From the Guidelines
To naturally lower chronically elevated ESR and CRP, adopting a Mediterranean diet and engaging in regular exercise, such as 150 minutes of moderate exercise weekly, are key lifestyle modifications that can help reduce systemic inflammation.
Key Lifestyle Modifications
- Adopt a Mediterranean diet rich in fruits, vegetables, whole grains, fatty fish, olive oil, and nuts, while reducing processed foods, refined carbohydrates, and red meat, as supported by studies such as 1 and 1.
- Aim for 150 minutes of moderate exercise weekly, such as walking, swimming, or cycling, as exercise has been shown to reduce long-term inflammation in epidemiological studies conducted in the general population and increased physical activity was associated with lower levels of CRP 1.
- Maintain a healthy weight, as excess fat tissue produces inflammatory compounds.
- Ensure adequate sleep (7-9 hours nightly) and practice stress management through meditation, yoga, or deep breathing exercises.
Considerations for Specific Conditions
- For conditions like polymyalgia rheumatica (PMR), dietary supplements like vitamin D may be beneficial in reducing symptoms and the need for corticosteroid therapy, as suggested by 1.
- In cases of vasculitis, ensuring adequate calcium intake and including foods rich in calcium, such as broccoli, skim milk, and yogurt, in the diet can help prevent osteoporosis, a potential side effect of steroid treatment 1.
Nutritional Considerations
- Marginal deficiencies in essential nutrients like magnesium can stimulate oxidative stress and secretion of proinflammatory mediators, leading to chronic inflammation, highlighting the importance of adequate nutrient intake 1.
- Subclinical vitamin C inadequacy has been associated with inflammation, elevated CRP levels, and depressed immune function, underscoring the need for a balanced diet that includes foods rich in vitamin C.
Supplements and Additional Measures
- Consider anti-inflammatory supplements like omega-3 fatty acids (1-2 grams daily), curcumin (500-1000 mg daily with black pepper extract), and ginger (1-2 grams daily), as they may help reduce inflammation.
- Stay well-hydrated and limit alcohol consumption to further support the reduction of systemic inflammation. These approaches work by reducing systemic inflammation, which directly impacts ESR and CRP levels. However, persistently elevated inflammatory markers warrant medical evaluation, as they may indicate underlying conditions requiring specific treatment beyond lifestyle modifications.