Chronic Inflammation: Risk Factors and Signs

In classical times, Roman physicians recognized inflammation by four cardinal signs: rubor (redness), calor (heat), dolor (pain), and tumor (swelling). These are the same signs looked for by doctors today, but they’re symptoms of acute inflammation, the short-term immune reaction that speeds healing in the body.

Chronic inflammation, a subtle, systemic immune response that can persist for months or years after the need for acute inflammation is past, is much harder to detect. This type of low-grade inflammation was not widely recognized until the nineteenth century, and it wasn’t until the late twentieth century that chronic inflammation began to be acknowledged as a major underlying factor of negative health outcomes.

Systemic inflammation is not itself a disease. Think of it as your body fighting a war it doesn’t need to fight. Under those circumstances, it can even begin to attack its own tissues, sapping ability to function and paving the way for many kinds of disease, including Alzheimer’s, Type 2 diabetes, rheumatoid arthritis, heart disease, and cancer. Harvard Health, a publication of Harvard Medical School, has even called chronic inflammation a “unifying theory of disease.”

Risk Factors

There are many risk factors associated with low-level chronic inflammation. Some of them—like genetics and increasing age—are factors you can’t do anything about. But many other factors are variables that can be influenced by choices you make every day.

Among these anti-inflammatory choices: a diet that avoids saturated and trans-fats and refined sugars, refraining from smoking, getting regular exercise, and drinking only in moderation. Other risk factors strongly correlated with chronic inflammation are obesity, high levels of stress (which can be either emotional or physical), and insomnia/irregular sleep patterns. Low levels of testosterone or estrogen, which can both suppress production of inflammatory markers, have been implicated in chronic inflammation, and environmental factors like prolonged exposure to irritants or inhaled industrial chemicals can also contribute.

How Do I Know It’s a Problem?

Don’t rely on your doctor to point out possible chronic inflammation to you; it doesn’t share the same visible symptoms as acute inflammation. The redness, swelling, and heat associated with acute inflammation usually aren’t present in levels detectable to the naked eye, and doctors will not usually suggest testing for chronic inflammation unless there is already an associated condition present. (Read “Top Seven Myths about Inflammation” to learn more.)

But there are things to look out for. They’re often the kind that are mystifying, frustrating, and affect your quality of life, but don’t feel like quite enough for to visit the doctor. They can seem like they might clear up at any time—but then they drag on for weeks, months, or years. These signs include achy joints and body aches; continuous fatigue with no discernible cause; insomnia; depression or anxiety; swollen or sore gums; weight gain; and gastrointestinal irregularities like diarrhea or constipation. Allergies, asthma, and skin conditions like eczema and psoriasis often occur with chronic inflammation. If you seem to get infections frequently, that may also be a sign of low-grade systemic inflammation.

One danger with these types of diffuse, long-term discomforts is that your baseline of what feels normal may shift so that even if you’re impaired, you can’t clearly remember what it was like to function well. It can be hard to tell whether you should be concerned. But if these symptoms occur in clusters over more than a few weeks, they can be a red flag for chronic inflammation. Medical tests are available. The most effective test is serum protein electrophoresis (SPE). There are also less expensive blood tests, such as those for fibrinogen and high-sensitivity C-reactive protein (hsCRP).

If you have medical conditions associated with low-level inflammation, it’s time to see a doctor. But since no definitive test exists, if you suspect that chronic low-level inflammation may be having an impact on your health and you do not yet have a diagnosed condition associated with inflammation, you may simply want to adhere to anti-inflammatory guidelines for lifestyle and see whether, in a few weeks, you feel better.

How to Treat Chronic Inflammation, Naturally

Chronic inflammation goes hand in hand with the so-called 21st-century lifestyle, brought on by a material abundance and societal changes: plentiful processed, convenient food; the ability to remain sedentary for long periods; increased levels of stress; an eroded ability to unplug; and many technological temptations that compete with quality sleep and rest. Taken together, those factors create the perfect lifestyle storm for today’s diseases of affluence that all share the common denominator of long-term, low-grade inflammation.

Fortunately, not only do we know more and more about inflammation’s systemic form, but the tools for mental, physical, and emotional health—many of which have their roots in ancient practices and have been confirmed by scientific research—are better understood and more widely available than ever. There are many natural steps you can take to combat chronic inflammation, which tends to respond best to a holistic approach—one that doesn’t rely on a single treatment, but looks at the big picture and makes adjustments to diet, exercise, healthy weight, sleep health and emotional health.

There’s more than one 21st-century lifestyle. It’s up to us which one we embrace.

Want more? Read another in Lavonne’s series on inflammation: “5 Things You Can Do to Decrease Systemic Inflammation That Have Nothing to Do with Food.”