← Dr. Osborne’s Zone
Dr. Osborne’s Zone
The Secret to Reducing Chronic Inflammation! SPM Crash Course
00:52:36
Here’s my go to source for SPM's: https://www.glutenfreesociety.org/shop/health-focus/joint-muscle/ultra-spm/ Is chronic inflammation keeping you in pain? Discover the power of **Specialized Pro-Resolving Mediators (SPMs)**—fat-derived molecules from...
Loading summary
Transcript1 lines
- [00:07]
A
Is this new scientific discovery the key to resolving chronic inflammation? Today on Dr. Osborne's zone, we're going to do a deep dive on something called spms. We'll be right back. You unlock this door with the key of compassion. Beyond it is another world. A world of science, a world of common sense, a world of, of sanity. You're moving into a land of both empathy and ethics, of nutritional knowledge and empowerment. You've just crossed over to Dr. Osborne's zone. SPMS, otherwise known as specialized pro resolving mediators. Now that's a mouthful. Let's talk about what SPMS actually are. Specialized proresolving mediators are a group of lipid molecules. In essence, they're fat derived from the essential omega 3 fatty acids EPA and DHA. So you haven't taken my crash course on omegas. I encourage you to go back and do that after the show. Omega 3s produce chemicals called EPA and DHA and SPMs, basically byproducts of these two molecules. Now here's the technical component of how they work. They switch macrophages from a pro inflammatory state to a pro resolving state, facilitating the clearance of dead cells and debris at inflammation sites, thereby promoting tissue healing and a return to homeostasis. Now what does that mean in English? They basically help change your white blood cells from the type that secrete chemicals that do damage to the type that come in and clear out the damage so that your body can heal and repair the damaged site. So for those with chronic inflammation, SPMs act as a break signal to stop excessive immune responses. They're currently being investigated as potential therapeutic for a variety of inflammatory diseases due to their ability to limit inflammation and promote repair. So in essence, they're fats derived from omega 3. So kind of classify them in your mind as a type of nutrient because you have to eat omega 3s. Omega 3s are essential fats that you cannot obtain anywhere else except through food or supplementation. So what does spm? What do they do? What are their functions? Number one is they resolve inflammation. We'll get into this in a minute. They help tissue regeneration and repair by clearing debris. Again, they move out. If you can imagine a construction site, imagine bulldozing down an old house. That's inflammation. Now imagine you're trying to build a new house, but you need to remove all that damaged debris and material you just tore down. That's tissue repair and regeneration. And, and that's what SPMs help to do. Now they also help regulate the immune system especially they draw in certain types of white blood Cells at certain components or times during inflammation, and they also have anti pain or analgesic effects. Now, I think before we dive too much deeper, we should talk a little bit about inflammation as it relates to these molecules. So when we're talking about inflammation, generally speaking, in the initiation phase, there's some type of assault or some type of an injury. In essence, this could be a physical damage. This could be a pathological damage caused by a microbe like a bacteria or a virus or a parasite or a fungi. This could also be diet or lifestyle induced inflammation, like behaviors such as smoking or, or alcohol consumption or the consumption of junk food. So any of these things that will initiate inflammation, you go through an initial phase, this phase you can see delineated by green. If it's normal, we have the inflammation. And then through a period of time, and this varies depending on the extent of the injury, the acute inflammation resolves, the tissue returns back to normal. So imagine you got a cut, the cut clots and then it scabs over and then the scab falls off and you're forming new skin and everything is better. That's the way we want to think about inflammation. But what happens to many is they have an assault and instead of having this nice acute response where they resolve the issue, they have a different kind of curve where the assault doesn't stop. And so you can see how it kind of curves here in this red line. Think about each one of these as another assault. In essence, you know, if you get a cut, hopefully you're not just stabbing yourself with a knife. You got it was an accident. But when it comes to chronic inflammation, what happens is people have behaviors that contribute to tissue damage repetitively over and over and over again. And so instead of the inflammation resolving the way that it should, and the body healing the way that it should, the inflammation remains on. And so your immune cells keep coming into the area where the damage is occurring and they're releasing chemicals that cause damage because that's their job. So if we look at kind of a more complex map inflammation, you can see here the initial injury right here in this site, and we'll blow this up for you. And so what happens, this initial injury is you get all these different types of cells from your immune system and nervous system penetrating into the area. And their job is to basically it's to release chemicals that clear out the damaged tissue and then you have a second phase of that. So once you have all these different cells come in here and release all of their chemicals and basically dissolve the damaged area, then you have specialized types of cells that come in, like little pac men that scavenge the area and chew up all of the debris and this process. So we're not going to get too technical in here, but this process is stimulated, you can see here, by spm. And so that's what this term phagocytosis means, is your SPMs are basically stimulating a specialized type of white blood cell that comes in there after all the damage has been done to chew up that damage and remove that damage. And that's important because in order for the body to finalize healing and repair, you've got to remove the damaged tissue and the debris. And so once that's done, you can see with spms, you get tissue regeneration. If the damage is bad enough, you get a scar. Like, if you cut your skin bad enough, it scar, or if the. Or if the damage is prolonged enough, you can get scar tissue. But as a general rule of thumb, we get resolution of the inflammation. So if you look at the initial injury is step one, then you have, generally you have pain that occurs as a result of that, but through this process of white blood cells, different types of white blood cells coming in. That's called the transition phase, where again, you're breaking down all the damaged material and you're pac manning that stuff out of there so that you can start healing. So we got initiation, transition, and then we have resolution. And then after resolution, everything goes back to normal. That's the way inflammation is supposed to work. But if the injury is repetitive, if the thing that's causing the injury continues to be present. I know a lot of you may be thinking about, like, a physical injury, but I'm talking about the chronic injury of consumption of something like gluten, right? So gluten causes inflammatory injury, other food allergies can. Environmental toxins can cause biochemical cuts, so to speak, and create inflammatory injuries. We know really there are four, really three primary triggers that can create biochemical injury that are not physical. So we could use the physical injury as an example. But we also have food, especially processed food. We have microbes, microorganisms, and we have environmental toxins, heavy metals, potentially mold toxins, other pollutants, things like alcohol, cigarette smoke. These are all things that can do that injury. So if these things aren't going away, then this injury never leads to a final resolution. In homeostasis, you just stay in this zone. So, like, you're stunted and you stop right here. And so all these different types of cells are just releasing their toxic chemicals Causing inflammatory responses that lead to pain and dysfunction. And it's SPM you can see right here, spm, specialized pro resolving mediators that allow for this chaos of inflammation to move forward in this process to resolution and then subsequently to full healing. So it's important to know that inflammation is not bad, it's not evil, it's normal part of human physiology. What becomes bad and evil is if it becomes chronic because the assault doesn't go away. And again, microbes, toxins, foods are all potential reasons why people can develop chronic inflammation. Certainly there are other lifestyle factors that play a role in it. Lack of sleep, lack of sunshine, sedentary behavior, all these things can contribute to inflammation. Even emotional traumas can drive inflammation as a process. So if we look at this diagram, you can see here the actions of SPMs or Specialized Pro resolving mediators. So if there's acute inflammation, not a big deal. This is like your acute trauma, your acute injury SPMs, if present, if you have plenty of SPMs, will lead to a resolution and to a homeostasis, which is a final healing and return to function. Now, if you have chronic inflammation here, this will lead to fibrotic tissue formation, scar formation, and persistent inflammatory problems like chronic pain, tissue and organ injury. Now, even if you have SPMS and you remember your body makes SPM from omega 3. So the byproduct of omega 3 are several different types, simplifying it here, but several different types of SPMs. And the job of SPMS is to resolve inflammation and damage. So if you're devoid of Omega 3, if you're not eating enough of these in your diet, then obviously you're not going to have enough of this. But if you're chronically inflamed, you're also keep in mind you're going to burn through these. Your body is trying to resolve inflammation. That's part of what it does. Innately, intelligently, it's trying to resolve that. But if the chronic injuries don't stop, you burn through your spm, you burn through your ingredients, and you can become deficient. As a matter of fact, some studies show that women make more SPM than men. And this is possibly one of the reasons why they tolerate pain a little bit better than most men do. But nonetheless, chronic inflammation, you see, can lead to tissue damage, can lead to chronic pain. But if you have adequate spm, your body can stimulate the resolution of that problem. Now, some of the diseases that we know can be caused by chronic inflammation and lack of SPM are listed on this diagram. So these you can see down here. These studies taken. This diagram is based on animal studies predominantly. So in vivo animal diseases. SPMs not only control classic and non resolving inflammation conditions, but also reduce collateral damage such as tissue and organ injuries, chronic pain and tissue fibrosis. They are normally active in picogram to low nanogram quantities that is 100 to 1000 times more potent than widely used classic NSAIDs. NSAIDs are non steroidal anti inflammatory drugs. This is what doctors commonly prescribe like ibuprofen, which ibuprofen is over the counter, but Celebrex is another example. Naproxen. These are examples of NSAIDs commonly used to what to block the inflammation. So what an NSAID is doing is blocking the inflammation. It's not helping the body resolve to go on to healing, it's just blocking the inflammation, which is going to lead to a reduction in pain, but not a resolution of the problem. And that's why people with chronic inflammatory conditions like arthritis and cancer and diabetes, etcetera, can't just take ibuprofen or Celebrex and the problem goes away because generally the assault on the body, it continues. And all the NSAIDs doing is blocking the body's perception of inflammation and pain, but not actually resolving it. So at any rate you can see a number of different diseases. So myocardial damage, so damage to your heart, to your kidney, to your cornea, that's the eyes and the retina, the spinal cord, the lung and the liver, neuropathic pain, fibromyalgia, cancer and arthritic pain. And then down here you can see as well colitis or inflammatory bowel disease, arthritis, gum disease, that's periodontitis, neurological disease, autoimmune conditions, cancer, cardiovascular disease, obesity, lung, kidney and liver damage and scarring can all occur as a result of not resolving the inflammatory cascade appropriately. So chronic inflammatory response that doesn't resolve can damage your tissues. This has been shown in multiple animal studies. So we've got quite a bit of data in animal studies on the inflammatory damage that not having SPM or chronic inflammation will contribute to. Now if we look at this diagram, you can see some of the effects of SPMS in general. And I'll walk through some of these. They inhibit some of this is a little, probably Greek if you haven't had physiology or pathophysiology as a background in your education. But they inhibit a type of cell called a neutrophil. And what a neutrophil is, is it's a cell, a white blood cell that contains all These little granules in it, these little granules are proteins that are spit out of the cell. Spit out of the cell. And what they do is they degrade the tissue around it. So they're basically breaking down that damaged tissue. So neutrophils come into that area, they spew out their contents to basically dissolve the the damaged tissue to help try to start removing it out of the way. SPMs inhibit this. Once it's happened enough, you don't want this process to continue indefinitely, because if it does, then tissue damage continues indefinitely. So SPMs lead to a resolution of this stage in inflammation. They also promote monocyte migration. Monocytes are these little Pacman I was telling you about that this enhances this phagocytosis is basically these monocytes chew up all the damage that these neutrophils created. So if this is step one, think of this as step two. First you come in, spew out all the chemicals that basically break down the damaged tissue. Then the monocytes come in, and then they chew that stuff up and move it out of the way. The other things SPMs do is they inhibit interleukins. Interleukins are inflammatory chemicals that can continue exciting the inflammatory process. So SPMs inhibit these guys. Again, what's the goal of an SPM? It's to resolve the inflammation. They also increase something called NK cell mediated eosinophil apoptosis, meaning these are specialized types of cells, white blood cells called natural killer cells. Natural killer cells help to induce the death of eosinophils. And if you know what an eosinophil is, it's a type of cell, a white blood cell, that releases histamine. And histamine is a very inflammatory excitatory chemical. So it's very similar to the stuff that neutrophils release. And so again, SPMs help stop that from continuing to happen. Then on the other side, so these are all parts of things that they work as far as directly with some of your white blood cells. But then on this other side over here, you can see it promotes memory B cells. Now, memory B cells are responsible for making antibodies. So if you've ever heard of antibodies, if you've ever heard at your doctor talking about whether or not you had an antibody to a certain disease. Antibodies are good. We want antibodies. Antibodies are protective. So if this was, you know, if this inflammation was caused, for example, by a viral infection, we would want the promotion of antibodies, we would want this to occur because this would give us future protection from that virus. So SPMs help to kind of schedule the immune system to make antibodies to protect itself in the future. They also inhibit this chemical called TNF Alpha, which is a very inflammatory byproduct from white blood cells. TNF alpha, tumor necrosis factor alpha. They also inhibit other kinds of interleukins from dendritic cells that are going to cause more inflammation and the persistence of a type of white blood cell tracking into the area that can stimulate autoimmune disease. So if these things are not done, let's say these things are being blocked, what ultimately ends up happening is you get the development of autoimmune type problems because by blocking these different types of chemicals, especially TH17, by blocking them, you resolve the inflammation. By not blocking them, they contribute to persistent inflammation that can lead to a hyper responsive or an overreactive immune system, which is generally what we call autoimmune disease. So these are just again chemical functions of SPMs. Now let's make it make better sense, let's make it easier, a little less chemistry. This is from Harvard. Anti inflammatory molecules and a sampling of their demonstrated benefits. So earlier I was saying that we get SPMs which are here, the primaries are here. These are SPMs, protectants, resolvins, mrisons. These are all kinds of SPMs. So think of these as types of SPMs. They're derived from these two omega 3 fatty acids. So if you're eating enough omega 3, in the case of omega 3, it's cold water fish, ideally sardine, mackerel, anchovy, salmon, you can see here some omega 3 and algae as well as in cod liver oil. For those of you that may be supplementing with cod liver oil or omega 3 supplements, this is one of my top supplements in my top five list that I think people should take. I mean unless you just love cold water fish, but even if you do, the toxicity, the metal toxicity risks of eating large quantities of fish can become problematic. But supplementation or food gives you a good source of EPA and dha. And actually grass fed beef would be on this side too, because grass fed beef does contain Omega 3, so really should be on this side of the equation. And then from these Omega 3, EPA and DHA we make these different SPMs and then look at the disease associations. Now these diseases listed here, some of them have been studied in humans, but most of them to date have been studied in animals. This is an area of ongoing research. Researchers are to better elucidate the therapeutic benefit of giving SPMs to patients to help resolve these chronic Inflammatory conditions, but a lot of different diseases here, as I showed you on the last page, from atherosclerosis all the way down to retinopathy, Alzheimer's, asthma, stroke, neurodegeneration, arthritis, etc. I won't read it to you, but all conditions that we need SPMS to help to resolve. And then we have another type of, this is also a type of SPM over here, but this one is derived from arachidonic acid, which you can get plenty of that from beef, chicken, fish and eggs. So animal foods. And then you can make these chemicals called lipoxins that have more of an anti inflammatory effect against asthma, inflammation of the colon, corneal disease, cystic fibrosis, eczema, neuroinflammation and periodontitis. So SPM is very important in their role biochemically in the human body to help resolve inflammation. So if you look here, this was published in Journal of Functional Foods, you see where they're researching potential disease resolutions by administering these types of SPMs. And so this is kind of a synopsis of some of the research. You can see the lipoxin has been studied in animals to reduce colorectal cancer, diabetic problems, kidney disease, hepatocarcinoma, which is liver cancer, arthritis and papillomas. Then we have also in animal studies, Parkinson's, atherosclerosis, ischemia of the heart, arthritis, diabetic wounds, cancer, and then myresin. This other SPM over here, Alzheimer's disease, obesity, atherosclerosis progression and rheumatoid arthritis. And then protectin on the end over here in animal studies has been shown to be beneficial in diabetes. Now from a human perspective, we know pancreatic cancer. Now this is not me telling you if you have pancreatic cancer that you need to go take spms. It's a conversation you need to have with your doctor. But we do have human cell studies showing that lipoxin can reduce the aggressive nature of pancreatic cancer and its ability to metastasize. We also know arthritis, osteoarthritis and Alzheimer's disease in human, in human cell lines and in humans. There's studies now, there's now been clinical trials in humans on arthritis where resolvins are very, very effective and helpful at reducing pain, improving quality of life. And I'll show you some of that here in just a moment. So let's talk about who might benefit. So you, maybe you're thinking about taking SPM directly. Anybody with a chronic inflammatory condition, whether it's an autoimmune condition or it's a non autoimmune but chronic inflammatory problem like heart disease or asthma or copd. Older adults, where aging is frequently associated with something called inflammaging. Right. The inflammation associated with aging, although I argue it's not really an age related condition as much as it is a damage accumulation over time related issue. And in athletes or the aggressively physically active, there's actually been some trials, some clinical single arm trials where they've looked at recovery in athletes and having improvement in recovery and physical performance. And then there's metabolic dysfunction. Emerging research links chronic low grade inflammation to obesity and insulin resistance. So SPMS could be beneficial in those situations. And then wounds that won't heal and that, you know, that could be a nagging injury that you have. You know, I've used SPMS a number of times for injuries that just wouldn't fully recover. It could be a post surgical injury. So if you've had surgery and you're not healing well or you've had surgical complications, you might consider talking with your doctor about SPM usage. And then as well, one of the other kind of common would be like a diabetic foot lesion. These things are tough to heal, tough to resolve in part because of the lack of blood flow, but to the extremity. But another area where theoretically people could be very benefited by using SPMs. Let's talk about some of the things they're finding with SPMS and infectious disease. So very interesting study that came out recently where they were using an animal model of infectious disease. So in this case they were using E. Coli as a bacteria. And so their conclusion of this study was infections encountered during ongoing inflammation in mice reset the resolution mechanisms of inflammation via SPM clusters. Low dose SPMs activate innate immune responses and pathways toward the resolution response that can be reprogrammed. What does that mean? Sometimes when people have a chronic infection, we generally can classify infection into two categories. You've got chronic and then you've got acute. And the acute is, you know, generally this is immediately life threatening. And you know, generally there's a lot of times there's a fever and there's some type of known exposure, like known immediate exposure. And so this is oftentimes one of those situations where if it's bad enough, you're treated in a hospital environment, not always, but sometimes where you go to an ER and then you get a prescription for something like steroids and antibiotics, if it's a bacterial infection, and that is to resolve the infection, right? And so that's acute. It's generally going to run a course between seven and 14 days, typically not longer. But then you have this chronic piece over here. An example of chronic would be something like Lyme, like an internal Lyme infection. Other examples of chronic, and really probably it's not. Infection is probably not the best word. Really probably the better word would be imbalance. Chronic microbial, the term is dysbiosis or imbalance. And so this could be, you know, it's very common to see gram negative bacteria in people's GI tracts, colonizing their GI tracts, creating all kinds of inflammatory problems. There's a number of bacterial overgrowths or imbalances in the GI tract linked to gastrointestinal inflammation. For example, H. Pylori, Helicobacter pylori is a bacteria that can cause stomach damage. And then you have other bacteria like Klebsiella and Pseudomonas and Enterobacter and Citrobacter. These are all gram negatives that can colonize the GI tract and contribute to gastrointestinal inflammation. And then you have things like, even E. Coli doesn't have to always be acute, it can sometimes be chronic. But C. Diff is another example of that where you have C. Diff, many of you probably heard of that in its relationship to inflammatory bowel disease or ulcerative colitis. And so these are bacterial more in terms of chronic, where they're not acute, they don't just come on all of a sudden and self resolve within 14 days because your immune system wins or because the doctor treated you. These are chronic infections that can embed inside the GI tract, create biofilms and be very, very hard to get rid of. And so when they create chronic inflammation and there's no resolution, the tissue just continues to be damaged repetitively over and over and over again. And then what ends up happening, typically if it's in the gut, is you get a leaky gut, which then allows for the chemicals that these microbes produce. One of the more common ones is called an lps, a lipopolysaccharide or an endotoxin that gets released into the bloodstream and it can travel systemically, causing inflammation throughout the whole body. And this is why these things are linked to the development of autoimmunity and autoimmune problems. And so one of the things we know about resolvins, about SPMs is they can help reset the immune system response, especially as it relates to after an acute infection. Because sometimes what happens if You've heard of long Covid, Many of you have. Covid is an acute viral infection. Long Covid is a chronic imbalance in the immune system that occurs after the fact, after your body's, you know, supposedly, you know, gotten the virus under control. But what can happen is you can, you can develop a, what's called a long Covid, a prolonged inflammation response even after the infection is gone. That just doesn't stop. And there are several mechanisms behind that. One of those mechanisms is something we were talking about this earlier, where neutrophils just keep coming into the area and creating or spewing out their compounds that break down tissue. And so that what's oftentimes called netosis and thrombo inflammation, which is just a persistence in inflammation. And so what SPMs do for people, and they're studying this now with long Covid, is they block this from happening. They stop that persistence of neutrophil, neutrophil induced damage. They also promote SPMs, as we mentioned earlier. They promote these pac man like cells. That's what this, remember phagocytosis to come in there and basically clean out that debris and begin the process of helping to, helping to resolve the inflammatory issue. And then they stimulate certain chemicals here that are anti inflammatory and help to resolve the issue. So SPM's very, very important. And I would suggest that if you have been diagnosed with long Covid or if you've been diagnosed with any kind of chronic infectious disease and you're really, really struggling, you should talk with your doctor about the potential for SPMS as part of your therapy. And coming back over to this. So specialized pro resolving mediators hold strong therapeutic potential in the management of COVID 19 as they can regulate macrophage infiltration and cytokine production, but also promote a resolving macrophage phenotype. In this review we discussed the homeostatic functions of SPM activity or acting directly on macrophages on various levels towards the resolution of inflammation. So they're looking more and more at this, you know, in people that have had chronic inflammation, that's not going away. Okay, to talk a little bit about kind of an extension of what I was talking about a moment ago, which was that, you know, a gut imbalance or a microbial imbalance in the GI tract can lead to a chronic inflammation type of response. Of course the gut is, is packed with microbes and even if there's not an infection per se, many of these microbes have chemicals that they produce that, you know, the gut has to chronically Kind of police. And so in the, in the surf, in the, in the GI tract itself, you can, you can see here, this term endotoxin or LPS is something that bacteria can produce. And these micro, microorganism byproducts can lead to damage of the gut lining. And so the gut cells have to have a mechanism or a way by which they can protect from those toxins, creating a, setting up the stage for chronic inflammation that would lead to kind of an intestinal leakage or a leaky gut situation. You can see here surfaces covered by epithelial cells termed mucosal surfaces. And we have these in our gut. We have mucosal surfaces in our sinuses serve special functions as selectively permeable barriers that partition the host in the outside world, meaning these are quarantine zones. Given its close association to microbial antigens or bacterial toxins, the intestinal mucosa has evolved creative mechanisms to maintain balance or homeostasis to prevent excessive inflammatory responses and to promote rapid and full inflammation resolution. In recent years, an active role for the epithelium has been attributed to the local generation. In other words, your gut cells can generate SPMs on demand in the maintenance of immunological homeostasis. Basically, they're using SPMS to regulate the inflammation in the tissue. So you can see SPMs are implicated in the resolution of acute inflammation that manifest specific epithelial directed actions focused on mucosal homeostasis, including the regulation of leukocytes or white blood cell trafficking, the generation of antimicrobial peptides, the dampening of endotoxin signaling and the attenuation of mucosal cytokine response. So multiple mechanisms Here you see this RVE1 that is an SPM. So you see RVE1, that's an SPM. Lipoxane A4 is an SPM. So there's different mechanisms at play that your gut cells can produce these fats, these fat byproducts, right, to modulate and control the immune system and prevent an aggressive inflammation from causing leaky gut, which would lead, as you all know, hopefully at this point, to a host of different types of problems. Okay, so I thought this article was interesting because we're seeing, now we're seeing the use, I'm using SPMs in my practice for many people that have lived in mold or occupied water damaged buildings. But there's no research on that topic yet. But anyway, you understand what I mean. Quenching the fires, pro resolving mediators, air pollution and smoking. So exposure to air pollution and other environmental inhalation hazards, such as occupational exposures to dust fumes, acro allergens and smoke, is a significant cause of chronic lung inflammation leading to respiratory disease. It's now recognized that resolution of inflammation is an active process controlled by a novel family of small lipid mediators, again termed specialized pro resolving mediators or SPMs. Derived mainly from omega 3 polyunsaturated fats. Chronic inflammation results from an imbalance. And SPMS and related molecules have exciting therapeutic potential to reverse or prevent chronic lung inflammation. With a focus on lung inflammation due to inhalation of environmental hazards, including urban particulate matter, organic dust and smoke, we're seeing, we're using it now in people that have been exposed to mold, because if you've ever been exposed to molding, you know what that's like. Chronic, chronic mold exposure, you get mold toxins, you get VOCs, you get microbial debris that you're breathing in from your air in that water damaged building. And those things are very toxic to the lungs. And SPMS are not a cure for mold toxicity. Getting out of mold has got to be the first step involved in the process of trying to recover. But what we're finding is that by the using SPMs, we're seeing people do much better and feel much better as a means of kind of controlling or regulating the inflammation better. The key takeaway is there don't think you can just take spms and do bad things. That's not what they're designed to do. They're designed to stop chronic inflammation that's been going on for a long time to reset the immune system, to reset the body, so that it can bring in the right, the right milieu to heal and repair that chronic damaged inflammation. I thought this was interesting on human breast milk. So human milk pro resolving mediators stimulate resolution of acute inflammation. So human milk contains nutrients and bioactive products relevant to infant development and immunological protection. Here we investigated pro resolving properties of milk using human milk lipid mediator isolates and determine their impact on resolution programs in vivo and with human macrophages. So this is not a, in live humans, but this is using human cell lines to determine this. And so what they found was evidence that human milk has pro resolving actions via comprehensive LMSPM profiling, describing a potentially novel mechanism in maternal infant biochemical imprinting. In essence, the mothers Give the babies SPMs through breast milk to help the baby's immune system. Breast milk, you know, and this is one of those things where I know a lot of you, you know a lot a Lot of doctors over the years have said, you know, use formula and as a matter of fact, not so much anymore. But you know, the past several decades, formula was really emphasized and in some cases still is. Now, if you weren't able to breastfeed, if you weren't producing adequate milk, this is not me saying you're a bad mother or you're a bad person. This is just me simply calling out that formula is such an inadequate food. I would go so far as to say formula is processed junk food. And it's the way babies are introduced to junk food. Initially in early life, a lot of times in most formulas in the major brands, number one ingredient is corn syrup solids. Imagine feeding your baby corn syrup out of a bottle, you wouldn't do it, right. Read the label on your formula, you'll see that corn syrup solids, usually it's to sweeten the stuff. And then several other ingredients in breast milk are corn derived or corn related sugars as well. And then the rest of it is basically it's highly processed proteins. A lot of times it's soy, Some of these formulas, soy protein or it's dairy. Why soy and dairy proteins? If we look at the top eight allergens in the United States, soy and dairy are on the list as top eight allergens. Why would we put some of the top eight allergens in breast milk in formulas for babies? This stuff is garbage anyway. If you're in this predicament where you're not producing breast milk, there are better brands of formulas. I just want to make you aware of that. I don't want you to make you feel like a horrible person if you've breastfed. But I want you to be aware that if you're using those standard formulas, there are much better brands where you can get a 2 formula. You can actually make your own and it would be much healthier. But none of these formulas, I can promise you, none of them contain SPMs. Now some of them might contain or they didn't used to. As a matter of fact, not having adequate Omega 3 in formulas was a major cause of retardation initially. But these babies need, growing babies need omega 3, especially DHA. DHA is for all intents and purposes is brain fat. So anyway, enough about formula. Hopefully you learned something. If you know somebody getting ready to have a baby, you can share that with them. Let's talk about some of the research in humans on using SPMs for pain. So in this one you can see early evidence of efficacy for orally administered SPM enriched Marine lipid fraction on quality of life and pain. And this is in adults. And so you see resolve and precursors may improve the quality of life, reduce pain intensity and interference and improve mood within four weeks of supplementation. That was a human trial. And then we have this double blind randomized placebo controlled trial that was recently published in 2023. You see specialized pro resolving mediators including 18 heap and 17 HDHA and 14 HDHA are recognized as potentially therapeutic in inflammatory diseases because SPMS regulate the inflammation process. This is what we've been talking about. The results of this study. Patients were enrolled from May 2018 to September 2021. They used VAS pain score. This is visual analog scales for pain score was evaluated in the protocol population in which we observed a statistically significant reduction after 8 weeks and after 12 weeks P value of.039 and 0.031. What is a P value? Those of you that aren't researchers anytime a p value is 0.5 or less. Basically what that means is it's extremely accurate. The research study is extremely validated. These P values is again less than 0.5. These are 0.039 and 0.031. So extremely, extremely valid in that regard. The only problem with this study was the quantity of people you see. There were only 51 total people enrolled in the study, 23 in the group that received supplementation and 28 in the group that received a placebo. We need more data, we need bigger studies. But this study was very good in the sense that you see these findings suggest sustained SPM's consumption reduces pain in osteoarthritis patients while improving quality of life. These results also support the safety profile of SPM supplementation, meaning they're safe at the doses and generally we'll talk about dosing in a minute. But SPMs are a very safe product and you don't have to take as high of a dose of an SPM as you do of a fish oil. To get pain relief with using fish oil, omega 3, concentrated EPA, DHA, you got to be upwards of 3 to 8 grams a day. So if you're taking fish oil capsules and they're the one gram capsules with concentrated EPA or DHA, you got to take three to eight of those big old capsules, one gram. With SPMs, you're looking at 150 to 450 milligrams per day. And so this is equated to, you know, anywhere between one and three tiny little 500 milligram capsules. That's usually the way these things are structured in their little gel caps. So they're tiny little things, easy to swallow. So if you're taking spm, you just have to take less of that to get the same kind of pain reduction effect. So 3 to 8 grams, which are 3 to 8 gram capsules, versus 1 to 3 small 500 milligram capsules. To get the resolution or to get the relief, I thought this was valuable for you as well. So what these researchers did is they were evaluating different patients with different types of arthritis. They were actually looking at their SPM levels, measuring whether or not they had adequate SPMs. And so you can see in this study, these are human studies. So on rheumatoid arthritis, patients with active RA have lower levels of Mar1 than healthy controls or patients with inactive arthritis. So they compared RA patients with non RA patients and found that in RA patients, their SPM levels were lower. Another study here, RA patients have lower levels of RVD1, which is another type of SPM, compared to healthy controls. And you can see down here, RA patients have disruption in SPM levels. They have lower levels of several types. You can see all these different types, several different types of SPMs. And then osteoarthritis patients have lower levels as well compared to RA patients. And then osteoarthritis patients have lower levels overall. And so is it, you know what we don't know, we don't have the answer to this yet. But do they have lower levels and that's why they hurt, or because they have inflammation chronically, they're burning through their SPMs, and so they don't. The body can't produce them adequately to keep up with the inflammatory demand. We don't know the answer to that question yet. But what we do know, we do know preliminary clinical trials that humans taking SPMs feel better, have less pain, improve quality of life, and do better generally as a whole. And I've seen that be the case for the past decade or so since SPMs have become available to use and practice. Okay, let's talk about some of the side effects, possibly of spm. So relatively safe. You know, research shows that they're relatively safe. But there are a couple of things just to be aware of, want to be aware of. One would be gastrointestinal distress. And so this would be kind of more of a minor type of an issue, but bloating, diarrhea, reflux. And this is predominantly from fish oils. When you take it in the larger quantities or in the Higher doses. This for some people with more finicky stomachs can experience this type of symptoms. So just be aware if that's you, then reduce your dose. Allergic reactions. Many people are allergic to different types of fish or marine products. So SPMs are typically derived from fish. So if you've got a fish allergy, specifically, you might want to read your label carefully and make sure that your SPM is not derived from something that you're allergic to. But it's possible to have an allergic reaction if you have an allergy to the fish that it's derived from. So as far as dosing is concerned, I think I mentioned a minute ago, you know, therapeutically. So maintenance dose would be 150 milligrams a day. But if you're really trying to get therapeutic amounts where maybe, maybe you want to try these and see if it helps you with your pain or with your discomfort or inflammation, I would encourage starting at 300 milligrams a day and going as high. We sometimes put people on 600 milligrams per day. And when I say 600 milligrams a day, that's 600 milligrams of standardized SPM. So the way these capsules are generally produced is that an SPM capsule is a 500 milligram capsule. So it's a 500 milligrams. This is not a big capsule. Usually they're little tiny pearls. But of this 500 milligrams, 150 of it is SPM. So generally speaking, you get 150 active SPMs per 500 milligram capsule. So when we're saying take 150, that would be one capsule. We're saying take 300, that would be two capsules. And if we're taking 600, that would be four capsules. So just to give you an idea of how to look at those different labels, because most SPMs are bottled in that way or contain their dosing structure in that way, where they're standardized to that amount, that 150total milligrams per capsule. So that's the quantity you can start with. Again, this is maintenance, more therapeutic. And then even more therapeutic if you want to go higher, it's pretty safe to do. The biggest symptom is GI distress, and that's super, super rare. It's very, very rare that I see that occurring for anyone. But we've been using now spms for probably close to a decade. I wrote about it in no Grain, no Pain originally. And When I did PBS, we did a national show on PBS in 2016. We talked in depth about about SPMs and their role in inflammation. So a lot of experience over the years with these products and generally they tend to work quite well and would encourage any of you struggling that are looking just for a natural alternative to ask your doctor about them and potentially think about using them as part of your care. Because they're a lot safer than non steroidal anti inflammatories and in my experience they can be oftentimes just as effective for the reduction of pain and inflammation. So there you have it. SPM101 I hope this crash course was helpful for you. Hey, don't forget to check out my crash course library if you haven't already. I'll put a link down to that library below and you can watch more of my long form courses on vitamins, minerals and nutritional topics to get yourself up to speed and up to date on things that could be life changing for you and your health. Thanks for visiting Dr. Osborne's Zone. We'll see you Thursday at 12:30 Central Standard Time for live Q and A and we'll be back again next Tuesday for another show. Take care. Thanks for tuning in to the Dr. Osborne zone. Don't forget to share like and subscribe for more content like this and make sure you come back next time Tuesday at 6pm Central Standard Time and Thursday at noon 30 for more episodes. Sa.