Does Your Patient Have High Inflammation? Signs, Symptoms & Testing Methods

By Jim Paoletti, B.S. Pharmacy, FAARFM, FIACP | Director of Education, Power2Practice

Inflammation Testing - P2P

Inflammation can present in many different ways…

Signs of high inflammation include:

  • Heart Disease
  • Cancer
  • Autoimmune Diseases
    • Ulcerative Colitis
    • Crohn’s Disease
    • Rheumatoid Arthritis
    • Multiple Sclerosis
    • Diabetes
    • Hashimoto’s Thyroiditis

Symptoms commonly associated with high systemic inflammation include:

  • Ongoing irritating aches & pains
  • Stiffness
  • Blood and mucous in stool
  • Allergies
  • Asthma
  • High blood pressure
  • Bloodshot eyes
  • High glucose levels
  • Heartburn, reflux or ulcers
  • Constipation or diarrhea
  • Fatigue or lethargy
  • Skin disorders
  • Weight gain
  • Swelling
  • Congestion
  • Fuzzy thinking
  • Memory lapses
  • Dry eyes
  • Shortness of breath






How to Test for Chronic Inflammation

There is not one test that is the gold standard for measuring inflammation levels in the body; multiple methods can be used.


Among the most commonly-used tests are high-sensitivity C-reactive protein (hsCRP), sedimentation rate and homocysteine.

  • An optimal hsCRP level should be 1.0 mg/L or less. HsCRP results above 3.0 mg/L indicate a high amount of inflammation and high risk for cardiovascular disease.
  • An optimal homocysteine level is 7–10 umol/L, and anything outside of that range should be addressed.
    • If the homocysteine level is 15 umol/L or higher I like to supplement a methylation support product that includes B2, B6, B12, Folate and a methyl donor like Trimethylglycine.
    • If the level is moderately high you can start more conservatively with folic acid 800mcg, B6 40 mg and B12 200 mcg daily.
    • Individuals with a genetic defect in folate metabolism will require a methyl folate supplement such as metafolin. B12 is better absorbed if given by injection or sublingual administration.
  • Sedimentation rate is said to be a non-specific test because an elevated result often indicates the presence of inflammation but does not tell the health practitioner exactly where the inflammation is in the body or what is causing it. An ESR can be affected by other conditions besides inflammation.
    • For this reason, the ESR is typically used in conjunction with other tests such as C-reactive protein.


Lesser used, yet clinically valid tests include ferritin level, monocytes, blood glucose and apolipoprotein B to A1 ratio.

  • Ferritin levels become high with high inflammatory states, so ferritin can be helpful if included when determining if inflammation is excessive. HDL will usually be high if there is chronic inflammation so measuring it may be helpful also.
  • Elevated monocytes can be a secondary indicator of inflammation. An elevated blood glucose level is another leading indicator of inflammation.
  • Apolipoprotein B to A1 ratio (ApoB/ApoA-1) is a new way to assess risk (early on) for future inflammatory disease. The Apo B/A-I ratio will provide better prediction of future cardiovascular events than measuring serum low-density lipoprotein (LDL)-cholesterol levels.
    • High Apo B values reveal the presence of many small, dense LDL particles, thus indicating substantial risk.
    • An ApoB/A1 ratio >0·65 in men and >0·62 in women is a marker of Metabolic Syndrome independent from conventional risk factors.


Jim Paoletti - Director of Education - Power2Practice

Jim Paoletti, BS Pharmacy, FAARM, FIACP, is the Director of Education at Power2Practice and a nationally-recognized expert in pharmacy, BHRT and custom compounding, and has previously served as Director of Provider Education for ZRT Laboratory and Education Director for the Professional Compounding Centers of America. At Power2Practice, Jim applies his wealth of knowledge and experience by hosting live webinars and creating clinical support tools, such as podcasts and blogs.


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