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What Is Inflammation?

With Gregory Plotnikoff, MD

Season 6, Episode 15 | March 14, 2023

Inflammation is a natural bodily response that is essential in acute circumstances — we need it to happen we get a paper cut or if we’re fighting a head cold. Its harmful effects occur, however, when it becomes chronic and systemic. Functional-medicine practitioner Gregory Plotnikoff, MD, shares what to know about inflammation, including what causes it, how it impacts our health, ways we can test for it, and proactive steps we can take in our daily lives to tame it.

Gregory Plotnikoff, MD, is a board-certified internist and pediatrician who has received national and international honors for his work in cross-cultural and integrative medicine. He is the founder and medical director of Minnesota Personalized Medicine.

Plotnikoff shares a few of the lab tests you can request from your healthcare professional to assess your body’s inflammation level:

  • High-sensitivity C-reactive protein: This is a measure of systemic inflammation. Less than 3 mg/L is considered normal, but less than 1 mg/L is ideal. (Levels will vary around menstrual cycles and following illness or vaccination, for example, so there are some considerations for testing timing and/or nuances in interpreting results.)
  • Sedimentation rate: This test has been around since the time of Hippocrates and is a means of assessing some forms of systemic inflammation. It involves looking at blood in a capillary tube and counting how many seconds it takes for it to settle.
  • Ferritin: This is the best measure of iron status and is frequently measured in women for iron concerns (it’s rarely measured in men). With systemic inflammation, ferritin can be falsely elevated, which is an important marker of inflammatory risk.
  • Vitamin D: Healthy vitamin D levels may reduce systemic inflammation — though deficiencies are widespread across the population. The Endocrine Society suggests ideal levels to be between 40 to 60 ng/mL.
  • Omega-3/omega-6 profile: If Plotnikoff could add one blood test to every panel, this would be it. It’s an important means of assessing pro-inflammatory risk. In his patients, he looks for an omega-3 index of 4.4 or higher, total omega-3s of about 10 percent, omega-6 DGLA in the normal range, and omega-6 arachidonic acid in the low-normal range.


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Transcript: What Is Inflammation?

Season 6, Episode 15  | March 14, 2023


Welcome to Life Time Talks. I’m Jamie Martin.

And I’m David Freeman.

And in this episode, we are talking about inflammation. This is a topic that is one of the most requested topics that we have gotten since we started the podcast. People are really interested in what it is, how it affects our health, why it’s essential, but also when it becomes too much.

So with that in mind, we are really excited to have Dr. Greg Plotnikoff with us today. Dr. Plotnikoff is a board certified internist and pediatrician who has received national and international honors for his work in cross-cultural and integrative medicine. He’s the founder and medical director of Minnesota Personalized Medicine. And he and his team serve people who have suffered from complex, chronic, and mysterious illnesses.

Dr. Plotnikoff is a graduate of Carleton College, Harvard Divinity School, and the University of Minnesota Medical School. He’s the recipient of several international awards for research and teaching, as well as the Early Career Distinguished Achievement Award from the University of Minnesota Medical School. And there’s more, he’s the author or co-author of more than 60 articles in the peer-reviewed medical literature, dozens of medical textbook chapters, and the celebrated book, Trust Your Gut– Heal from IBS and other Chronic Stomach Problems Without Drugs.

Dr. Plotnikoff or Greg consciously chose to attend divinity school before medical school to deepen his understanding of suffering and of human responses to suffering. After eight years of medical school and residency training, he helped establish the Center for Spirituality and Healing at the University of Minnesota where he served as its first medical director. And there’s more. We’re going to link to that all online. So we’re going to talk a little bit about your experience in Tokyo when we get going here. So it’s awesome.

Wow. I mean, to kick off with, obviously, a lot of the credentials, the experience is what stood out to me there. And Jamie alluded to it that this is the most requested topic, inflammation. And knowing that you have a lot of experience in this space, there’s a lot of things that we want to get right into right now as far as the various forms of inflammation that we see out there. And we have the acute, the chronic, the localized, the systemic. So I just want to hear from you as far as in this space around inflammation, how do these things come about?

Well, classic understanding of inflammation is what we can see, what’s visible, what we can feel. And we talk about swelling, and redness, and pain, and warmth, and maybe disruption and function. That’s classic acute or things. So we think of sprained ankle, infected cut, things of that sort. And that inflammation we consider good, positive inflammation. That’s part of the healing response.

It’s the invisible inflammation, and the chronic inflammation, the systemic inflammation that is actually captured a lot of attention. And I think that’s where everyone really is interested in things, because it’s been tied with so many of chronic illnesses that we’d all like to avoid– the diabetes, the heart disease, the cancer, the Alzheimer’s, et cetera, et cetera. So to stay as young and healthy as possible, no matter what age we are is means some attentiveness to things which could drive inflammation.

Absolutely. So before we started recording, you actually shared a little bit of a story. I’d love if you’d be willing to share about an experience you had in Tokyo, an introduction to different approaches to this.

Yes, well, I was a visiting professor of medicine at Keio University Medical School in Tokyo. And so had one of these aha moments one day. So I’m standing in the hospital and in a small group of physicians who are talking about a case. And this patient has– very clearly has a fever, which in the United States, you don’t even think about it. You just give people acetaminophen.

But no one was talking about that. I’m just like, it’s not on the action plan. So I ask the question. Oh, why not give acetaminophen? And people just look at each other and just and look down. And no one’s making eye contact. And no one’s responding.

I’m just like, maybe I’m not translating correctly, maybe they use paracetamol. And so I translate that into Japanese. And people then really start looking down. And finally, the chief physician turns to me, straight in the eye he goes, Greg san, why would you ever suppress the body’s natural healing /

Well, I’ve been trained since day one. We give acetaminophen for everything, for breakfast, anything. And you wouldn’t ever let a patient ever have a fever. You just load them up with acetaminophen. And I realized, wow. I hadn’t even ever thought about that, but that is our predisposition.

We are into suppressing, squashing, making everything the same. And rather than working on the body’s natural healing response. So for inflammation, we have all these fabulous expensive drugs, and tumor necrosis factor, and things where we can suppress things. We use prednisone a lot to literally squash and suppress inflammation.

And the new shift, and this is where self-care comes in is actually being able to facilitate the body’s capacity to actually roll back inflammation. So something happens. It’s like we get a cut, or we sprain an ankle, or something like that. And signals goes out– the signal goes out to the– hey, immune system. We need some help over here. And so things rush in, activated, and roll out the body’s natural healing response and sometimes they get stuck.


Hey, we’ve been at this for a while, where’s the off switch? I can’t find it. OK, keep going. And that’s when we would be tempted then to squash it with prednisone or gosh that’s been going on and destroying the joint. Let’s give an anti-tumor necrosis factor, alpha agent, and things of that sort, things that we all hear about on TV ads, rather than how about rolling things back, how about down regulating things. And that’s the exciting new things because it’s in our power as human beings to do just that.

Exactly. Well, I think we know that. And you’ve already said this. Inflammation is a necessary biological reaction for healing, for maintaining health, and all of those pieces, but yet too much can lead to other health issues, which you’ve already mentioned.

So what are some of the reasons or causes that inflammation has become too much of a good thing? When does that balance tip like, oh, it’s staying stuck on? And why? Are there environmental factors or what are the things that are causing that more frequently it seems or more commonly?

Yes, well this is such a profound question. And so I will try to make a reasonable answer for it, but know that there’s a lot of interest in this area. So for example, why has inflammatory bowel disease skyrocketed in recent years? [INAUDIBLE] what is going on? Well, we know that there’s a lot of things in our processed foods. Glyphosate is everywhere. We’re using antibiotics like acetaminophen for breakfast.


And so there’s disruption to that, the chemicals that we come across. So a patient we were talking about before this broadcast, I saw this morning. We did a special toxin profile on them, actually, we were able to do probes into the mitochondria to measure. And it’s like there is mold toxins, and heavy metals, and phthalates, and triclosan, so antibiotics, and lindane.

And it just like, well, we carry a lot of stuff with us. So inflammation is in some part due to the fact that we have a lot of environmental stress around us, but then add physical stress. Some of it is good. So when you– in program, for example, it says like, yeah, we are creating an inflammatory state, but it’s a healthy inflammatory state. And it’s going to actually boost the body rather than deplete the body.

But take that too much further, so people I rented some of the other day who did a 90-kilometer run over like two days or three days. I’m just like some of these people we see prematurely age. And so premature aging physically in the face it can be reflection of they’re just overwhelming body, and doing things, and some of the uber things.

Then there’s also the emotional components. The emotional stressors we all carry with us. Anything from anger to the most toxic of all human emotions, resentment, carry that, that then feeds into physical stressors like impaired sleep, which then feeds into environmental stressors of like creating an environment where you’re even angrier.

Right, it’s a cycle. It just feeds itself it seems like.

Yes, then you had pharmaceutical stressors and dietary stressors. And also, oh, we’ve got a lot of factors that can be playing role in this. The greatest of them are, of course, those that are going to lead to things like atherosclerosis, or impaired gastrointestinal functioning, or drivers of migraines, et cetera, et cetera. These are all opportunities, symptoms of opportunities for us to deepen awareness and recognize, OK, we have a concern here. And it can be addressed.

I like the opportunities. Let’s tackle that. So we now know what can cause chronic inflammation and what can we do about it, because we know there are good news in this space of opportunity and the power that we can effect within our lifestyle factors. So you describe this under the umbrella of true primary care. Can you talk a little bit more about what this is and why it matters?

Yeah, true primary care is what we do for ourselves. And somehow we forgot that.


And the worst term ever invented, the most insulting term, at least for health professionals, is primary care provider. Primary care provider implies that we’re not in the position to take care of ourselves. And a provider implies some transactional relationship, which is one way. I like health professional, where there’s a profession of an oath. And where there’s a bidirectional relationship for things.

And that’s where we have a health professional as thought partner in things rather than dictator or general with a one-way direction. But true primary care being what we do for ourselves, I think about the five fundamentals– breathing, eating, sleeping, moving, as in exercising, and loving, that is living a life of passion, purpose, and connection.

And if we think about life in those terms, we can self-assess, well, how am I doing on breathing? Maybe this moment not so well, but how am I doing with eating? How am I doing sleeping? How am I doing with moving? How am I doing with living a life of meaning, and purpose, and connection?

Yeah. It goes back to, we talk about this all the time, the pillars that we frequently come back to in what we’re doing. It’s all of these things. And when you work on one, it can influence the other. And also when you’re neglecting one, it can influence another. And so there’s all these– they’re intertwined. And it’s hard not to have them to see them that way.

Yes, and so that’s why it doesn’t matter where you start. What’s important is you start. And this has taken me 62 years to learn. And I’m still teaching myself, but I share this with patients frequently. The secret is, every day intentional, deliberate, baby step in the right direction with a good dose of self compassion.

Yep, absolutely. Absolutely. So let’s talk, I mean, all of those pieces. I mean, that really comes down to– well, there’s a mindset element there too and awareness within yourself. When we’re talking about what people can do– I would love to dive into a little bit in terms of from a nutrition standpoint and eating standpoint. We talk about people’s inflammatory loads, how we can dial things back. What are some proactive steps people can take on their own, but also obviously we know they want to work with a health care provider for more serious conditions?

Well, actually a health care professional.


I knew it was going to happen. Lay up, dunk. You got it. Yeah, that was good.

OK, professional.

Professional. That is a top partner in these things. And where do you start? Well, sometimes because– a good place to start is, well, we’re often deciding what we’re going to eat three times a day.


OK, so just even doing a self-assessment without judgment, OK, how much of that is a whole food? And how much of that is processed? And I love what actually the Japanese government recommends. They don’t recommend a pyramid. They don’t make a plate. They say, aim for 30 different ingredients per day.

And it’s so much more constructive and– because if you’re getting 30 ingredients and they’re not high fructose corn syrup, and polysorbate x, y, z, but actually real ingredients, you’re going to be doing really well. And so people start realizing, oh, I had a four ingredient breakfast today. And it’s like, and well, how can I up that? Well, let’s add some blueberries and a multigrain granola, for example. Oh, I’m up to 10. Cool.

Oh, I didn’t even think about that. So the idea about– and then, oh, I took a baby step today. I added blueberries. Pat on back. A good dopamine surge because you’ve completed a loop. You’ve made a step in the positive direction and it empowers you to move forward and another step, OK.

So, yeah, starting with diet is very easy, but maybe some people say, oh, I haven’t slept well in years. OK, well let’s talk about that. Difficulty achieving sleep, difficulty maintaining sleep, both. You’re waking up between 1:00 and 3:00 in the morning, between 3:00 and 5:00 in the morning. What’s going on?

I think, I love what the traditional east Asian medicine has to say about sleep. Waking between 1:00 and 3:00 in the morning is liver energy, so frustrations, angers, resentments, will wake one up between 1:00 and 3:00 in the morning. Oh, well, how do we address that? Well, are they pro-inflammatory? Absolutely. Is poor sleep pro-inflammatory? Absolutely. Maybe we need to do some journaling. Maybe we need– there’s a variety of things for that.

Between 3:00 and 5:00 in the morning is grief. It’s a long hour. Grief resides in the lungs, oh. So I can’t tell you how many times I’ve asked, someone said, oh, you’re waking up consistently around this time. This is lung our. Lung resides in the grief. Tell me, does grief play any role in your life? And that’s when tears just start to flow. And they said, no one’s ever asked me about this.

I said, absolutely, this is a health issue. And absolutely there’s no pill for it. But I do tell people, I love this quote. I can’t recall where I heard it. It’s not original, but anything that has the power to bring tears is worth writing about, even writing for yourself. And so we think about inflammatory diseases like asthma and rheumatoid arthritis.

There was a great study done about 25 years or so ago published in the Journal of the American Medical Association, got the editor in big trouble. The study was this. It was people with severe asthma or severe rheumatoid arthritis. And severe was defined as on maximum medical therapy, and still symptomatic, with quantifiable measures of disruption like impaired airflow and frequent ER visits.

And the intervention was simply this, 30 minutes a day, pen to paper, writing non-stop, only for oneself, stream of consciousness, no perfect verbs, no perfect sentences, no perfect paragraphs, just writing for oneself, oneself only, 30 minutes, one topic. The most stressful event of my life. The result, in this population, a profound reduction in medications, significant improvement in all quantifiable measures, and near elimination of ER visits.

So interesting.


Like getting that out, yeah.

Getting it out. Now, if there was a pill, maybe a zillion dollar best seller.


Right, right.


But it’s self care. And self-care looking at a dimension that there is no need for a pill. In fact, a pill can be profoundly disempowering. Mrs. Jones, the answer’s in this pill.



Right. Well, that goes back to so much of the foundation of functional medicine is we want to help our bodies function optimally. We don’t want to suppress or hide the root causes of these things. So how do we investigate those? And however you end up doing that, but I think it goes back to the roots of what we’re talking about today.

Yes, well, one my favorite athletic coaches is a guy by the name of Tim Gallwey. He had a great quote. He said, performance equals potential minus interference. And I said, oh, well, that refers to health. Optimal health equals potential minus interference. So what’s the potential at any age? And what are these interfering factors? In most cases, the interfering factor is not enough pills, the prescriptions.

And so what are those interfering factors? So being able to explore those and address those is part of our self care, but it means using these different crucibles of challenges we have as opportunities to gain self awareness, the metaphorical vitamin A, awareness.

Yeah. So when you think of our health care professionals, like right now, we have maybe once or twice a year that we’re going in to maybe do our annual or checkup or whatever it may be. Being aware of all this information that we’re empowering our listeners with, what are certain tests that we can ask our health care professionals? Yes, I would like to have this tested, see where I’m at in these categories.

Yes, well, for information, number one would be a high sensitivity C-reactive protein.

C-reactive protein, OK.

And that is a great measure of systemic inflammation. You don’t want to see that high. We want to see it, ideally, they say normal is less than 3. Ideally want to see it probably less than 1.

What’s optimal? What would you say is optimal?

Optimal would be less than 1.

Less than 1, OK.

OK, now, it will also vary with like menstrual cycle. So ovulation, it will go up, for example. So there’s some nuances in interpreting it. You wouldn’t want to do it right after a vaccination. You wouldn’t want to do it right after a cold.


But in general, that is an inexpensive test to do. A test that’s been around for 2,400 years or longer, from time of Hippocrates is called the sedimentation rate. It’s literally just blood in a little capillary tube and just counting how many seconds does it take for it to settle.


And that’s a general measure of inflammation. There are other measures of inflammation people might be getting for other reasons like a ferritin level is a great way of measuring iron, but it’s an acute phase reactant, which means that if there’s inflammation, it will be falsely elevated.

So if you’ve come across a high ferritin, oh, that’s a concern. Copper is another one. When you come across a high copper, that’s a concern now. Now, every woman on an oral contraceptive has excessively high copper. And it’s just known, but no one knows what to do about it. Now we high copper is toxic in the long run for people, but that’s off topic. So we won’t go there. But those are classic ones.

Now, there are new ones which are emerging. So a lot of people are measuring something called C4a. And C4a has been associated with mold toxicity and other things, but it’s actually a very nonspecific marker for inflammation. And normal levels are around 2,800. The woman I saw this morning with a severe pain condition at level over 29,000.

And that’s just like, OK, something is going on, which is actually a relief for her because so many people with– unless they have a broken leg, or have an IV pole, or something like that, or hair is falling out have invisible illness. And so measuring these things can give people relief, oh, thank god, an abnormal lab value. So there really is something going on, as opposed to, oh, you’ll be fine. It’s just anxiety. It’s just stress.

Right, but there is actually you can measure it and say like, now we can do something too. I mean, you could do– there’s things obviously in our day-to-day lives, but now there’s support with your health care professional and partner.

Yes, and so that’s why I also strongly believe in a couple other blood tests. One is vitamin D level. And there’s strong pushback. People are pushing or trying to prevent people from getting vitamin D level, but I have to tell you it’s a huge issue in this country, vitamin D deficiency.

And I don’t understand why there’s pushback from the medical profession against measuring it, especially in the time of COVID, especially in time of RSV, which is a huge issue right now, but just look at the National Library of Medicine for RSV and vitamin D. You will be shocked, why aren’t we out there getting everyone up to speed in vitamin D this winter? I don’t know why. It’s cheap. It’s inexpensive. The blood test itself, wholesale cost is about $20. It’s not a big deal.

Right. So when you talk about vitamin D because this is one thing– we’ve done an episode on this. And I would need to refresh my memory. But when we’re looking at optimal levels of vitamin D, we were just talking about this yesterday with someone who was like, they said this was normal, but it was actually really low by [INAUDIBLE] medicine standards.

Well, so the question is, what is normal? Who is normal? These are very political questions. And there are a lot of value judgments behind it. So normal can be a population bell curve and 95% of the middle, but that has nothing to do with physiological functioning. So what you really want is optimal functioning. And that’s debatable. Now, the Endocrine Society is the most renowned organization on the planet, and most trustworthy for setting things. And they say minimum of 30 nanograms per ml. But they say– but evidence suggests that maybe 40 to 60 would be optimal.


Got it.

So again, for a population, for an individual, it might be very different. And as we look at the genomics of vitamin D receptors, and transporters, and metabolizers, it’s going to be– we’re getting at more detail on that. But in general, those are good places to go.

I want to just ask a quick question here about genetics and the role. Do your genetics– I mean, obviously, we know there’s epigenetics and genetics, but do genetics predispose people to inflammation, some people, depending on–

Yes, yes. So when you think about the very important and essential fatty acids– the omega-3s and the omega-6s, there are two genes– FADS1 and FADS2 that play a role in their transformation. And so we have flaxseed, or chia seeds, or hemp seeds, or walnuts with short chain omega-3s. To make them long chain, we have to go through FADS1 and FADS2. The long chains, the one that are biologically most active, and most important, and would represent– if I could add one blood test to every panel in the United States, it would be measuring the omega-3, omega-6 panel.

The omega-6s’ short chains come from healthy sources are like safflower oil, sunflower oil a bit, and avocado oil, olive oil. And those are short, but they have been elongated for a variety of reasons. And these all depend upon genomics. That’s one easy to understand role. There’s a lot of more difficult to understand roles.

And part of the problem is we think in single variables, for example, when the three of us were in school, we were taught there’s one gene for eye color. We now know there’s seven genes for eye color. And if we look at something complex like height, we know now that takes the contribution of our 700 genes to determine 80% of height.


So what we’re really talking about is very complex systems. So focusing on the epigenetics, which is exactly what this is all about.

Right, exactly, the lifestyle factors.

The lifestyle factors are most important because otherwise, at least at this point in world history, trying to figure out the contribution of 700 genes for something it’s just– we don’t even have the supercomputers yet for that.


But it’s old style thinking– one gene, one problem. And that’s where we fell down this huge rabbit hole, which is unfortunate about like MTHFR. So it’s like, no, there are at least 16 genes in that pathway. One may be important, but you can overemphasize that.

You bring up MTHFR, it’s like, oh, we should do a news story about that and do an update on that. It’s been a while.

Well, methylation is a very important thing. Over 60 key genes for mood, memory, energy, sleep, and generalized oomph power are all depend upon methylation. And it’s easily assessed.


$10 blood test.


How about that?


So as we continue to progress and evolve as individuals in this space, I’m just thinking back to your craft. You said now at the tender age of 62 and still continuing to evolve in your craft, what are certain things that you would say, OK, we now have all this information around inflammation? What’s a go to of, hey, this is where I want you all to know right now listening?

I like the part that you said as far as the true primary care, as far as starting with yourself, self-care. And gave a few different resources as far as how to get back on track there. But I want to double down on what I said earlier, for those individuals who are going in and getting their annual and knowing what to ask for. And then also empowering them with the knowledge of, OK, these markers.

And we can obviously link a lot of this information. We want optimal versus to your point, the subjectivity of demographic and what it’s based off of. So I don’t know, I don’t want to go too far down the rabbit hole, but we should be looking for optimal. And then what test should we be asking for when we go to see our health care professional?

Yeah, so the health care professionals sometimes get their hand slapped if they order too much. And so that’s a problem. But if you’re working with a health professional who’s willing to go out or if you– or now, some places offer capacity. You can order your own blood tests and pay out of your own pocket. I think the omega-3, omega-6 profile is really important.

And the reason is because of the anti-inflammatory nature of these things. So let me put a little bit of historical context. So in 1975, Secretary of Agriculture, Earl Butz on behalf of the Nixon administration made a major change in US agricultural policy to promote corn and soybeans as low cost means for supporting a hungry planet.

And so overnight, the Minnesota farms went from being flax to corn and soybean. Now, no one thought of the nutritional impact upon that. So the nutritional impact was, all of a sudden, we’re getting a lot of omega-6 fatty acids and very low omega-3s. And so where we previously had a nice teeter totter balance or ideally we would, the US food supply wont very much high omega-6s very low than omega-3s.

Now no one has really addressed this at a policy level, at a national level. There are a lot of people who are deeply concerned about this. And here’s what people need to know. Essential fatty acids mean we have to eat them. We can’t make them. And if they’re not in our diet, we’re just out of luck.

And if we have a high processed food diet, we’re really out of luck. The processed foods tend to be very high in omega-6s, some of which are good, so like something called DGLA, which can be made from supplementation with evening primrose oil. It can be very helpful with menstrual concerns and very helpful for other anti-inflammatory activities, but I like measuring it.

I don’t like just giving it. And this is where people get in trouble. They say, oh, I hear omega-3s are good. I’m going to take 4 grams a day or 7 grams a day forever and ever and ever. And they come into my clinic. And they have sky high omega-3 levels and profoundly low omega-6 levels. And they’re wondering why they have 36 concerning health symptoms.


And it’s like, yeah, you’re out of balance. But the good things that come from healthy omega-6s and from healthy omega-3s are things which help roll back inflammation. We call them fun words like resolvins, or protectins, or maresins. And those are the true scientific terms.


And that plays a big role. So going back into the primary care office, it’s just like, no one’s looking at this. No one’s asking about nutrition. So if someone comes in, I want to ask about their diet. Oh, you’re gluten free, and vegetarian, or vegan, where are you getting your methionine? Who’s talking about that? No one’s talking about that.

No methionine and then you can’t make a variety of other really important things like creatine, and carnitine, and glutathione, and so much more. Oops. So there’s– so essentially, since these things aren’t being taught in medical school right now, we’re all have to teach ourselves. And this is exactly why you guys are here, to help transform and really empower people to be in position.

So my little contribution today would be say, yeah, actually the omega-3s and the omega-6s are really important. And yes, we should ensure that if we’re not eating sardines, and salmon, and walnuts, and other things, or particularly if we’re vegetarian or vegan, we make sure that we’ve got good levels of these. And they’re measurable. The technology exists. And it’s not that expensive.

What’s important is, can we have a good balance? And do we have enough of these so that we can actually– when inflammation is present, we can roll it back or we can keep it– or can keep– shift ourselves in doing a teeter totter off balance here, saying that if we really have high omega-6s and low long chain omega-3s, every little thing come along, it’s just going to be accentuated, exaggerated, excessive. and. We have limited ability to turn it off.

Yeah, I want all of our listeners, anybody who’s watching this, the next test you ask for is omega-3, omega-6 profile, I love this. The more people who know this, it seems, the better, right?

Yeah, yeah. Well, what happens when the doctor says, I’ve never heard of this. I don’t know, but thankfully that isn’t going to be the case, but oh, we have a prescription for that.

But we can ask– we can ask more questions. We’re our own best advocates, right? We can ask them to be informed, that we want to empower people with this information, which is what we do in all the content we’re aiming to create.

Yeah, see other thing, it’s very interesting. I need to add this. It’s very important for every reader, every listener to really know about. And that is dental health. 37 years ago when I started medical school, it was like “back then.” The idea of medical health and dental health were two completely separate worlds. Now we know, oh, my goodness, they are just– they’re one and the same. And so paying attention, close attention to dental health is foundational to anti-inflammatory actions.

We can have a lot of things stuck in things. So let me share a true story, which is exceptional in terms of how powerful this can be. And that is, I was seeing a young person, anyone younger than me is young, but they were in their 50s. And they had pretty severe dementia. On a dementia test that you the three of us would score 30 on, they scored an 18 on. I mean, they’re pretty close to being in a care unit.

And they come to me, I do– they’re young. And it’s just like, this doesn’t make any sense. We do the complete workup and don’t really find anything, but they have a history of four very old root canals. And I said, well, this can be a driver of things and a variety of things.

So we do a CT cone beam scan to look for what’s called a periapical abscess. That is, a root canal can be actually a little vacuum that nature doesn’t like. And bacteria can actually grow and fester in there, and send off a variety of toxins, and create problems. And came back as he had four periapical abscesses, one for each root canal.

Now, the family is trying to decide, oh, my goodness. This is expensive to take care of, but at the same time they realize, a month in memory care is really expensive itself. So they said, OK, we’ll go ahead and get these taken care of not knowing what it would do. I saw him again somewhere like four to six months later. And he’s doing a lot better.

So we repeat the score. And depending on how you score the test, he came back at a 23 or 24. This is unheard of. This is unbelievable. No one gets better on these tests. And that, a little bit here and there, perhaps or we slow the progression of the test. This is a major reversal. This is someone who can go to dinner parties now.

This is not someone who’s going into memory care. And it was simply taking care of that. That’s an extreme example, but these micro-inflammatory things in the teeth need to be taken care of. We really do need to floss. We do need to do these things. They really are important. Our dentists can be our best friend for an anti-inflammatory self-care.

I love that. We have a couple of articles actually about this exactly, what your mouth is trying to tell you. And a lot of the things that we covered were about inflammation. And then other more natural, some dental care pieces as well, because why? The mouth is a symbol, it can be a symbol of the health of your body or can influence it.

Yes so it’s a window to things.


So the connection between dental health and cardiac health, a driver of cardiac inflammation, which drives atherosclerosis, which drives heart attacks and strokes, driver of neuro-inflammation very positive connections with other things, who knows what else is going to be discovered, but it’s very clear. We need to take good care of our teeth.

Well, we covered a lot of inflammation. Get it? Let me stop. Inflammation. We covered a lot with that just now. And before we go into our mic drop moment, is there anything else that you want to leave our listeners with before we go into the mic drop?

Maybe something will come up, maybe a mic drop will actually prompt something.

Prompt something? OK.

We might come back to that, yes.

Alright, so here we go. Mic drop moment, one question, one answer. 20 years ago, everything that you know currently right now, you go back 20 years ago. I even say 22 so we can get to the top of 2000. The information that you know now, if you can take it and apply it from 2000, what would you have implemented that you now see as an area of opportunity that could probably send us into promised lands in this space?

That would be the autonomic nervous system. OK, so the autonomic nervous system is everything that our body does that we don’t think about– pupil size, goosebumps, blushing, heart rate, blood pressure, intestinal motility, and so much more. It’s all the autonomic or some people call it the automatic nervous system.

What I’ve learned in the past three months has blown me away. I truly have had more tears of joy in my office in the last three months than I have in 35 years– in a three-month period in 35 years of seeing patients. And it’s all due to paying attention to the autonomic nervous system.

And what’s important about this, for listeners, is our care and attention to one half of the autonomic nervous system, which we call the parasympathetic nervous system, this is the vagus nerve. And the vagus nerve is what attaches our brain to our eyes, and sinuses, and throat, and esophagus, and lungs, and heart, and stomach, and gallbladder, and pancreas, and spleen, and intestines, and ovaries, and testes and more.

And it’s operating behind the scenes. It’s the optimal, it’s the ultimate and non-artificial intelligence. It’s like it’s got its own algorithms. It’s running things. Attentive to this has completely blown me away in terms of, what it means for all kinds of symptoms that people experience.

And how it’s related to inflammation is that when we pay attention to the vagus nerve in our body, and activate the vagus nerve, and their exercises, breathing exercises, and gargling, and chanting, and Tai Chi, and Qigong, and so many things like that.

When we pay attention to our vagus nerve and make sure that it is in a nice teeter totter balance with the other half of the sympathetic nervous system, which we consider the get up and go, the fight or flight, the adrenaline system, then we activate something called the cholinergic anti-inflammatory pathway.

Now, the cholinergic anti-inflammatory pathway was only described about 20 years ago. So it’s new. And most people have never heard of it, but all the vagus nerve activities that you guys have described in the podcasts, and in the magazine, and elsewhere, all these activities support the anti-inflammatory actions in our body.

So if we are– actually, if we’re constantly in a fight or flight state, as opposed to a rest and digest state, then we tend to be more pro-inflammatory just from that. And that is we don’t not– we’re giving time for the other half of the teeter totter to activate this whole other pathway. And this all other pathways can turn out to be really profound.

The receptor for this pathway is where viruses can enter our body, including the– oh, also favorite, COVID virus, for example, oh, wait a second, what’s going on here? So this is– so there’s a lot to that. So my self 20 years ago, I would say, pay attention to this autonomic nervous system. It’s going to change the world. And again, it supports everything that you guys feel so passionate about, about self-care. This is in our power.

And now, we have the– thanks to NASA, thanks to the astronaut program, who knew when astronauts go into space for two days or more, they come back to earth and their autonomic nervous system can be in complete disarray? So NASA’s taken a lot of interest in this.

So there are now ways of assessing this, now are ways of addressing this. It’s been phenomenal. And I see this as being a huge new frontier in medicine. So myself 20 years from now, I hope I’m still practicing. I figured I’d work till I’m 81. So we’ll talk about retirement then.

You got some time.

Well, I figured by then I’ll finally understand medicine.


Yes, but this has been a whole, whole new area. And so I think that you’ll be hearing more about it, seeing more about it, more insights, and more things about what we can do for ourselves, that true primary care that is so important. And oh, it’s anti-inflammatory and pro-health.

I love that.

It’s so great, so great. Well Dr. Plotnikoff, thank you so much for taking the time to come and spend time with us in the studio TODAY. I cannot wait for this to drop for our listeners and viewers. And oh, we’ll share the feedback with you.

OK, alright.

They’re going to be excited. So to learn more about you, they can find your work at Minnesota Personalized Medicine, your website for that. We’ll link to that, They can search you out on LinkedIn as well. Anywhere else they can find you? Those are the two primary.

I suppose if you google me, you’ll find something. I haven’t done that for a while, but who knows what you’re going to find?

Who knows what you’re going to find? We’ll make sure to include those links in our show notes so people can connect with you if they need to. So thank you again.

Oh, well, thank you. Thank you both. This has been great fun. And I really appreciate this opportunity.

We appreciate you.


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