What’s Inflammation and Why Does It Matter?

“Doc, I have inflammation.”  I hear this every day from patients, yet no two people mean the same thing.  

It’s a term often used to describe a variety of symptoms, including brain fog, fatigue, restless sleep, body aches, joint pain, digestive issues, stress, anxiety, and exhaustion. In short, it often means, “Doc, I don’t feel my best, and something’s off.” 

In the coming years, the diagnosis and management of chronic inflammation will become a foundational component of disease reversal, prevention, and healthy aging. 

Let’s take a deeper look. 

Acute Versus Chronic Inflammation 

Acute inflammation is a protective and short-lived response to injury or infection, facilitating tissue repair and recovery. On the other hand, chronic inflammation is a low-grade, persistent activation of the immune system that can last for weeks, months, or even years. Essentially, the body stays in a prolonged state of high alert without a clear external threat, reflecting an imbalance between proinflammatory signals and the body’s ability to resolve them. This process is driven by a complex interplay of factors, including stress, sleep, nutrition, gut health, physical activity, environmental exposures, visceral adiposity, and social support.  

When It Turns Against You 

The relationship between chronic inflammation and disease is now well-established across multiple organ systems. In musculoskeletal tissue, it may present as inflammatory arthritis such as rheumatoid arthritis or lupus. In the heart and circulation, it can be painless but persistent, quietly contributing to coronary artery disease and atherosclerotic plaque formation. In metabolic disease, it’s a key player in insulin signaling and glucose uptake. In the brain, neuroinflammation may precede measurable cognitive decline. In the liver, it can progress from steatosis to steatohepatitis. At a molecular level, hormones and cytokines (signaling molecules) like IL-6, TNF-alpha, and hsCRP influence vascular function, insulin signaling, lipid metabolism, and gene expression.  

The Tests That Can Reveal Hidden Inflammation 

From a clinical perspective, it’s important to consider both disease treatment and reversal, as well as preventive care. Advanced biomarker testing alongside a broader panel may include hs-CRP, ApoB, LP(a), lipid panel, fasting insulin and HbA1c, hormone levels, and ferritin, among others. Continuous glucose monitoring may provide insight into glycemic variability, while a sleep study can help identify nonrestorative or fragmented sleep, which, when present independently, amplifies proinflammatory pathways. DEXA body composition testing is a powerful tool that measures visceral fat (which secretes pro-inflammatory cytokines), percent body fat, and muscle mass.  

What You Can Do 

The good news? Chronic inflammation can be managed in a variety of ways, including:  

1. Optimize Body Composition: Get a DEXA scan for a baseline assessment. Even modest reductions in visceral fat or increases in muscle mass significantly change inflammatory signaling.  

2. Focus on Nutrition: Support your gut microbiome with at least 3 to 5 servings a day of fresh or frozen fruits and vegetables, emphasize omega-3-rich foods and fiber intake, and reduce ultra-processed foods.  

3. Prioritize Quality Sleep: Aim for a consistent bedtime routine and quality sleep. If you’re not waking up feeling rested and refreshed most days, this may warrant a deeper look.  

4. Physical Activity: Start where you are and build slowly and consistently, with a combination of aerobic and strength training. This is key to progress over time and to prevent injury.  

5. Manage Stress: Consider mind-body techniques, mindfulness, journaling, and gratitude practices, to begin. Audit your inputs, including technology usage that may unintentionally increase stress.  

6. Social Connection and Purpose: Loneliness has increased globally and is a key driver of stress and inflammation. Reach out first, engage in a community, and laugh with friends. Find purpose in your daily life.