Inflammation is currently a popular topic, and I must admit that I’ve fallen into the trap of vilifying this natural physiological phenomenon. Simply put, inflammation is our body’s response to infection, injury, or insult. Heat, redness, swelling, pain, and pus signal that you are injured or sick and provide the necessary feedback to seek treatment or avoid further injury.

Human nature often leads us to categorize things as either good or evil, but the reality is that the optimal balance is usually found somewhere in the middle. Excessive or insufficient inflammation can be problematic, but in moderate and controlled amounts, inflammation promotes healing and resilience. If you catch a cold or get a paper cut, a normal inflammatory response and subsequent cascade promote the healing of damaged tissues.

So, what has led to inflammation being labeled as the new “boogie man”?

Well, over the past few decades, study after study has suggested that nearly all diseases associated with modern lifestyles are related to an excessive amount of a good thing. Diseases associated with excessive inflammation, also known as “TMI” (Too Much Inflammation), include cardiovascular disease, diabetes, arthritis, asthma, allergies, lupus, and the list goes on.

Understandably, the knee-jerk response is to consider how we can reduce the intensity or extinguish the fire. However, it turns out that the immune system is more complex, and sometimes, just like in real life, we need to fight fire with fire itself.

Let’s extend the analogy further:

Water: When the fire is intense or our disease is flaring, such as in an asthma exacerbation or lupus flare, we need to extinguish it quickly to prevent total devastation or organ failure.

Example: Rescue medications such as systemic corticosteroids.

Sprinkler system: The fire (inflammatory disease) is still relatively contained, and we want to keep it that way.

Example: Disease-modifying drugs, topical corticosteroids, immunotherapy. These treatments may take weeks to months to take effect and are generally continued long term to prevent flare-ups.

Fighting fire with fire: Just like a controlled burn, moderate and controlled doses of inflammatory stimuli help build resilience and restore balance, making flare-ups less likely over time.

Example: Exercise, setting and working towards goals.

Flame retardants: If we want to prevent the onset and flares of TMI conditions, we need to create an environment less prone to ignition.

Examples: A whole food plant-predominant diet, sufficient sleep, clean air, spending time in nature, minimizing chronic emotional stressors, and nurturing strong supportive relationships.

Wired for pleasure and survival, humans have demonstrated our tendency to fall into the trap of too much of a good thing, and diseases associated with TMI follow that pattern as well. After a few generations of relative neglect, we need a multi-pronged approach to turn the tide and start caring for our immune systems better—one day at a time.

Kara Wada is a quadruple board-certified pediatric and adult allergy and immunology, lifestyle, and functional medicine physician, a Sjögren’s disease specialist, and a Sjögren’s patient herself. She spent nine years on faculty at The Ohio State University Wexner Medical Center, where she served as associate program director of the allergy and immunology fellowship and led the Mast Cell Center of Excellence.

In 2025, she left academic medicine to build the kind of practice she could not find as a patient: the Immune Confident Institute, a national direct-care immunology practice licensed in 27 states. She treats the patients the health care system sends ping-ponging between specialists, people with complex, chronic, multisystem disease including mast cell activation syndrome (MCAS), dysautonomia, Sjögren’s disease, immune dysfunction, and the seronegative and “in-between” diagnoses that do not fit neatly into a single specialty.

Her premise is simple: These patients are not the problem. Fragmented care is. Medicine has become exceptionally good at looking through microscopes while losing sight of the telescope, the bigger picture of the person in front of us. Her work challenges a health care culture that demands compliance when it should assume competence, and aims to make strategic, compassionate immune-directed care the standard, and the exam room a place where patients are finally seen, heard, and believed.

Most of her reach is built outside the exam room. Her YouTube channel drew roughly two million views this past year, and more than 100,000 people follow her work across platforms, including a Sjögren’s community of about 6,600. She founded and hosts the Virtual Sjögren’s Summit, now in its sixth year and drawing some 4,300 registrants worldwide. She appears regularly on national television and in the health press, including Prevention, SELF, Good Housekeeping, WebMD, Medscape, and MedPage Today, and she writes for KevinMD on the diagnoses that live in the shadows and the medical gaslighting that surrounds them.

A TEDx speaker and sought-after keynote, Wada speaks to clinician and patient audiences about complex immune disease, the experience of being disbelieved, and what changes when the physician is also the patient. She is also an unlikely pageant titleholder, having served as Dr. Ohio America 2022 and Dr. Midwest America 2023, and has written about how pageantry sharpened skills medicine rewards but rarely teaches.

She earned her medical degree with honors from the University of Illinois College of Medicine at Peoria and completed internal medicine-pediatrics residency, allergy and immunology fellowship, and clinician educator fellowship at The Ohio State University and Nationwide Children’s Hospital. She lives in Columbus, Ohio, with her medical school sweetheart turned husband, Akira, and their three children.