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Should you be Tested for Inflammation?

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Understanding Inflammation: How to Test for It and Why It Matters

Inflammation has gained a negative reputation due to its link to chronic illnesses and even death. However, recent advancements in medical research have provided us with a better understanding of how chronic inflammation can impair our health. As a result, questions arise: Can one have inflammation without knowing it? How can we determine if we have inflammation? Are there tests available to detect inflammation?

Fortunately, there are well-established tests that can detect inflammation. However, it is essential to understand that these tests cannot distinguish between acute inflammation, which may develop from a cold, pneumonia, or injury, and chronic inflammation, which is more damaging and may accompany diabetes, obesity, or an autoimmune disease, among other conditions.

Four common tests used to detect inflammation:

  • Erythrocyte sedimentation rate (ESR) or sed rate measures how fast red blood cells settle to the bottom of a vertical tube of blood. Inflammation can cause the red blood cells to fall faster as higher levels of proteins in the blood cause these cells to clump together. A normal result is usually 20 mm/hr or less, while a value over 100 mm/hr is quite high.
  • C-reactive protein (CRP) is a protein produced in the liver that tends to rise when inflammation is present. A normal value is less than 3 mg/L. However, body-wide inflammation can cause CRP to rise to 100 mg/L or more.
  • Ferritin is a blood protein that reflects the amount of iron stored in the body. Ferritin levels tend to be low when anemic, indicating an iron-deficient state, while high ferritin levels may indicate too much iron in the body. However, inflammation can also cause ferritin levels to rise. A typical normal range is 20 to 200 mcg/L.
  • Fibrinogen is a protein commonly measured to evaluate the status of the blood clotting system. Inflammation can cause fibrinogen levels to rise. A normal fibrinogen level is 200 to 400 mg/dL.

While these tests may be useful in certain situations, it is important to understand their limitations. They cannot distinguish between acute and chronic inflammation, and elevated levels may not necessarily indicate a specific condition or illness.

In conclusion, testing for inflammation can be helpful in certain circumstances, but a complete evaluation by a medical professional is necessary to determine the underlying cause of inflammation and appropriate treatment.

 The Role of Inflammation Tests in Medical Evaluation

Inflammation is a natural response of the body to infection or injury, but chronic inflammation can lead to several health conditions. Inflammation tests, such as ESR and CRP, are often used in medical evaluation to diagnose and monitor inflammatory conditions. However, these tests are not foolproof and may sometimes provide false results.

Diagnosing Inflammatory Conditions:

ESR is commonly used to diagnose inflammatory conditions like giant cell arteritis, where an elevated ESR can increase the suspicion of the disease. On the other hand, a normal ESR may argue against this diagnosis.

Monitoring Inflammatory Conditions:

In rheumatoid arthritis, ESR or CRP tests help determine the activity of the disease and how well treatment is working. However, none of these tests is perfect, and false negative or false positive results may occur.

Routine Inflammation Testing:

Currently, expert guidelines do not recommend routine inflammation testing for all adults. Although CRP testing is encouraged to assess cardiac risk, it adds relatively little to assessment using standard risk factors like hypertension, diabetes, smoking, high cholesterol, and family history of heart disease. Only companies selling inflammation tests directly to consumers recommend routine testing for inflammation for all without a specific reason.

Silent Inflammation and Testing:

Chronic inflammation may not cause specific symptoms, but it is often linked to conditions like excess weight, diabetes, cardiovascular disease, hepatitis C, and autoimmune diseases. Standard medical evaluation for most of these conditions does not require testing for inflammation. Therefore, it is less helpful to look for evidence of inflammation through a blood test without any sense of why it might be there. Instead, adopting healthy habits and getting routine medical care that screens for common causes of silent inflammation can identify and treat the conditions that contribute to harmful inflammation.

Conclusion

Inflammation tests have their place in medical evaluation and monitoring of certain health conditions. However, routine inflammation testing is not clearly helpful for everyone. A better approach is to adopt healthy habits and get routine medical care that can identify and treat the conditions that contribute to harmful inflammation.

Caroline Buckee

Caroline Flannigan is an epidemiologist. She is an Associate Professor of Epidemiology and is the Associate Director of the Center for Communicable Disease Dynamics.

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