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Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia on a Monday and today we're diving into a marker that doesn't get nearly enough attention to my mind when it's just a little bit high and that is your C-Reactive protein. So this is a blood test that you can get just through your doctor and you you might have had your bloods done, this may have even been included. Everything looks pretty normal but your CRP might come back at say four or five.

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It's not alarming on the surface and particularly at four milligrams per liter. Your doctor certainly doesn't raise any flags, but it's not optimal either. And if you're thinking like many of my clients that, you know, is this even a problem? What's causing it and what can I do about it? And this is an episode for you to at least get the ball rolling on some of these things. So that's exactly what we're going to cover today. So I'll walk you through what CRP is, why it matters, even when it's only mildly elevated.

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and also how to identify your potential triggers using just some super common categories to identify some patterns and what might be missing for you. So first up, CRP or C-reactive protein is a marker of inflammation that is made by your liver. It's part of your body's early warning system, the innate immune response. When there's inflammation in the body from infection, injury,

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chronic stress, poor metabolic health, or even food sensitivities, your liver will produce CRP. It's not specific to where the inflammation is, but it does tell us that inflammation is present. Now, normal lab reference ranges often say CRP is fine, under 5, or even 10 mg per liter. But most functional and integrative health experts, like the likes of, say, Chris Presser or Chris Masterjohn, they argue that optimal CRP is below 1.

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and anything above 3 suggests low-grade chronic inflammation and it is something worth taking notice of. Master John particularly makes a point that CRP isn't a disease-specific marker, but rather a risk amplifier, which is a really great way to think about it. It may not cause issues itself, but it's a smoke signal. And where there's smoke, there may be metabolic fire, cardiovascular issues, insulin resistance, gut inflammation, or immune dysregulation.

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So if your CRP is three or four, you're not in crisis mode, but your body is telling you that there's something going on. And the trick really is to try to figure out what that something is. So what are some of the root causes of this mildly elevated CRP? And even saying mildly elevated sort of sounds like I'm being a little bit zealous, like, ah, alarm bells. But actually this is something to pay attention to.

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So if it is sitting in around three or four or similar, even if you're otherwise feeling pretty good, then things do get a little bit interesting. One of the reasons that I love thinking about CIP is it's often a window into systemic inflammation. Doesn't though tell you where the fire is. So.

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This is a section that helps you figure that out. CRP is like an integrator. It reflects the cumulative inflammatory burden from your gut, your hormones, your immune system, your environment, and your lifestyle. It doesn't point a finger, but it does raise a flag. So the first category or where inflammation may be coming from is that immune or allergy related inflammation. So CRP often gets elevated due to a subtle immune system activity.

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Not things that would land you in bed for a week, but they still do trigger this low-grade inflammation. So the first thing is a recent viral or bacterial infection. So you may have had a cold, a stomach bug, or even just a sore throat seven to 14 days ago, and now you feel fine. But CRP can remain elevated during recovery. Even minor immune system activation without full-blown symptoms can push CRP up for several days or even a week.

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Histamine intolerance or mast cell activation is another cause of this low-grade inflammation. Histamine isn't just about sneezing or rashes, it's also involved in vasodilation, immune signaling, and gut permeability. So if you've been consuming high-histamine foods like aged cheeses, leftovers, wine, kombucha, sauerkraut, and your body isn't breaking it down very well, it can provoke a subtle systemic response.

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So that's one thing to consider. And food sensitivities, this is another one and I'm not actually talking about allergies. These are like stealth triggers, gluten, dairy, soy, eggs, and even seemingly healthy foods like almonds or avocado could be triggering gut inflammation and immune activity. And these don't always show up in standard allergy tests. And for what it's worth, someone does try and talk you into something like an IgG test.

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I just think it's not money worth spending because what the Immunoglobulin G test tells you is what foods you've been exposed to, i.e. what have you been eating over the last few weeks or few days, or I can't even think of the time, carried off the top of my head, but it doesn't necessarily tell you what you're sensitive to. What I really encourage you to do is, with this information about food sensitivities, is being really honest about foods that you tolerate and foods that you don't.

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And I do just want to say this because I work with so many people who for whatever reason will do everything else but remove some super simple triggers like dairy, for example. Like we're not very good at giving up dairy just as a rule. We find it super difficult to do and it almost feels like this like deep set sort of deprivation, but so many people actually have this intolerance to it, but they sort of ignore it. They ignore some of the warning signals like, know,

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the runny nose, the sinus infection, the skin irritation and things like that. So that's just an example of how you can sort of avoid listening to your body when it comes to food sensitivities. But this can, in the absence of other signs, show up as a sort of an elevated CRP. So if you do have foods that you know you don't really tolerate, but you eat them anyway, and you get a blood test result that has a mildly elevated CRP,

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then certainly that's telling you something and is something to address. What I would also say though is track how you feel after meals. Symptoms like fatigue, brain fog, itchiness or bloating can show up hours later and they're often dismissed. So actually keeping a record of the food that you eat and any symptoms or patterns that you feel can help.

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you get to the bottom of any food sensitivities and this may relate to that elevated CRP that you're seeing on your blood test that can't be explained by anything else. And this of course leads me to a second driver of that mildly elevated CRP which is gut driven inflammation. This is definitely one foundational system to assess in the

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presence of that elevated CRP. And the gut is the single largest interface between your body and the outside world. And if it's inflamed, your whole system will be. So some signs of this gut driven inflammation include dysbiosis or small intestinal bacterial overgrowth. And these are incredibly common and don't always present with obvious symptoms.

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A little bloating, irregular stool, or food intolerance may be the only sign. Yet the low-grade inflammation from these issues can quietly elevate that C-reactive protein. Leaky gut or intestinal permeability is another reason for this gut-driven inflammation. And this is where the tight junctions in the gut lining become loose, allowing bacterial fragments or food proteins to enter the bloodstream. Now, what I will say is we need these tight junctions to loosen, to allow nutrients in food,

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through to where it's supposed to be. But it is when they do not tighten again and they just sort of remain that sort of looseness, that's when that bacterial, the bacterial pathogens and food proteins into the bloodstream. Your immune system sees them as foreign and responds, which can push up your C-reactive protein. Also in the gut area, a new probiotic or fermented food reaction. And look, this is a bit of a twist. Sometimes the things we add to improve gut health can backfire. There can be this

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probiotic mismatch, where strains aren't compatible with your current microbiome and can actually trigger an immune response. The same goes for fermented foods as well, especially in people with histamine issues, because of course fermented foods are high in that histamine increasing compounds. So if you've just added a probiotic or you're eating more kraut or kimchi and you notice new symptoms, or you see this concomitant increase in CRP on your blood work, consider

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causing it for a few weeks just to see whether that changes anything. And I really like how Dr. Michael Ruscio talks about probiotics in the gut and that just layering on one probiotic isn't necessarily going to address any of these gut related issues because sometimes we're adding on a probiotic that we don't really need. So that can create or

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drive up the bacterial overgrowth and lead to additional symptoms. again, this is another reason why really keeping an eye on sort of the things that you're taking and the food that you're eating and any symptoms that are likely or could be contributing. Now, another potential trigger for an elevated CRP are these hormonal shifts in metabolic health. And this of course is especially relevant for women and it's an area where inflammation and hormones cross paths all of the time.

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So estrogen helps maintain gut barrier integrity, improves insulin sensitivity, and modulates immune responses. And as levels fluctuate, particularly in perimenopause where they can be three times higher than what they otherwise would, women may become more sensitive to inflammatory triggers. So an elevated CRP during your late-nutel phase or in that perimenopausal time of your life,

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might not mean pathology, but it can be a clue. And this is where sort of getting to the heart and trying to address symptoms associated with your hormones really can be helpful in the long term.

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Another thing to really consider is of course polycystic ovary syndrome in irregular cycles and endometriosis, adenomyosis. These conditions often coincide with insulin resistance, not all of the ones that I mentioned, but particularly polycystic ovary system does, which is a known driver of low grade inflammation. But also if I'm considering endo and the inflammation that is caused from the lesions which are creating a of

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pain and a lot of discomfort, then that can be driving obviously the CRP up.

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And of course, I mentioned insulin resistance, that and metabolic inflexibility can also cause additional pain. And you just can't ignore the metabolic lens when we're interpreting inflammation. So you might have normal blood glucose, but if your fasting insulin is elevated or your post-meal energy crashes are frequent, that's enough to drive up CRP in itself because the...

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fluctuating crashes or the incoming insulin can change our overall stress hormone response too. So if you're feeling sluggish after meals or you get hangry between them, start thinking about insulin resistance, even if you're lean, and of course have a think about what's going in in terms of that macronutrient distribution. And then of course we've got those lifestyle factors. So these are things that we can control, but we often underestimate. Just one night of four to five hours of sleep,

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So sleep deprivation has been shown to increase inflammatory markers the next day. So if CRP is creeping up and your sleep's been poor for a few days, that actually might be it. Overtraining is particularly true of endurance athletes. And what I'll say is if you've gone to get your bloods tested, 72 hours even, after doing a really hard training session, your CRP can likely be elevated. And in fact, this is another reason why I suggest that if you do get bloods, you want to be really well recovered.

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because if you're looking at things like ferritin, that's an acute phase reactant. It's a marker of iron, and I've talked about it a lot over the last few weeks, but it can also be increased because of inflammation. So whenever you get bloods done such as iron, you do want to get CRP done as well.

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But particularly true of endurance athletes, there is a sweet spot for training and recovery for that adaptation, and you don't want to be in that constant breakdown. Long runs, double training days, or lack of rest can push CRP up temporarily. And this is particularly true if on top of the training stress, you've got some sort of inadequate fueling going on, you don't have the right nutrients on board, or you're not getting enough sleep, and you're stressed. So all of this stuff,

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will lead to this increased stress response in the body that will just be further driving that CRP level up. And you know what? There is something to be said for psychological stress too. So cortisol plays a role in suppressing acute inflammation, but can drive this chronic low grade inflammation. Stress doesn't have to be big, even subtle things like overwhelm, unresolved conflict or perfectionism, which we might live with on a day-to-day basis and it may have even normalized.

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This can create a steady trickle of cortisol, disrupting sleep, gut function, immune regulation, and ultimately showing up in blood test results. So one thing to consider is that if you're tracking HRV and noticing consistent dips alongside elevated CRP, you want to take that seriously. And of course, you've got these environmental and hidden sources. So these are some of the most overlooked contributors to mild inflammation, and they're ones that we don't really see or feel. So mold is a classic.

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Chronic exposure to mold, whether it's at home, in a damp car, or in old office, is a major inflammatory trigger. the unfortunate thing is, that inflammation and fatigue for a lot of people don't really resolve until they remove themselves from a moldy environment. And particularly in environments like New Zealand, I know Australia is likely the same, although it might not be as wet, and maybe definitely States or Canada, you do get

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Houses that just aren't equipped to deal with the kind of dampness that's often present. And so it's not unusual for people to live in moldy houses or moldy environments. And look, that's a really hard thing to tackle, but you can't ignore it if you've got other underlying symptoms and elevated CRP and you live in a moldy environment. Don't also forget personal care products, fragrances particularly, and cleaning agents.

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I talked about this area as a whole last year when I spoke to Alex about environmental stress and I'll put a link in the show notes to that interview because it really was enlightening. Your skin is not a wall, it's a sponge and many products contain endocrine disruptors or immune irritants like phthalates and parabens. As I mentioned, fragrances are a huge one.

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They don't cause a huge reaction overnight, but over time they can contribute to the body's inflammatory burden that some people aren't able to resolve. So do be mindful of your personal care and your cleaning products. And then dental issues. Even mild gum inflammation or cavities can be enough to raise CRP. There's emerging research linking oral bacteria to systemic inflammation and even heart disease. So if you haven't had a dental checkup in a while and your CRP is elevated,

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This is something worth doing. And there are even functional doctors such as Chris Kresser who recommends functional dentistry screening if CRP is stubbornly high and no other source of inflammation is very clear. So you can see that CRP is a multifactorial marker. It's not just about one thing. It's the sum total of many small stresses that your body is managing. But that could actually be great news because it means we have multiple leverage points to bring it down.

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and you don't need a diagnosis to start listening to what your body is telling you. So what I suggest you do is write down a few of these different areas and start tracking symptoms and exposures, things and just what's going on. Like, have you been exposed to recent infections? What gut symptoms are you experiencing on an everyday basis, if any? Can you tie it to any of the food that you're eating? What about sleep quality? What's that like over the course of a week?

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or two weeks on a scale of 1 to 10 in terms of how refreshed you feel when you wake up, how easy it is to get to sleep, and what kind of disruptions do you have across the night. You do not need a sleep tracker for this by way. And what about hormonal status? Are things worse for you in your late-luteal phase or is it a constant flux of symptoms because you're in perimenopause? With any sort of food elimination, if you reintroduce foods, do these trigger any kind of gut or brain related

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issues that may be linked to this elevated CRP. What are your stress levels like on a day-to-day basis, one to ten? How do you react and respond to different things going around you? And what about those environmental factors? Do a real audit of cleaning agents, your personal care products, how dry your environment is. These are all really important things and you don't need to track these things forever, but doing it for one to two weeks can be a game changer.

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patterns will emerge. For example, you might see if you're doing this sort of multiple tests that your CRP is higher after a bad sleep week or after introducing something like sauerkraut or other high histamine foods or after you have an intense race. You want to track what you need to or want to change. And this is about self-experimentation and empowering you to understand your own data and then not to fear it. And then of course, you know, what do you do about all of these things?

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So the first thing to do, you've ruled out obvious infections, you've started sort of tracking some of those things that I've mentioned, and you might've even spotted a few patterns, like a flare up after certain foods, poor sleep, or a new supplement. The first thing to consider is additional testing to go a little bit deeper. Even if your basic iron panel is normal, there are some tests that can provide context for low-grade inflammation. Fasting insulin in HbA1c, even mildly elevated insulin, over six, can suggest early insulin resistance.

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Erythrocyte sedimentation rate or ESR is another inflammation marker that, when paired with CRP, can offer more insight. I mentioned ferritin as an acute phase reactant, much like CRP.

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High ferritin with other normal iron parameters may reflect inflammation. have liver enzymes such as ALT, AST, and GGT, which could suggest low-grade liver stress such as metabolic-associated fatty liver disease that will silently drive up your C-reactive protein. Low vitamin D is often associated with elevated inflammation and immune dysregulation.

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Comprehensive stool tests like a GI map or a GI 360 and you can order that through functional practitioners such as myself and other nutritionists if you have gut related issues and also the Dutch hormone testing, dried urine tests for comprehensive hormones if you suspect there's some sort of hormonal imbalance or cortisol issues due to perimenopausal shifts. And that's another one you can order through a functional practitioner.

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And this might be helpful if your CRP doesn't drop after four to six weeks of intervention, which of course means that you need to test and retest. And you can do that in New Zealand through mytests.co.nz and then just work with a practitioner to really understand what's going on. Of course, nutritional strategies, you don't need to overhaul your entire diet, but a few strategic tweaks can significantly reduce inflammation. The obvious ones are removing these key immune activating foods like gluten,

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dairy, particularly A1 beta-casin, soy, for some people, alcohol, ultra-processed foods, and seed oils. Reducing histamine load, like limiting leftovers, fermented foods, bone broth, aged cheeses, wine, vinegar, spinach, and avocado. Track how you feel, then reintroduce one at a time, while watching symptoms and retesting CRP. Again, that's done.

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much better with the guidance of a practitioner. And then you want to add some anti-inflammatory foods such as wild salmon, sardines, polyphenols like olive oil, berries, maybe some dark chocolate, turmeric, green tea, cruciferous vegetables like broccoli, cauliflower, cabbage, broccoli sprouts to support liver detox pathways, and herbs and spices like ginger, rosemary, and cinnamon.

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which have been described as small but mighty in terms of their effects. So focus on what to remove and what to restore because inflammation often lives in that gap there. Of course, lifestyle interventions are huge. Aim for seven and a half to nine hours sleep with consistent wake and sleep times. Ideally, you'd be in bed before 10.30, use blue light blockers or amber lighting 90 minutes before bed, trial something like magnesium glycinate,

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heart, cherry juice or glycine pre-bed if sleep is disrupted. Focus on stress. Using an HRV tracker to watch for dips during high periods of inflammation or high stressful periods. Can you start a breathing practice like box breathing or physiological sighs? These tend to work well to help engage your parasympathetic nervous system.

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and then build in micro breaks through the day. So taking a 10 minute walk, this can really help reset your nervous system. You're constantly in vital flight, then your C-reactive protein will constantly have that mild elevation. And then if you have been over training, like a lot of athletes can get into the pattern of, swap that high volume or high intensity for

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a little bit more sort of walking, zone two, pilates, certainly strength work. And if you're sedentary, then add some movement snacks in. Five to 10 squats or a short walk every few hours reduces that inflammatory signaling. So where you're at right now can help determine what you might need to do in that movement space. And some targeted supplements are really based on your symptom picture.

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You want to match supplements to the likely mechanism of your inflammation. So this is why keeping a track of what's going on is super helpful. General anti-inflammatory support is your Omega-3s, 1.5 to 3 grams daily from a high quality fish oil like the Peliformans that I use, turmeric, which is curcumin but with piperine as well, 500 to 1,000 milligrams a day.

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looking for that Meriva formulation for absorption or therokurmin, and mentioned magnesium 300 to 400 milligrams a day, glycinate or threonate. Thinking about the gut, L-glutamine is one that's often used five grams a day to support gut lining. Zinc, carnosine, or DGL, deglycerinated licorice for mild gut inflammation. Digestive enzymes or bitters, if you suspect.

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poor digestion, histamine support or mast cell activation specific. You'll want to be looking at a DAO enzyme before meals if high histamine meals trigger symptoms. Quercetin 250 to 500 milligrams twice a day stabilizes to mast cells.

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Vitamin C and B6 can support histamine breakdown pathways. mindful though because there is an upper limit to B6 or 50 mg a day. Berberine or inositol is a hormone or metabolic support if fasting insulin is high or blood sugar dysregulation is suspected. Dim or calcium D aggluricate to support estrogen clearance, particularly in perimenopausal women. Definitely get tested and use a DUT test to determine if this is your problem. That's what I would say about that one because you can determine

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a Dutch test, what estrogen metabolite may be overloaded and might need supported. So you do want some further testing before you use something like DIM. And of course, in any of these situations, when we're thinking about hormones and metabolism, you want to end the gut, work with a practitioner is what I would suggest. And then when you do implement any of these changes, do give it four to six weeks and retest CRP. Use

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the notes that you've been and the tracking that you've been making a note of to track your energy, your mood, your sleep and digestion. And you don't have to be perfect either. You just wanna recognize the variables that move the needle for you. That's where true functional health tends to live. The last thing which I forgot to mention actually was in that personal care, fragrance cleaning agents sort of space, I would suggest that you start swapping out.

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what might be triggering issues for you or that does have phthalates or parabens and things like that and start swapping them out for ecostore type products and ones which are much milder and gentler on your skin and on the environment as well. So if I sort of go full circle, this has all been about reducing that inflammatory load, albeit a mild inflammatory load, like a CRP of three and four. It doesn't mean that something's wrong, but it does mean that there's something that

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could be underlying and the earlier you listen to that, the less likely it becomes a bigger issue down the line. So hopefully you found this helpful. Let me know. I'm always keen on your feedback and whether or not any of this is something that you're dealing with. You can catch me over on Facebook @mikkiwillidennutrition, Instagram threads or X @mikkiwilliden. Head to my website mikkiwilliden.com and book a call with me and we can go through some of these things which may be affecting you.

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All right, team, have the best week. See you later.