Some inflammation is chemical. (and does not always involve white blood cells or antibodies).

The chemical messengers released are signalers for other cells to rise up and fight the assaulting event.

These are called cytokines, and they are quite potent. Inflammatory cytokines do many things, healing, and also causing redness or tissue reactions (which may cause pain or discomfort).

I have arthritis and have had elevated ESRs for my whole adult life. But I don't have any other markers for inflammation. I do have a modest elevation just above normal in alkaline phosphatase and that seems related to the joint/bone arthritis.

Inflammatory cytokines are blocked when elevated by 1) increasing omega-3 fatty acids in the diet, 2) controlling insulin spikes by not eating sugar or high glycemic carbs in excess, 3) taking fish or krill oil to dampen the Cox-2 cytokines which come from diets low in Omega-3s.

Some people like antioxidants as well, to quench inflammation.
Grape seed extract is one commonly used, and there is an antioxidant naturally present in krill oil. Vitamin C is useful for maintaining joints and collagen production.

I have found that fatigue in general very responsive to d-ribose supplements. This is really helping me with stamina issues.
Also acetyl carnitine helps with mitochondria functions.

Here is my supplement thread with some suggestions:
ribose is near the end of that thread.
I haven't put up "everything" there yet, like lipoic acid.
But you can search "lipoic" on the regular PN forum and there are tons of posts about it.
http://neurotalk.psychcentral.com/thread121683.html

Thanks for this, Mrs. D!

I guess there's no reason I can't have a cytokine response on top of the T-cell inflammation. Being the scientifically-minded person that I am I'm hesitant to jump in and start taking everything at once. Would you suggest starting with any particular supplement first and then adding specific ones along the way?

Athena

To start, the best way to lower Cox-2 cytokines is by dietary control.

1) reduce the amount of Omega-6 fats you eat. Too many of these are then converted to Cox-2 cytokines.
Increase flax oil and fish oil in your diet. Many foods now have Omega-3s added to them. Eggland's Best Eggs, peanut butter, cereals, mayo, butter substitute spreads (all by Smart Balance),
some cheeses and yogurts, even some types frozen chicken nuggets (we buy ours at Costco).
Some salad dressings have canola oil in them now. You can take flax oil in capsule form. 3 of those a day. Increase the ratio of Omega-3s eaten to the Omega-6's you eat --which are very common everywhere-- will reduce basic inflammation in the body.

2) Start with fish oil (or Krill oil). If fish: 3 a day to start if they are the regular strength or 1 double or triple concentrated type.
One or two Krill oil, (I use MegaRed), but there are others.
The fish oils go better with food.

This can have dramatic improvements on inflammation.
If you eat alot of sugar, that has to go also. Insulin spikes favor production of Cox-2 cytokines. The Zone diet was made to control inflammation and insulin levels. It is easy to follow and not dramatic.

If you decide to go with this dietary approach, you will need a Bcomplex and some magnesium, as the oils are metabolized best using them.

This is a very general easy way to start.

If you see some improvements, often within a month or so, you can then add other things. I'd do the grapeseed extract next.

I had a huge response to this routine 10yrs ago, when I started the oils. My asthma cleared up, my GERD went away, and my arthritis improved. At 3 months I was no longer using my medications for these problems! And back then we didn't have these new "smart foods" to help with it all.

Thanks again! I incorporated many of these changes into my diet a few years ago, and even eliminated the common food allergens - gluten, dairy, eggs, soy - just because, and felt wonderful. I've gotten lazy, though. I'll revamp my efforts and add your recommendations. It can only help.

Ummm, does high-quality dark chocolate have a place here??

Athena (hastily gobbling my Trader Joe's dark chocolate)

Yes, you can do some chocolate.... it is not that much sugar. Dark has antioxidants in it. Used in moderation, is it a good treat I think.

Donuts, cookies, pies, etc...those are the worst. Also some candy is all sugar like gummies.

Dark chocolate has magnesium in it, and if you get almonds, too, 3oz of almonds is 270mg of mag!

My Kroger's is offering no sugar added pies -- little ones--this season. I've tried the peach and cherry... modestly. I leave most of the crust too!

Avoid high fructose corn syrup, and transfats. (transfats are getting to be less and less). But transfats really gum up the workings of your nerves...so they must be totally avoided!

It is the ratio of Omega-3 to Omega-6 you need to control
1:1 or up to 1:5 is considered optimum. Olive oil doesn't count, in either ratio. Also suggested is to limit saturated fat, but you don't need to remove it all. It is considered "neutral" to inflammation. But it does have some natural transfats in it. So trim roasts, buy low fat meats, lower fat dairy etc.

Athena -

Thanks for posting all the tests you've had so far. Please keep us posted about how you're doing as you go forward with more diagnostics or even if you don't.

Trader Joe's dark chocolate is SO good - I'd be gobbling it, too. Actually, chocolate is my middle name.

Take care and best wishes.

Sheltiemom