How to understand inflammation patterns with your blood work

You want to know what one of my favorite tools as a practitioner is?

Blood work.

Does that surprise you?

As far as lab testing goes, it’s one of the most affordable options, and we get so much information on the health and function of different systems. So we can support those body systems with functional foods + good nutrition, and lifestyle habits.

Over the next few weeks, I want to share a little more on a few of the different patterns we look at, to understand which systems are out of balance and need support.

Some of the markers I want to look at more deeply with you come up in patterns of inflammation, liver health, blood sugar, as well as digestion, absorption and nutrients.

And while I’m not going to share specific numbers or ranges for markers in this series (work with a practitioner for your labs - or I'd be happy to hop on a quick call and give you my thoughts), know that there can be a big difference between what’s flagged by the lab, known as conventional ranges, and where we want your levels to be for optimal health outcomes.

Let’s start with inflammation.

Inflammation is an incredibly general term, used to describe the normal immune response to injury, irritation or infection. When you hit your toe and it gets swollen, that's inflammation kicking off the healing process. Sometimes irritations are internal (in places like our gut tissue, muscles, joints, or blood vessels). Inflammation is protective by design (we can’t heal without inflammation), but can become destructive when it becomes chronic, and is left unchecked.

Long term, chronic inflammation can lead to conditions like arthritis, eczema, IBS, hormonal imbalances, autoimmune conditions, cardiovascular disease, insulin resistance and diabetes. It’s safe to say that better understanding relative inflammation status in your system is an important factor for anyone dealing with chronic health symptoms they want to resolve.

Because inflammation can take on so many shapes, we see it “rear its head” in a lot of different ways throughout blood work. Some of the primary markers we look at to understand inflammation: lipid panel, c-reactive protein, high-sensitivity c-reactive protein, homocysteine, vitamin D, and ferritin (yes - an iron marker, of all things!)

How in the world are all these things connected? Let’s dive in…

Lipid panel (cholesterol, triglycerides, etc.)

Here’s a new way to think of it - cholesterol is actually a protective compound. Our liver increases cholesterol levels to “patch up” damage caused by oxidative stress and free radicals. So when we see elevated total cholesterol, LDL, and triglycerides we’re not necessarily thinking about reducing food sources of cholesterol. In fact, only 25-30% of cholesterol level can be attributed to diet, while your liver makes up the other 70-75% of cholesterol production (1).

When inflammation levels are higher, tissue damage increases, and your body has higher demand for protective molecules like cholesterol to patch things up. “During chronic inflammatory diseases, inflammation and infections can also induce a variety of alterations in lipid metabolism, including decreases in…HDL cholesterol, increases in triglycerides...and LDL levels.” So if it’s not dietary cholesterol that’s raising cholesterol in the blood, then let’s address inflammation.

We’re going to hit on some of the things that are driving inflammation in the next few weeks as well - but as a quick spoiler - blood sugar, gut health, inflammatory diet, and toxin or chemical exposure are a few of them.

So when cholesterol comes back elevated, that’s our first clue about inflammation.

CRP + HsCRP

Unlike cholesterol, c-reactive protein (CRP) is a widely accepted marker to measure relative levels of inflammation. But just like cholesterol, CRP is also produced by the liver, and increases in response to infections, inflammatory conditions, and trauma.

High-sensitivity CRP (HsCRP) is measured using a more sensitive assay (aka analysis technique) and is specific to cardiovascular-related inflammation and cardiovascular disease. HsCRP is another widely accepted marker to understand relative cardiovascular health and disease risk. (3)

Homocysteine

Homocysteine is a little bit different, because it’s not so much a direct result of inflammation (like cholesterol, and CRP/HsCRP), but it can cause inflammation itself when elevated.

Homocysteine is a by-product of a more complex process called methylation (which can be a topic for a different day). Homocysteine is a “mid-process” compound that needs to be converted into other amino acid compounds using B vitamins. If your body does not have adequate nutrients to make those conversions, homocysteine is left to circulate at higher levels in the body. Higher levels of homocysteine in the blood lead to damage of the cells lining blood vessels and vasculature. This leads to inflammation in blood vessels, and is linked to atherosclerosis and cardiovascular events.

While elevated homocysteine is an indicator of inflammation, the next step is more straightforward than the markers above. That's because you can address elevated homocysteine with the nutrient building blocks needed to clear it - active B vitamins.

Vitamin D

Vitamin D is a well studied, and honestly quite complex nutrient, but adequate levels of Vit D have well documented links to improved immune health, bone health and anti-inflammatory processes.

Unfortunately, chronically low Vitamin D is something we see a lot in blood work. There are a few reasons why someone might not be able to synthesize or hold onto Vitamin D at adequate levels. Of course, inflammation (as you might have guessed…), as well as heightened immune activity or chronic infection, fat metabolism and biliary/gallbladder issues, liver dysfunction (5), insufficient dietary intake or low sun exposure, as well as some medications.

A recent study has shown that deficiencies in Vit D may contribute to chronic inflammation. Researchers found an association between low Vit D level and elevated CRP (that widely-accepted inflammation marker from earlier!). Interestingly, this was a one way relationship – meaning that low vitamin D may be a driver for high CRP, but not the other way around.

Declining Vitamin D status is also associated with active inflammation - think of it like Vitamin D being called to arms to help fight inflammation (6).

Ferritin

Our gut tissue takes iron and converts it into ferritin, so ferritin is an iron marker (the measureof stored iron). Ferritin is part of the iron picture, but it’s also a well known indicator of inflammation when elevated.

Latest research suggests that ferritin elevates during the inflammatory process, because it’s leaked from damaged cells (7). Cells become damaged due to oxidative stress, which means cells are chemically altered by unstable compounds. We are ALL exposed to oxidative stress at every moment of the day. Producing these “unstable compounds” is a part of normal cell functioning. And our bodies can totally handle it, with the help of antioxidants. Antioxidants neutralize free radicals (the unstable compounds) causing this damage. Free radicals come from internal cell processes, but we experience a higher amount of free radical activity in our modern world - from industrial chemicals, air pollutants, highly processed foods, and even stress can generate free radicals.

Phew - we know a little more about where this “damage” comes from and how it can impact our cells. So when our cells are injured, they set off inflammatory alarms to call in more back-up like antioxidants, as well as the immune system. So we’re seeing higher ferritin in the blood, we know there’s often a larger inflammation response happening behind the scenes too.

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These are just a few of the markers we look at to understand the larger inflammation picture and help put together a solid plan for rebalancing and nourishing the whole system. So often it’s not just about 1 food, 1 symptom, or 1 supplement - it’s about putting the clues together to find patterns in the lab work, your symptoms, health history, and environment.