Follow on

Best Blood Tests For Measuring and Monitoring Inflammation- CRP, ESR, Homocysteine, more

Chronic Inflammation is a component of a wide range of diseases. Today, we will review the best blood tests for measuring and monitoring inflammation. Blood tests or blood biomarkers such as CRP, ESR, Homocysteine, Ferritin, Insulin and many others can be very useful in managing and monitoring the disease process.  It might be temping to jump into taking supplements to treat inflammation but Testing for Inflammation is one of the most important things you can do to successfully monitor your therapeutic progress. From these blood tests, you can now set goals, implement specific dietary strategies and leverage a treatment protocol aimed at getting to the root cause of your health problem.

Best Blood Tests For Measuring And Detecting Inflammation

Chronic inflammation can last for years and it can sneak up on us.  As you know from previous articles and videos I have done on this topic, Chronic inflammation can show up in a number of ways. Problems like weight gain, low energy, joint pain, skin conditions, thyroid problems, depression, diabetes, sleep disorders, poor gut health, hormonal problems, autoimmunity, heart disease, and this just scratches the surface.

There are several blood tests that can help determine the level of inflammation in your body but they can also guide you and your functional medicine doctor to the degree of inflammation and how you are improving. If any of these markers are elevated, I recommend retesting within 2-3 months depending on their levels.

C-Reactive Protein (CRP)

The C-Reactive Protein (CRP) test is a blood test marker used to assess levels of inflammation in the body. CRP is a protein produced in the liver. It is an acute phase reactant, which means it goes up or down with the degree of inflammation or trauma present in your body.

There are two different kinds of CRP tests- The one I recommend is the hs-CRP-test.

hs stands for high sensitivity. This is often used for cardiovascular risk assessment since high-sensitivity CRP has been linked to heart disease and mortality.

CRP is also useful in diagnosing and monitoring other chronic health problems like Crohn’s disease, Ulcerative colitis and Celiac disease.

I will often recheck these levels every 2-3 moths in patients who have autoimmune diseases. I like to see these levels at zero.

The next test I often check on patients with Chronic health problems is the Erythrocyte Sedimentation Rate or ESR for short.

Erythrocyte Sedimentation Rate (ESR)

When your body is inflamed, red blood cells or “erythrocytes” stick together. The Erythrocyte Sedimentation Rate is a test that measures how fast your red blood cells sink to the bottom of a test tube over the course of an hour.

High ESR levels indicate high levels of active inflammation. These can be elevated in patients with autoimmune disease, conditions like Rheumatoid arthritis, connective tissue disorders, Lupus, Hashimotos disease, Inflammatory bowel disease, vascular diseases, and Infection.  As ESR is not specific to the kind of disease you have and so if levels are elevated, other tests might be needed to identify the location and cause of the inflammation or infection.

ESR - What Is the Erythrocyte Sedimentation Rate Blood Test?

The next test for identifying inflammation will be your Ferritin levels.


Ferritin is another test that can be done during a routine blood test. Ferritin is actually the storage protein for iron. While low levels of ferritin indicate anemia (low iron levels) or blood loss, elevated ferritin indicates cellular damage and leakage.

Like the CRP test I mentioned in the beginning of this video, Ferritin goes up with inflammation, chronic infection, liver disease, obesity, alcohol use, autoimmune disease and cancer.

Inflammation will cause hepcidin production to increase. The increase in response to inflammation helps our bodies defend against invading pathogens.

Foreign invaders, like bacteria and viruses, need iron to survive. Your body is so smart that it responds to these invaders by increasing hepcidin.

The amazing thing about this is that increasing hepcidin removes the iron in the blood so it’s no longer available to the bacteria and viruses. The result? Iron in the blood circulation being put into storage and converted into ferritin. This is why ferritin levels increase during infection.


Homocysteine is an amino acid and (a building block of protein) that is produced in the body and signifies some form of vascular inflammation. In fact, a high level of homocysteine is a risk factor for heart disease.

When homocysteine levels are elevated- it can damage the lining of the arteries. High homocysteine levels also make the blood clot more easily than it should. This can increase the risk of blood vessel clot also called a thrombus. The problem with a thrombus is that if dislodges, it can travel through the bloodstream and get lodged in your lungs, brain or heart.

Studies also show that high homocysteine are associated with neurodegenerative diseases like Parkinson’s, Alzheimer’s and dementia. I will often see elevated levels of homocysteine in my patients with depression and migraines as well.

Like the previous blood tests for inflammation, high levels of homocysteine don’t tell us where the inflammation is coming from only that there is inflammation somewhere in the vascular system.

If your homocysteine level is too high, you may not be getting enough B vitamins which are needed to break down and recycle homocysteine into methionine.

In some cases, high homocysteine levels might be caused by a B6, B12, folate deficiency.

Other possible causes of a high homocysteine level include:

  • Methyl CpG | Ortho Molecular ProductsLow levels of thyroid hormone.
  • Kidney disease
  • Smoking
  • Excess Coffee intake
  • Low Levels of Choline
  • Injury to the Gastrointestinal lining
  • Oxidative Stress
  • Pernicious Anemia which causes B12 deficiency
  • Certain medications like birth control pills, antacids, and antidepressants (deplete many of your B vitamins and affect methylation pathways.
  • Genetic (SNP) Mutation in the MTHFR gene.

If you have high homocysteine, I recommend that you start taking Methyl CPG.  It contains all B vitamins needed to support the conversion of Homocysteine into methionine. Be sure to retest your levels in 3 months and work with a Certified Functional Medicine Doctor who can identify the root cause of your high homocysteine.

The last test for inflammation I want you to be aware of are typically related to problems with blood sugar, this is your fasting insulin.

High Homocysteine | Linus Pauling Institute | Oregon State University

Fasting Insulin

Insulin is a hormone that is produced and stored in the pancreas. Insulin helps transport glucose from the blood to cells but elevated insulin is also a sign of inflammation.

When your body recognizes that sugar in the blood (glucose) is getting a little too high, the pancreas releases insulin.

Insulin has the important role of taking glucose out of the blood and transporting it into the cells so the cells can turn that glucose into energy. The most common symptoms associated with high insulin include fatigue, brain fog, Inflammation, weight gain, weakness or fatigue after a meal, hormone problems, high blood pressure and depression.

Decades ago, researchers identified higher levels of inflammation in the bodies of people with type 2 diabetes. The levels of certain inflammatory chemicals called cytokines are often higher in people with type 2 diabetes compared to people without diabetes.

Researchers discovered that in people with type 2 diabetes, cytokine levels are elevated inside fat tissue. Their conclusion: Excess body fat, especially in the abdomen, causes continuous (chronic) inflammation that alters insulin’s action and contributes to the disease.

Optimal levels or levels I like to see Fasting insulin are less than 6.

If you have a fasting insulin above 6, along with morning glucose levels over 100, I recommend that you start a paleo anti-inflammatory diet, higher protein, higher fat, fruits that fall under the low glycemic index category, resistance training and supplementation with Berberine VasoQX

Berberine activates an enzyme inside cells called AMP-activated protein kinase (AMPK). This enzyme is sometimes referred to as a “metabolic master switch

It is found in the cells of various organs, including the brain, muscle, kidney, heart and liver. This enzyme plays a major role in regulating glucose metabolism, insulin levels and cardiovascular function.

Several studies have confirmed that Berberine and Gymnema can be just as effective as the diabetic drug metformin– without all the side effects that come with metformin.

Final Thoughts And Reminders About Chronic Inflammation

Inflammation is associated with most chronic health problems. Heart disease, cancer, diabetes, Thyroid disease, hormone problems, depression, problems with weight to name just a few. Today I talked about some of the most important tests that can help clue you in to the degree of inflammation within your body.

I talked about CRP, ESR, Homocysteine, Fasting Insulin, Ferritin.

Sometimes it is possible to have one elevated while other markers of inflammation are normal- the other thing to keep in mind is that when these markers are elevated, we still need to investigate the cause of chronic inflammation.

Diagram Description automatically generated with low confidence

If you have any of these inflammatory markers be sure to discuss root cause with your Functional Medicine Doctor.

Additional Recommended Articles On Inflammation

  1. Chronic Inflammation? Here are 7 reasons you could be Inflamed
  2. Best Blood Tests For Measuring and Monitoring Inflammation
  3. Foods That Cause Chronic Inflammation- Stop eating these foods. 
  4. Best Supplements to Reduce Chronic Inflammation Naturally
  5. Is Chronic Inflammation Sabotaging Your Weight Loss Efforts?
  6. Is Your Gut Causing Your Skin Problems? Acne, Psoriasis, Eczema, Rosacea
  7. Improving DAO function when you suffer with Histamine Intolerance
  8. Hashimotos Disease and High Homocysteine- A Bad Combination for the Heart
  9. H.pylori and Low Stomach Acid- Causes, Treatment and How To Prevent Re-infection

Irritable Bowel Syndrome 1

See Other Recent Post!

Creating health doesn't have to be a guessing game!

Our Team will help you harness your health so you can trust your body and feel like YOU again. We can help find your Root Cause.