What Inflammation Markers in Blood Tests Really Mean

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Immune & Inflammation

What Inflammation Markers in Blood Tests Really Mean

Oct 22, 2025

Jake Kaiser

Jake Kaiser

What Inflammation Markers in Blood Tests Really Mean

September 2025 update

The American College of Cardiology now recommends high‑sensitivity C‑reactive protein (hsCRP) screening for cardiovascular disease risk, even for people not yet considered high risk.[1] Evidence shows hsCRP is at least as predictive of future cardiovascular events as the more commonly tested risk factor, LDL cholesterol.
It is predicted this will be included in primary care screening labs (and covered by insurance), but this will likely take years.

Insurance coverage and what’s standard in primary care lag behind practice shifting changes to guidelines. GoodLabs helps bridge this gap by including inflammation markers at no-cost alongside your blood donation.

Why inflammation markers matter now

Routine blood work does not include inflammation markers like hsCRP, despite chronic inflammation being linked to heart disease, type 2 diabetes, Alzheimer’s, autoimmune conditions, and cancer.[2]

This approach has been reasonable because inflammatory markers are considered “non-specific”, as they require context to interpret and no single marker can diagnose disease by itself.
However, as the new guidelines around hsCRP demonstrate, as evidence builds related to the link of inflammation and chronic disease, and the labs become more targeted, we will likely see these inflammatory markers play a more important role in preventive health.

What is inflammation?

Acute inflammation is your body’s normal response to injury or infection. It is targeted and resolves once the threat is gone.
Chronic inflammation is low‑grade, persistent activation of the immune system that can damage healthy cells and tissues over time. It often lacks clear symptoms early on. Blood tests can reveal patterns consistent with inflammation.

Why inflammation markers matter

Chronic inflammation can be subtle and gradual. By the time symptoms are obvious, significant changes may have developed.

Cardiovascular disease: Inflammation contributes to vessel wall damage and plaque formation.[3]
Type 2 diabetes: Inflammation interferes with insulin signaling.[4]
Alzheimer’s disease: Linked to chronic brain inflammation and cognitive decline.[5]
Autoimmune and cancer risk: Inflammation can trigger autoimmune activity and may promote tumor growth.[6]

These markers provide context, not diagnoses. Always interpret with your healthcare provider, considering history, symptoms, and other tests.

C‑reactive protein (CRP) and hsCRP

CRP is produced by the liver in response to inflammation. The high‑sensitivity assay (hsCRP) has more recently been established as an independent risk factor cardiovascular risk.

Risk cut points for hsCRP:[7]
- Less than 1.0 mg/L: Low CV risk
- 1.0–3.0 mg/L: Average CV risk
- Greater than 3.0 mg/L: Higher CV risk
- Above 10 mg/L: Prompt clinical evaluation

What this could mean for you if hsCRP is elevated (and you are not acutely ill):

Start with lifestyle changes: diet, exercise, sleep, stress
Consider preventive medications like statins where appropriate
Re‑test or pursue further evaluation if levels remain high

Coverage note: Preventive hsCRP may not be covered everywhere, yet; discuss out‑of‑pocket costs with your clinician.

Erythrocyte sedimentation rate (ESR)

ESR measures how quickly red blood cells settle; it rises with inflammatory proteins.[8]

Reference ranges vary by lab, age, and sex.
Elevated ESR can reflect autoimmune disease, infection, IBD, kidney disease, or some cancers.
ESR is less specific than CRP, though is often ordered to add further support for inflammatory state.

Ferritin

Ferritin reflects iron storage and is most often use to assess for iron-deficiency. However, it is also an “acute‑phase reactant” where a higher level might be associated with an inflammatory state.[9] Typical ranges are about 24–336 ng/mL for men and 11–307 ng/mL for women, but labs differ.[10]

High ferritin can indicate elevated iron stores or inflammation. Liver disease and alcohol can also increase ferritin.
It’s best to use a full iron panel to differentiate. Persistently high ferritin with normal transferrin saturation suggests inflammation rather than iron overload.[9]

White blood cell (WBC) count

Typical range is roughly 4,000–11,000/µL, lab‑dependent.[11]

High WBC: Often infection, inflammation, allergic reactions, some autoimmune or hematologic disorders.[11]
Low WBC: Bone marrow disorders, autoimmune issues affecting WBCs, medications, or severe infections.[12]
A CBC with differential (neutrophils, lymphocytes, monocytes, eosinophils, basophils) adds pattern insight.[13]

Platelet count

Normal is commonly 150,000–400,000/µL.[14]

Elevated platelets can be reactive to inflammation, iron deficiency, infection, surgery, or blood disorders.[15][16]
Track trends over time and evaluate persistent abnormalities.

Fibrinogen

A liver‑derived clotting protein that rises with inflammation and associates with cardiovascular risk.[17][18]

Homocysteine

Elevated homocysteine relates to endothelial dysfunction and higher CV risk.[19] B‑vitamin therapy lowers homocysteine but has not consistently reduced CV events in trials. Many labs flag ≥15 µmol/L; some target less than 10 µmol/L.[20]

What actually lowers inflammation markers

Research‑supported strategies, also emphasized by the 2025 ACC statement:[1]

Exercise: Regular moderate activity lowers CRP and other markers.[21] Aim for at least 150 minutes per week of moderate‑intensity exercise.
Weight: Losing 5–10% of body weight can reduce inflammatory markers if overweight.[22]
Sleep: Adults should target 7–9 hours; sleep loss increases inflammatory markers.[23][24]
Diet: Favor Mediterranean or DASH‑style patterns rich in vegetables, fruits, legumes, whole grains, nuts, olive oil, and fish. Include EPA and DHA from fatty fish 2–3 times per week.[1]
Stress: Manage chronic stress through meditation, yoga, breathing, or counseling.[25]
Smoking: Stop completely.
Supplements: Omega‑3s, curcumin, vitamin D may help in some contexts; discuss with your clinician.[26]
Medications: For certain patients with established CVD and elevated inflammation, there is evidence low‑dose colchicine (0.5 mg daily) can reduce major CV events when added to standard care.[1]

Lifestyle is foundational and complements, not replaces, indicated medical therapy.

Understanding your results: context matters

Numbers need clinical context. Your clinician will consider:

Symptoms and history
Trends over time, not single measurements
Other lab and imaging results
Medications and co‑conditions
Individual risk factors and family history

Temporary elevations are common after recent illness, injury or surgery, vaccination, strenuous exercise, stress, or poor sleep. Many clinicians repeat abnormal tests before major decisions.

When standard testing misses the mark

Typical panels include a CBC and CMP and sometimes a lipid panel. Specific inflammation markers like hsCRP, ESR, fibrinogen, and homocysteine are usually ordered only when indicated by significant symptoms such as persistent joint pain or certain rashes.

Prevention vs diagnosis

Prevention and optimization: Regular monitoring can inform habits, but modest elevations do not predict disease on their own.
Diagnosis and management: In symptomatic conditions, markers help assess activity and response to treatment when interpreted with clinical findings.

Get your inflammation markers tested

If you want broader insight, discuss inflammation testing with your clinician and track trends over time.

Goodlabs option: Donate at Vitalant’s SF location through GoodLabs to receive testing for 70+ biomarkers including CRP, WBC, platelet count, ferritin, and other indicators. Testing is performed by CLIA‑certified labs. Results typically arrive in 4–6 business days with clear explanations.

Book your donation + free inflammation testing →

FAQ

Can inflammation markers be too low?
- Very low CRP (below 1.0 mg/L) is associated with low cardiovascular risk. Very low WBC may indicate other issues and needs evaluation.[7]
How often should I test?
- Many people repeat annually or semi‑annually for optimization. If elevated or managing a condition, testing every 3 months or as guided by your clinician.
Do markers fluctuate day to day?
- Yes, especially during infections (even common viral colds) or acute stressors. Trends matter more than single values.
Will medications lower my markers?
- NSAIDs, corticosteroids, and other agents can lower markers, but do not always address root causes. Discuss risks and benefits with your clinician.
Can stress alone elevate markers?
- Chronic stress can contribute and often interacts with sleep, diet, and activity.[25]