Inflammation
Everything in the library studied for it, medical and holistic together. Within each kind, what was shown to help comes first, strongest evidence first. What was tested and not shown to help stays on the list.
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Medication
Rheumatoid arthritis
Shown to ease joint tenderness and pain in rheumatoid arthritis more than placebo or NSAIDs, and to slow joint damage on X-ray over 1 to 2 years.
The numbers and sources
- Effect
- Low-dose prednisolone, at no more than 15 mg a day, improved joint tenderness against placebo by 12 tender joints (95% CI 6 to 18) and improved pain (SMD 1.75, 95% CI 0.87 to 2.64) and grip strength. Against NSAIDs it improved joint tenderness by 9 joints (95% CI 5 to 12) and pain (SMD 1.25, 95% CI 0.26 to 2.24) [4]. Across 15 studies, mostly in early disease and added to other disease-modifying drugs, glucocorticoids slowed X-ray progression (SMD 0.40, 95% CI 0.27 to 0.54), with a similar effect at 2 years (0.42, 95% CI 0.30 to 0.55) [5]. In a 2-year trial of prednisone 10 mg a day, clinical improvement over placebo was seen mainly in the first 6 months and X-ray progression was lower after month 6, with more osteoporotic fractures in the prednisone group [6].
- Population
- 320 people with rheumatoid arthritis in 10 short-term studies [4]; 1,414 people in 15 studies [5]; people with early active rheumatoid arthritis not yet on disease-modifying drugs [6].
- Sources
- [4], [5], [6]
- Caveats
- The short-term review covers small trials [4]. The mean cumulative dose in the X-ray studies was 2,300 mg of prednisone equivalent in the first year [5].
Severe COVID-19 and pneumonia in hospital
Shown to lower 28-day deaths in hospitalized COVID-19 patients, 22.9% against 25.7%, with the benefit limited to those on oxygen or a ventilator.
The numbers and sources
- Effect
- Dexamethasone 6 mg a day for up to 10 days, by mouth or vein, lowered 28-day deaths from 25.7% on usual care to 22.9% (rate ratio 0.83, 95% CI 0.75 to 0.93). Deaths were 29.3% against 41.4% in those on a ventilator and 23.3% against 26.2% in those on oxygen. In those on no respiratory support they were 17.8% against 14.0% (rate ratio 1.19, 95% CI 0.92 to 1.55) [13]. In severe community-acquired pneumonia, added corticosteroids lowered deaths (RR 0.47, 95% CI 0.3 to 0.74) and C-reactive protein on day 8 (SMD -0.8, 95% CI -1.11 to -0.5), with no difference in gastrointestinal bleeding or high blood sugar [14].
- Population
- 6,425 people hospitalized with COVID-19, 2,104 on dexamethasone and 4,321 on usual care [13]; 665 people with severe community-acquired pneumonia in 10 trials [14].
- Sources
- [13], [14]
- Caveats
- The COVID-19 trial was open label [13]. The pneumonia trials were small and used several corticosteroids and dosing schedules, so they do not test oral treatment alone [14].
Peptides and SARMs
Inflammation
Not studied in people. Animal and lab studies report lower inflammatory cytokines.
No study in people. This rests on animal studies, lab studies.
The numbers and sources
- Effect
- A 2025 systematic review of mostly preclinical studies found that BPC-157 reduced inflammatory cytokines and acted on pathways involved in cell growth and new blood vessel formation [16]. A 2026 review reports reduced inflammatory cytokine activity and improved small blood vessel integrity across preclinical models [24].
- Population
- Animal models and cell studies [16][24].
- Sources
- [16], [24]
- Caveats
- The review abstracts give no effect sizes for inflammation. The human research located is limited to small pilot studies of musculoskeletal pain, interstitial cystitis and intravenous use [24].
Gut inflammation and colitis
Not studied in people. In mice and rats with induced colitis, KPV reduced colon inflammation and weight loss.
No study in people. This rests on animal studies, lab studies.
The numbers and sources
- Effect
- In human intestinal and immune cell lines, KPV entered cells through the PepT1 transporter, inhibited NF-kappaB and MAP kinase inflammatory signaling, and reduced pro-inflammatory cytokine secretion. Given in drinking water, it reduced DSS- and TNBS-induced colitis in mice, with lower pro-inflammatory cytokine expression [8]. In two mouse colitis models, KPV-treated mice recovered earlier, regained more body weight and had fewer inflammatory cells in the colon. In mice with a nonfunctional melanocortin-1 receptor, KPV kept all treated animals alive through DSS colitis [9]. KPV delivered by mouth in nanoparticles reduced mucosal damage and TNF-alpha in a mouse model of ulcerative colitis [10]. KPV in a rectal hydrogel reduced weight loss, disease activity scores, colon shortening and inflammatory cytokines in rats with TNBS colitis [11].
- Population
- Mice and rats with chemically induced or transfer colitis, and human cell lines in the lab [8][9][10][11].
- Sources
- [8], [9], [10], [11]
- Caveats
- Colitis induced in rodents does not show what happens in people with inflammatory bowel disease. Two of the studies gave KPV inside a delivery system, nanoparticles or a hydrogel, rather than on its own [10][11]. FDA found no clinical studies or human exposure data for KPV by any route [3].
Skin inflammation, psoriasis and eczema
Not studied in people. KPV is the end piece of alpha-MSH, a hormone that reduced skin inflammation in animals. No KPV study of psoriasis or eczema was located.
No study in people. This rests on how it acts in the body, lab studies.
The numbers and sources
- Effect
- A 2008 review reports that the anti-inflammatory effects of alpha-MSH were confirmed in animal models including irritant and allergic contact dermatitis, and that KPV, its C-terminal tripeptide, keeps the anti-inflammatory effect without alpha-MSH's pigmenting action. The authors propose KPV for future treatment of inflammatory skin disease [12]. A 2007 review attributes most of alpha-MSH's anti-inflammatory activity to KPV [13]. In human skin cells (keratinocytes) in the lab, KPV did not raise cyclic AMP, and raised intracellular calcium only when the cyclic AMP pathway was blocked [14].
- Population
- Animal models of skin inflammation treated with alpha-MSH, reviewed in [12]. Human keratinocytes in the lab [14].
- Sources
- [12], [13], [14]
- Caveats
- The animal skin findings in these abstracts are for alpha-MSH, the parent hormone, not for KPV itself [12][13]. No study of KPV in a psoriasis or eczema model was located for this page.
Inflammation
Not studied in people. In lab brain immune cells and in a mouse model of Alzheimer's disease, TB-500 lowered signs of inflammation.
No study in people. This rests on lab studies, animal studies.
The numbers and sources
- Effect
- In a microglia cell line, the brain's immune cells, TB-500 suppressed the nitric oxide production and pro-inflammatory cytokine expression set off by bacterial lipopolysaccharide. In 5xFAD mice, a model of Alzheimer's disease, it reduced glial activation in the brain [18].
- Population
- Cells in the lab, and 5xFAD mice [18].
- Sources
- [18]
- Caveats
- The study measured brain inflammation in a model of Alzheimer's disease, not the injury or joint inflammation TB-500 is taken for. It tested another thymosin beta-4 fragment, Ac-SDKP, alongside TB-500 [18].
Supplements
C-reactive protein and other inflammation markers
Shown to lower CRP and some other inflammation markers in adults with inflammatory conditions or diabetes. These are blood markers, not clinical outcomes.
The numbers and sources
- Effect
- In 9 studies, curcumin lowered CRP by 3.67 mg/L (95% CI -6.96 to -0.38). In 23 studies hs-CRP was lower than placebo, with stronger effects below 2,000 mg a day [14]. In 28 RCTs in prediabetes and type 2 diabetes, curcumin or turmeric lowered CRP (SMD -0.50), TNF-alpha (SMD -1.70) and IL-6 (SMD -2.97) [15]. In 6 RCTs (472 adults with type 2 diabetes), hs-CRP was 1.06 mg/L lower (95% CI -1.97 to -0.16, I² 17.3%) [16]. In 21 knee osteoarthritis studies (1,705 patients), CRP (SMD -0.906, 95% CI -1.543 to -0.269) and TNF-alpha were lower than placebo, while ESR, IL-1beta, IL-6 and PGE-2 did not differ [17]. With piperine added, 18 RCTs showed lower IL-6, while CRP and TNF-alpha did not change significantly [18].
- Population
- People with proinflammatory or autoinflammatory conditions [14]; adults with prediabetes or type 2 diabetes [15][16]; adults with knee osteoarthritis [17]; adults in curcumin with piperine trials [18].
- Sources
- [14], [15], [16], [17], [18]
- Caveats
- Blood markers, not clinical outcomes. Certainty was low for every marker in the 28-trial review, which also found publication bias for CRP [15]. The curcumin with piperine review found no significant CRP change [18].
Oxidative stress and inflammation
Shown to lower blood malondialdehyde, an oxidative stress marker, and IL-6 in type 2 diabetes. CRP and TNF-alpha did not change.
The numbers and sources
- Effect
- Astaxanthin lowered blood malondialdehyde (SMD -0.95, 95% CI -1.67 to -0.23). IL-6 fell in type 2 diabetes (WMD -0.70 pg/mL, 95% CI -1.29 to -0.11). CRP and TNF-α did not change [7].
- Population
- 380 participants in 12 RCTs [7].
- Sources
- [7]
- Caveats
- Few trials measured each marker. These are biomarkers, not disease outcomes.
Inflammation markers
Shown to lower CRP by about 0.6 mg/L and lower TNF in adults. These are blood markers, and the reviews disagree on IL-6.
The numbers and sources
- Effect
- In 16 RCTs, garlic lowered CRP by 0.61 mg/L (95% CI -1.12 to -0.11, I² 76.9%, 13 trials), IL-6 by 0.73 ng/L (5 trials) and TNF by 0.26 ng/L (7 trials). Adiponectin and leptin did not change significantly [8].
- Population
- Adults in 16 RCTs lasting 2 to 52 weeks [8].
- Sources
- [4], [8]
- Caveats
- Blood markers, not clinical outcomes. Heterogeneity for CRP was high [8]. The 108-trial review found CRP 1.6 mg/L and TNF 3.94 pg/mL lower, effects several times larger than [8], and found no change in IL-6 [4].
Inflammation markers
Shown to lower CRP, TNF-α and IL-6 in adults, more in people with health conditions. These are blood markers, not clinical outcomes.
The numbers and sources
- Effect
- In a 2025 GRADE-assessed meta-analysis of 29 RCTs, ginger lowered CRP by 0.86 mg/L (95% CI -1.10 to -0.62), TNF-α by 1.90 pg/mL (95% CI -2.61 to -1.18) and IL-6 by 1.15 pg/mL (95% CI -1.90 to -0.41). Malondialdehyde fell, and total antioxidant capacity and superoxide dismutase rose [8].
- Population
- Adults in 29 RCTs [8].
- Sources
- [8]
- Caveats
- Blood markers, not clinical outcomes. The authors report high heterogeneity among trials and larger effects in people with underlying health conditions [8].
Inflammation markers
One small trial found 1,000 mg a day lowered IL-6 in 60 women with PCOS. Trials of other inflammation markers conflicted.
The numbers and sources
- Effect
- In 60 women with polycystic ovary syndrome, 1,000 mg a day of oil for 12 weeks lowered serum IL-6 against placebo (adjusted mean difference -4.21, 95% CI -6.34 to -2.08) and fasting glucose by 8.16 mg/dL. Fasting insulin and HOMA-IR did not differ [9]. A review of 4 human trials found conflicting results for the adhesion molecules VCAM-1 and ICAM-1 [10].
- Population
- 60 women with PCOS [9]. Patients with coronary artery disease, type 2 diabetes, Hashimoto's thyroiditis or cardiovascular risk factors [10].
- Sources
- [9], [10]
- Caveats
- One small trial for IL-6 [9]. The adhesion molecule review also included 15 animal and in vitro studies, which are not counted here [10].
Inflammation markers
One trial found a boswellic acid syrup lowered several inflammation markers more than placebo in mild to moderate COVID-19.
The numbers and sources
- Effect
- In patients with mild to moderate COVID-19, a boswellic acid syrup (Inflawell) for 14 days lowered serum IL-1α, IL-8, TNF-α and MCP-1 more than placebo. The abstract reports p values only, not the size of the changes [7].
- Population
- Patients with mild to moderate COVID-19. The abstract does not give the number randomized [7].
- Sources
- [7]
- Caveats
- One trial of one product during an acute infection. Blood markers, not symptoms or disease outcomes [7].
Inflammation and metabolic markers (fisetin alone)
Small trials found lower inflammation and insulin resistance markers with 200 mg a day of fisetin in men with obesity, most with training.
The numbers and sources
- Effect
- Over 12 weeks, IL-6 and TNF-α fell in the fisetin-only group, and fasting glucose, insulin and HOMA-IR fell in all active groups, most in training plus fisetin [11]. A second report from the same research group found weight loss in the fisetin-only group compared with placebo, and the largest drops in asprosin and MCP-1 with training plus fisetin [12].
- Population
- 44 men with obesity at 200 mg a day [11]; 60 sedentary men with obesity at 200 mg a day [12].
- Sources
- [11], [12]
- Caveats
- Both reports come from one research group with similar four-arm designs. Neither measured senescent cells.
Rheumatoid arthritis
Mixed results: reviews agree probiotics lower CRP or IL-6 in rheumatoid arthritis, but disagree on disease activity.
The numbers and sources
- Effect
- Across 9 studies (361 patients), probiotics lowered IL-6 (SMD -0.708) and did not change disease activity scores (MD 0.023, 95% CI -0.584 to 0.631) [8]. Across 4 RCTs (153 participants), DAS fell (SMD -0.58, 95% CI -0.97 to -0.19), CRP fell borderline (SMD -0.32, 95% CI -0.65 to 0.00), and ESR and cytokines did not change [9]. A review of 8 RA trials (344 patients) found CRP 3.04 mg/L lower (95% CI -4.47 to -1.62). With high risk-of-bias trials excluded, DAS28 did not differ from placebo (SMD -0.54, 95% CI -1.94 to 0.85) [10].
- Population
- Adults with rheumatoid arthritis, mostly women, over 8 weeks to 1 year [8][9][10].
- Sources
- [8], [9], [10]
- Caveats
- The reviews agree on lower CRP or IL-6 and disagree on disease activity. Strains, doses and durations varied [10].
Inflammation and blood lipids
Mixed results: reviews disagree on whether CRP falls, and most found no change in LDL or triglycerides.
The numbers and sources
- Effect
- One meta-analysis found no change in CRP (WMD -0.144 mg/L, 95% CI -0.968 to 0.680), total cholesterol, LDL, triglycerides or glucose. HDL fell slightly (WMD -4.18 mg/dL, 95% CI -6.54 to -1.82) [4]. A later meta-analysis found lower TNF-α (WMD -0.44, 95% CI -0.71 to -0.16) and hs-CRP (WMD -0.27, 95% CI -0.5 to -0.02), with no change in IL-6 [6]. In 25 RCTs in metabolic disorders, CRP fell (SMD -0.18, 95% CI -0.33 to -0.03), and IL-6 and TNF-α did not change significantly [7]. In 6 RCTs in type 2 diabetes (533 participants), CRP fell (SMD -1.40, 95% CI -2.60 to -0.21) [8]. Apolipoprotein B (WMD 2.11 mg/dL, 95% CI -1.53 to 5.75) and apolipoprotein A-I did not change in 7 RCTs [9]. An umbrella review rated as high certainty a 0.19 mmol/L drop in total cholesterol in adults with overweight (95% CI 0.06 to 0.32) [5].
- Population
- 10 RCTs [4]; 17 RCTs with 736 adults [6]; adults with metabolic disorders [7]; adults with type 2 diabetes [8]; 7 RCTs [9]; meta-analyses of RCTs [5].
- Sources
- [4], [6], [7], [8], [9], [5]
- Caveats
- The reviews disagree on CRP, and the CRP effect in [8] is several times the size of that in [7]. Heterogeneity in [6] was about 50%. Evidence in [8] was low certainty. CRP is a marker, not a clinical outcome [7].
Inflammation markers (CRP)
Limited evidence: CRP fell in hemodialysis patients but not with high-dose EPA, in knee osteoarthritis, or in most trials of trained people.
The numbers and sources
- Effect
- In 13 hemodialysis trials (678 patients), omega-3 in triglyceride form lowered CRP (SMD -0.62, 95% CI -1.22 to -0.03, I² 74%), and so did doses under 2,000 mg a day (SMD -0.32) [32]. In 3 trials of trained people, only 1 found a significant drop in CRP after exercise [33]. High-dose EPA did not change hs-CRP across 6 outcome trials [9], and krill oil did not change CRP in knee osteoarthritis [29].
- Population
- Hemodialysis patients [32]; trained individuals [33]; cardiovascular and osteoarthritis trials [9][29].
- Sources
- [32], [33], [9], [29]
- Caveats
- The reviews disagree by population. In rheumatoid arthritis, only leukotriene B4 of five inflammatory markers fell [11].
Inflammation
Limited evidence: a 50-trial review found lower CRP, while an earlier review found no effect.
The numbers and sources
Inflammation markers (CRP, IL-6)
Small trials found lower IL-6 and CRP in diabetic nerve pain, while a COVID-19 trial lowered other markers but not those two.
The numbers and sources
- Effect
- In 70 people with diabetic nerve pain, IL-6 and raised CRP fell more on 600 mg a day than on placebo (p 0.05), and fibrinogen did not differ [5]. In 60 unvaccinated adults recently diagnosed with COVID-19, 600 mg twice a day for 4 weeks lowered soluble P-selectin, IL-1 beta and IL-2 against placebo. IL-6 and CRP were primary outcomes and are not among the markers reported as reduced [9].
- Population
- 70 adults with type 1 or type 2 diabetes [5], and 60 adults aged 19 to 53 with COVID-19 not in hospital [9].
- Sources
- [5], [9]
- Caveats
- Two small trials. A systematic review of 47 RCTs lists 10 that measured blood or tissue markers but gives no pooled estimate [10].
Mitochondrial and cellular markers
Small trials found changes in mitochondrial and inflammation blood markers in middle-aged and older adults. All were run or funded by the maker.
The numbers and sources
- Effect
- Four weeks at 500 or 1,000 mg a day changed plasma acylcarnitines and muscle mitochondrial gene expression in older adults [4]. Acylcarnitines, ceramides and CRP fell more than on placebo in older adults over 4 months [3], and acylcarnitines and CRP fell in middle-aged adults [2].
- Population
- Healthy, sedentary older adults [4]; 66 older adults [3]; middle-aged adults [2].
- Sources
- [4], [3], [2]
- Caveats
- These are markers, not health outcomes. All three trials were run or funded by the maker.
Inflammation markers
Limited evidence: CBD and THC trials found no significant change in IL-6, IL-8, IL-10 or TNF-alpha.
The numbers and sources
- Effect
- In a meta-analysis of randomized trials of CBD and THC, pooled changes in IL-6 (SMD -0.17, 95% CI -0.56 to 0.23), IL-8 (-0.30, 95% CI -0.62 to 0.01), IL-10 (-0.10) and TNF-α (-0.09, 95% CI -0.45 to 0.27) did not differ significantly from control [8].
- Population
- 13 trials, with 2 to 4 trials and about 78 to 129 people per arm in each pooled marker [8].
- Sources
- [8]
- Caveats
- The review pooled CBD and THC interventions. GRADE certainty ranged from very low (IL-6) to moderate (IL-8, TNF-α) [8]. Blood markers, not symptoms.
Inflammation markers (CRP)
Small trials found no change in CRP in knee osteoarthritis, and lower airway inflammation markers in asthma.
The numbers and sources
- Effect
- In 100 adults with knee osteoarthritis, CRP and ESR did not differ between powder and placebo after 12 weeks [3]. In the asthma crossover trial, airway markers including cysteinyl leukotrienes and 8-isoprostane in exhaled breath fell on PCSO-524 against placebo [6].
- Population
- 100 adults with knee osteoarthritis [3] and 20 adults with asthma [6].
- Sources
- [3], [6]
- Caveats
- Two small trials measuring different markers. No meta-analysis of inflammation markers was located.
Therapies
Inflammation, wet cupping
One trial of 126 people with metabolic syndrome found wet cupping did not change high-sensitivity C-reactive protein over 12 weeks.
Compared with dietary advice alone [13]
Practices
Inflammatory markers
Shown to lower interleukin-1 beta and raise interleukin-10 in a meta-analysis of 11 small trials. Single sessions after exercise did not change interleukin-6 or C-reactive protein.
The numbers and sources
- Effect
- Across 11 RCTs (274 participants), serum interleukin-1 beta was lower with cryotherapy than control (SMD -2.08) and interleukin-10 was higher (SMD 0.78) [9]. In 11 endurance-trained men, one 3-minute session at -110°C after interval running did not change interleukin-6, interleukin-10, C-reactive protein, cortisol or testosterone against rest [10]. In two placebo-controlled trials, neither cryotherapy nor cold water changed inflammation or muscle damage markers against placebo, apart from C-reactive protein at 24 hours [4][5].
- Population
- 274 people in 11 RCTs, including athletes and people with obesity [9]. 11 trained men in a crossover [10]. 31 and 24 trained men [4][5].
- Sources
- [9], [10], [4], [5]
- Caveats
- The pooled trials are small and differ in population and exposure. Blood cytokines are lab markers, and none of these studies tied the change to a health outcome.
Hyperventilation breathwork and inflammation
Small trials of a program combining cyclic hyperventilation, cold exposure and meditation found a blunted inflammatory response to injected endotoxin, and a fall in ESR in spondyloarthritis.
Compared with untrained volunteers [17]; a control period without training [18]
The numbers and sources
- Effect
- After 10 days of training in meditation, cyclic hyperventilation with breath retention, and cold immersion, 12 volunteers given intravenous endotoxin had higher plasma adrenaline and anti-inflammatory IL-10, lower TNF-alpha, IL-6 and IL-8, and fewer flu-like symptoms than 12 untrained controls [17]. In 24 patients with axial spondyloarthritis, ESR fell over 8 weeks of the program from a median of 16 to 9 mm/hr (p = 0.040) with no change in controls, and hs-CRP did not change [18]. A systematic review of 8 trials of the Wim Hof Method concluded it may reduce inflammation and found mixed effects on exercise performance [19].
- Population
- 24 healthy volunteers [17]. 24 patients with moderately active axial spondyloarthritis and raised hs-CRP [18]. 8 trials [19].
- Sources
- [17], [18], [19]
- Caveats
- The breathing was never tested apart from the cold and meditation in these trials. The spondyloarthritis trial was open label [18]. Endotoxin injection is a laboratory model of inflammation, not a disease [17].
Inflammation and white blood cells
Limited evidence: small company-funded trials found white blood cell counts shifted after damaging exercise with grounding. No study measured C-reactive protein or an inflammatory disease.
Compared with sham grounding [4][5]
The numbers and sources
- Effect
- On day 3 after exercise, neutrophils were higher in grounded than sham-grounded men (P = 0.05), and platelets rose significantly in the grounded group on days 2 to 4 [4]. White blood cell counts were among the measures that differed by 10% or more in the 8-person pilot [5]. A review by researchers holding shares in the sponsoring company states that grounding alters circulating neutrophils, lymphocytes and inflammatory factors [6].
- Population
- 32 healthy young men [4]. 8 healthy adults [5]. Studies summarized in a review [6].
- Sources
- [4], [5], [6]
- Caveats
- A higher neutrophil count is not a lower level of inflammation, and the trials did not say whether these shifts help or harm. The review's authors disclose contracts with and shares in the company sponsoring grounding research [6].
Inflammation and C-reactive protein
Mixed results: one meta-analysis found C-reactive protein fell against active controls, while a review of trials found a fall in three of six that measured it.
Compared with active control groups [17]; waiting list, usual care and active control groups [18]
The numbers and sources
- Effect
- Across 45 trials against active controls, meditation reduced cortisol, C-reactive protein, blood pressure, heart rate, triglycerides and tumor necrosis factor alpha [17]. In a systematic review of 20 randomized trials, six measured C-reactive protein. One found a reduction and two found a trend toward reduction. The reviewers called the immune findings tentative and heterogeneous [18].
- Population
- Participants in 45 randomized trials [17]. Participants in 20 randomized trials, including people with cancer, HIV and ulcerative colitis [18].
- Sources
- [17], [18]
- Caveats
- The meta-analysis abstract gives no effect sizes [17]. Assay methods and populations varied widely [18].
Inflammation markers
Mixed results: frequent sauna users had lower C-reactive protein in a study of 2,084 Finnish men, while a 4-week trial in 15 men found no change.
The numbers and sources
- Effect
- Mean C-reactive protein was 2.41, 2.00 and 1.65 in men using a sauna once, 2 to 3 times and 4 to 7 times a week, an inverse association that held after adjustment [23]. In 15 untrained young men randomized to cycling 3 times a week with or without a 30-minute sauna afterward, high-sensitivity C-reactive protein did not differ between groups after 4 weeks. Gut bacteria and intestinal barrier markers did not differ either [24].
- Population
- 2,084 Finnish men aged 42 to 60 without acute or chronic inflammation, measured once [23]. 15 men aged 22 on average [24].
- Sources
- [23], [24]
- Caveats
- The larger study is cross-sectional, a single measurement that cannot show sauna use came first. Its abstract gives the unit as mmol/L, and C-reactive protein is usually reported in mg/L, so the unit may be a reporting error [23]. The trial was a pilot [24].
Inflammation
Not shown to lower inflammation. Inflammatory markers rose in the hour after immersion, and post-exercise reviews found no change in C-reactive protein or interleukin-6.
The numbers and sources
- Effect
- In healthy adults, inflammation markers were higher immediately after immersion (SMD 1.03, 95% CI 0.37 to 1.68) and 1 hour after (SMD 1.26, 95% CI 0.59 to 1.94) [14]. Across meta-analyses of post-exercise immersion, there were no significant effects on C-reactive protein or interleukin-6 up to 72 hours [6]. Five weeks of immersion after interval training did not change inflammatory markers in muscle [12].
- Population
- Healthy adults in 11 randomized trials [14]. Healthy people in 15 meta-analyses of post-exercise immersion [6]. 16 men [12].
- Sources
- [14], [6], [12]
- Caveats
- The acute rise was measured within an hour and the reviewers call it an acute inflammatory response. Long-term markers in everyday users were not pooled [14].
Antioxidant effect of the Earth's electrons
Not studied in people. Grounding researchers propose that electrons from the ground act as antioxidants around injured tissue, a mechanism no human study has measured.
No study in people. This rests on how it acts in the body.
The numbers and sources
- Effect
- The main hypothesis of one review is that free electrons from the Earth's surface spread into the body and have antioxidant effects, creating an antioxidant microenvironment around injury that limits damage from reactive oxygen species [6]. An earlier review proposes that losing contact with the Earth's electrons contributes to physiological dysfunction [10].
- Population
- No people. Hypotheses in reviews [6][10].
- Sources
- [6], [10]
- Caveats
- The authors of both reviews have ties to the company sponsoring grounding research [6].
Food and drink
Inflammation and C-reactive protein
Mixed results: one meta-analysis found fermented dairy lowered C-reactive protein slightly, while two meta-analyses of kefir trials found no change.
Compared with control groups the abstract does not describe [5]; people who did not drink kefir [6]; control groups [7]; a high-fiber diet, with changes measured over time in each group [8]
The numbers and sources
- Effect
- Across 14 trials of yogurt, fermented milk and kefir, C-reactive protein fell (SMD -0.21, 95% CI -0.40 to -0.02), mainly in people with metabolic disease, and TNF-alpha and interleukin-6 did not change [5]. Kefir did not change C-reactive protein (WMD -0.17 mg/L, 95% CI -0.84 to 0.49), though it fell in trials of 8 weeks or longer [6]. A second kefir review found no significant effect on inflammatory markers [7]. In a 17-week trial, a high fermented food diet steadily raised gut microbiome diversity and lowered inflammatory markers [8].
- Population
- 14 trials [5]. 385 adults in 7 trials [6]. 24 studies [7]. 36 healthy adults, 18 in each diet group [8].
- Sources
- [5], [6], [7], [8]
- Caveats
- Few small trials with different foods. The abstract of [8] does not name C-reactive protein among the markers that fell.
Inflammation
Mixed results: one pooled analysis found C-reactive protein fell 0.64 mg/L with olive oil, while a later one found no change in C-reactive protein or interleukin-6.
Compared with control groups, with control diets that varied [12]; trials comparing olive oil or flaxseed oil with controls [13]
The numbers and sources
- Effect
- Olive oil lowered C-reactive protein (mean difference -0.64 mg/L, 95% CI -0.96 to -0.31, 15 trials) and interleukin-6 (-0.29) and raised flow-mediated dilation by 0.76% against controls [12]. A pooling of trials in adults with normal or mildly raised blood pressure found no effect on C-reactive protein (8 trials) or interleukin-6 (3 trials) [13].
- Population
- 3,106 participants in 30 randomized trials [12]. 17 randomized trials, 14 of olive oil [13].
- Sources
- [12], [13]
- Caveats
- The first review calls for conservative reading because olive oil was given as a supplement or within a diet and control diets varied [12].
C-reactive protein and inflammation
Mixed results: two pooled analyses of trials found whole grains lowered C-reactive protein slightly, while a third found no significant change.
Compared with refined grains [11]; refined grains or placebo [9]; control diets low in or without whole grains [10]
The numbers and sources
- Effect
- Whole grains lowered high-sensitivity C-reactive protein (Hedges' g -0.22, 95% CI -0.45 to 0.00) and interleukin-6, with no change in TNF-alpha, and high heterogeneity (I² 69%) [11]. Another review found lower C-reactive protein (SMD -0.22, 95% CI -0.44 to 0.00) [9]. A third found no significant change in C-reactive protein (-0.29 mg/L, 95% CI -1.10 to 0.52), interleukin-6 or TNF-alpha, with effects in people with raised C-reactive protein and in trials with matched calories [10].
- Population
- 466 participants in 13 trials [11]. 25 trials [9]. 1,238 adults in 14 trials [10].
- Sources
- [11], [9], [10]
- Caveats
- Heterogeneity was high across reviews [10][11]. The intervals of the two reviews that found a fall reach zero.
Inflammation and blood vessel function
Not shown to lower C-reactive protein in two meta-analyses of nut trials. Blood vessel widening, a measure of vessel function, improved in one.
Compared with control conditions the abstract does not describe [13]; control arms without nuts [4]
The numbers and sources
- Effect
- Across 25 trials, nuts made no significant difference to C-reactive protein (WMD -0.01 mg/L, 95% CI -0.06 to 0.03) or other inflammation markers. Flow-mediated dilation rose 0.79% (95% CI 0.35 to 1.23) across 8 trials [13]. Tree nuts had no significant effect on C-reactive protein in 61 trials [4].
- Population
- 32 randomized trials in adults, 652 participants for vessel function [13]. 2,582 adults in 61 trials [4].
- Sources
- [13], [4]
- Caveats
- The authors note the C-reactive protein result may have been influenced by two studies [13].
Diets
C-reactive protein
Linked to lower odds of elevated C-reactive protein, about 10% for each point lower on the Dietary Inflammatory Index.
Compared with people with higher (more pro-inflammatory) Dietary Inflammatory Index scores, per point [6]
The numbers and sources
- Effect
- In 14 studies (59,941 people), each one-unit rise in the index was linked to 10% higher odds of elevated C-reactive protein (OR 1.10, 95% CI 1.06 to 1.14, I² 0%) [6].
- Population
- Adults in observational studies [6].
- Sources
- [6]
- Caveats
- Observational. The abstract's confidence interval for the highest against lowest category (OR 1.39) does not contain the estimate, so only the per-unit figure is reported here [6].
Inflammation markers
Shown in two reviews to lower CRP about 0.4 to 0.8 mg/L more than comparison diets in adults, with one result sensitive to single trials.
Compared with control diets the source does not describe [1]; a control group the source does not describe [5]
The numbers and sources
- Effect
- CRP fell 0.41 mg/L more than on control diets (95% CI 0.008 to 0.81) [1] and 0.84 mg/L more in people with metabolic disorders (95% CI 0.06 to 1.62) [5].
- Population
- Adults in 8 RCTs [1]; adults with metabolic disorders in 10 RCTs [5].
- Sources
- [1], [5]
- Caveats
- Confidence intervals reach close to zero. In [1], the CRP result changed when single studies were removed. CRP is a blood marker, not a disease outcome.
Inflammation
One trial found the inflammation marker hs-CRP fell on a 7-day lemon detox but not on a calorie-matched placebo juice, in overweight Korean women.
Compared with before the diet, in the same people (overweight Korean women), with a calorie-matched placebo juice group measured the same way [1]
The numbers and sources
- Effect
- Serum hs-CRP fell only in the lemon detox group. Hemoglobin and hematocrit stayed stable on the lemon detox and fell in the other two groups [1].
- Population
- 84 premenopausal overweight Korean women [1].
- Sources
- [1]
- Caveats
- One short trial, with a blood marker rather than a disease outcome. Each group was measured against its own starting level, and no test between the groups is reported for hs-CRP [1].
Inflammation markers
Mixed results: CRP fell 0.62 mg/dL in one review of short and long trials, and a review of trials lasting a year or more found no CRP difference.
Compared with diets that did not restrict carbohydrates to the level of ketosis
The numbers and sources
- Effect
- In 5 RCTs pooled, CRP fell 0.62 mg/dL (95% CI 0.40 to 0.84) and IL-6 did not change significantly (-1.31 pg/mL, 95% CI -2.86 to 0.25) [11]. In 13 trials of 12 months or more, CRP was measured and was not among the outcomes that differed from low-fat diets [1].
- Population
- 218 adults with overweight or obesity in 7 RCTs of 8 weeks to 2 years [11]; adults in trials against low-fat diets [1].
- Sources
- [1], [11]
- Caveats
- Few small trials. The abstract of [11] does not say whether the CRP change was measured against the control diet or from baseline. CRP is a blood marker, not a disease outcome.
Inflammation markers
Not shown to change CRP, IL-6 or TNF-alpha in adults in Nordic countries.
Compared with control groups the source does not describe [8], [9]
The numbers and sources
- Effect
- In 6 trials (613 adults), CRP did not change (-0.17 mg/L, 95% CI -0.69 to 0.35), and TNF-alpha and IL-6 did not change in 3 trials [8]. A 2025 meta-analysis also found no effect on CRP [9].
- Population
- Adults in Nordic countries [8]; adults in 15 RCTs [9].
- Sources
- [8], [9]
- Caveats
- Short trials. In SYSDIET, IL-1 receptor antagonist rose on the control diet and not on the Nordic diet [4], a finding not tested in the pooled analyses.
Lab markers
Coronary heart disease and stroke
Linked to more coronary heart disease and stroke at higher levels, about 37% more coronary disease per threefold rise after adjusting for standard risk factors.
The numbers and sources
- Effect
- In pooled individual records from 54 prospective studies, the risk ratio for coronary heart disease per one standard deviation higher log CRP (a threefold higher level) was 1.63 (95% CI 1.51 to 1.76) adjusted for age and sex, 1.37 (1.27 to 1.48) after conventional risk factors and 1.23 (1.07 to 1.42) after fibrinogen as well. For ischemic stroke the figures were 1.44, 1.27 and 1.32 [6]. In initially healthy US women followed for 30 years, the top fifth of hs-CRP had a hazard ratio for a first major cardiovascular event of 1.70 against the bottom fifth (95% CI 1.52 to 1.90), compared with 1.36 for LDL cholesterol [7]. In statin-treated patients from three trials, the top quarter of hs-CRP had hazard ratios of 1.31 for major cardiovascular events (95% CI 1.20 to 1.43) and 2.68 for cardiovascular death (2.22 to 3.23) against the bottom quarter [8].
- Population
- 160,309 people without vascular disease in 54 studies, 27,769 outcomes [6]. 27,939 women, mean age 54.7, with 3,662 events [7]. 31,245 patients with or at high risk of atherosclerotic disease on statins [8].
- Sources
- [6], [7], [8]
- Caveats
- Observational. The pooled analysis found the association depends considerably on conventional risk factors and other markers of inflammation, and that CRP was tied about as strongly to deaths from several cancers and lung disease, which its authors say leaves its relevance unclear [6].
Death from any cause
Linked to more deaths at higher levels, about 75% more in the highest than the lowest category across pooled general population studies.
The numbers and sources
- Effect
- In a meta-analysis of prospective studies in the general population, the highest category of hs-CRP had a pooled risk ratio of 1.75 for death from any cause against the lowest (95% CI 1.55 to 1.98), 2.03 for cardiovascular death (1.65 to 2.50) and 1.25 for cancer death (1.13 to 1.38) [10]. In pooled individual records, the risk ratio per threefold higher CRP after adjustment for conventional risk factors was 1.55 for vascular death (95% CI 1.37 to 1.76) and 1.54 for non-vascular death (1.40 to 1.68) [6].
- Population
- 83,995 participants in 14 studies [10]. 160,309 people in 54 studies [6].
- Sources
- [10], [6]
- Caveats
- Observational. CRP rises with many illnesses, so a higher level may mark disease already present. The link with cancer death was seen in men and not in women [10].
Cardiovascular events in trials that selected people by hs-CRP or lowered inflammation
Shown in trials: a drug that lowered hs-CRP without changing cholesterol cut cardiovascular events 15%, while one that did not lower it made no difference.
The numbers and sources
- Effect
- In people with a previous heart attack and hs-CRP of 2 mg/L or more, canakinumab lowered hs-CRP by 26 to 41 percentage points more than placebo without lowering lipids. At 150 mg it reduced the primary end point of heart attack, stroke or cardiovascular death (HR 0.85, 95% CI 0.74 to 0.98). Fatal infection was more frequent, and death from any cause did not differ (HR 0.94, 95% CI 0.83 to 1.06) [12]. Low-dose methotrexate did not lower C-reactive protein and did not reduce cardiovascular events (HR 0.96, 95% CI 0.79 to 1.16) [13]. In apparently healthy adults with hs-CRP of 2.0 mg/L or higher and LDL cholesterol below 130 mg/dL, rosuvastatin reduced the primary cardiovascular end point (HR 0.56, 95% CI 0.46 to 0.69) while lowering LDL cholesterol by 50% and hs-CRP by 37% [14].
- Population
- 10,061 patients followed a median 3.7 years [12]. 4,786 patients with stable atherosclerosis and diabetes or metabolic syndrome followed a median 2.3 years [13]. 17,802 men and women followed a median 1.9 years [14].
- Sources
- [12], [13], [14]
- Caveats
- The statin trial lowered LDL cholesterol and hs-CRP together, and had no group with low hs-CRP, so it cannot show that hs-CRP identified who benefited [14]. Canakinumab acts on interleukin-1 beta, upstream of CRP, so the trial tests lowering inflammation, not lowering CRP itself. The canakinumab trial was funded by its maker [12].
Cardiovascular disease
Linked to more heart failure, heart attack and peripheral arterial disease at higher counts within the usual range, in two large United Kingdom cohorts.
The numbers and sources
- Effect
- In linked English health records, a count of 6,000 to 7,000 cells/µL against 2,000 to 3,000 had adjusted hazard ratios of 2.04 (95% CI 1.82 to 2.29) for heart failure, 1.95 (1.72 to 2.21) for peripheral arterial disease, 1.78 (1.51 to 2.10) for unheralded coronary death, 1.58 (1.42 to 1.76) for nonfatal heart attack and 1.36 (1.17 to 1.57) for ischemic stroke. There was no association with stable angina or bleeding in the brain. The associations were linear, with higher risk already at 3,000 to 4,000 [12]. In UK Biobank, the highest tenth of neutrophil count against the fifth had hazard ratios for cardiovascular death of 1.59 (1.22 to 2.08) in men and 2.15 (1.38 to 3.35) in women. In an analysis that left out people with existing illness and the first two years, each 1,000 cells/µL higher count had a hazard ratio of 1.07 (1.04 to 1.11) in both sexes combined [13].
- Population
- 775,231 adults aged 30 or older with no history of cardiovascular disease, 55,004 cases over a median 3.8 years [12]. 478,259 UK Biobank participants followed a median 7.0 years [13].
- Sources
- [12], [13]
- Caveats
- Observational. Smoking, infection and long-term illness raise the count and also raise cardiovascular risk, and adjustment may not remove this. The UK Biobank authors call for trials of treatments that lower neutrophils to investigate causality [13].
Type 2 diabetes
Linked to more type 2 diabetes at higher levels, with a 26% higher risk in a meta-analysis of 22 cohorts.
The numbers and sources
- Effect
- A meta-analysis of prospective studies found elevated CRP was associated with a higher risk of type 2 diabetes (relative risk 1.26, 95% CI 1.16 to 1.37), with no sign of publication bias [11].
- Population
- 40,735 participants with 5,753 cases in 22 cohorts [11].
- Sources
- [11]
- Caveats
- Observational, and the abstract does not give the size of the CRP difference the estimate refers to [11].
Death from any cause
Limited evidence: one Dutch cohort of 5,226 older adults linked an ESR of 20 to 50 to 23% more deaths, and above 50 to 89% more.
The numbers and sources
- Effect
- Against an ESR below 20 mm/hr, the adjusted hazard ratio for death from any cause was 1.23 (95% CI 1.12 to 1.35) at 20 to 50 mm/hr and 1.89 (1.38 to 2.60) above 50 mm/hr. In people older than 75 with no other illness recorded, an ESR above 20 mm/hr still had a hazard ratio of 1.29 (1.01 to 1.64) [7].
- Population
- 5,226 participants in the Rotterdam Study, mean age 70.3, with 3,749 deaths over a median of 14.9 years [7].
- Sources
- [7]
- Caveats
- One observational cohort of older adults. ESR is a nonspecific sign of illness, and the source did not test whether lowering it changes the risk of death [7].
Death from coronary heart disease
Limited evidence: one Norwegian cohort of 2,014 men linked a higher ESR to more deaths from coronary heart disease over 23 years.
The numbers and sources
- Effect
- After adjustment for age, hemoglobin, smoking, cholesterol and systolic blood pressure, ESR was a strong short-term and long-term predictor of death from coronary heart disease, most of all in men who had developed angina or had a positive exercise test at a second survey 7 years later. More deaths from other causes and more nonfatal heart attacks were seen only in the upper range of ESR [11].
- Population
- 2,014 apparently healthy men aged 40 to 60 examined in 1972 to 1975 and followed for 23 years [11].
- Sources
- [11]
- Caveats
- One observational cohort of men. The abstract gives no hazard ratios and no ESR levels [11].
Diagnoses found at 100 mm/hr or above
Limited evidence: among 4,807 clinic patients with an ESR of 100 or above, infection was found in 40%, autoimmune disease in 38% and malignancy in 36%.
The numbers and sources
- Effect
- The leading diagnosis associated with an ESR of 100 mm/hr or above was infection (1,932 patients, 40%), followed by autoimmune disease (1,839, 38%) and malignancy (1,736, 36%). The authors report that almost all patients had an identifiable cause. Values were slightly higher in men than in women, and did not correlate with age, race or C-reactive protein [10].
- Population
- 4,807 patients with an ESR of 100 mm/hr or above examined at Mayo Clinic in Rochester, Minnesota, from 2002 to 2011 [10].
- Sources
- [10]
- Caveats
- Retrospective, at one referral center, with no comparison group below 100 mm/hr. The diagnosis groups overlap [10].
Coronary heart disease in genetic studies
Not shown to cause coronary heart disease: gene variants that raise CRP did not raise risk in 194,418 people.
The numbers and sources
- Effect
- In a Mendelian randomization meta-analysis, variants in the CRP gene each changed CRP concentration by up to 30% per allele and were unrelated to other risk factors. The risk ratio for coronary heart disease was 1.00 (95% CI 0.90 to 1.13) per standard deviation higher genetically raised log CRP, against 1.33 (1.23 to 1.43) for the same difference in measured CRP in prospective studies (P = 0.001 for the difference). The authors concluded that CRP concentration itself is unlikely to be even a modest causal factor in coronary heart disease [9].
- Population
- 194,418 participants in 47 studies in 15 countries, including 46,557 with coronary heart disease [9].
- Sources
- [9]
- Caveats
- The finding concerns CRP itself. It does not test whether the inflammation that CRP reflects is a cause [9].
On a blood test: High-sensitivity C-reactive protein (hs-CRP)
Every finding in the library that measured this test, including studies that were mainly about something else.
Shown to lower it
- StrongThunder god vineCautionRheumatoid arthritis
Across 40 RCTs (3,092 patients), tripterygium glycosides added to DMARDs lowered morning stiffness, tender and swollen joint counts, pain scores, CRP, ESR and rheumatoid factor against DMARDs alone (all p < .001).
- StrongTurmericC-reactive protein and other inflammation markers
Shown to lower CRP and some other inflammation markers in adults with inflammatory conditions or diabetes. These are blood markers, not clinical outcomes.
- StrongTurmericRheumatoid arthritis
Across 7 RCTs, DAS28 fell by 1.47 (95% CI -1.68 to -1.26), with lower rheumatoid factor, ESR and CRP.
- ModerateOral corticosteroidsSevere COVID-19 and pneumonia in hospital
In severe community-acquired pneumonia, added corticosteroids lowered deaths (RR 0.47, 95% CI 0.3 to 0.74) and C-reactive protein on day 8 (SMD -0.8, 95% CI -1.11 to -0.5), with no difference in gastrointestinal bleeding or high blood sugar.
- ModerateBeta-sitosterolBlood pressure and other heart risk markers
Plant sterols and stanols lowered systolic blood pressure by 1.55 mmHg (95% CI 0.42 to 2.67), diastolic by 0.84 mmHg, apoB by 0.06 g/L and hs-CRP by 0.25 mg/L.
- ModerateFisetin and quercetin (senolytics)Liver enzymes and lipids in fatty liver disease (quercetin alone)
A 2025 meta-analysis of 7 RCTs (540 patients) with metabolic dysfunction-associated steatotic liver disease found that quercetin lowered ALT, AST, GGT, direct bilirubin and C-reactive protein, lowered total cholesterol, LDL and triglycerides, and raised HDL.
- ModerateGarlicInflammation markers
Shown to lower CRP by about 0.6 mg/L and lower TNF in adults. These are blood markers, and the reviews disagree on IL-6.
- ModerateGingerInflammation markers
Shown to lower CRP, TNF-α and IL-6 in adults, more in people with health conditions. These are blood markers, not clinical outcomes.
- ModerateProbioticsRheumatoid arthritis
Mixed results: reviews agree probiotics lower CRP or IL-6 in rheumatoid arthritis, but disagree on disease activity.
- ModerateTart cherryRecovery after strenuous exercise
A 2026 meta-analysis of 19 trials in trained athletes found faster recovery of maximal strength at every time point (ES 0.63 right after exercise to 4.82 at 96 hours) and lower CRP up to 48 hours (ES -0.46 to -0.73).
- ModerateVitamin DInflammatory bowel disease
In adults, the Harvey Bradshaw Index for Crohn's disease fell by 1.47 points (95% CI -2.47 to -0.47) and hs-CRP fell by 1.58 mg/L.
- ModerateZincBlood sugar
Across 32 placebo-controlled interventions (1,700 participants, 14 countries), zinc lowered fasting glucose by 14.15 mg/dL (95% CI -17.36 to -10.93), 2-hour glucose by 36.85 mg/dL, HbA1c by 0.55% (95% CI -0.84 to -0.27) and hs-CRP by 1.31 mg/L.
- ModerateRed light therapyWeight and waist size in obesity
Across 11 RCTs (569 patients), photobiomodulation improved waistline (mean difference -7.28, 95% CI -9.97 to -5.67), weight (-3.54, 95% CI -5.97 to -1.11) and BMI (-1.18, 95% CI -1.93 to -0.43), and lowered C-reactive protein, total cholesterol and HOMA-IR.
- ModeratePaleo dietInflammation markers
Shown in two reviews to lower CRP about 0.4 to 0.8 mg/L more than comparison diets in adults, with one result sensitive to single trials.
Compared with control diets the source does not describe; a control group the source does not describe
- LimitedBoronJoint pain and arthritis
In 60 adults with knee osteoarthritis, 15 days of calcium fructoborate improved C-reactive protein, fibrinogen and sedimentation rate against placebo, with no serious adverse events.
- LimitedGrape seed extractInflammation
Limited evidence: a 50-trial review found lower CRP, while an earlier review found no effect.
- LimitedTart cherryKnee osteoarthritis pain
One trial found knee pain scores did not differ significantly from placebo in adults with knee osteoarthritis, though CRP fell.
- LimitedUrolithin AMitochondrial and cellular markers
Acylcarnitines, ceramides and CRP fell more than on placebo in older adults over 4 months, and acylcarnitines and CRP fell in middle-aged adults.
- LimitedLymphatic drainage massageMuscle recovery after hard exercise
One trial of 36 combat athletes found drainage after jumping exercise raised pain thresholds and lowered creatine kinase and C-reactive protein more than passive rest.
Compared with passive rest; intense sports massage
- LimitedJuice cleanseStudied in womenInflammation
One trial found the inflammation marker hs-CRP fell on a 7-day lemon detox but not on a calorie-matched placebo juice, in overweight Korean women.
Compared with before the diet, in the same people (overweight Korean women), with a calorie-matched placebo juice group measured the same way
Shown to raise it
- ModerateCLAInflammation and oxidative stress markers
Shown to raise CRP in adults across 14 studies. Sources disagree on oxidative stress, with one marker rising and another falling.
Studies disagree
- StrongDietary nitrateRecovery from muscle damage
Creatine kinase and oxidative stress did not change; C-reactive protein was higher than placebo at 48 hours (SMD 0.55). CRP, IL-6 and TNF-α did not change.
- StrongTart cherryBlood pressure and cardiometabolic markers
Across 21 trials, blood pressure, heart rate, hs-CRP and IL-6 did not change, while CRP fell by 0.39 mg/L (95% CI -0.74 to -0.05, moderate certainty).
- StrongVitamin DRheumatoid arthritis disease activity
Shown to lower disease activity modestly in adults with rheumatoid arthritis. Reviews disagree on CRP, ESR and pain.
- ModerateResveratrolInflammation and blood lipids
Mixed results: reviews disagree on whether CRP falls, and most found no change in LDL or triglycerides.
- ModerateFermented foodsInflammation and C-reactive protein
Mixed results: one meta-analysis found fermented dairy lowered C-reactive protein slightly, while two meta-analyses of kefir trials found no change.
Compared with control groups the abstract does not describe; people who did not drink kefir; control groups; a high-fiber diet, with changes measured over time in each group
- ModerateOlive oilInflammation
Mixed results: one pooled analysis found C-reactive protein fell 0.64 mg/L with olive oil, while a later one found no change in C-reactive protein or interleukin-6.
Compared with control groups, with control diets that varied; trials comparing olive oil or flaxseed oil with controls
- ModerateWhole grainsC-reactive protein and inflammation
Mixed results: two pooled analyses of trials found whole grains lowered C-reactive protein slightly, while a third found no significant change.
Compared with refined grains; refined grains or placebo; control diets low in or without whole grains
- ModerateKeto dietInflammation markers
Mixed results: CRP fell 0.62 mg/dL in one review of short and long trials, and a review of trials lasting a year or more found no CRP difference.
Compared with diets that did not restrict carbohydrates to the level of ketosis
- LimitedFish oilInflammation markers (CRP)
Limited evidence: CRP fell in hemodialysis patients but not with high-dose EPA, in knee osteoarthritis, or in most trials of trained people.
- LimitedPalmitoylethanolamideInflammation markers (CRP, IL-6)
Small trials found lower IL-6 and CRP in diabetic nerve pain, while a COVID-19 trial lowered other markers but not those two.
- LimitedMeditationInflammation and C-reactive protein
Mixed results: one meta-analysis found C-reactive protein fell against active controls, while a review of trials found a fall in three of six that measured it.
Compared with active control groups; waiting list, usual care and active control groups
Tested, and not shown to change it
- StrongTMGHigher cholesterol
Triglycerides, HDL, glucose, CRP, liver enzymes and blood pressure did not change.
- StrongVitamin DPsoriasis severity
Across 4 studies (333 patients), PASI, DLQI and CRP changes did not differ from control.
- StrongNutsInflammation and blood vessel function
Not shown to lower C-reactive protein in two meta-analyses of nut trials. Blood vessel widening, a measure of vessel function, improved in one.
Compared with control conditions the abstract does not describe; control arms without nuts
- ModerateAstaxanthinOxidative stress and inflammation
Shown to lower blood malondialdehyde, an oxidative stress marker, and IL-6 in type 2 diabetes. CRP and TNF-alpha did not change.
- ModerateFish oilCardiovascular outcomes with purified EPA (prescription)
Across 6 trials (42,738 adults) of 1.8 g a day or more of EPA-dominant omega-3, hospitalization for unstable angina fell (RR 0.75, 95% CI 0.66 to 0.87), while cardiovascular death, ischemic stroke and hs-CRP did not change significantly.
- ModerateFish oilRheumatoid arthritis
Across 18 RCTs (1,018 patients), tender joint count fell (SMD -0.59, 95% CI -0.79 to -0.39), while ESR, CRP and DAS28 did not change significantly.
- ModerateLactoferrinRespiratory infections
In adults, IL-6 fell by 24.9 pg/mL, while CRP and NK cell activity did not change.
- ModerateRhodiolaEndurance performance
Creatine kinase (ES -0.84) and lactate fell, and IL-6 and CRP did not change.
- ModerateCold water immersionInflammation
Not shown to lower inflammation. Inflammatory markers rose in the hour after immersion, and post-exercise reviews found no change in C-reactive protein or interleukin-6.
- ModerateWhole-body cryotherapyAnkylosing spondylitis
Shown to improve pain, function and disease activity scores in people with ankylosing spondylitis in a meta-analysis of 5 studies. C-reactive protein did not change.
- ModerateHigh-protein dietBlood pressure and triglycerides
Total and LDL cholesterol, C-reactive protein and HbA1c did not change.
Compared with diets with less protein
- ModerateNordic dietInflammation markers
Not shown to change CRP, IL-6 or TNF-alpha in adults in Nordic countries.
Compared with control groups the source does not describe
- LimitedDeer antler velvetArthritis
In 168 people with rheumatoid arthritis on standard treatment, 6 months of elk velvet antler did not differ from placebo on joint pain and swelling, disease activity, function, quality of life or CRP.
- LimitedGreen-lipped musselInflammation markers (CRP)
Small trials found no change in CRP in knee osteoarthritis, and lower airway inflammation markers in asthma.
- LimitedL-carnitineTMAO and cardiovascular markers
In healthy older women, 24 weeks of L-carnitine raised plasma TMAO tenfold but did not change CRP, IL-6, adhesion molecules or lipids.
- LimitedCuppingInflammation, wet cupping
One trial of 126 people with metabolic syndrome found wet cupping did not change high-sensitivity C-reactive protein over 12 weeks.
Compared with dietary advice alone
On a blood test: Erythrocyte sedimentation rate (ESR)
Every finding in the library that measured this test, including studies that were mainly about something else.
Shown to lower it
- StrongThunder god vineCautionRheumatoid arthritis
Across 40 RCTs (3,092 patients), tripterygium glycosides added to DMARDs lowered morning stiffness, tender and swollen joint counts, pain scores, CRP, ESR and rheumatoid factor against DMARDs alone (all p < .001).
- StrongTurmericRheumatoid arthritis
Across 6 publications (539 patients), curcumin lowered DAS28 (MD -1.20, 95% CI -1.85 to -0.55), ESR (MD -29.47), swollen joint count (MD -5.33) and tender joint count (MD -6.33) against controls.
- LimitedBoronJoint pain and arthritis
In 72 people with rheumatoid arthritis on etanercept, calcium fructoborate or borax (6 mg of boron a day) for 60 days improved disease activity scores and lowered ESR, hsCRP, IL-1α, IL-6 and TNF-α against placebo.
Studies disagree
- StrongVitamin DRheumatoid arthritis disease activity
Shown to lower disease activity modestly in adults with rheumatoid arthritis. Reviews disagree on CRP, ESR and pain.
Tested, and not shown to change it
- StrongTurmericC-reactive protein and other inflammation markers
In 21 knee osteoarthritis studies (1,705 patients), CRP (SMD -0.906, 95% CI -1.543 to -0.269) and TNF-alpha were lower than placebo, while ESR, IL-1beta, IL-6 and PGE-2 did not differ.
- ModerateFish oilRheumatoid arthritis
Across 18 RCTs (1,018 patients), tender joint count fell (SMD -0.59, 95% CI -0.79 to -0.39), while ESR, CRP and DAS28 did not change significantly.
- ModerateProbioticsRheumatoid arthritis
Across 4 RCTs (153 participants), DAS fell (SMD -0.58, 95% CI -0.97 to -0.19), CRP fell borderline (SMD -0.32, 95% CI -0.65 to 0.00), and ESR and cytokines did not change.
- LimitedGreen-lipped musselInflammation markers (CRP)
In 100 adults with knee osteoarthritis, CRP and ESR did not differ between powder and placebo after 12 weeks.