If you are striving to keep yourself healthy for now and many years to come, and you want to know what single thing you should be paying attention to more than anything else, it is this: inflammation.
The reason inflammation is so critical is that it has been found to be a player in almost every chronic disease, which affect approximately 133 million Americans, representing more than 40% of the total population of the United States. And if inflammation hasn’t been shown to be associated with a chronic disease, it’s probably just because no one has looked for it.
You probably wouldn’t be surprised to hear that inflammation is a major part of autoimmune diseases since they are all directly caused by the immune system. Maybe you’ve also already heard that the white blood cells that sneak into the walls of your arteries are major contributors to cardiovascular disease, meaning it’s not just about cholesterol build-up. Perhaps you also know that cancer tends to form in areas that are chronically inflamed. But you might not have expected inflammation to be a component of osteoarthritis, a disease that scientists thought was just from the wear and tear of the bones, maybe too much tackle football or tennis. Inflammation even plays a role in hypertension and depression.
What is chronic inflammation?
To back up for a moment, let me give you a very brief primer on inflammation. It’s a complex system in our bodies with an ever-growing list of identified components, but the big picture is that it occurs in two main ways. It can be a self-limited response to an injury or infection, for example, if you get a paper-cut or a sprained ankle. You’ll notice redness, pain, warmth and swelling in the area. But once all the cells from the inflammatory response have done their job and the injury is healed, that inflammation disappears. That’s the kind of inflammation you want to happen.
The other kind of inflammation, called chronic inflammation, is the problematic one. It may occur if the immune system is trying to fend off an infection, like Lyme disease, but isn’t having success. Or it may occur if the immune system becomes confused, such as in someone who has antibodies to gluten that also end up attacking other parts of the body that resemble gluten. Inflammation also happens when the immune system senses that something isn’t right, such as when LDL cholesterol makes its way into the lining of an artery. White blood cells follow, but instead of fixing the problem, they inadvertently make it worse by making the plaque unstable and more likely to rupture.
Top 5 symptoms of chronic inflammation
At Parsley Health, one of our main goals is to help people prevent and reverse chronic disease, so we pay a lot of attention to chronic inflammation. We look for symptoms of inflammation beginning at our patients’ very first visit.
Here are five common indications that someone may have a chronic inflammatory condition:
1. Body pain
Body pain such as muscle aches and joint pain are commonly caused by increased systemic inflammation. When inflammatory cytokines are elevated in the body, they can attack muscle and joint issue resulting in redness, swelling, and pain. Skin rashes, such as eczema or psoriasis
2. Skin rashes
Skin rashes such as eczema or psoriasis, are inflammatory skin conditions which are characterized by red, rough, and flaky skin. Both eczema and psoriasis are linked to hyper-sensitivity of the immune system and individuals with these conditions are more likely to have a greater number of inflammatory mast cells which when activated, trigger the skin rashes to surface.
3. Excessive mucus production
Always needing to clear your throat or blow your nose? Sounds like you might be inflamed! When inflamed, mucous membranes produce thick phlegm in an attempt to protect epithelial cells in the lining of the respiratory system which results in coughing, sneezing, and a runny-nose.
4. Low energy
Constantly feeling fatigued despite getting adequate nightly sleep is yet another clue your body is fighting off chronic inflammation. Just like you feel run-down when you’re sick, when you’re chronically inflamed your immune system remains active and continues to work overtime to regulate its response. In turn, chronic inflammation increases the requirement of cellular energy to ensure rapid regeneration of immune cells and further depletes you of the fuel you need to feel fully energized.
5. Poor digestion
Common digestive issues including bloating, abdominal pain, constipation, and loose stool may also suggest an issue with inflammation. Chronic inflammation throughout the body can contribute to leaky gut syndrome, or intestinal permeability, which can cause bacteria and toxins to “leak” through the intestinal wall into the rest of the body. A “leaky gut” can further fuel ongoing systemic inflammation and contribute to digestive symptoms such as abdominal distention and irregular bowel movements.
The tests your doctor should be doing
Not only do we listen for inflammation in our patients’ histories, but we also test for it in every patient we see using these three biomarkers:
- White blood cell count: A high white blood cell count is an indication that the immune system is activated and working to fend off an infection or injury. Chronically elevated white blood cells indicate the immune system is regularly in overdrive. When systemic inflammation is high, white blood cell count can be elevated. At Parsley Health, we consider a white blood cell count between 5,000 and 8,000 per microliter in an ideal range while a typical laboratory reference range is between 3,400 and 10,800 per microliter.
- Sedimentation rate (ESR): Your sedimentation rate or ESR is a measure of how quickly your red blood cells settle in a blood sample. Because red blood cells typically settle slowly, a fast rate of settling may indicate inflammation in the body. The normal range is considered 0 to 22 mm/hr for men and 0 to 29 mm/hr for women. At Parsley Health, we hope to see members with an ESR <15 and optimally <10 mm/hr.
- High sensitivity c-reactive protein (hs-CRP): hs-CRP is a protein that is produced in response to inflammation in the body. Levels of hs-CRP rise when a specific injury or infection occurs in the body and will increase simultaneously when inflammatory enzymes such as IL-6 (interleukin-6) are present. It is important to note that about a third of the adult U.S. population has an elevated CRP. People with higher hs-CRP values not only are inflamed but also have the highest risk of cardiovascular disease and those with lower values have less risk. A typical lab range for hs-CRP is between 0 and 3.0 mg/L and at Parsley Health, we aim to have members below 1.0 mg/L.
Each one of these looks at different components of the blood to see if there is inflammation in the body. They are non-specific, meaning they don’t tell us where the inflammation is coming from, but they do clue us in to look harder for it. Taken together, we get a pretty good idea as to whether inflammation is an issue, and we can also use them to track if the inflammation is resolving or worsening.
How to heal chronic inflammation
If all this talk of chronic inflammation and its pervasive effect on chronic disease is getting you nervous, don’t worry! You actually don’t need to know which cytokine blocks which receptor to know what to do.
Here’s our recommended approach for healing chronic inflammation:
- Remove the foods that are known to cause inflammation, like sugar, dairy and simple carbohydrates.
- Avoid foods that you are sensitive to. This is something we often test for or figure out with an elimination diet.
- Exercise. Regular exercise of moderate intensity improves immune function and decreases inflammation. (Even occasional exercise has benefits, but high-intensity exercise may actually have a detrimental effect on the immune system.)
- Minimize stress and optimize how you respond to it.
- Supplements such as probiotics, turmeric, resveratrol, and fish oil are known to help fight inflammation. Check with your doctor to see if any of these additions to your regimen might be helpful for you.
Inflammation is an amazing unifier of most chronic diseases, so if you want to optimize your current and future health, you can do so by minimizing inflammation. Take note if you have symptoms that seem consistent with inflammation, check for it with blood tests and the guidance of a physician, and do your best to adopt an anti-inflammatory diet and lifestyle.