C-reactive protein

There's so much compelling science on curcumin for the brain, curcumin for heart health, curcumin for cholesterol.

Curcumin for a myriad of reasons, because we know that it impacts NF-kappa B, interleukin-6, CRP, all these things.

But what really stood out to me was as our estrogen declines, we are kind of losing this shield of protection against inflammation.

Right.

So sometimes that's just food sensitivities.

Sometimes that's looking at a CRP, other metrics in the blood chemistry to say, hey, how are you digesting and absorbing food? I love to look at nutrients in the blood.

What's your zinc? What's your B12? What's your magnesium? There's a lot of people that are actually doing the work with supplements by taking it.

And it's not actually an intake.

I just want to follow up on the ICM diagnosis.

And again, those of us who were there, I think, were surprised by the fact that there were some things that have fallen out of favor, right? Namely, the serum, inflammatory markers, ESR, CRP, really we're not using anymore in the new United definition.

My question, again, particularly as someone who does not aspirate joints, you know, typically my understanding is that these definitions are made really with mostly the common bacteria in mind.

And in thinking about aspiration, aside from a culture, is there anything different about, say, the number of inflammatory cells, the type of inflammatory cells that we can look at to say, oh, that may be more likely fungal as opposed to bacterial, or is that still something that has yet to be seen.

And really, that's the sort of best guess that we have at the moment.

Now, I was very interested that the inflammatory markers are dropping out of importance, because in Oxford, we haven't performed an ESR for 15 years.

And we do the CRP to look at the general health of the patient, if you like.

We certainly don't use it to diagnose a PGI.

I had a patient the other day who had a staph aureus in his hip for over a year and his blood markers were only mildly elevated.

CRP was in the low 20s.

He was well.

We look at him and he's walking around with a tiny bit of a limp.

So that's why I think it's important to recognize that infection is always the forefront of any problem joint.

Okay.

The starting point should always be inflammatory markers, a CRP and ESR, on all patients with a painful joint.

If your ESR and CRP are normal, that gives you a 98% chance of no infection.

Let's talk about glycemic control and inflammation at scale.

A 2025 systematic review and dose response meta-analysis pooling multiple sesame product trials, 521 participants total, doses ranging from 60 mg to 50 g a day, found a statistically significant improvement in HbA1c and meaningful reductions in the inflammatory markers CRP and IL-6.

That's a real aggregated signal across a genuinely wide range of doses and sesame forms.

But let's talk about where the pooled evidence gets honest.

And I mean, there could be your cholesterol could be high.

You could have high inflammation markers at CRP and you could have blood sugar dysregulation and also be overweight.

And I'm treating all those underlying factors, which is going to also work on weight loss.

So as we go up, obviously weight loss happens.

So you notice your immune cells, white cell count coming down.

You might notice CRP, so C-reactive protein slightly coming up, but it presents like a very low grade inflammatory response rather than something that's like really elevated.

So yeah, that's unfortunate, but that is a reality of mold exposure as well.

Now, another thing that you can do is actually test your environment.

And your doctor says your iron is fine, but it isn't.

Always get ferritin with a CRP in the full iron panel.

transfer transferrin saturation especially a normal ferritin with a high crp and low transferrin saturation is a red flag for iron being locked up by inflammation so don't mega dose iron on your own during active inflammation absorption is blocked anyways and too much iron has its own risk so work with a provider on timing and doses uh Obviously, I'm a fan of supplements.

Also, good quality food.