Understanding Inflammation: Tests, Myths, and What You Need to Know

Inflammation often gets a bad rap—and for good reason. Chronic inflammation is a known contributor to serious conditions like heart disease, cancer, and dementia. If you skimmed health headlines, you might believe wiping out inflammation could prevent these diseases and even slow aging. But the truth is more complex.

Recent advances have deepened our understanding of how chronic inflammation harms health, sparking common questions: Can I have inflammation without symptoms? How do I know if it’s there? Are there tests to detect it? The answer to the last question is yes—here’s what you should know.

Common Tests for Inflammation Several established tests help detect inflammation in medical settings. However, these tests don’t differentiate between short-term (acute) inflammation—say, from a cold or injury—and chronic inflammation tied to conditions like diabetes or autoimmune diseases. Knowing the distinction matters.

Here are four widely used inflammation tests:

1. Erythrocyte Sedimentation Rate (ESR or Sed Rate)
   This test tracks how quickly red blood cells settle in a tube. Inflammation speeds this up due to increased blood proteins causing cells to clump. Normal results are typically 20 mm/hr or less; over 100 mm/hr signals significant inflammation.
2. C-reactive Protein (CRP)
   Produced by the liver, CRP levels rise with inflammation. A normal value is below 3 mg/L. Levels above this may indicate cardiovascular risk, while widespread inflammation can push CRP to 100 mg/L or higher.
3. Ferritin
   This protein reflects stored iron but also spikes during inflammation. Normal ranges (often 20-200 mcg/L) vary by lab and gender. It’s typically used to assess iron levels, but elevated ferritin can signal inflammation.
4. Fibrinogen
   Linked to blood clotting, fibrinogen levels (normal: 200-400 mg/dL) increase with inflammation, making it a dual-purpose marker.

Are Inflammation Tests Worth It? In specific cases, these tests shine:

• Diagnosing Conditions: For rare diseases like giant cell arteritis, a high ESR supports diagnosis alongside symptoms like headaches or jaw pain, while a normal result may rule it out.
• Monitoring Diseases: In rheumatoid arthritis, ESR or CRP tracks disease activity and treatment effectiveness.

But these tests aren’t foolproof. False negatives can miss real inflammation, while false positives may suggest inflammation that isn’t there.

Should You Get Routine Inflammation Testing? Experts don’t recommend blanket inflammation testing for all adults. CRP testing is sometimes used to assess heart attack risk in people with intermediate risk profiles—not high or low—but for most, it adds little beyond standard checks like blood pressure, cholesterol, or family history.

Direct-to-consumer test companies may push routine inflammation screening, but medical guidelines don’t back this for everyone.

Silent Inflammation: Why Not Test Anyway? Chronic inflammation can lurk without obvious signs. Yet, broad testing without context is less useful than routine care targeting its common causes, such as:

• Excess weight
• Diabetes
• Heart disease or stroke
• Chronic infections like hepatitis C
• Autoimmune disorders

Standard evaluations for these don’t typically require inflammation tests. If diagnosed, your doctor can tailor treatments without them.

The Takeaway: Focus on Prevention, Not Just Testing Inflammation testing has a role in diagnosing and managing specific conditions, but it’s not a must-have for everyone. Instead of chasing test results, prioritize healthy habits—balanced diet, regular exercise, not smoking—and routine checkups to catch and address inflammation’s root causes early.