5 Signs of Chronic Inflammation

Your bloods came back normal. Your scan was clear. And still…something feels off.

It’s a common reason for someone seeing me in clinic.

After thousands of patients and thousands of procedures, I’ve learned the body shows early warning signs that something is off.

Obvious symptoms get investigated.

However, patients frequently tell me that quiet symptoms are dismissed.

These are five of the quiet signs I look for that hint at an upset gut.

One thing first. A symptom is not a diagnosis. It’s a clue. And one clue rarely solves the case.

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General Disclaimer: This is general advice, not personal medical advice. If something here worries you, please see your own doctor. New, severe, or persistent symptoms always deserve a proper set of eyes.

Inflammation is not always a bad thing! It’s usually a warning sign.

Sprain your ankle and it swells. Catch a bug and you spike a fever.

That’s acute inflammation…the immune system doing exactly its job. It’s important and allows us to rest and get better.

Chronic inflammation is the dinner partyy guest who won’t go home. Low-level, persistent, unnecessary. Humming away in the background for months or years.

A 2019 Nature Medicine review linked this silent, smouldering inflammation to heart disease, diabetes, autoimmune conditions and more. Quiet…but far from harmless.

You sleep eight hours. You wake up exhausted. Bloods normal. Stool tests normal. And you reach for a second coffee just to feel human.

Sound familiar?

Fatigue is one of the trickiest symptoms I deal with, because often there’s nothing obvious to point at. But absence of a finding is not absence of a cause.

The immune system itself can make you tired.

When Lasselin and colleagues gave healthy volunteers a harmless inflammatory trigger, the ones with the biggest rise in inflammatory messengers (cytokines) felt the most fatigue and sleepiness. The two moved together.

Here’s roughly how it works. A disrupted gut microbiome and a leaky, more permeable gut wall possibly creates a low-grade inflammatory state.

Those cytokines travel the gut-brain axis and disturb the brain. Chronic inflammation also flips on an enzyme called IDO, which diverts tryptophan away from serotonin. Less serotonin. More of that flat, foggy tiredness.

Worth noting…women appear more vulnerable to fatigue than men.

Tired doesn’t always mean a sleep problem. Sometimes it means an inflammation problem.

(I’m a big fan of coffee btw…read about it here

You can’t find the right word. You walk into a room and forget why you’re there.

You’ve been told it’s stress, or peri-menopause, or just life.

Maybe. But brain fog is real, and it has a potential biology.

Dantzer and colleagues described it years ago…low-grade inflammation and cytokines acting on the brain, producing what they named sickness behaviour.

More recently, a 2024 Nature Neuroscience paper by Greene and colleagues used MRI to show something striking. In people with long covid and brain fog, the blood-brain barrier itself was leaking. Inflammation in the body, made visible in the brain.

You already know this feeling, even if you’ve never named it. Think of the heavy, foggy head after a nasty flu or a bout of gastroenteritis.

That’s your brain telling you to stop and rest. Useful for a week. A problem for a year.

And because the gut and brain never stop talking, inflammation in the gut wall can keep the fog switched on. This is why I go on…and on…about a clean diet. Repair the gut barrier and you help protect the brain.