hsCRP: the silent fire that burns without you feeling it.
Low grade chronic inflammation doesn't hurt. It doesn't show. But it predicts heart disease, Alzheimer's, and cancer years before symptoms.
Inflammation has a reputation. We associate it with heat, swelling, redness, with something that hurts. But there is a second kind: low grade, systemic, chronic inflammation that produces no symptoms at all. You can have it for a decade without feeling anything. Your blood will tell you.
High sensitivity C reactive protein (hsCRP) is the most clinically useful marker we have for this quiet form of inflammation. Produced by the liver in response to inflammatory signals, hsCRP rises within hours of an acute infection or injury and falls again when the insult resolves. But when it stays chronically elevated, even at low levels, it is a sign that something in the body is quietly and continuously on fire.
What chronic inflammation is actually doing.
The MRFIT study, followed for 30 years and published in the New England Journal of Medicine, established hsCRP as an independent predictor of heart attack risk, stronger than total cholesterol alone. Subsequent meta analyses confirmed that people with hsCRP above 3 mg/L are three times more likely to suffer a cardiovascular event than those below 1 mg/L.
- Atherosclerosis: chronic inflammation accelerates plaque formation in arterial walls.
- Type 2 diabetes: inflammation impairs insulin sensitivity at the cellular level.
- Alzheimer's disease: neuroinflammation is now understood as a key driver of cognitive decline.
- Cancer: chronic inflammation is one of the hallmarks of tumour promotion.
- Depression: the inflammatory hypothesis of depression has substantial clinical support.
A person with hsCRP of 3 mg/L and perfect cholesterol is at higher cardiovascular risk than someone with mildly elevated cholesterol and hsCRP below 1. Cholesterol is not the whole story.
What optimal looks like.
- Below 1 mg/L: low risk.
- 1 to 3 mg/L: intermediate risk.
- Above 3 mg/L: high risk (when not explained by acute illness).
What lowers it.
Aerobic exercise (consistently), quality sleep, reducing ultra processed food intake, omega 3 supplementation, smoking cessation, and weight loss (particularly visceral fat) all produce measurable reductions in hsCRP within 90 days. The most powerful lever is usually the one the panel reveals.
