Inflammatory Markers – A Guide to Understand Your Blood Analysis

What Are Inflammatory Markers?

Before delving into the nitty-gritty details of inflammatory markers, let's first understand what they are.

Inflammatory markers are biomarkers and can be determined through blood analysis. Think of biomarkers as tiny biological signposts that help scientists understand what's happening inside your body. These markers are biochemical, molecular, or cellular alterations that are measurable in biological tissues, cells, or fluids. They act as clues telling us about your health.

Biomarkers are extremely useful because they can reveal various biological processes in your body and even predict what might happen in the future. For example, checking your blood sugar is using such a biomarker (your blood sugar) to see if you might have diabetes.

Scientists use biomarkers to narrow down diagnoses, detect medical conditions or catch diseases early. So, these tiny markers are like health detectives, helping us keep an eye on our well-being!

Inflammatory markers refer to substances in your body that signify the presence of inflammation — a response of the immune system to various stimuli, such as infections, injuries, or chronic conditions. These inflammatory markers act as messengers, communicating an ongoing battle between your immune system and potential threats or injuries.

The primary players of inflammation that act as inflammatory markers include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and plasma viscosity (PV). [1]

Inflammatory Markers List:

• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• Plasma viscosity (PV)
• Leukocyte count/White blood cells (WBC)

These markers can be assessed through different blood tests, offering physicians and healthcare professionals a glimpse into your body's inflammatory landscape.

What Blood Tests Are Used to Detect Inflammation?

Since inflammatory processes affect different aspects of our body and influence numerous biological processes, there are different tests available that can test for inflammatory markers.

At CARE, we use the CBC to detect and interpret your inflammatory markers. This test allows us to test for several biomarkers at once, and the potential connections between your inflammatory markers and other biomarkers can give us important and comprehensive information about your health status.

Nevertheless, we will introduce you to the ESR test, the C-reactive protein test (CRP), the CBC, and the PV test. All these tests are capable of detecting inflammatory markers in a slightly different manner. All these tests are non-specific tests, which means they simply let us know that there is inflammation somewhere in your body, but it doesn't show us what is causing the inflammation. [2]

Further tests and diagnoses are typically required to narrow down the cause of inflammation. Inflammation can be caused by a mild cold or a more serious cause. [2]

The “Sed Rate” – Erythrocyte Sedimentation Rate (ESR)

The erythrocyte sedimentation rate test, casually referred to as sed rate, is a blood test indicating inflammation. The sed rate evaluates the rate at which your red blood cells (erythrocytes) settle in a thin tube. [2]

When your blood is placed in a tall, thin tube, the red blood cells gradually fall to the bottom (sedimentation). Inflammation can cause the cells to clump together. Since these clumps are heavier than individual red blood cells, they settle to the bottom more quickly. [2]

Therefore, the sedimentation rate correlates with the presence of inflammation in your body. It serves as a valuable tool for screening inflammatory conditions, infections, and certain cancers. [2]

• Purpose: Evaluate the rate at which red blood cells settle in a tube, indicating the presence of inflammation.
• Use Cases: Screens for inflammatory conditions, infections, and certain cancers.

C-reactive Protein Test (CRP)

Your body produces proteins as part of a response to infection or inflammation. One of these proteins is called C-reactive protein (CRP), which is produced by the liver. CRP is released pretty quickly at the start of infections or inflammatory conditions and is, therefore, a reliable indicator of inflammation. [1]

The CRP test measures the levels of C-reactive protein in your blood. Its applications range from detecting acute inflammation and chronic inflammation to monitoring autoimmune conditions and assessing cardiovascular risk.

• Purpose: Measures the levels of CRP, a protein produced by the liver in response to inflammation.
• Use Cases: Detects acute and chronic inflammation, monitors autoimmune disorders, and assesses cardiovascular risk.

Complete Blood Count (CBC)

The CBC is a comprehensive examination that scrutinizes the number and types of blood cells, including white blood cells, red blood cells, and hemoglobin, crucial for immune responses in your body.

A Complete Blood Count (CBC) can indicate inflammation by revealing an elevated white blood cell count (leukocytes), particularly an increase in neutrophils, which are immune cells that respond to inflammation and infection. Additionally, an elevated level of C-reactive protein (CRP), often measured alongside a CBC, further confirms the presence of inflammation in the body. [3]

The CBC offers a broad overview of your overall health, highlighting potential inflammation or infection.

• Purpose: Examines the number and types of blood cells, including white blood cells, that play a role in the immune response.
• Use Cases: Provides a broad overview of overall health, including potential inflammation or infection.

How Thick is Your Blood? — The Plasma Viscosity Test (PV)

The plasma viscosity test assesses the thickness and flow of blood, which can be influenced by inflammation. Inflammatory processes typically lead to changes in blood thickness (viscosity), and the PV test measures these alterations. This is done by calculating the force needed to send plasma, the liquid part of your blood, down a thin tube during a specific amount of time. During inflammation, this thickness increases because lots of different protein levels rise in the blood, which makes it harder for the serum to flow. [1]

Elevated plasma viscosity can indicate the presence of inflammation, helping healthcare professionals diagnose and monitor inflammatory conditions such as rheumatoid arthritis or certain infections.

• Purpose: Assess inflammation by measuring blood viscosity and diagnose and monitor inflammatory conditions.
• Use Cases: Rheumatoid arthritis and infections, and Contribution to risk assessment in cardiovascular diseases.

The Procalcitonin Test (PCT)

Procalcitonin is a protein that tends to rise in response to bacterial infections, making it a valuable biomarker for distinguishing bacterial infections from viral ones. This is especially important if a doctor wishes to administer antibiotics and needs to distinguish between a viral and bacterial infection. [4]

The PCT test measures the levels of procalcitonin in your blood, helping medical professionals identify the cause of an infection and determine the most appropriate treatment. [4]

• Purpose: Identify bacterial infections and guide antibiotic therapy. Monitor treatment effectiveness by assessing PCT levels over time.
• Use Cases: Suspected sepsis and lower respiratory tract infections, and for postoperative monitoring for infections.

What Are The Normal Ranges of Inflammatory Markers?

Understanding what constitutes a “normal” range is crucial for interpreting inflammatory marker results. While specific ranges may vary slightly among laboratories, generally accepted norms provide a baseline for assessment:

1. C-Reactive Protein (CRP):

• Normal Range: Less than 3 mg/L [5]
• Interpretation: Elevated levels may indicate inflammation but are nonspecific, necessitating further investigation.

2. Erythrocyte Sedimentation Rate (ESR):

• Normal Range: 0 to 22 mm/hr (men) and 0 to 29 mm/hr (women) [5]
• Interpretation: Raised inflammatory markers suggest the presence of inflammation but do not pinpoint the cause.

3. Complete Blood Count (CBC):

• White Blood Cell Count (WBC): 4,000 to 11,000 cells/mcL [6]
• Interpretation: Elevated WBC may indicate infection or inflammation.

4. Plasma Viscosity Test (PV)

• Normal Range: 1.50-1.72 mPA [5]
• Interpretation: Higher values can suggest chronic disorders, malignancy or vascular disease.

What Do High Inflammatory Markers in Your Blood Mean?

The revelation of high inflammatory markers in your blood can be akin to a red flag waving within your body's fortress.

Elevated levels of CRP, ESR, or white blood cells may signal various underlying conditions, which can be mild, like a common cold, or even more serious, like chronic conditions.

Acute Infections – Internal Works of the Immune System

A sudden spike in inflammatory markers can indicate an ongoing infection, prompting the immune system to mount a rapid response. If you have been sick lately, say with the flu or a common cold, it is common to have inflammatory markers in your blood due to the immune reaction of your body to fight the cold. If you recently had surgery, inflammatory markers can be present in your blood due to the internal reparation works of your immune system to heal your wounds.

The majority of high inflammatory markers in blood tests do not indicate a serious illness like cancer or chronic disease and can instead be identified as false positives. [7]

If serious underlying conditions can be ruled out and your high inflammatory markers persist in the absence of infection or threat, chronic inflammation can be the cause for that. [8]

Chronic Inflammatory Conditions – Lifestyle Factors or Chronic Conditions

Persistent elevation of inflammatory markers may point toward chronic inflammatory conditions like rheumatoid arthritis, inflammatory bowel disease, or lupus. A comprehensive evaluation by a specialist is crucial for accurate diagnosis and management. If serious chronic conditions can be ruled out, chances are that your lifestyle conditions are the cause of your high inflammatory markers.

Chronic inflammation can be perpetuated by various social, environmental, psychological, and lifestyle factors. Air pollution [9], a diet rich in processed foods [10], or stress [11] can cause inflammation in your body.

Cardiovascular Risk

Elevated inflammatory markers, such as C-reactive protein (CRP) and plasma viscosity, are associated with an increased cardiovascular risk. Chronic inflammation contributes to the development and progression of atherosclerosis, the build-up of plaque in arteries, which can lead to heart attacks and strokes. Therefore, monitoring and managing inflammatory markers can be crucial in assessing cardiovascular risk and implementing preventive measures to reduce the likelihood of cardiovascular events. [12]

Lifestyle modifications, such as adopting a heart-healthy diet and regular exercise, are crucial for maintaining heart health and preventing heart disease or cardiac events.

When Are Inflammatory Marker Blood Tests Used?

The strategic use of inflammatory marker blood tests is a cornerstone of preventive and diagnostic healthcare and can be advantageous in various scenarios.

Symptomatic Presentation – Detecting Inflammation

Investigating the cause of unexplained symptoms like persistent fatigue, joint pain, or fever warrants seeking medical attention. Testing for inflammatory blood markers aids in early diagnosis and intervention of chronic disease or other causes of inflammation. [1]

Monitoring Chronic Conditions – Inflammation

Do you already have a chronic condition? Regular monitoring of inflammation levels in people with chronic conditions like rheumatoid arthritis or inflammatory bowel disease helps adjust treatment plans for optimal disease management. [1] [7] [8]

How Can High Inflammatory Markers Be Treated?

Addressing elevated inflammatory markers involves a multi-faceted approach aimed at both the underlying cause and overall health optimization. Most of the blood tests that detect inflammatory markers are non-specific and do not reveal the cause of inflammation.

Therefore, further diagnosis is required to determine the root cause of your inflammation.

Target the Underlying Cause

Once you have found out what is causing your inflammatory markers to increase, your treatment varies based on the specific condition causing inflammation. Consulting with a healthcare professional is imperative to identify and address the root cause of the inflammation in your body.

Lifestyle Modifications – A Healthy Diet, Exercise & Relaxation

Adopting a healthy lifestyle can help mitigate inflammation.

Embracing a balanced diet rich in anti-inflammatory foods, engaging in regular physical activity, and managing stress through relaxation techniques are pivotal to keeping your inflammatory markers in balance.

Avoid ultra-processed foods and environmental toxins like smoking tobacco or drinking too much alcohol, as these factors can lead to inflammation in your body. [10] [13]

Medication – NSAIDs or DMARDs

In certain cases, often in chronic diseases like arthritis and abnormal immune response, medications like non-steroidal anti-inflammatory drugs (NSAIDs) or disease-modifying antirheumatic drugs (DMARDs) may be prescribed to treat the inflammatory processes in your body. [14]

Strict adherence to prescribed medications under medical supervision is crucial.

If your blood test results revealed high inflammatory marker levels in the absence of autoimmune disease, chronic conditions, or other threats, adjusting certain lifestyle factors might be advisable to balance your inflammatory response.

A major game changer for inflammatory processes in your body can be an adjustment of your diet by incorporating anti-inflammatory foods into your meals.

Harnessing the Power of Nutrition to Bring Down Inflammatory Markers

Anti-inflammatory foods are not just a trend; they represent a scientifically grounded approach to nurturing our bodies and balancing our body's inflammatory processes.

Certain foods possess anti-inflammatory properties that can help quell the flames of chronic inflammation, promoting a balanced immune response. [15]

Let's explore some key players in the anti-inflammatory food arsenal:

Fatty Fish – Omega-3s For the Win

Rich in omega-3 fatty acids, fatty fish like salmon, mackerel, and sardines are renowned for their potent anti-inflammatory effects. Omega-3s play a crucial role in reducing the production of inflammatory molecules. [15]

Leafy Greens – Kale, Spinach & Swiss Chard

Vegetables like kale, spinach, and Swiss chard are rich in antioxidants, vitamins, and minerals. These nutrients combat oxidative stress and contribute to an anti-inflammatory environment. [15]

Berries – Flavonoids Reduce Inflammation at the Cellular Level

Packed with flavonoids, berries such as blueberries, strawberries, and raspberries exhibit strong anti-inflammatory properties. These compounds have been shown to reduce inflammation at the cellular level. [15]

Turmeric and Ginger – The Inflammation Warriors

These spices are not just culinary delights; they boast potent anti-inflammatory and antioxidant properties. Curcumin, found in turmeric, has been extensively studied for its ability to modulate inflammatory pathways. [15]

Olive Oil – The Secret of the Italians

Italians have a reputation for aging gracefully and healthily. Extra virgin olive oil might be their secret, as it is a cornerstone of the Mediterranean diet, celebrated for its anti-inflammatory effects. Rich in monounsaturated fats and antioxidants, olive oil has been linked to reduced inflammation and improved heart health. [15]

What Are The Limitations of Inflammatory Biomarkers?

While inflammatory markers provide invaluable insights, they have limitations, as we have already mentioned.

Non-Specificity – Detecting the Root Cause

Elevated inflammatory markers may indicate inflammation, but pinpointing the exact cause requires additional investigations to diagnose the cause of inflammation accurately. A comprehensive assessment, including imaging and other specialized tests, is often necessary. [2]

Inter-individual Variability – Uniqueness of a Person

Normal ranges for inflammatory markers can vary among individuals, making interpretation complex at times. Considering individual health history and consulting healthcare professionals for personalized insights is paramount.

Transient Elevations – Exercise, Life Circumstances & Seasonal Infections

Inflammatory markers can temporarily rise due to factors like strenuous exercise or mild seasonal infections like the common cold. Repeat testing and considering contextual factors are necessary for an accurate interpretation of your blood result. Most inflammatory markers tests are false positives rather than indicating a serious illness. [7]