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I was recently reviewing the labs of an 83-year-old patient and was pleasantly surprised to see that his primary care provider had ordered C-reactive protein (CRP) and hemoglobin A1C (HbA1c) tests. These tests aren’t commonly included in standard blood work, but many experts agree that they should be.
They are simple, relatively inexpensive ways to give key insight into some of the most common underlying causes of illness and accelerated aging: inflammation, blood sugar dysregulation, and glycation.
High Sensitivity C-Reactive Protein (hs-CRP)
High sensitivity C-reactive protein (hs-CRP) is one of the most common and useful tests for evaluating low-grade, chronic, body-wide inflammation.
Chronic inflammation is the common denominator of many age-related diseases, including metabolic syndrome, diabetes, heart and lung diseases, cancer, osteoporosis, arthritis, and dementia. We now use the term inflammaging to refer to that state of chronic, low-grade, body-wide inflammation related to these inflammatory conditions.
CRP is a type of protein made in response to inflammation. The high sensitivity (hs) test for CRP can detect even very small amounts of systemic inflammation, such as that which occurs at the very small level of the blood vessel wall and leads to atherosclerosis. This is why hs-CRP testing is so good at predicting your chance of having a heart attack or stroke.1
The normal hs-CRP range is 0-3 mg/L. When hs-CRP is used as an independent predictor of risk for coronary artery disease, the cut-off points are:
- Low risk: less than 1.0 mg/L
- Average risk: 1.0 to 3.0 mg/L
- High risk: greater than 3.0 mg/L
Most natural medicine practitioners help their patients strive for levels less than 1.0 mg/L to reduce inflammaging as well as risk for many chronic diseases, not just heart disease.
Hemoglobin A1c (HbA1c)
Hemoglobin A1C (HbA1c) evaluates long-term blood sugar control and a process called glycation, which is one of the leading theorized causes of aging. Glycation occurs when blood sugar (serum glucose) reacts with important protein and lipid molecules in your body. The reaction damages the molecules and can render them nonfunctional.
Glycation also causes the formation of advanced glycation end products (AGEs), which cause inflammation and oxidative stress and are implicated in a host of age-related chronic diseases.2
HbA1C is a reflection of this detrimental reaction.
Measuring glycated hemoglobin (HbA1c) reflects average blood glucose levels over eight to 12 weeks, providing a useful longer-term gauge of blood glucose control compared to measuring glucose directly. Think of HbA1C as a way to track how well your body has been keeping your blood sugar levels under control over the past two to three months.
HbA1c reference ranges and ideal levels:
- Normal: less than 5.7%
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
- Ideal: less than 5.0%
If your level is 5.7% or higher, your body’s sugar levels have been too high for too long. Elevated long-term glycation levels are associated with accelerated aging and other chronic diseases. A high HbA1c is not just about diabetes and its complications, it’s also about premature aging and your risk for other chronic age-related diseases, including cardiovascular disease, cancer, dementia, kidney disease, osteoporosis, cataracts and macular degeneration.2
Natural Approaches to Reduce Chronic Inflammation and Glycation
Much can be done to naturally lower your hs-CRP and/or HbA1c and to decrease your body’s levels of chronic inflammation, excess glucose, and the damaging effects of glycation. Many natural therapies even tackle all these issues simultaneously. The following are some of the most important, best-researched treatments.
Improve your diet
Many radically different healthy diets can be used to lower inflammation and improve blood sugar regulation, including Paleo,3 vegan,4,5 and Mediterranean diets.6,7 Different healthy diets work for different people because of their individual health challenges, lifestyles, beliefs, preferences, genetics, and more.
One shared key between all these diets is the total elimination or drastic reduction in sugars, highly refined carbohydrates, and processed foods, and a switch to fresher meals made from whole, unprocessed ingredients. Another commonality is the focus on phytonutrient-rich plant foods. Many phytonutrients, such as flavonoids, exert well-evidenced anti-inflammatory properties.
Even if, instead of adopting a strict Paleo, vegan, or Mediterranean diet, you simply focused on decreasing sugars and refined carbs while increasing plant foods, you would go a long way towards regulating blood sugar and lowering inflammation.
Decrease your consumption of AGEs
AGEs aren’t only formed by having too much glucose in your bloodstream; they come from foods too.8 When food is heated to high temperatures, the characteristic “browning” generates AGEs, as does deep-frying, broiling, roasting, grilling, and high-temperature processing of pasteurized dairy products, cheeses, sausages, and processed meats.2 Eating more raw, steamed, and gently cooked foods can make a positive difference.9
People who are weaker and/or more sedentary have higher levels of chronic inflammation, whereas those who report more physical activity have lower CRP levels.10,11
While exercise initially results in an increased inflammatory state, it paradoxically lowers systemic inflammation. Both aerobic exercise and strength training have powerful anti-inflammatory and blood-sugar-lowering benefits, and the combination of strength training and cardiovascular training has better effects than either type alone.12
No matter what your current fitness level, there’s an exercise program out there that’s right for you and that will lower your levels of chronic inflammation and excess blood sugar. The key is to find what you like to do regularly.
Fish oil. Omega-3 polyunsaturated fatty acids (PUFAs) have beneficial effects on chronic inflammation. Over the last 20 years, the anti-inflammatory action of omega-3 PUFAs from oily fish, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been demonstrated in many studies.13 Regular use of fish oil supplements is associated with significant reductions in hs-CRP concentrations.14,15
A recent analysis of 68 randomized controlled trials involving more than 4,000 subjects found that supplementing with marine-derived EPA and DHA lowers CRP levels in healthy people as well as in people with all kinds of chronic diseases.15
Supplementation may also lower HbA1c levels, improve blood insulin sensitivity and reduce the risk for diabetes and its complications.16
Berberine. One of the most potent natural medicines for lowering HbA1c is berberine, a compound found in the roots and barks of several plants, such as berberis, goldenseal (Hydrastis canadensis), and Coptis chinensis. Berberine significantly improves glucose tolerance and insulin action, lowering HbA1c levels in people who are obese and/or have metabolic syndrome or type 2 diabetes.17-19 The recommended dose of berberine HCl is 500 mg two to three times a day.
Curcumin, from the spice turmeric, is one of the most powerful and well-researched anti-inflammatory plant compounds.20 Curcumin supplementation has been found to substantially lower hs-CRP levels in people with cancer, osteoarthritis, and several other conditions associated with chronic inflammation.21-23
Because it is notorious for being very poorly absorbed, many manufacturers have created curcumin supplements that enhance bioavailability so that more curcumin can enter the bloodstream and decrease inflammation. Two such curcumin supplements with research supporting their increased bioavailability and effectiveness are Meriva (curcumin phytosome) and curcumin combined with piperine (black pepper extract). The recommended dose is 500 mg curcumin phytosome or 500 mg curcumin combined with 20 mg piperine two to three times daily.
Knowing your hs-CRP and HbA1c levels is a simple, convenient, and relatively inexpensive way to monitor chronic inflammation and excess blood sugar levels, two of the most powerful causes of major age-related chronic diseases.
If you need to work on improving these markers, you have many natural therapies to choose from. The treatments discussed here—decreasing sugar and refined carbs, increasing phytonutrients, decreasing dietary AGEs, exercise, and supplementing with fish oil, berberine, and curcumin—are just a few of the literally hundreds of ways to naturally decrease inflammation and control blood sugar and glycation.
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