Testing for Chronic Low-level Inflammation

Metabolic Stress and Inflamation

Metabolic stress induces low-grade inflammation and an acute phase response. Low-grade inflammation is associated with Metabolic Syndrome, metabolic diseases, sedentary lifestyle, and poor diet including consumption of processed foods.

Positive acute phase reactants

  • C-Reactive Protien
  • Fibrinogen
  • Serum Amyloid A

Negative acute phase reactants

C-Reactive Protein

Blood Cholesterol

A blood test called 'high-sensitive C-reactive protein' (HS CRP) can measure C-reactive protein level, which is an index of chronic inflammation and better predicts risk of coronary heart disease and other metabolic disorders than LDL cholesterol.

Chronic inflammation increases risk of coronary heart disease and other disorders. (Ridker 2007)

CVD Risk: Low Intermediate High
CRP Level (mg/l) <1 1-3 >3

In the Physician's Health Study, men with greater than 2.11 mg/L had about 3 times the risk of suffering a heart attack compared with individuals with CRP less than 0.55 mg/L (the lowest quartile of scores).

However, intraindividual variation of CRP has shown to be significantly greater than that for cholesterol measure (DeGoma 2012).

Some medications can affect your CRP levels : birth control pills; statins; nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin, others); and acetaminophen (Tylenol, others).


  • Optimal range (200 - 300 mg/dl)


  • Expensive test but can help identify specific factors that are causing systemic inflammation.
    • Tumor necrosis factor alpha (TNF-α)
    • Interleukin-1 beta (IL-1β)
    • Interleukin-6 (IL-6)
    • Interleukin-8 (IL-8)


DeGoma EM, French B, Dunbar RL, Allison MA, Mohler ER 3rd, Budoff MJ (2012). Intraindividual variability of C-reactive protein: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 224(1):274-9.

Ridker PM, JE Buring, N Rifai, NR Cook (2007). Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: The Reynolds Risk Score. JAMA 297(6), 611-19.

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