Chronic inflammation can quietly affect your health for years before obvious symptoms appear. Could routine blood tests help us identify important warning signs early?Inflammation is a natural defence mechanism. It helps the body fight infections and repair damaged tissues. However, when inflammation persists, it may contribute to insulin resistance, type 2 diabetes, cardiovascular disease, fatty liver disease and other chronic conditions.The challenge is that chronic, low-grade inflammation may not always cause obvious symptoms. Certain blood tests can provide valuable clues about inflammatory activity, its possible causes and associated metabolic problems.Here are 10 important tests and their normal and optimal functional medicine ranges.

1. hs-CRP (High-Sensitivity C-Reactive Protein)CRP is produced by the liver in response to inflammation. Elevated hs-CRP may indicate inflammatory activity and can help assess cardiovascular risk. Infection, injury and other conditions can also raise it. The clinical range is 0 to 3 mg/L, while the optimal range is 0 to 1 mg/L. 

2. HbA1c (Glycated Haemoglobin): HbA1c reflects average blood glucose over approximately three months. Elevated levels indicate impaired glucose regulation, which is associated with oxidative stress and inflammatory processes. The clinical range is between 4.8 and 5.6, while the optimal range is 4.5 – 5.2. Above 5.7% is considered prediabetic and 6.5% or higher is diabetes.

3. Fasting Insulin: Elevated fasting insulin may indicate insulin resistance, a metabolic condition associated with chronic low-grade inflammation. The clinical range for fasting insulin is 2.6  – 24.9 uIU/ml, and the optimal range is 2.0 – 5.0 uIU/ml. 

4. Serum Ferritin: Ferritin reflects the body's iron stores. It can also increase during inflammation, infection and liver disease. An elevated result needs interpretation alongside iron studies and other clinical findings. The normal range for serum ferritin is approximately 20–300 ng/mL in men and postmenopausal women; 10–150 ng/mL in menstruating women. The optimal range is 50-150 ng/mL for females and 75 – 150 ng/mL for males. 

5. Homocysteine: Homocysteine is an inflammatory amino acid formed through the metabolism of another amino acid called methionine. Elevated homocysteine may be associated with cardiovascular risk, high blood pressure, blood clots, dementia and Alzheimer’s disease. High homocysteine occurs due to deficiency of vitamin B2, folate, vitamin B6 and vitamin B12, zinc and choline. The normal range for homocysteine is 5 -15 umol/L, while the optimal range is 4-8 umol/L.  

6. Neutrophil-Lymphocyte Ratio: The Neutrophil-to-Lymphocyte Ratio (NLR) is calculated by dividing the absolute neutrophil count by the absolute lymphocyte count and can provide clues about inflammation and help assess the prognosis of conditions such as metabolic disease, cardiovascular disease, infections and certain cancers. An NLR of 1.2–2.0 is considered an optimal range, while a higher ratio may indicate increased inflammatory activity.

7. ESR (Erythrocyte Sedimentation Rate) measures how quickly red blood cells settle. An elevated result may indicate inflammation associated with infection, autoimmune disease or other conditions.ESR above 20 mm/hr indicates significant inflammation, and optimal results should be under 10 mm/hr.

8. LDH (Lactate Dehydrogenase) LDH is an enzyme found in many body tissues, including the heart, liver, kidneys, muscles, brain, and red blood cells. Elevated levels may indicate tissue injury or other medical conditions, but the test is not specific for inflammation. Normal levels of LDH are between 140 – 280 U/L.  Optimal levels are between 140-180 U/L. A low LDH, under 140, is a sign of poor glycolysis, where the cells struggle to produce energy from glycolysis. 

9. Liver Enzymes: ALT, AST, GGT and ALP. Abnormal liver enzymes may indicate liver injury or metabolic dysfunction. They can help identify people who need further evaluation for fatty liver disease. Normal range: ALT 4–36 U/L; AST 8–33 U/L; GGT approximately 5–40 U/L. 

10. Lipid Profile: Triglycerides, HDL cholesterol, LDL cholesterol and lipid ratios help assess metabolic and cardiovascular risk. These abnormalities may coexist with chronic low-grade inflammation.A balanced ratio of LDL to HDL and triglycerides to HDL is essential for our health. Optimal range:Triglycerides: 40–80 mg/dLHDL cholesterol: 55–80 mg/dL. Levels above 100 can indicate chronic inflammation. LDL: HDL ratio: 3:1 or less, 2:1 being optimal. Triglyceride-to-HDL ratio: 2:1 or less, 1:1 being optimal.

It is important to note that no single blood test can diagnose chronic inflammation. hs-CRP and ESR are nonspecific inflammatory markers, while the other tests provide complementary information about metabolic health, nutritional status, tissue injury and possible underlying causes.

Integrated Medicine encourages us to look at the complete picture rather than focusing on a single laboratory result. Preventive healthcare is not simply about checking whether the results are normal. It is about understanding what those results mean and taking the right steps to protect our health. A balanced diet, regular physical activity, adequate sleep, stress management and appropriate medical care can all support long-term metabolic health.

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