Healthcare is complicated enough, and here you have a doctor discussing inflammatory markers. But, hear us out; such markers can be used as a guide to direct your focus on health.
Overoptimizing
Anytime a patient asks if they should have a lower homocysteine or if a CRP of 1.1 is still okay, we redirect the question and ask how they are doing with their basic routine this week.
- Did you get good quality sleep last night?
- Do you have stress levels you can cope with?
- What zone 2 exercises did you do this week?
- How was the quality of your resistance training?
- Are you following the diet you set out for yourself?
There are ways to lower lab values with medications and certain tricks which may not necessarily impact your overall health.
Great example, I can lower a person’s blood pressure with a beta blocker, but their overall mortality from hypertension won’t change. So then, what’s the point of taking that medication?
Common Inflammatory Markers
The most common inflammatory markers are as follows. And they are important because they can increase the risk of tissue damage, infection, and cancer.
- CRP or hs-CRP
- ESR
- Interleukins
Less known but commonly used biomarkers for inflammation also include:
- Ferritin
- Homocysteine
- TNF-alpha
- Uric acid
- Platelets
- Fibrinogen
- Neutrophils/lymphocytes
Comparing one person to another is less effective when it comes to the interpretation of these markers. It often confuses and frustrates the patient.
Instead, using inflammatory markers to gauge how well your body responds to lifestyle changes is a more useful tool.
Again, to repeat the above: only after the patient has successfully adjusted their lifestyle habits, only then should the focus be placed on inflammatory markers.
Lowering Inflammatory Markers
Diet: It seems that some individuals respond poorly to sugar or gluten, or dairy. But that’s not the case for everyone. Others have a hard time with nuts.
Stress: Whether it’s the cortisol hormone or its effect on insulin or a whole other pathway we don’t yet understand, stress consistently increases inflammatory markers.
Sleep: It’s the number of hours in bed but the quality of sleep a person gets. If you don’t feel rejuvenated, focused, with a slight skip in your step, then sleep might need more attention.
Exercise: Quite a few people overtrain, which increases inflammation. Others live more sedentary lives and suffer from poor tissue oxygenation and perhaps more undesirable cellular metabolism byproducts.
Data Overload in Medicine
It’s a good thing that we have more data than we know what to do with or the technology to process it. It’s also a bad thing because all of this data, though seemingly useful, rarely impacts a patient’s life.
Nobody is guaranteed to avoid a heart attack because of a super low apoB or a super high LDL-C. We use these values in our practice as a guide to know what to optimize for.
We have noticed a trend where patients focus excessively on inflammatory markers and other serum health markers and spend time worrying about them instead of using that time for meditation or exercise.
Disease Prevention
As a virtual Primary Care practice, we focus mostly on preventing chronic disease. Next, we focus on treating chronic diseases.
Preventing a disease starts by identifying which chronic medical conditions a person is at risk for, and using serum inflammatory markers, we can determine how aggressive we need to be with our interventions.
Beyond that, constantly rechecking those serum markers is of little use.
Standins for Systemic Inflammation
A person with migraines or arthritis can tell us easily when her body is inflamed; the migraines come on and she’ll wake up with stiff and painful joints.
It’s our goal to rely more on self-perceived inflammation signals whenever possible instead of serology. Such standings are common and include:
- Acne
- Joint pain
- Stool changes
- Intestinal symptoms
- Fatigue
- Water retention
- Sleep quality
- Menstrual changes
- Skin changes
- Anxiety
- Agitation levels