Chronic Inflammation: What Causes It and How Can You Reduce It?

Blood tests can provide important clues, but there is no single blood test that tells us everything about chronic inflammation.

CRP

C-reactive protein, or CRP, is produced mainly by the liver in response to inflammatory signalling.

It can rise substantially during infections, inflammatory diseases and tissue injury.

An elevated CRP tells us that inflammatory activity may be occurring. It does not tell us, by itself, where the inflammation is located or what is causing it.

ESR

The erythrocyte sedimentation rate, or ESR, is another commonly used marker.

Like CRP, it is nonspecific and needs to be interpreted alongside symptoms, examination findings, medical history and other investigations.

hs-CRP

High-sensitivity CRP, or hs-CRP, can detect lower concentrations of CRP and has an established role in cardiovascular risk assessment in appropriate clinical contexts.

It should not, however, be marketed as a universal test for “silent inflammation”.

Yes.

Some inflammatory and autoimmune diseases can be present despite normal CRP or ESR results.

This is an important reason why we do not interpret laboratory values in isolation.

There is rarely one universal cause.

The clinical question is which factors are relevant for the individual patient.

Metabolic health and visceral fat

Adipose tissue is not simply passive energy storage.

It is biologically active tissue that communicates with the immune and endocrine systems.

In particular, excess visceral fat around the abdominal organs is associated with altered inflammatory signalling and insulin resistance.

This helps explain why obesity and metabolic dysfunction are strongly associated with chronic low-grade inflammation.

Where these factors are present, improving metabolic health can reduce an important source of inflammatory signalling.

This is not simply about a number on the scales.

Waist distribution, glucose regulation, physical activity, muscle mass, diet and overall metabolic health can all matter.

Smoking

Smoking exposes the body to repeated oxidative and inflammatory stress and alters immune function.

Stopping smoking is therefore one of the most powerful interventions available when tobacco exposure is contributing to cardiovascular and inflammatory risk.

Physical inactivity

Muscle is also metabolically active tissue.

Regular movement influences glucose regulation, cardiovascular health, body composition and immune signalling.

Research consistently shows that regular exercise can reduce several markers associated with chronic inflammation.

Persistent disease

Sometimes inflammation is not primarily a lifestyle problem.

It may be driven by:

• autoimmune disease
• chronic inflammatory disease
• persistent infection
• inflammatory bowel disease
• inflammatory arthritis
• metabolic disease
• other underlying medical conditions

In those situations, identifying and treating the disease itself takes priority.

The internet is full of lists of supposedly “anti-inflammatory foods”.

Some foods certainly have useful nutritional properties, but the scientific evidence is more convincing when we look at the whole dietary pattern.

Mediterranean-style dietary patterns have some of the strongest evidence.

They typically emphasise:

• vegetables
• fruit and berries
• legumes
• nuts and seeds
• olive oil
• fish
• fibre-rich foods
• whole grains where appropriate and well tolerated
• herbs and spices
• relatively little ultra-processed food

Randomised trials and meta-analyses have found improvements in several inflammatory markers with Mediterranean-style dietary interventions.

Your overall dietary pattern matters more than adding one “anti-inflammatory” superfood to an otherwise poor diet.

Sugar deserves attention, but the message needs to be more precise than “sugar causes inflammation”.

The metabolic context matters.

A diet high in sugary drinks, refined foods and excess calories can contribute to weight gain, visceral fat accumulation, insulin resistance and poorer metabolic health.

These changes can in turn promote an environment associated with chronic inflammatory signalling.

This is one reason we frequently encourage patients to reduce added sugars and sugar-sweetened drinks.

That does not mean fruit needs to be feared because it contains natural sugars.

Whole fruit provides fibre, micronutrients and plant compounds and behaves very differently within the overall diet from a soft drink or repeatedly consuming refined sugary foods.

A high intake of ultra-processed foods is associated with poorer cardiometabolic health and multiple chronic disease outcomes.

These foods can also displace the foods we want more of: vegetables, fibre, legumes, nuts, seeds and minimally processed protein sources.

Rather than trying to classify every ingredient as inflammatory or anti-inflammatory, a practical strategy is often to shift the balance of the diet towards recognisable, minimally processed foods.

The relationship between the intestine and immune system is real and scientifically important.

The intestinal tract contains an enormous microbial ecosystem, and the intestinal barrier is in constant communication with immune cells.

Microbial metabolites, dietary fibre, intestinal permeability and immune signalling all interact.

This has led to intense research into the gut microbiome and chronic inflammation.

It has also led to considerable commercial overreach.

It is too simplistic to say:

“Your microbiome is imbalanced, therefore your symptoms are caused by systemic inflammation.”

Current microbiome science cannot support that conclusion in every patient.

At Centre Algos, we take digestive health seriously without assuming that every chronic symptom begins in the gut.

Supporting intestinal health when it is relevant

When digestive health appears clinically relevant, the first step is to understand the problem.

That can include considering:

• bowel habits
• abdominal pain or bloating
• food tolerance
• dietary fibre intake
• medication use
• previous gastrointestinal disease
• unexplained weight change
• nutrient deficiencies
• signs of malabsorption
• inflammatory symptoms

Nutrition can then be adapted accordingly.

For many people, supporting the intestinal ecosystem means increasing dietary diversity, plant foods and fibre while reducing excessive reliance on ultra-processed foods and added sugars.

Fermented foods can also be useful for some people when well tolerated.

But there is no universal “gut-healing diet”.

A patient with irritable bowel syndrome, inflammatory bowel disease, coeliac disease or significant malabsorption requires a different approach from someone simply eating too little fibre.

When can stool testing be useful?

Stool testing is useful when it answers a clinical question.

For example, faecal calprotectin is an established marker of intestinal inflammation and can help distinguish inflammatory bowel disease from functional gastrointestinal disorders in appropriate situations.

Other stool investigations can be useful when infection, maldigestion or another specific gastrointestinal problem is suspected.

Commercial microbiome testing is different.

A detailed microbiome report can produce large amounts of information, but not every bacterial abundance or “dysbiosis score” has a validated clinical meaning.

At Centre Algos, testing is therefore selected according to the patient’s history and the question we are trying to answer.

The purpose of a test is to improve a clinical decision, not simply to generate more data.

Exercise sometimes sounds contradictory in discussions about inflammation because strenuous exercise can temporarily increase inflammatory signalling.

That short-term response is part of normal adaptation.

Regular appropriately dosed exercise has a very different long-term effect.

Research shows improvements in inflammatory markers with aerobic exercise, resistance training and combined programmes.

Exercise also improves insulin sensitivity, cardiovascular health, muscle mass, glucose regulation, physical capacity, sleep and body composition.

For someone who has been inactive for a long time, the solution is not necessarily intense exercise immediately.

The appropriate starting point depends on current capacity, pain, disease and previous activity.

Consistency matters more than punishment.

Sleep is an important regulator of metabolic and immune function.

Research links persistent sleep disturbance and repeated sleep restriction with higher inflammatory markers, including CRP and IL-6.

One bad night’s sleep does not create chronic inflammation.

The pattern matters.

Repeatedly sleeping too little, fragmented sleep and untreated sleep disorders can become part of a wider metabolic and inflammatory picture.

When fatigue and inflammation are being investigated, sleep therefore deserves serious attention.

Psychological stress does not simply “cause inflammation” through one hormone.

The relationship is more complex.

Persistent stress can influence sleep, eating behaviour, physical activity, autonomic nervous system activity, metabolic regulation and immune signalling.

These systems interact.

Stress management can therefore form part of a broader strategy, particularly when persistent stress is clearly affecting sleep, recovery or behaviour.

At Centre Algos, approaches such as controlled breathing can be considered alongside the other drivers rather than presented as a standalone cure for inflammation.

Nutrition is not only about calories and macronutrients.

Micronutrients are required for normal immune function, antioxidant systems, energy metabolism and tissue repair.

Where deficiencies or insufficiencies are present, correcting them can be clinically important.

Depending on the patient’s history, diet and symptoms, assessment may include nutrients such as:

• vitamin D
• iron and ferritin
• vitamin B12 and folate
• zinc
• other micronutrients when clinically indicated

Omega-3 fatty acids are particularly interesting in the context of inflammatory regulation.

Meta-analyses of supplementation trials have reported reductions in inflammatory markers including CRP, IL-6 and TNF-α, although results vary according to population, dose and study design.

Food remains an important source, particularly oily fish.

Supplementation can be considered when appropriate to the individual patient’s diet and clinical context.

Certain plant-derived compounds also have measurable effects on inflammatory pathways.

Curcumin, derived from turmeric, is among the most extensively studied.

Large meta-analyses of randomised trials have reported reductions in inflammatory biomarkers such as CRP.

This does not mean turmeric or curcumin treats every disease associated with inflammation.

It does mean phytotherapy can have biologically meaningful effects and deserves to be considered on the basis of the individual condition, evidence, dose, formulation, medication use and potential interactions.

At Centre Algos, phytotherapy is used as part of an individual treatment strategy rather than as a generic “anti-inflammatory detox”.

An autoimmune disease should not be reduced to the concept of “silent inflammation”.

Conditions such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis and psoriatic arthritis, axial spondyloarthritis, lupus, coeliac disease and Hashimoto’s thyroiditis involve specific disease processes.

Nutrition, physical activity, sleep, micronutrition and phytotherapy can be valuable supportive components of care.

But the first priority is recognising the disease and ensuring appropriate medical assessment and treatment.

This is particularly important when uncontrolled inflammation can cause irreversible tissue or organ damage.

Sometimes inflammation contributes substantially to pain.

Inflammatory arthritis is an obvious example.

But chronic pain is more complex than inflammation alone.

Persistent pain can involve ongoing tissue pathology, mechanical loading, nerve irritation or injury, nervous-system sensitisation, sleep disturbance, reduced physical capacity, psychological and social factors, metabolic health and inflammation.

This is why simply finding a mildly elevated inflammatory marker does not necessarily explain someone’s pain.

The clinical picture has to fit.

We start with the patient, not with a panel of laboratory tests.

That means understanding:

• the symptoms and when they began
• known diagnoses
• medications and supplements
• previous investigations
• digestive health
• dietary habits
• sleep
• physical activity
• smoking and alcohol exposure
• metabolic health
• weight changes
• stress and recovery
• family and medical history

Existing blood results are reviewed before deciding whether additional investigation would actually add useful information.

Depending on the clinical picture, testing can include standard inflammatory and metabolic markers as well as more targeted functional biology, nutritional or digestive investigations.

This can include assessment of micronutrient status and, when clinically justified, stool or other specialised testing that goes beyond a routine general-practice blood panel.

The objective is not to search indefinitely for abnormal numbers.

It is to identify findings that can change what we do next.

There is no single Centre Algos “anti-inflammatory protocol”.

Treatment depends on what the assessment identifies.

A plan can therefore include several components.

Nutrition

Improving the overall dietary pattern, reducing excessive added sugar and ultra-processed food, increasing nutrient density and adapting nutrition to metabolic and digestive needs.

Digestive health

Addressing relevant gastrointestinal symptoms, dietary tolerance, bowel function and identified intestinal problems rather than assuming that every patient has “dysbiosis”.

Micronutrition

Correcting documented or clinically relevant nutritional insufficiencies and using supplementation strategically rather than prescribing a long list of products to everyone.

Phytotherapy

Using evidence-informed plant-based treatments when they are appropriate to the condition and compatible with medications and medical history.

Movement and exercise

Building regular activity and physical capacity at a level the patient can tolerate and progressively develop.

Sleep and recovery

Identifying persistent sleep problems and improving the conditions required for adequate recovery.

Stress regulation

Addressing persistent stress where it is contributing meaningfully to sleep, recovery, behaviour or symptoms.

Medical coordination

When the pattern suggests an inflammatory, autoimmune, infectious or other medical disease, further medical investigation takes priority.

These elements are not separate competing philosophies.

They are different tools used according to the biological and clinical problem in front of us.

Persistent or unexplained symptoms deserve medical assessment, particularly when accompanied by:

• unexplained weight loss
• persistent fever
• night sweats
• swollen, hot or persistently stiff joints
• blood in the stool
• persistent diarrhoea
• significant abdominal pain
• unexplained anaemia
• marked weakness
• new neurological symptoms
• persistent abnormal inflammatory markers
• rapidly worsening symptoms

These findings should not be managed simply with supplements or an anti-inflammatory diet.

They require an appropriate diagnostic assessment.

Chronic inflammation is real, but it is not one hidden disease responsible for every chronic symptom.

CRP and other inflammatory markers can provide useful information, but they need context.

The same applies to microbiome testing, micronutrient testing and digestive investigations.

The strongest evidence for reducing chronic low-grade inflammatory burden points towards fundamentals that are remarkably consistent:

good metabolic health, regular movement, adequate sleep, not smoking, a nutrient-dense Mediterranean-style dietary pattern and treatment of any underlying disease.

Micronutrition, digestive support and phytotherapy can then add more targeted options when there is a clinical reason to use them.

At Centre Algos, our objective is therefore not simply to “fight inflammation”.

We identify what may be driving it, investigate where necessary and build the treatment strategy around the findings.

What is chronic inflammation?

Chronic inflammation is persistent inflammatory activity that continues beyond the short-term response the body uses to fight infection, react to injury and repair tissue. Unlike acute inflammation, it does not always produce visible redness, heat or swelling.

What is silent inflammation?

Silent inflammation is a patient-facing term for low-grade inflammatory activity that occurs without the classical signs of acute inflammation. It is a description, not a formal diagnosis, and it cannot be assumed simply because someone feels tired or has pain.

What are the symptoms of chronic inflammation?

There is no symptom pattern that proves chronic inflammation. Depending on the underlying condition, inflammatory disorders can be associated with fatigue, joint or muscle discomfort, stiffness, digestive symptoms, poor sleep, reduced exercise tolerance or general malaise. All of these are nonspecific.

How do I know if I have inflammation in my body?

Only a clinical assessment can answer that. Symptoms, history, examination and existing results are reviewed together, and blood tests are interpreted in that context rather than on their own.

Can I have chronic inflammation with a normal CRP?

Yes. Some inflammatory and autoimmune diseases can be present despite normal CRP or ESR results. This is why laboratory values are never interpreted in isolation.

What foods help reduce inflammation?

The dietary pattern matters more than any single food. Mediterranean-style eating, rich in vegetables, legumes, fruit, nuts, olive oil, fish and fibre with little ultra-processed food, has the most convincing evidence for improving inflammatory markers.

Does sugar cause inflammation?

The relationship runs through metabolic health. A diet high in sugary drinks, refined foods and excess calories can promote weight gain, visceral fat and insulin resistance, which are associated with chronic inflammatory signalling. Whole fruit behaves very differently from a soft drink.

Can gut problems cause inflammation?

The intestine and immune system interact continuously, and digestive disease can involve genuine inflammation. But not every chronic symptom starts in the gut, and a commercial dysbiosis score is not evidence of systemic inflammation.

Can exercise reduce chronic inflammation?

Regular, appropriately dosed exercise is one of the most effective measures available. Research shows improvements in inflammatory markers with aerobic training, resistance training and combined programmes, alongside better insulin sensitivity, sleep and physical capacity.

Which supplements can help with inflammation?

Supplementation is only useful when it answers a documented need. Omega-3 fatty acids and certain plant compounds such as curcumin have measurable effects on inflammatory markers, and correcting genuine micronutrient insufficiencies can be clinically important. None of this replaces treatment of an underlying disease.

Is chronic inflammation the same as autoimmune disease?

No. Autoimmune diseases involve specific disease processes and require appropriate medical assessment and treatment. Nutrition, activity, sleep, micronutrition and phytotherapy can support care, but they do not replace it.

Can Centre Algos test for chronic inflammation?

Yes, when it is clinically justified. We review existing results first and can then use standard inflammatory and metabolic markers as well as targeted functional biology, micronutrient or digestive investigations. A test is requested when its result can change the treatment plan.

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• Autoimmune and Inflammatory Conditions
• Functional Biology and Micronutrition
• Phytotherapy
• Vitamin D and Autoimmune Disease
• Autoimmune Disease, Diet and Gut Health
• Digestive Problems and Naturopathy
• Fatigue Despite Normal Blood Tests