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6 Sneaky Signs of Inflammation​

Underlying a host of serious conditions, this off-course immune response can be easy to miss

three signs of inflammation include fatigue skin rashes and susceptibility to catching colds

Frank Rothe; Westend61; Luis Alvarez / Getty Images

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Feeling wiped out. Random aches and pains. Frequent trips to the bathroom. What you might write off as signs of aging could be symptoms of chronic inflammation, which, if left untreated, can raise your risk of heart disease, dampen your immune system and leave you looking and feeling anything but your best.

Keep in mind that inflammation itself isn’t necessarily the villain; in fact, this downstream effect of the immune system can be a good thing. “It’s a normal part of physiology and your body’s response to anything dangerous,” says Robert Shmerling, M.D., a rheumatologist at Harvard Medical School and senior faculty editor at Harvard Health Publishing. When you’re exposed to something threatening, whether it’s pollutants in the air or cancer cells, your body releases inflammatory chemicals known as cytokines, which draw an army of white blood cells to the site. This is a short-term response, which disappears within hours, if not days.

But sometimes this inflammation persists or your body goes into overdrive to rid itself of something that it thinks is foreign that isn’t. In that case, your body is essentially attacking itself, Shmerling says. Lifestyle factors, such as a poor diet, being sedentary, smoking and drinking, and being overweight, can also cause inflammation.

Older adults are especially susceptible. “The aging process is not kind when it comes to inflammation — organs are less resilient to its effects, and as you age you’re more vulnerable to the insults of the outside world,” says Daniel Monti, M.D., the Ellen and Ron Caplan chair of the department of integrative medicine and nutritional sciences at Thomas Jefferson University in Philadelphia. As Monti explains, lifestyle habits that you could get away with when you were younger — not getting enough sleep, eating junk food, being exposed to constant stress — can take their toll and cause more inflammation as you age.

Here are six signs of chronic inflammation to keep in mind.

1. Fatigue

A common misconception about aging often causes this red flag to be missed, notes Bindiya Gandhi, M.D., an integrative medicine specialist in Atlanta. “Many older adults think it’s normal to take naps in the afternoon as they age, but it really isn’t; it’s a warning sign that something’s going on underneath.”

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One real cause, Gandhi says, may be decreased activation of the brain’s reward center, known as the basal ganglia, which are very vulnerable to the effects of pro-inflammatory compounds that the body makes. It also may be the result of prolonged, chronic stress. “Our body’s fight-or-flight response was designed for short-term use, like fighting off a lion in the jungle,” says Scott Kaiser, M.D., director of geriatric cognitive health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California. But, as Kaiser points out, the lions of yesterday have been replaced by the constant stress of today, which sets off the continual release of hormones like cortisol that can trigger inflammation.

2. Muscle aches and joint pain

It’s normal to feel a little stiff when you first get up in the morning or after a tough workout. But if there’s no known cause for achy joints or muscles, or if pain lingers for days or even weeks, it could be a sign of chronic inflammation, Shmerling warns. The most likely culprit? Rheumatoid arthritis, a condition in which your immune cells begin to attack your joints — and one that often starts in your 60s. Along with physical exams and imaging, it can be diagnosed through blood tests that check for specific markers of inflammation, such as erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP).

3. Gastrointestinal issues

Your digestive tract is one of the first places where you may experience inflammation, Gandhi says. “Many older adults are on over-the-counter medications such as proton pump inhibitors, which can cause a lot of disruption to the bacteria in the gut,” she explains. “As a result, inflammatory compounds have an easier time entering the bloodstream, which can cause digestive problems like gas, bloating, diarrhea and/or constipation, as well as ongoing inflammation.” Your doctor can take a stool sample to check for calprotectin, a protein that indicates inflammation and that has been linked to inflammatory bowel disease.

4. Weight gain

Obesity itself can cause inflammation, since excess calories in the body stored within fat tissue can kick off the activation of immune cells. Over time, being in this metabolic inflammatory state causes other related conditions, such as high blood glucose levels, high cholesterol and elevated blood pressure, Shmerling says. While excess weight anywhere isn’t good, it’s particularly concerning if it’s clustered around your belly; this type of fat, known as visceral fat, pumps out immune system chemicals called cytokines that ramp up inflammation and raise the risk of cardiovascular disease.

The good news is that many of these inflammatory markers can be changed through diet, says Shmerling, who notes that the Mediterranean diet — rich in fruits, vegetables, whole grains, beans, nuts and healthy fats from sources like olive oil and fatty fish — is the most recommended. One 2018 study published in the journal Nutrients found that people who followed this type of plan had lower blood levels of inflammatory substances such as c-reactive protein.

5. Catching lots of bugs

When chronic inflammation causes your immune system to go out of whack, it may mistakenly attack your body’s own cells. While this can cause autoimmune diseases like rheumatoid arthritis and inflammatory bowel disease, it may also mean that your immune cells don’t respond as well to germ-y invaders such as cold and flu bugs, Kaiser says. As a result, you may find that you catch every cold that comes your way and that symptoms linger for weeks. Research shows, for instance, that people with rheumatoid arthritis are more likely to come down with the flu and experience complications from it.

6. Skin rashes

Chronic skin issues, such as psoriasis and eczema, can also signal overall inflammation in the body. “These are all inflammatory skin conditions that usually signal an over-reactive immune system,” Shmerling explains. That’s why it’s important to not just treat the skin disease itself but to adopt an anti-inflammatory lifestyle, as well, he adds. This can include following a Mediterranean diet, getting regular exercise, sleeping seven to eight hours a night, not smoking and managing stress through relaxation activities like deep breathing, meditation and yoga.

Hallie Levine is a contributing writer and an award-winning medical and health reporter. Her work has appeared in The New York Times, Consumer Reports, Real Simple, Health and Time, among other publications. ​

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