Optimizing the inflammatory response with nutrients and herbs

As a DC, you are an expert in addressing patients’ inflammation. But inflammation can be a double-edged sword.

While occasional inflammation is a necessary biological process that facilitates healing and protects the body from infections and injuries, chronic inflammation is a root cause of many musculoskeletal disorders, joint degeneration and systemic diseases that you commonly encounter. Addressing inflammation at its source through targeted nutritional and herbal interventions can enhance chiropractic care, support patient recovery, reduce pain, and improve long-term musculoskeletal health.

When patients hear the term “an anti-inflammatory,” they usually think about NSAIDs or over-the-counter medications. However, we have the opportunity to shift that paradigm and promote the powerful, anti-inflammatory constituents in whole foods and herbs.

Exploring the power of natural alternatives

Bioactive compounds found in foods and herbs can have similar chemical benefits to drugs, yet they generally lack the potential to cause the types of negative side-effects found in pharmaceutical medications. Many patients can benefit from the anti-inflammatory properties in foods and herbs; however, they need guidance and education on where to find them and how to harness their power.

The following are key anti-inflammatory nutrients and herbs that can attenuate inflammation and support overall well-being:

Turmeric. From the root of the Curcuma longa plant, turmeric is a potent anti-inflammatory herb widely used in both traditional and modern medicine. Curcuminoids are the primary bioactive compounds in turmeric, with curcumin being the most well studied. Curcumin

modulates inflammatory pathways by inhibiting NF-κB, COX-2 and other pro-inflammatory mediators. This makes turmeric valuable for managing systemic inflammation linked to conditions like arthritis, metabolic syndrome, and cardiovascular disease.¹

One of the drawbacks of turmeric root, in its purest form, is its reduced bioavailability of curcuminoids. Upon digestion, the active curcuminoids can be broken down during liver metabolism, losing some of its concentration and potent properties.

New technologies, such as FenuMAT™, have created an innovative way to preserve more of the bioactive compounds and enhance their bioavailability. FenuMAT™ technology uses fenugreek seeds to create a gel-like matrix that encapsulates curcuminoids and shields them from breakdown as they go through liver metabolism. With this enhanced technology, FenuMAT™ allows a greater concentration of curcuminoids to be absorbed, promoting a superior therapeutic outcome. This innovative delivery method of curcumin has been found to yield a 45x better bioavailability than unprocessed curcuminoids.

Boswellia. Another powerful herb, also known as Indian frankincense, Boswellia has been used for thousands of years in traditional Ayurvedic practices. The triterpenes in boswellic acids inhibit the enzyme lipoxygenase (5-LOX), preventing the production of leukotrienes. Boswellia has a longstanding history of use for chronic inflammatory conditions and has been found to reduce knee pain and stiffness while improving high-sensitivity CRP levels in subjects with osteoarthritis.²

Vitamin D is a key immunomodulator and powerful antioxidant. Research has shown the association between vitamin D deficiency and elevated CRP levels.³ Vitamin D supports a healthy immune response and enhances the body’s ability to return to homeostasis following the resolution of systemic inflammation. While the body can produce vitamin D endogenously when the skin is exposed to sunlight, most people do not get adequate sun exposure, inhibiting their ability to create optimal vitamin D levels. Measuring serum 25-hydroxy, vitamin D is a helpful adjunct to understanding the patient’s baseline levels, and this can be supported with food or supplementation if indicated. This can play a significant role in the immune response and modulate inflammation.

Omega-3 polyunsaturated fatty acids. When addressing inflammation, Omega-3s are an essential dietary component to consider. Pro-resolving mediators known as resolvins and protectins are synthesized from EPA and DHA and support the resolution of systemic inflammation.⁴ Omega-3s have been found to improve inflammation in the musculoskeletal system and have cognitive effects, such as enhancing mood and mitigating neuroinflammation.

While the main source of omega-3 fatty acids is fatty fish, including salmon, sardines, mackerel and tuna, most Americans do not consume fish twice a week. Supplementation can be helpful in these cases to bridge the nutrient gap and improve the omega-6 to omega-3 ratio to support healthy inflammatory processes.

The gut as a hidden source of inflammation

The complex environment of the gut microbiome plays a significant role in systemic inflammation. When the gut barrier is compromised due to hyperpermeability, pathogens and toxins are able to leak into the bloodstream. Once these harmful particles are in the blood, the immune response is alerted and initiates an inflammatory cascade. Gastrointestinal inflammation can also play a role in neuroinflammation, increasing the risk of mood issues and neurodegenerative conditions.⁵

Prebiotics and probiotics work synergistically to maintain gut barrier integrity and support the health of a diverse microbiome. Research indicates that prebiotic 2′-fucosyllactose (2’-FL) has the ability to reduce intestinal inflammation and enhance gut barrier integrity.⁶ A human milk oligosaccharide (HMO), 2′-FL provides anti-inflammatory benefits to the gut microbiome and reduces pathogenic cell adhesion, preventing the colonization of harmful microbes.

Like the action of other prebiotics, such as inulin, 2’-FL selectively feeds beneficial probiotic bacteria, supporting commensal balance and enhancing the production of anti-inflammatory cytokines.

Anti-inflammatory properties of probiotic strains

Probiotics modulate inflammation in the gut microbiome, supporting the immune system and various metabolic processes.⁷ Specific strains of microbes can alter the production of cytokines and influence inflammatory signaling pathways.

Saccharomyces boulardii is a probiotic yeast that reduces the expression of pro-inflammatory cytokines, including IL-6 and TNF-a. S. boulardii supports the integrity of the gut barrier and healthy microbial composition.⁸

Research shows beneficial anti-inflammatory effects of the combination of probiotic strains including Lactobacillus acidophilus and Bifidobacterium animals subsp. lactis. These strains have been found to attenuate inflammation by modulating NF-kB and MAPK signaling pathways in intestinal epithelial cells.⁹

Lactobacillus paracasei has been found to stimulate the production of anti-inflammatory cytokines, including IL-10 and reduce pro-inflammatory IL-1β.¹⁰

While probiotics can be found naturally in fermented foods, supplements that contain specific strains at efficacious doses can offer a therapeutic and targeted approach.

Integrating nutrients and herbs into chiropractic care

If you’re looking to enhance patient outcomes, integrating targeted nutrition and herbal interventions can complement manual adjustments, soft tissue modalities and rehabilitation therapies.

Educate patients on the role of diet in systemic inflammation, encouraging anti-inflammatory whole foods while minimizing processed and pro-inflammatory foods.
Consider supplementation when dietary intake is insufficient.
Monitor patient progress, adjusting protocols based on symptom improvement and lab markers where applicable.

Final thoughts on systemic inflammation

Nutrition and herbal medicine serve as powerful tools in a holistic, patient-centered approach to modulating inflammation and supporting musculoskeletal health. By addressing systemic inflammation at its root, you can optimize your patients’ healing processes, reduce reliance on pharmaceutical interventions, and enhance the effectiveness of chiropractic treatments.

About Standard Process

There are many supplement companies, but only one Standard Process — a pioneer in whole food nutrition since 1929. Though much has changed in that time, our dedication to Farm, Family, and Innovation remains as strong as ever. The vast majority of the raw plant ingredients we use in our products are grown on our 850+ acre certified organic farm in rural Wisconsin — located just a mile from our headquarters — which helps us ensure quality From Seed to Supplement®. While others in our industry have become multinational entities funded by private equity, we remain family owned as we enter our fourth generation of leadership. We continue to lead the way with groundbreaking techniques that include world-class manufacturing and our Nutrition Innovation Center: a first-of-its-kind research facility in Kannapolis, North Carolina. Only at Standard Process can you find a practitioner-focused partner with more than 300 products that are designed to change lives for people and pets. To find out how Standard Process can support your practice, visit standardprocess.com/OnlyAtSP.

References

Nurcahyanti ADR, et al. Curcuminoids for metabolic syndrome: Meta-analysis evidences toward personalized prevention and treatment management. Front Nutr. 2022;9:891339. PubMed. https://pubmed.ncbi.nlm.nih.gov/35757255/. Accessed March 27, 2025.
Majeed M, et al. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019;33(5):1457-1468. https://pubmed.ncbi.nlm.nih.gov/30838706/. Accessed March 27, 2025.
Zhou A, Hyppönen E. Vitamin D deficiency and C-reactive protein: A bidirectional Mendelian randomization study. International Journal of Epidemiology. 2023;52(1):260-271. https://academic.oup.com/ije/article/52/1/260/6586699. Accessed March 27, 2025.
Duvall MG, Levy BD. DHA- and EPA-derived resolvins, protectins, and maresins in airway inflammation. Eur J Pharmacol. 2016;785:144-155. PubMed. https://pubmed.ncbi.nlm.nih.gov/26546247/. Accessed March 27, 2025.
Kim JS, et al. Inflammatory bowel disease and neurodegenerative Diseases. Gut Liver. 202315;17(4):495-504. PubMed. https://pubmed.ncbi.nlm.nih.gov/36843420/. Accessed March 27, 2025.
Cristofori F, et al. Anti-Inflammatory and immunomodulatory effects of probiotics in gut inflammation: A door to the body. Front Immunol. 202126;12:578386. PubMed. https://pubmed.ncbi.nlm.nih.gov/33717063/. Accessed March 27, 2025.
Wang Y, et al. The protective effects of 2′-fucosyllactose against ColiO157 infection are mediated by the regulation of gut microbiota and the inhibition of pathogen adhesion. Nutrients. 2020;12(5):1284. PubMed. https://pubmed.ncbi.nlm.nih.gov/32369957/. Accessed March 27, 2025.
Kelesidis T, Pothoulakis C. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therap Adv Gastroenterol. 2012;5(2):111-125. https://pubmed.ncbi.nlm.nih.gov/22423260/. Accessed March 27, 2025.
Li SC, et al. Combination of lactobacillus acidophilusand bifidobacterium animalis lactis shows a stronger anti-inflammatory effect than individual strains in ht-29 cells. Nutrients. 2019;11(5):969. https://pubmed.ncbi.nlm.nih.gov/31035617/. Accessed March 27, 2025.
Yamazaki T, et al. Lactobacillus paracaseiKW3110 prevents inflammatory-stress-induced mitochondrial dysfunction in mouse macrophages. International journal of molecular sciences. 2022; 23(3):1443. https://pubmed.ncbi.nlm.nih.gov/35163375/. Accessed March 27, 2025.