problem is that my sister stops me from achieving my goal. She's always getting me into trouble and saying very hurtful things to me. On most days I'm petrified to speak to anyone in my family for fear that I'll be shouted at or my words will unintentionally cause trouble. Every time I try to change into a better person, my sister says or does something that really hurts me, and therefore I'm back to square one. My older brother is just as bad: Almost every single day he comes around the house and begins to moan and complain about his work and personal life, which always results in screaming, fighting, and shouting.

Although I have a few friends, unfortunately, I don't have any close ones around my age-group to hang out with or to visit. I'm pretty much a loner, so I have nowhere to escape to for a break.

Please, can you help me find the answer to becoming a better person without the hurtful words or actions of others getting in the way? It's so difficult to change yourself into a better person when you're constantly surrounded by people who beat you down and make you feel so miserable!

—B.K., London

Dear B.K.

It sounds as though everyone in your family is troubled. No matter what other people say or do, you're the only thinker in your mind. The thoughts you are choosing to think are the ones that are creating your future. Your thoughts are a direct line to the Source of all energy. You don't need to be a better person; you already have within you the ability to be happy in the midst of chaos. Although you might be quite a young girl, your thoughts still have power.

Instead of reacting in the usual way to your family, begin to go within and find that peaceful haven inside you. The next time someone tries to upset you, say silently to yourself, I bless [my sister, brother, or whomever] with love and know that there is a peaceful place within this person, too. We are all creating harmony in our family. We are all safe. Keep repeating this over and over. It may feel stupid the first few times you say it; however, as you continue to repeat this affirmation, things will change. You have the power to create peace in your family. They have no power over you unless you continue to play their games.

I'd also suggest that every time you pass a mirror, you stop, look into your own eyes, and affirm: I live in a peaceful family who support me and want me to be the best I can be. This is what you really desire, so create it in your thoughts. I know that you can do it . . . begin now.


Dear Louise,

Since turning 30, I've been suffering from PMS. My symptoms have only gotten worse over the years. Now each month I can be affected by severe symptoms for up to 12 days. I long to become a mother, but in this condition, how can I? Can you offer any advice?

—J.S., Los Angeles

Dear J.S.,

On a physical level, you need to go to a good nutritionist and have your diet checked out. Poor food choices can have devastating effects on your menstrual cycle. Don't wait another moment. If you don't know where to go, ask at your local health-food store. Los Angeles is full of knowledgeable nutritionists.

On a metaphysical level, this cycle has a great deal to do with creativity. How are you stifling your creative processes? What are you not allowing yourself to do? Every woman needs a creative outlet. What do you do that gives you great joy? Love yourself enough to make time in your life for this activity. Affirm: I am in the rhythm and flow of life. All is well in my world.

Louise L. Hay is a metaphysical teacher and the bestselling author of numerous books, including You Can Heal Your Life , Empowering Women, and I Can Do It! . Subscribe to the Louise Hay Newsletter! Call for a Free Issue: (800) 654-5126. Questions for Louise? Write to: Dear Louise Column, c/o Hay House, Inc., P.O. Box 5100, Carlsbad, CA 92018-5100 (letters may be edited for length and clarity). Visit Louise and Hay House at: or