Chronic inflammation is a persistent and prolonged immune response within the body, often referred to as a “silent” condition. Unlike acute inflammation, which is a normal and necessary defense mechanism against injury or infection, chronic inflammation occurs when the body’s immune system continuously releases pro-inflammatory molecules. This sustained inflammation can impact various organs and tissues, leading to various health issues.
Chronic inflammation has been linked to several diseases, including cardiovascular problems, diabetes, autoimmune disorders, and even certain types of cancer. Understanding chronic inflammation’s mechanisms and potential consequences is crucial for maintaining overall well-being and implementing effective preventive measures.
Do you often feel tired, achy, and just overall unwell? It could be more than just daily fatigue. Hidden within your lab results lies a secret that could reveal the source of your discomfort: chronic inflammation. In this article, we will dive deep into chronic inflammation and explore the seven lab tests that can provide invaluable insights into your overall health. By understanding these tests and their implications, you’ll be equipped to take proactive steps toward combating chronic inflammation and improving your well-being.
Understanding Chronic Inflammation
Before we explore lab tests for chronic inflammation, it’s important to have a solid understanding of what exactly chronic inflammation is and why it matters. Chronic inflammation is a complex bodily response that occurs when the immune system mistakenly triggers an inflammatory response, and it persists over a long time. While acute inflammation is a normal and necessary response to injury or infection, chronic inflammation is different—it’s a relentless state of low-grade inflammation that can wreak havoc on your overall health.
Chronic inflammation is often called a silent killer because it can quietly simmer within your body, causing damage to your organs and tissues without any overt symptoms. It has been linked to a wide range of chronic diseases and conditions, such as heart disease, diabetes, arthritis, and even some types of cancer. Additionally, chronic inflammation has been shown to contribute to accelerated aging and reduced quality of life.
Common Inflammatory Conditions
Chronic inflammation can manifest as feeling unwell, a new diagnosis of a chronic disorder, or a combination of disorders. Examples of diseases that are a result of chronic inflammation are:
- Heart Disease
- Diabetes
- Arthritis
- Cancer
- Lupus
- Psoriasis
- Dementia
- Inflammatory Bowel Disease
There are two types of inflammation. Acute inflammation is the immune system’s response to infection, injury, and tissue damage. Acute inflammation follows a pathway of damaged tissue, creating cellular signals that cause the recruitment of white blood cells to start the inflammatory response. White blood cells release many chemicals that encourage blood flow, raise the body’s temperature, and prepare the body to fight an invasive infection or injury.
Understanding the underlying causes of chronic inflammation is crucial in combatting its effects. Lifestyle factors such as poor diet, lack of exercise, stress, and inadequate sleep can all contribute to the development of chronic inflammation. Environmental factors like pollution and exposure to toxins can also play a role. Furthermore, certain medical conditions, such as autoimmune disorders and chronic infections, can trigger chronic inflammation.
You can better navigate the road ahead by gaining a deeper understanding of chronic inflammation and its underlying causes. With the knowledge of how chronic inflammation can impact your health, you’ll be motivated to take the necessary steps to reduce inflammation and promote overall well-being. In the next section, we will explore common inflammatory conditions that are often associated with chronic inflammation, shedding light on specific health concerns that may stem from this hidden menace.
Environmental factors like pollution and exposure to toxins can also play a role. Furthermore, certain medical conditions, such as autoimmune disorders and chronic infections, can trigger chronic inflammation.
The Importance of Lab Tests
There are 7 numbers I recommend to assess to determine if chronic inflammation is present. These numbers are clear indications that a person is developing chronic inflammation. Having these lab results to review gives us a quantifiable target. These are numbers you can have checked initially, make important changes, then check again for improvement. Pairing these numbers with your physical symptoms as well will also guide you in the next steps in your care. Many of these numbers are abnormal long before a disease process has started.
| Inflammatory Marker | What it Means |
|---|---|
| ESR (Erythrocyte Sedimentation Rate) | Elevated levels means there is infection, damage or overall inflammation in the body. |
| C-RP (C Reactive Protein) | Large cholesterol particles that, when it’s low, can mean overall poor metabolic function and inflammation. |
| HDL | Large cholesterol particle that when it’s low can mean overall poor metabolic function and inflammation. |
| Triglycerides | Elevated levels mean metabolic disturbance and inflammation |
| VLDL | Small, dense cholesterol that may elevated in chronic inflammation |
| Ferritin | Marker used to check for anemia, can be elevated in chronic inflammation. |
| Weight | Obesity has been shown to increase risk of death from COVID |
These inflammatory markers can be easily checked in blood work. Many are part of typical panels that are drawn in yearly labs. Knowing and monitoring these numbers is a great way to know if you are treating your body well. Inflammatory markers will respond positively when the underlying condition, such as diabetes, obesity, or high cholesterol.
 Let us review the specific labs and my recommendations to help improve these numbers immediately.
C-Reactive Protein
C-reactive Protein (or CRP) is a protein produced by the liver. CRP is an acute-phase protein created whenever the body is damaged by injury or infection. CRP is elevated whenever we are sick with infections such as pneumonia or a urinary tract infection2
Normal C-Reactive Protein is less than 10mg/L. 4
Elevated C-Reactive Protein may be a result of an infection, an injury, or signs of an autoimmune disease.
People with a risk of heart disease, such as coronary artery disease, may have elevated C-reactive Protein levels, which may indicate damage to arteries.
Actions Steps for Elevated CRP
I recommend reviewing your symptoms closely, particularly over the past 2-3 months before having your labs checked. 
Some symptoms indicate you may need a further workup. These symptoms are:
- Unexplained Weight Loss
- Night Sweats
- Fever
- Chills
- Bone and Joint Pain
- Rashes
Elevation in C-RP can indicate serious autoimmune disease, infection, or cancer. Working with your physician to review symptoms and discuss if any of these diagnoses should be considered.
I recommend reviewing C-RP in relation to your cholesterol. Elevated CRP can be an sign of being at high risk of cardiovascular disease. Having an elevation in C-RP increases risk of Cardiovascular disease and death from cardiovascular disease.5
You will want to target improving your cardiovascular diet. Improving your nutrition with an anti-inflammatory meal plan will help normalize inflammation that can drive heart disease. Increasing your healthy movement will also help lower C-RP over time. Reducing your overall stress with meditation can help to lower inflammation levels.
High-density lipoprotein (HDL)
The Total Cholesterol Panel, which may be checked with annual exams, holds valuable information about your body’s immune system. Part of the total cholesterol is the HDL or high-density lipoprotein. HDL is a cholesterol particle that is produced by the liver. HDL particles are known as scavenger particles because they collect debris within the bloodstream that causes damage and carry it out of the body. HDL also inactivates bacterial lipopolysaccharide, reducing the amount of damage bacteria can have on the body3. Having elevated levels of HDL protects the heart and other organs, so this is a lab that you want to see higher than the normal lab values. 
With my patients, I advise them to aim for an HDL that is higher than 40 mg/dl. 
Diseases that cause chronic inflammation in the body can lower HDL. These include:
- Liver Disease
- Poorly Controlled Diabetes
- Kidney Disease
Increasing HDL
 When my patients have low HDL, I advise them to stop the consumption of excessive sugars as soon as possible.  Consuming too much sugar causes the liver to produce more oxidative chemicals, which damage the arteries in the entire body.
 I also advised the patient to stop consuming processed foods as much as possible. Some processed foods have health benefits, but until I know for sure what the patient has in their regular diet, it is best to assume that if they are eating processed foods, these foods may be high in chemicals that create inflammation and put more stress on the liver, causing a lower HDL.
You can increase your HDL naturally by increasing your physical activity. Any physical activity will assure that your HDL levels will go up. Cardiovascular exercise such as walking is great for HDL levels. Resistance training or yoga will also encourage your HDL to rise naturally.
Triglycerides
The cholesterol panel also checks Triglycerides. Triglycerides are a form of cholesterol the body uses to store fat absorbed from foods. It is a normal response for triglycerides to go up after meals. Triglycerides should return to normal after fasting, which is usually less than 150 mg/dL.
Triglycerides that are elevated persistently can be a sign of metabolic disorders. High blood sugar in uncontrolled diabetes can cause persistent elevation in triglycerides. Triglycerides may also be elevated with inflammation of the pancreas (pancreatitis) or liver (hepatitis).
in addition to being a marker of inflammation, high triglycerides can cause damage in the arteries, the pancreas, and kidneys.
Lowering Triglycerides
 The 1st steps to lowering the triglycerides naturally is to stop consuming excessive sugars. Consuming refined sugars such as in candy and sweets can drive your triglycerides up faster than anything else.
 Increasing her fiber intake with every meal can also help to lower triglycerides.
Foods High in Fiber
- Black Beans
- Tofu
- Avocado
- Brussle Sprouts
- Asparagus
- Turnip
- Peas
Very Low-Density Lipoprotein (VLDL)
 Similar to HDL and triglycerides, the very low-density lipoprotein, where VLDL, is a marker of inflammation within the body and metabolic status. Measurement of the VLDL may not be done on every cholesterol panel. If this number is available and it is elevated it is also a measure of having inflammation as well as increased risk of cardiovascular disease.
Improving VLDL
 As we have discussed above, improving VLDL will look her with consuming more plant based foods that are high in fiber, increasing physical activity, lowering stress, and consuming less processed foods that are high in sugar.
 Certain foods can cause the blood sugars to rise rapidly and stay high for a long time. These foods are known as having a high glycemic index. With a high glycemic index can be particularly damaging for individuals with a history of heart disease or diabetes.
 Sticking the foods that are high in protein, healthy fats, and high in fiber will ensure that you do not consume foods with a high glycemic load. Examples of foods with a low glycemic load include avocados, butternut squash, beets, hummus, and apples.
 Ferritin
ferritin is a protein that circulates in the bloodstream. Ferritin stores iron and transports it was in the bloodstream. Ferritin levels can be measured when assessing anemia. Ferritin also is an acute phase reactant meaning that this level will go high if the body is dealing with acute inflammation.
 Measuring the ferritin levels can be helpful when trying to evaluate for acute or chronic inflammation particularly in someone who is suffering from anemia. If ferritin is elevated and you are not anemic proceeding with a further evaluation for causes of chronic inflammation is necessary.
ferritin can also be measured as a part of diagnosing and managing cancers.
 Normalizing ferritin
 To normalize your ferritin you will need to be aware of the readings of your complete iron profile. This lab work is often checked in conjunction with ferritin levels. If you are iron deficient correcting this can be done by intake of iron rich foods or supplementing with iron if need be.
 Foods high in iron
- Oysters
- Tofu
- Soybeans
- Blackstrap Molasses
- Spinach
- Pumpkin seeds
weight
unlike the other measurements that we have discussed, your weight is a vital sign rather than a lab. However, your weight can indicate if your suffering from acute or chronic inflammation.
 Sudden changes in weight including rapid weight gain or weight loss can be an indication of acute inflammation. Slow weight cane over several months or years can be a sign of chronic inflammation.
 Although addressing the weight particularly if you are OB so wanting to lose weight is beneficial, I often 0.02 my patients that having weight changes are being unable to gain or lose weight as a sign of inflammation that should be addressed but may not be a direct target of treatment.
Know Your Nutritional Status
There is a temptation to feel that if your weight is normal, or if you are overweight, your nutritional status is good. Unfortunately, being overweight often increases your risk of being malnourished. Having low levels of needed nutrients in your
body not only increases you chances of infection, but also of cancers and advanced aging.
| Lab/Marker | Risks of Disease or illness |
|---|---|
| Vitamin D | Low levels increase risk of contracting COVID, bone disease, and cancer. |
| Vitamin B12 | Low levels can damage nerves and brain health |
| Potassium | Low levels usually in a diet poor in fruits/vegetables; can worsen high blood pressure |
| BUN/Creatnine | Markers of kidney function. Even small elevations require a workup. |
| AST/ALT | Test for liver function. Elevated levels may be marker of metabolic disease |
| Protein/Albumin | Markers of protein levels, which help the body heal and recover. |
| Magnesium | Electrolyte that helps blood vessel function and can help in blood pressure control. |
Healing Inflammation
Working with a Functional Medicine physician, you can start getting down to the root cause of what’s causing inflammation in your body. Part of the Holistic Annual Membership with me is assessing inflammation levels. 
1.Zabetakis I, Lordan R, Norton C, Tsoupras A. COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation. Nutrients. 2020 May 19;12(5):1466. doi: 10.3390/nu12051466. PMID: 32438620; PMCID: PMC7284818. 
2. Herwald, H., & Egesten, A. (2021). C-Reactive Protein: More than a Biomarker. Journal of innate immunity, 13(5), 257–258. https://doi.org/10.1159/000519091). CRP also becomes elevated if the immune system attacks the body in an autoimmune disease. Autoimmune diseases that can cause elevation of CRP are Lupus, Rheumatoid Arthritis, or Scleroderma.
3. Herwald, H., & Egesten, A. (2021). C-Reactive Protein: More than a Biomarker. Journal of innate immunity, 13(5), 257–258. https://doi.org/10.1159/000519091). CRP also becomes elevated if the immune system attacks the body in an autoimmune disease. Autoimmune diseases that can cause elevation of CRP are Lupus, Rheumatoid Arthritis, or Scleroderma.
4. Snyder, L., & Rao, L. (2021). Wallach’s Interpretation of Diagnostic Tests (10th ed.). Wolters Kluwer.
5. Burger, P. M., Pradhan, A. D., Dorresteijn, J. A. N., Koudstaal, S., Teraa, M., de Borst, G. J., van der Meer, M. G., Mosterd, A., Ridker, P. M., Visseren, F. L. J., & Utrecht Cardiovascular Cohort-Second Manifestations of ARTerial disease study group (2023). C-Reactive Protein and Risk of Cardiovascular Events and Mortality in Patients with Various Cardiovascular Disease Locations. The American journal of cardiology, 197, 13–23. https://doi.org/10.1016/j.amjcard.2023.03.025