How to Tell If You’re Inflamed: Objective and Subjective Inflammatory Markers

In the comments section of last week’s post on inflammation, many of you expressed a desire for a post explaining how to know if one is actually suffering from systemic, chronic inflammation. I thought that was a great idea and decided to put the other followups on hold so I could tackle this one. Obviously, it’s easy to tell if you’ve got some acute inflammation going on – swelling, pain, heat radiating from a part of your body that’s suddenly assumed a rosy hue, and throbbing open wounds are all blatant indicators of the inflammatory process at work – but tests for markers of inflammation are not yet standard across most medical practices. With that in mind, I’ll be giving info on both objective markers for which you can test, as well as on the subjective markers I use on myself that you can “test” and use to evaluate your own level of inflammation.

Let’s get to it.

CRP, or C-Reactive Protein

CRP is a protein that binds with phosphocholine on dead and dying cells and bacteria in order to clear them from the body. It can always be found (and measured) in the bloodstream, but levels spike when inflammation is at hand. During acute inflammation caused by infection, for example, CRP can spike by up to 50,000-fold. CRP spikes due to acute inflammation peak at around 48 hours and decline pretty quickly thereafter (post acute-phase inflammation CRP has a half life of 18 hours). Thus, if the incident causing the inflammation is resolved, CRP goes back to normal within a few days. If it persists, the infection/trauma/etc. probably persists as well.

CRP elevates in response to essentially anything that causes inflammation. It’s highly sensitive to many different kinds of stressors. This makes it valuable for determining that inflammation is occurring, but it makes it difficult to determine why that inflammation is occurring – because it could be almost anything. But if you’re looking for confirmation that you are chronically, systemically inflamed, an elevated CRP in absence of any acute infections, injuries, burns, or stressors is a useful barometer.

“Normal” CRP levels are supposedly 10 mg/L. Absent infection or acute stressors, however, ideal CRP levels are well under 1 mg/L. You want to stay well below 1; you don’t want “normal.” Between 10-40 mg/L (and perhaps even 1-9 mg/L, too) indicates systemic inflammation (or pregnancy), while anything above that is associated with real acute stuff. Note that exercise can elevate CRP.

IL-6, or Interleukin-6

T cells (type of white blood cell that plays a huge role in the immune response) and macrophages (cells that engulf and digest – also known as phagocytosing – stray tissue and pathogens) both secrete IL-6 as part of the inflammatory response, so elevated IL-6 can indicate systemic inflammation.

Tissue Omega-3 Content

This is a direct measurement of the omega-3 content of your bodily tissue. It’s not widely available, but it is very useful. Remember that anti-inflammatory eicosanoids draw upon the omega-3 fats in your tissues and that inflammatory eicosanoids draw upon the omega-6 fats. People having a higher proportion of omega-6 fats will thus produce more inflammatory eicosanoids. Now, we absolutely need both inflammatory and anti-inflammatory eicosanoids for proper inflammatory responses, but people with high omega-6 tissue levels make way too many inflammatory eicosanoids. Studies indicate that people with the highest omega-3 tissue levels suffer fewer inflammatory diseases (like coronary heart disease).

Research (highlighted and explicated here by Chris Kresser) suggests that omega-3 tissue concentrations of around 60% are ideal, which is a level commonly seen in Japan – seemingly paradoxical land of high blood pressure, heavy smoking, and low coronary heart disease rates.

Omega-3 Index

This measures the EPA and DHA, the two important omega-3 fatty acids, as a percentage of total fatty acids present in your red blood cells. It doesn’t correlate exactly to tissue amounts, but it’s pretty good and a powerful predictor of cardiovascular disease risk. The omega-3 index doesn’t measure omega-6 content, but those with a low omega-3 index are probably sporting excessive omega-6 in their red blood cells.

Anything above 8% corresponds to a “low risk,” but levels of 12-15% are ideal and roughly correspond to the 60% tissue content mentioned by Chris’ article. 4% and below is higher risk and can be viewed as a proxy for increased inflammation (or at least the risk of harmful systemic inflammation developing from normal inflammation).

Systemic Inflammatory Response Syndrome Score

There’s the systemic inflammatory response syndrome, which is incredibly serious and has four criteria. If you have two or more of them at once, congratulations: you qualify – and should probably see a health professional immediately. This isn’t relevant for low-grade systemic inflammation, like the kind associated with obesity or autoimmune disease.

  • Body temperature less than 96.8 F (36 C) or greater than 100.4 F (38 C).
  • Heart rate above 90 beats per minute.
  • High respiratory rate, 20 breaths per minute or higher.
  • White blood cell count fewer than 4000 cells/mm³ or greater than 12,000 cells/mm³.

Of these objective markers to test, I’d lean toward CRP and one of the omega-3 tests. CRP is pretty comprehensive, and, while omega-3 tissue or blood cell content doesn’t necessarily indicate the existence of systemic inflammation in your body, it does indicate the severity of the inflammatory response you can expect your body to have. Taken together, both tests will give you an idea of where you stand.

And now, some subjective markers that I’ve picked up on over the years. These are a few signs and symptoms to watch out for. They may be harmless artifacts, but they may indicate that something systemic is going on.

Flare-up of Autoimmune Conditions You Haven’t Heard from in Ages

Sore joints, dry, patchy, and/or red skin, and anything else that indicates a flare-up. For me, this is usually mild arthritis.

Water Retention

As we discussed last time, acute inflammation is often characterized by swelling at the site of injury. The same effect seems to occur in states of systemic inflammation, although they aren’t localized, but rather generalized.

Stress Load

If you feel stressed, you’re probably inflamed. I’m talking about the kind that has you rubbing your temples, face palming, sighing every couple minutes, and pinching the space between your eyes very, very hard.

Persistent But Unexplained Nasal Congestion

Could be allergies, sure, but I’ve always noticed that when I’m under a lot of stress and generally in an inflamed state, my nose gets clogged. Certain foods will trigger this, too, and I think it can all be linked to a persistent but subtle state of inflammation.


If you fit the bill for the eight signs of overtraining listed in this post, you’re probably inflamed.

Ultimately, though? It comes down to the simple question you must ask yourself: how do you feel?

I mean, this seems like an obvious marker, but a lot of people ignore it in pursuit of numbers. If you feel run down, lethargic, unhappy, your workouts are suffering, you struggle to get out of bed, you’re putting on a little extra weight around the waist, sex isn’t as interesting, etc., etc., etc., you may be suffering from some manner of systemic, low-grade inflammation. Conversely, if you’re full of energy, generally pleased and/or content with life, killing it in the gym, bounding out of bed, lean as ever or on your way there, and your sex drive is powerful and age appropriate, you’re probably good.

And really, isn’t that the most important health marker of all?

Anyway, I hope this was helpful. Systemic inflammation is a pretty nebulous state, and pinning it down can be tough, even with the help of actual objective lab markers. And because inflammation and all the maladies associated with it are so intertwined and feed off each other and have so many different effects, we often feel helpless. Well, try not to pile too much on your shoulders. Get some markers tested if you can, but ultimately it’s going to come down to eating better, moving better, sleeping better, relaxing better, and avoiding too much stress. And if you feel great, I wouldn’t really worry. Don’t be the guy or gal who chases “inflammation,” and don’t go looking for a drug that reduces the liver’s production of CRP. Instead, be the one who eliminates the ultimate cause, or causes (because there are always more than one) of the chronic inflammation. Revisit the list from the end of the last inflammation post and make sure you’re not omitting anything that you should be including or including anything that you should be omitting.

Take care and be sure to leave a comment! How do you tell if you’re in a state of low-grade inflammation?

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

If you'd like to add an avatar to all of your comments click here!

81 thoughts on “How to Tell If You’re Inflamed: Objective and Subjective Inflammatory Markers”

Leave a Reply

Your email address will not be published. Required fields are marked *

  1. I experience a lot of stress in my work, even though it is my dream job. I have noticed I tend to continue retaining water even when I clean up my diet…that must be why. Now to figure out how to stop that stress reaction because I am not stopping the job 🙂

    1. I’ve noticed similar things – it doesn’t matter how clean my nutrition is if I’m stressed or lacking sleep. Health is definitely a holistic enterprise – everything needs to be in order for you to feel your best.

    2. I’ve been experimenting with fasting….cycles of 3 days at a time…just cold water and vitamins during fasting days followed normal eating but with portion control of low inflammatory foods and have seen a huge drop in inflammation.

      Lost 12 pounds over 90 days days.

      Problem is I still cheat a bit on eating days…and as a result I can predict when the inflammation reaction hits. I feel I am in control now as a result.

  2. I have noticed I don’t have joint pain in the same way as I did before going primal. I will take that as a big sign that the inflammation has lessened.

    Also, I don’t seem to have the same allergies in the spring and fall.

  3. My daughter has a skin writing condition, dermatographia. We’ve tried allergy testing and she has no allergies. I wonder if with her the CRP would be elevated. Thanks for this post, I’m going to have her checked for that. And try some Omega 3 supplement, it’s got to be better than long term use of allergy medications.

  4. “And really, isn’t that the most important health marker of all?”


    How do you feel? If you feel great, don’t worry. If you don’t feel so great and it lasts more than a few brief moments then take some action as Mark suggests.

    It can be simple. Living primally is your best chance to not be inflamed.

    1. Is acne a sign of inflammation? It seams reasonable to say yes.

      When I cut out low fat dairy products my acne improved dramatically pre primal. I’m not sure if I can handle high fat dairy with minimal lactose… I need to experiment some more.

      So, perhaps one would see dramatic improvements by eliminating all dairy.

      Just a thought.

      1. Read this recently. Makes a pretty good case for dropping dairy altogether.

        I think dairy is one of those ingredients you really need to be certain you can tolerate with no side effects if you insist on using it. The Paleo folks go this route anyway don’t they? Still trying to convince my wife to drop dairy as she clearly can’t tolerate it, but she had enough trouble coming to grips with dropping grain.

        1. My 18 year old daughter has problems with acne. She dropped dairy a couple of years ago. Made no difference whatsoever.

      2. Yes eliminating all dairy got rid of acne for me as well as mucus and breath issues. The last thing to go for me was butter. But I feel a lot better and my weight is closer to my ideal than it have ever been before!

      3. Consider giving up dairy that’s not either raw or cultured. I find I can tolerate it raw & cultured just fine and that now I’m coming to prefer it cultured. AND creme fraiche is the easiest gourmet food I know of!

  5. Inflammation is an under-addressed issue, especially in the medical arena. I’m glad you’re bringing it to light.

  6. I agree, inflammation is not well understood or talked about, but it is the cause of so many of today’s health issues. Crohns is my main auto-immune disorder but with that also comes joint inflammation, asthma, allergies, and skin infections like eczema. All of these things have shown marked improvement since I stopped eating grains, dairy and sugar. Doctors never seem to address the whole picture (nutrition, deficiency, inflammation, exercise) but instead address each symptom like it is exclusive of the other when in reality they are all related.

  7. Eye boogers. If I drink alcohol or eat a lot wheat (holidays) I always retain water and leak out my eyes while I sleep. Also, snoring intensifies with inflammation. One quick question, how do you get your CRP tested? What do you ask your doctor, if you need a prescription for the blood work? Thanks in advance. This is my first post, by the way. I’m no longer just an MDA stalker.

    1. You know what you’re right. I never thought about this much but ever since going primal my eyelids arent glued up with green/yellowish boogery stuff.

      Also, my ear canals are much cleaner.

  8. Great. Just great. On the Systemic Inflammatory Response Syndrome Score, I have a possible three out of four – on a *good* day. And my (former) doctor thinks this is fine.

  9. “Persistent But Unexplained Nasal Congestion”

    Yes, I’ve been congested since about 2006 and have only experienced relief while eating paleo. If I drink a lot of beer or eat too many non-paleo food I get VERY congested.

    1. Same here. I get that reaction when I follow coffee with chocolate ore eat a lot of dairy. Lots of bee doesn’t help, either.

  10. Well, the only things I can measure myself, breathing rate and heart rate, are 12 breaths/minute and 50 beats/minute, which is pretty good.

    I know I still have some work to do, though, because my belly and chest still have teh dredded fatz. Less than they used to, though!

  11. Ever scratch your arm…and get a slight burning sensation…maybe followed by some red marks? This is a histamine reaction…which means your cells are inflamed. When and if this happens to me I can usually narrow it down to a food I ate in the recent. I never knew what it was until my chiro explained it!

    1. Huh, that always happens when my skin is really itchy from excema, which is exacerbated by my allergies and probably inflammation.

  12. Hmmm…maybe that’s why the first sign of pregnancy for me has always been a stuffy nose. I guess pregnancy would naturally raise inflammation levels.

  13. I’ve been walking out of my shoes lately. They’ve gotten so loose. I don’t have foot pain anymore either and I suffered that for years. I’m pretty sure that’s a sign my inflammation is gone. Happy feet! Thanks Mark!

    1. my feet and shoe size seem to have gotten smaller too! its good to hear it from someone else- that means it is possible! (for a while i just thought it was wishful thinking on my part).

      1. Could be a strengthened arch shortening your foot too, if you’ve been going barefoot or wearing VFFs in that time.

    2. I went down 1/2 a shoe size when going paleo too! I thought it was because of weight loss, but it could have been inflammation too.

  14. I have hereditary gout. Everyone on my Dad’s side had it. By going primal and taking about 6000IU of fish oil daily, most of those gouty symptoms have all but disappeared. I just have a very minor arthritic stiffness in those big toe joints, which I can live with. Proof that one does not need to go on Rx drugs to “cure” this. In contrast, my aging Uncle has been medicating his gout for 40+ years, still eats grains and all the other high-glycemic foods that exacerbate this, and complains of the painful gout symptoms he’s going through. He will never change his diet. In his mind, if the gov’t says we need to eat our grains, drink OJ, etc. etc., then he will listen to his gov’t. It is sad to watch. I am 46, not exactly a child, but will never be given credit for knowing anything–even with the proof of my good health staring him in the face. Oh well, I guess you cannot save everyone…

    1. i’ve too have found that it’s one of the strange side effects of going Primal is that you almost pity/want to slap those who ignore what’s in front of their faces. It’s a bit of a helpless and frustrating feeling. But I guess that’s not bad as far as side effects go.

    2. Hey, I just want to share this with you.

      Some people are addicted to their ‘story’ or their hardships. So letting them go is really hard. It might also be one of their only means of getting attention from other people.

      Some of the issue with those people ‘who won’t hear the message’ has to be cured first mentally – for example a psychotherapist. Provocative therapy might work wonders.

      Remember the ole adage: “When the pupil is ready, the teacher emerges.”

  15. I think the natural next question is, if we DO think we’re in a state of low-level inflammation, what do we do?

  16. First post and this and these posts on inflammation are what I’ve been searching for.

    I’m being treated by a very smart doc…he’s all about inflammation. We have to do phone consults so conversations are not as thorough as I’d like.

    I’m still not where Id like to be. I have left sided nasal stuffiness/PND which is awful when I wake up in the morn..also my sleep is not refreshing at all, I can sleep 11 hrs no problem.

    I’m guessing this is a bigger issue than I thought as far as causing me not to feel well/not sleep. I have not stopped dairy but it’s looking like the answer.

    What do you all think of IGG/IGE food allergy testing as far as being conclusive? B/c I did test positive on both for dairy. THX

    1. I found that when I stopped drinking milk, I pretty much stopped producing mucous from my nose. Now that I have really cut back on all dairy (only have a little cream in my tea and a small amount of cheese a couple of times a week) I really notice that I hardly have any stuffiness. When I do go a bit overboard on either cream or cheese, I do notice within a couple of hours that mucous production has increased.

      I also feel better in general with the less dairy I consume.

      Perhaps try cutting out all dairy for a couple of weeks and see if that makes a difference.

      1. +1…dairy is very much related to mucus congestion! i gave it up years ago (and went to soy instead -ugh! live and learn). i can handle some butter and cream and occasional yogurt, but too much yogurt stuffs me up! and i just dont use milk or cheese at all.

    2. Just go for it! Try dropping dairy and you will most likely feel better and be un-stuffed in just 3-5 days. Maybe a week, if you’ve been regularly consuming a lot of dairy.

      I found that giving up all dairy and cleaning out my ear canals with hydrogen peroxide resulted in immense relief from congestion.

  17. This is very interesting, Mark… especially about persistent nasal congestion.

    Lately, in the late few months I had a very persistent nasal congestion especially when I go to bed. I couldn’t hardly breath and I found it hard to go to bed on time since my heart-rate was too high.

    I thought cheese and double-cream was to blame because of it dairy contents, but it wasn’t.

    It was when I started doing heavy deadlift and my lower back was sightly inflamed. I did the ICE method and heat via a water bottle wrapped in moisten towel. I didn’t realised that I was over-doing it and it turned into chronic inflammation.

    I backed off from deadlift completely and after about a week, my nasal congestion disappeared along with my mild chesty cold.

    I tried cheese and double-cream again and noticed no nasal congestion.

    Whew!!… I cannot live without my double-cream in my organic coffee! 🙂

  18. I sprained my ankle this weekend & was actually amazed to see the inflammatory response — swelling, redness, pain, etc in a matter of seconds. It’s crazy that our bodies can react to injury so quickly! (My son is into fire fighters right now & it reminded me of them zooming out of the fire station at lightning speed to fight a fire!)

    I went to the DR yesterday to get a walking cast (awesome invention – keeps it steady at a 90 degree angle which feels so much better) & she offered me two different kinds of pain killers (not so awesome!). I declined both. I’d rather listen to my body instead of masking the pain (& risk walking on my ankle too soon). It needs to heal after all!

  19. Can the level of fatty acids in our cell membranes actually be changed? I’ve seen conflicting research on this (i.e. suggests its set).
    I took the Vital Choice test when it was on special $99 and was surprised that my O3s were lower than I would have expected considering Cod Liver Oil and fairly regular oily fish consumption, etc.

  20. I definitely get the arthritic feeling. I also notice that my nose gets very runny and my eyes dry. If I don’t address things then everything else starts to suffer. Sleep, energy, digestion, pain levels. You name it. Stress sucks!

    I’ve also been on many expeds where you camp and walk for miles every day (Sahara treks, etc). It always amazes me how quickly you become at one with yourself and the World when you remove modern day stressors.

  21. I use to get one or two sinus infections a year every winter, and sometimes it would kick up the Asthma, and end up with bronchitis. Since going primal, I had one time that a sinus infection was starting to cause a Upper Respiratory Infection, but I was able to get it cleared up without the use of an antibiotic. Milk causes mucus, I can tolerate some cheeses, there does not seem to be an problem with butter, I can tolerate ice cream now and then. It feels good to be able to go to bed at night and not have to be concerned that I’m getting all stuffed up and then have to find a remedy to clear it up. There are still more things I need to clean up in my diet, but some of them I haven’t let go of yet.

  22. veggies, fruit, meat, & fat…tahdah!

    No more issues!

    …as clean and fresh as possible

  23. oh yea… LHT, move frquently at a slow pace, sprint, play rest.

  24. I had my CRP tested and it came back at 5.87 on a scale of 0-3. 🙁 Went primal for 30 days and re-tested at a 5. Still some more work to be done, but I’m definitely sticking with this! Hopefully I can get my thyroid and cortisol issues sorted out in the process. So thankful I found this lifestyle!

  25. I think inflammation is the root of a lot of medical problems people experience today. stress is a big one we need to learn how to control. It really is a killer!

  26. Mark
    Interesting article. However I do have a little dilemma. Though I do not see myself as over training , I do seem to have the symptoms.
    I keep fit by doing the primal fitness twice a week yet I am now struggling. This is how it goes, pushups: two weeks ago I managed 47 on my first set later in week I managed only 40 and the week later only a mere 35. I have now managed to get back up to 40, now pullups another story. Managed 12 but over the last few weeks I have went down to 8 and struggling. Can this be associated with over training. But yet I work out twice a week. Your thoughts and others aedvice is needed

    1. What do you weigh? You may not be eating enough protein.

      I had that experience not able to progress until I sorted out my protein requirement.

      I am 161 lbs and my LBW (lean body weight) is 151 lbs so therefore, I eat approx 150 to 160gms of protein a day.

      1. I weigh 160 lbs. I find it really hard to eat that much in protein. my portions would have to be huge. I try to compensate with 2 protein shakes a day but thats still doesn’t add up to 160 g. maybe your right not enough, I cant think of anything else

    2. With full recovery, you should be able to do at least as many reps as the previous session.

      Recovery depends on a lot of external factors (rest, stress, activity, diet, etc.) and it may be that two sessions a week is too many.

      I know I’ve made gains by cutting back on the number of sessions.

  27. Hi, this post has drawn a lot of former lurkers into the light (me included) …

    First I need to say that this is a very well researched post! Keep up the good work, Mark & wbees 😉

    I didn’t see anyone ask (or freak out about) Systemic Inflammatory Response Syndrome or SIRS but just in case – this has not a lot to do whether you are living a healthy lifestyle and taking enough omega 3. If you are sitting on your computer and reading this YOU DON’T HAVE IT!!! It’s an acronym we use in a hospital intensive care setting to decide whether our (probably also septic but DEFINITELY critically ill) patient is starting to go downhill and on the road to mutlicple organ failure. I am a veterinarian and have never ever seen a patient with SIRS that was able to walk, most of them are barely conscious. In people it’s pretty much the same. So no worries, it doesn´t really belong in Mark´s (very cool and helpful) list and hopefully most of us will never ever experience it 😀

  28. This all describes me to a T when I am eating poorly or overstressed. My dad passed away a few months ago, which was a huge stressor. I also had been going VLC (very low carb) for many months when I was very close to my goal weight, and fasting once a week, which I think was very stressful on my body. I was also doing too much dairy, which I know makes me congested. Sum all that up, and I got a bout of adrenal fatigue (see Dr. BG’s Animal Pharm for a good analysis of adrenal fatigue) and 3 sinus infections in 3 months. Also got plantar fasciitis in one foot, a return of tendonitis in one wrist and floaters in one eye. Talk about systemic inflammation! I blame it all on stress, too much dairy, and being too low carb and fasting. I’ve been following Jack Kruse’s advice about eating meals early, focusing on getting really good sleep (no electronics after 8 pm, asleep by 10 pm), and eating fruits and veggies, including potatoes and rice, to my heart’s content. Symptoms are resolving on a FIFO basis. Adrenal fatigue and chronic sinus infections gone, and the others soon will be. Highly recommend Animal Pharm and Jack Kruse if you have an adrenal problem or for leptin reset. Sometimes it takes more than being paleo/primal, depending on the circumstances!

    1. “Sometimes it takes more than being paleo/primal, depending on the circumstances!”

      I came to MDA looking for help with GERD, which started about 3 years ago. I’ve been following the VLC and high fat diet, moderate exercise, no sugar or veg oils,etc. for about 3 months. At first I felt a lot better with a lot more energy, but after the first month I’ve became so fatigued that I can hardly walk and my eyesight has deteriorated as well. I want to keep on the primal diet since some of my previous issues have resolved, such as IBS, constant nausea and depression. The GERD, however is still a problem and the pounds have not melted off around the middle, as it has for others (although I wasn’t all that concerned with the weight anyway; I’m 62, 5’2″ @ 118 lbs). But it was the overwhelming exhaustion factor, despite following good sleep protocol, that was a deal breaker for me. Also, GERD episodes increased! I noticed that every time I had more carbs than usual, like a yam or increased my veggie intake I felt a little better; but until I read your post I didn’t really understand what was going on. So thanks SO much for your input on this. I think I will check out the web sites you mentioned, plus start including more carbs in my diet. It’s possible that I am grain sensitive but just need more adreanal support.

      1. Diana, Yes, I found that I could be very low carb easily when I was significantly overweight and when I was younger, but not now that I am close to goal weight and older with MS. You might find the Jaminet’s Perfect Health Diet helpful too. Mark has said that PB and PHD are very similar, but slightly different reasoning behind the diets and PHD is on the upper end of PB carb-wise. PHD recommends 400 cals a day from glucose/safe starch. I found that REALLY helpful for energy and adrenal fatigue. Good luck! My own web site has a lot of recipes you might find helpful. Just click on my name.

        1. I started eating more veggies and had some potatoe since reading your post and I am already feeling much better. Thanks! I was feeling pretty bad but didn’t want to give up the paleo diet. I like PB because of it’s simplicity. The last thing I want to do is spend all of my time being obsessed by my food etc. And I think you’re right, being older and not overweight makes a difference in ones response to LC. Perhaps being female also plays a part. I’m currently exploring the PHD website and also Hunt.Gather.Love; I’m finding some useful insights at these sites. I’ll check out yours,too. I think, for me, this is all going to require a lot more experimenting than I originally thought. Thanks again for your help, I appreciate it.

  29. Barefootking: I am currently a MDA stalker. 🙂 This is my first comment. For the past few, I’d say 4-5 months, I’ve been reading up on Paleo and similar and recenty started reading Primal Blueprint (on Chapter 4). I have Rhuematoid Arthritis and have had it going on 13 years (I was 17 when I was diagnosed but had symptoms long before that). I was waking up barely about to walk and in terrible pain. Random joints/muscles would hurt so bad I couldn’t move them and then it would just go away after a couple of days. I was sleeping with the windows open in the middle of winter because I was sweating and burning up all over from inflammation. I was started on Vioxx and methotrexate and eventually joined a study for a new drug. Currently, I’m only on methotrexate and would love not to take that! I can’t even consider children with my husband because of the evil methotrexate. I’m so scared to come off it though because my rhuemy said I’d “probably have a flare up.” Now, I rarely have pain and often wonder if I even have RA. I don’t take anything for pain other than for an occasional headache or stiff neck. I’m very interested in a diet that reduces inflammation and improves autoimmune diseases and feel that drugs are NOT necessary and lifelong as I feel all the doctors I’ve talked to think of RA. I’m slowly educating myself, but like anyone that has grown up eating fast food, carbs, and sugar, I’ve been holding back. It’s hard to change from Conventional Wisdom when it’s been the only thing I’ve ever known. Thanks for all of the helpful information on this site and in the books. I know it can be done…I just gotta buckle down and know this will only be better in the short and long run! 🙂

    1. My daughter was forced to drop out of college Oct. 2010 because of severe RA. She went on a Weston A. Price diet – very similar to PD – and is now completely out of pain with NO drugs and regaining range of motion in her joints. This diet is very powerfully healing, however it was not a quick process for her. Sleep was critical.

    2. When you go off methotrexate, definitely taper off slowly. I decided to stop all at once and the symptoms all came back within a month or so and I’m now back on and tapering slowly to see if and when the symptoms come back.

  30. My knees tend to crack sometimes and the right one gets sore on occasion due to an old injury. Salmon and fish oil always seem to help.

  31. This is VERY timely for me. I have all of these auto-immune issues that came out of nowhere in the last year.

    I am struggling now with figuring out of I am also overtrained. I have high cortisol as well. Not sure if that’s internal or externally sourced.

  32. I took some bloodtests some months ago and they were fairly comprehensive, but one of the figures that was elevated was C reactive protein, as well as elevated levels of white blood cells. I haven’t felt well in some time and im currently working with Laurent Bannock and might use Chris Kresser as well.

  33. Hi Mark,

    Great article but I noticed you do not mention Sedimentation Rate. Can you please explain why not? I am of the understanding that elevated sed rate is a major marker of inflammation.


  34. I’ve been going primal for about 44 days so far. Today I feel kind of hot, I’m breathing about 30 breathes per minute and my heart rate is about 70 bpm.

    I’m not sure what is wrong with me but I ate for the first time today around 6pm and fasted for most of the day. I kind of had a big meal so I think it might have something do with it.

    Anybody have any advice?

  35. i had blood taken this week every thing came back ok but one that i had inflamation what is wrong thanks

  36. Just for a note on acne, while eating plenty of pasta/bread/carbs for the last 10 years, I tried dairy/no dairy and it didn’t really make much of a difference that I saw. For the past 3 months I’ve been doing paleo and have had lots of full fat cheese and yogurt, and lots of whole fat milk & cream (organic/grass fed as much as possible).

    Have not had major (or minor, really) acne problems over the last 3 months.

  37. 50 yrs old. History of MRSE Osteomyelitis, spine after multiple spine fusion surgeries/hardware. Horrible back pain continuese. Chronic Elevated sed rate and crp. WBC low-norm. Chronic chills, sweats, severe fatigue. Feel exhausted all of time. Skin color worsening pale to pasty color. Recently diagnosed with Rheum. Arthritis (neg rhem factor). Just recovered from adrenal crisis. Have hypothyroidism. Baseline vital signs: BP 90-100/60-70, HR 90-100, RR 20-24 (SOB frequently), temp always low 96.0-96.8. Docs missing something. I feel horrible; cannot function seriously. No one individual should feel this bad nor be brushed off by the medical community for help. I am a Registered Nurse. Help me doctors. Kentucky.

  38. Speaking of inflammatory responses and such. I’m just starting out with paleo, 53 years old, very overweight at 260. I’m also a former jock, and jumped into some high intensity intervals with perhaps too much enthusiasm. BP was great at annual physical, about four weeks into program, at 115/68. My HDL is up ten points. But my liver enzymes were seriously elevated, about five times normal, ditto for C-reactive protein. My doctor is scratching his head, but I reckon it’s a normal response to a new, stringent diet that’s knocking off fat cells, along with some muscle probably, and perhaps too much exercise to start off with. Anyway, I’m not worrying, and I bet we are on the way back to normal when we recheck. I’m putting on muscle in spite of it all and losing fat like a demon. So grok on!

  39. i would like to know if there is any device which could detect inflammation ….theres a person i know who died in a accident ,he was taken to a hospital doctors could not find out the tissue which has inflammed inside the body can anyone atleast help me out in designing such a device so that it could be helpful for others

  40. The comments about inflammation and eye issues are interesting. I am self – diagnosed gluten intolerant (doctors have been next to useless in my quest for improving my chappy health) and the past couple days I’ve made bread for my family. I didn’t eat any but just kneading it caused a huge flare up in inflammatory response- swollen &crusty eyes and extreme fatigue. Also certain eye makeups will do the same thing.

  41. Dear Mark,
    I have been on a quest since the age of 13 to better health through diet. I gave up soda and red meat. While in college, I became a full vegetarian and only ate veggie burgers, veggie chicken, etc as a protein source . Then I found almond milk and restricted a lot of dairy. I’m from a very rural town and low fat diet was always preached to me. I began a going to the gym about 5 or 6 nights a week. After grad school. I obtained a job and after starting work, maintaining vegetarian diet, and workout devotion I was diagnosed with an autoimmune disease at 26. It was the most horrific news and I know that’s somewhat selfish but it’s true. Through reading your posts and other resources, I understand how my vegetarian diet contributed to my current state. I began the paleo diet in July 2013 and after that time still have a lot of problems. So being incredibly stubborn, I did more research discovering the autoimmune Paleo diet. Again my brain is buzzing with food I have to eliminate, replace. Not having dark chocolate breaks my heart. Can you offer any guidance to help me on this journey, avoid traps, etc.
    Thank you

  42. I can tell within minutes if what i have eaten has triggered inflammation in my body. Swelling in my hand and ankles, and if i go over board on the sugar/grains (even whole grains) my face will even swell.. I can lose 2 inches over the course of a few days simply by cutting the sugar and the grains from my diet. I also notice increased pain in my knees. I control my these issues, using my own diet on but mostly just cutting the carbs. in all forms. The effect they have on your body is amazing!

  43. Have you heard any correlation between BP MEDICATION, Ramipril as the cause of chronic Inflamation? I suffered devastating side effects from this medication – where I could not even get of of bed by pushing myself to a sitting position. Next came a flare up of Inflamation which caused muscle weakness, muscle soreness, loss of muscle strength, and joint stiffness. It has gotten progressively worse. I stopped that BP MEDICATION 3 months ago. I lost 20 lbs and now have good BP AND DO NOT NEED IT!
    Now I have been dealing with constant flare-ups which involve my legs and keep me from walking, climbing stairs, or even simply exercising every day!
    I also get leg flare ups for two days, then upper body flare up, and in between I only feel moderately normal, until it starts all over again.
    My CRP LEVEL Is 15 and my Dr said it s/b below 8
    No RA or Lupus
    No joint problems noted in X-Ray of shoulders, hips, and knees.
    No tendon or ligament problems.
    Not sure if I have arthritis, but doubts that.
    I’m not taking any pain MEDS until I see a Rheumatologist.
    What can I do that will help me out of this Inflamation cycle?

    Before this happened I exercised every day and never once had any pain in my life. I just turned 66, and I’m a grandmother.

  44. Seen a few of your posts, I’m not sure if I have it or not… I’m taking tablets for my eyes that reduce inflammation and promote blood circulation, that and fish oil (omega 3 only). I was suppose to be clear by 3 months, it’s now like 10…. It’s now a pain, every time I contact them they aren’t helpful as much. At first I had orange skin due to beta-carotene, I drink water/soft drinks/herbal teas… eventually went down, my eyes are still dry and red. Could I ask for this test and to see if i’m consuming omega 3? I’m getting acupuncture done to. Going to do it every 2 weeks possibly to see if it helps, with eye exercises, I go to college 2 and a half days, I have a normal diet: I love trying to eat healthier thought… I do eat chocolate and crisps… I am suffering from a bit of stress… when I asked my gp about the chest pains it was told it was just panic attacks. My acupuncturist disagreed, (I agreed with what they said). They treated my upper eye brows, and legs aiming for the liver, due to me being tired which to them was described as not getting what I need from the food. I’m at a loss, I’ve seen acupuncture cure some people, and a healthy diet for others… (Doubt I’m lucky enough). I just wanna be able to get this under control. The redness makes me very unhappy about my eyes, as I use to like them. I suspect my periods by about 90%, I use computers but this has never happened… (never experienced dryness once…) Any advice would be helpful! I emailed (the person I mentioned about diet) they recommended a nutritionist. Thanks a lot!

  45. I’m 34 with Crp that keeps rising. It’s at 11. I can’t find the cause. I have back injury (disk bulge and herniated disk) and suspicion of endometriosis. I also have mild inflammation in my stomach and esophagus.

    I do need to lose 25lbs. I think I’m going to try a gluten free and dairy free diet. I wouldn’t be surprised if I had food sensitivities. I’m having a hard time finding others with this high Crp that have brought it down to a healthy level.

  46. I have chronic pain in soft tissues – bilateral patellar tendinosis, bilateral epicondylitis, and bilateral hip bursitis. A chiropractor recommended getting tested for CRP and ESR, which I did yesterday but don’t have the results yet. Tests in 2016, when I also had these conditions, were CRP < 4 and ESR 5. Prior to the onset of the patellar tendinosis and epicondylitis (20 years apart), I had taken Cipro for sinus infections. I later learned these cause tendinopathies.

    My question is: if my current results are low for these tests, would I benefit from a grain and dairy free diet, including corn, rice, legumes, nightshades etc.? Thank you very much.

  47. I am sensitive to aspirin, had 7 operations to remove polyps. 4 years ago I started getting panic attacks. Then realise that salicylates and benzoates were in most of the products that I use. I started putting SUNFLOWER OIL on my body for a moisturiser. I started getting sore thigh muscles. It is mostly at night when I sleep and when I sit for a long time.
    I read an article about the ratio omega 3 and 6. And then discovered your article when I google “Eicosanoids” thanks for that. I also have very dry , itchy eyes for the last 3 days. I am going on a low omega 6 diet and going to see my dr for a test to confirm the inflammation. ( I also have a lot of food allergies because of the salicylates) thanks again.