5 Symptoms of Chronic Inflammation and How to Reduce Them Through Diet

Added: 2026-05-26

[00:00:00]Today, five symptoms that I take seriously when I'm trying to figure out whether or not a person has chronic inflammation. These are the ones that many people overlook, but I think they're really important. These are the kind that kind of get explained away or swept under the rug. Oh, it was a busy week. I just had a bad night of sleep.

[00:00:18]I'm just getting older. Excuses, [music] excuses. I'm a triple board certified gastroenterologist with over 20 years in medicine. I've cared for tens of thousands of patients and these are the patterns that I'm seeing time and time again. So, we're going to walk through all five, what they are, what's actually happening underneath, and why each one [music] is worth taking seriously instead of normalizing. And if two or three of these hit for you, I have something free to share with you. The link is in the description and I'll discuss more at the end, okay?

[00:00:50]Let's get into it. [music] There's an important point that I want to make so that we're all on the same page before we go and jump in.

[00:01:03]Inflammation can kind of manifest as two different things. There's acute inflammation and that's what you experience with a sprained ankle, a fever during the flu, the redness and swelling that surrounds that cut. That's actually your body healing. The immune system is doing its job and then it's standing down. Whereas chronic low-grade inflammation is something very different. The immune system doesn't let up. It's stubborn, persistent, overstaying its welcome. The immune system stays active even at a low volume for months, possibly even years. And that unnecessary activation reaches every organ system through the bloodstream. This is the kind of inflammation that gets tied to heart disease, type 2 diabetes, autoimmune conditions, depression, dementia, and a lot of people just feeling a little bit off. Today, we're going to be discussing the stubborn, overactive immune system and how it shows up in your body. Not just blood tests or scans, but more importantly, to be honest with you, how you feel. These are the signals your body is already giving you that we need to acknowledge starting today. Now, there's one important thing before we start. None of these symptoms on their own, and there's five of them, means that you have chronic inflammation.

[00:02:19]Symptoms themselves aren't actually a diagnosis. They're a manifestation of disease, not the disease itself. So, we need to go deeper, but I want you to be approaching this the same way that I approach this as a medical doctor. When I see two or three of these symptoms clustering together in the same person, now it's a pattern, and I start asking the inflammation question. That's the way that I approach this. So, we got five symptoms. Here we go. Symptom number one, we're coming in hot, by the way.

[00:02:51]Brain fog and mental fatigue. This is a fascinating one, everyone. So, here's the pattern. Someone in her 40s tells me she can't find words mid-sentence. She's reading the same paragraph three times before it lands. She's walking into rooms and forgetting what she's even trying to do. She's been told it's stress, perimenopause, screen fatigue.

[00:03:11]Sometimes those are real factors, but there's another player that is not being discussed enough. There was a classic review article in Nature Reviews Neuroscience from Dancer and colleagues where they laid this out almost two decades ago, and the science has caught up substantially in recent years, and I'm going to tell you about that. When the immune system is activated in the body, even at low levels, there are pro-inflammatory cytokines that signal the brain. Now, you can think of these cytokines as being like little messages, little post-it notes that float around, and they tell the other immune cells to like get active, start doing stuff. But, this is more than just cytokines because your brain has a protective barrier, and it's called the blood-brain barrier. And it, by the way, is extremely similar to your gut barrier, and its job is to protect your brain. But here's the part that I think is actually pretty crazy. I promised they recent study. Here it is.

[00:04:08]A 2024 Nature Neuroscience study used MRI to show that when there's inflammation in the body, such as what you'll find in long COVID, the inflammation actually disrupts the blood-brain barrier. Now, the wall that was supposed to protect your brain has gaping holes in it. What I'm saying to you right now is that brain fog isn't just brain fog.

[00:04:32]It's leaky brain. With a disrupted brain barrier, those inflammatory cytokines that are floating through the blood, they start to pour across into the brain tissues. No surprise, this results in inflammation in the brain, which we call neuroinflammation. But also, the brain starts to read those cytokines as "Whoa, whoa, whoa, something's going on here.

[00:04:52]The body must be fighting something." As a protective mechanism, the brain goes into energy conservation mode. So, it starts to actually dampen motivation, focus, mental sharpness. That's actually the mechanism that many people are experiencing when they have brain fog.

[00:05:06]There's slower processing, there's harder retrieval, there's mental fatigue that's really it feels out of proportion to what you actually did that day. You may feel like people roll their eyes when you say you have brain fog. I think many of you experienced this. Your brain fog is 100% real. It's the same circuitry that makes you feel mentally wiped when you have the flu. But there's a difference. When it's the flu, that's adaptive. Your brain is telling you to rest because your immune system is doing the work.

[00:05:36]But when it's chronic, that's a cytokine signal that never turns off, and it just becomes your baseline state, and that's not where you want to be. And the gut is an important part of this story. A big chunk of the chronic immune signaling actually starts in your gut. The gut barrier is actually the largest immune surface in the entire body. When it starts to break down, which we could call leaky gut if we want to, what we get is chronic low-grade inflammation in the gut wall. Now, the immune system is chronically activated. Unfortunately, that activation of the immune system can be felt throughout the entire body. And then here comes the brain barrier being disrupted by that inflammation. That's our second barrier broken down. If you're keeping score, two broken barriers, not one. This is why people who clean up their diet, restore their microbiome, and reduce systemic inflammation, they often describe it this way, "My head feels so much clearer." That is definitely not a placebo response. That's you repairing and restoring the gut and the brain barrier, and now the cytokine signal that was pouring into your brain is being turned down. The brain doesn't manufacture brain fog. It is the response to the signals that are coming from the rest of your body. If your brain fog isn't tied to a clear cause, like bad sleep, a specific medication, an obvious stressor, we need to take that seriously. Symptom number two, persistent fatigue that sleep does not fix. This is the person sleeping 7, 8 hours, sometimes more, they're still waking up and they're exhausted. This person, he's optimized his sleep. He's tried things like cutting caffeine. He's ordered the labs and they come back normal. And the fatigue is persistent.

[00:07:22]So now he's stuck and he's drinking energy drinks trying to get enough energy to get through the day and get his work done. Research shows inflammation does this directly. A 2018 review in Frontiers in Neuroendocrinology brought all of the human studies together. Researchers actually gave healthy volunteers a small controlled inflammatory stimulus. They were activating the immune system and they measured what happened in the hours that followed. The findings were consistent across the studies. The immune system gets activated even in healthy humans. This ends up causing fatigue, worsened mood, and pain sensitivity within just a number of hours. These people, they 100% feel it.

[00:08:02]But also, brain imaging studies actually confirm what we're seeing. Inflammation is a direct driver of fatigue. I want to pause here real quick to say something that I've seen overwhelmingly through the years. There are so many people out there with low energy and tons of fatigue. I mean, why do you think energy drinks are like a bajillion dollar industry? These people are struggling to get through the day and they're not really sure why. And fatigue is, let me be honest, a difficult symptom for us doctors. It could be so many things. But the reason that it could be so many things is really important. It's because it's often inflammation. And inflammation is at the heart of all of these different things that can manifest with fatigue. The things that I learned while writing Plant Powered Plus, which is my new book about inflammation and how it's connected to the gut, have completely changed my understanding of fatigue. So, in that 2018 review article, they made a specific point.

[00:08:58]Women appeared to be more vulnerable to the behavioral effects than men. Now, that's interesting because in my many years of practice, the patients telling me about this kind of fatigue have overwhelmingly been women. That low-grade inflammatory signal, it often starts in the gut. Let me take you through the sequence. You ready? Here we go. Disrupted microbiome, leaky gut barrier, low-grade gut inflammation.

[00:09:23]Now, the immune system is chronically activated. The blood-brain barrier, once again, ends up getting disrupted. Now, cytokines are circulating into the brain. The body is sitting in a low-grade sickness mode.

[00:09:36]Except, you're not actually sick. It sounds a lot like the brain fog story, am I right? Well, there is one additional element that I want to sprinkle in here. Inflammation in the brain has been shown to activate an enzyme called IDO. It disrupts serotonin levels in the brain. So, it's not just leaky gut, it's not just leaky brain.

[00:09:55]Now, we're also dealing with altered brain chemistry. This is why the lab work can look completely fine and you may feel totally exhausted. Standard laboratory panels aren't picking up the kind of low-grade inflammatory signaling that we're discussing right now. Blood counts, chemistries, thyroid studies, iron studies, they may all come out normal. Everything is fine. No, it's not and you know it's not. So, we need to acknowledge that tired is not just a sleep problem. Many times, it's an inflammation problem. Fatigue that survives good sleep, normal labs, and a reasonable lifestyle is not just you getting older. This is a signal and it is worth investigating.

[00:10:39]Symptom number three, morning joint stiffness, especially the kind that takes longer than 30 minutes to loosen up and I'm going to explain why. Now, here's the pattern. 30 minutes after waking, the body is stiff. Your hands take a while to unclench. Your knees and your hips, they feel rusty going down the stairs. After moving around for half hour or so, it starts to loosen up a little bit. By mid-morning, you've actually forgotten about it. It's like feels like it's a non-issue. So, then you move through the rest of the day like nothing happened. You don't really think of it as being a symptom of anything and this is just how your mornings are. Well, I'm here to tell you that's not normal. This is a classic inflammatory pattern. Inflamed joints stiffen overnight. This is actually something that I discussed in chapter six of Plant Powered Plus. Inflammation is nocturnal. In the morning, your circadian rhythm brings down your immune system and movement starts to disperse the cytokines that were accumulating in your joints overnight. This is why you start to loosen up as the morning goes on. And there's an entire cytokine pattern behind what we're discussing right now. There's two main players, TNF alpha and IL-6. And those same two cytokines show up across most chronic inflammatory health conditions. Your body isn't compartmentalized. When there's inflammation in one place, there can be inflammation just about everywhere. Now, here's something cool that I want to teach you. A key marker that rheumatologists, who are the experts in joint disease, use to distinguish inflammatory joint patterns from purely mechanical ones is morning stiffness lasting longer than 30 minutes. This is why I kept saying 30 minutes. The duration becomes the key.

[00:12:22]If it's less than 30 minutes, that's usually mechanical, so that we call that wear and tear. But when it's longer than 30 minutes, you got to start asking the inflammation question. Now, to me, there is inflammation as a part of all of it.

[00:12:35]The wear and tear stuff has inflammation, too. But when I hear 30 minutes of stiffness in the morning, I'm paying attention to that. That tells me that we're dealing with a stronger inflammatory pattern in the joints.

[00:12:46]Joint inflammation and gut inflammation are once again linked through the immune system. The microbiome impacts the immune cells that start to accumulate in the joints at night. When the gut barrier is disrupted, bacterial parts can start to cross into the bloodstream.

[00:13:02]The immune system sees them, goes, "Whoa, whoa, whoa, whoa, you're not supposed to be here." And it's going to react. And then unfortunately, that reaction is what you actually feel in your joints or potentially other places.

[00:13:14]This is part of why the gut immune story matters a lot for arthritis type conditions. Again, you think of the problem as being exclusively in your joints. And I'm telling you right now that your gut is a part of that story.

[00:13:27]And this is why dietary patterns that calm gut inflammation, they often calm joint inflammation in parallel. Two birds, one stone. So, stiffness that takes 30 minutes to loosen up, we're not calling that aging. That's a cop-out.

[00:13:41]That's the immune system going too far overnight. If that pattern is showing up for you, it's worth surfacing it with your healthcare provider. Not normalizing it as, "Oh, I'm just not as young as I used to be." No, no, no. We don't accept that. Symptom number four, the stubborn skin issues that don't want to go away. I'm talking about the 40-year-old who's still breaking out like she's 17. I'm talking about the cheeks that flush hot at the wrong times. A little bit of wine, some stress, a warm room. Talking about that patch of eczema that itches so much, and it's coming and going in that location for years. Each of these, you think of them as being a skin problem. So, what do we do? Topical creams, dermatology referrals. I mean, look, sometimes those things help, but what are we really treating? We're treating the outcome.

[00:14:32]We're not treating the cause. A 2018 review article in the journal Frontiers in Microbiology pulled together the entire body of literature on the gut-skin axis. And the main takeaway was that the gut microbiome is a major regulator of skin biology. The authors describe how the gut microbiome, from a distance, impacts the skin's immune system and the response within the skin.

[00:14:57]It shapes the way that the skin cells form and renew. It influences inflammation across multiple different skin conditions. Now, when I think of skin and the gut, there's a few specific ones that immediately come to mind every single time. Atopic dermatitis, which we also call eczema, psoriasis, and acne.

[00:15:15]Here's how this works. You can think of the skin and the gut as being actually quite similar. A patient once used an expression, they're cut from the same cloth. They're both barrier organs. We got the gut barrier and we got the skin barrier. They both face the outside worlds. Yes, I know that's weird with the gut, but the gut is in fact facing outside your body. They both have a resident microbiome that's really important in shaping what's happening in those surfaces. These are the two largest microbiomes in the entire body and they both have an immune system parked right next door interacting not only with the local microbes, but also being influenced from a distance by the distant microbes. And the body isn't compartmentalized as I've said so many times here today. Inflammation it isn't just in one place. It spreads. So when the gut microbiome is unbalanced, when the barrier is disrupted, when the immune signal starts landing in other places, for some people it lands in the joints, for others it may cross into the brain, and right now we're talking about the skin. This is why so many adult onset skin conditions don't fully respond to skin-only approaches. You're treating the downstream symptom, but there's an upstream engine that's driving the problem and it's still running at full speed, out of control, and it's not slowing down. Your skin is a manifestation of health within your gut that you can actually see. Adult onset eczema, rosacea, still breaking out acne that isn't responding to dermatology as usual, that's worth looking at as a gut immune story, not just a skin one. And finally, symptom number five. And then of course this is the one that I see the most, bloating.

[00:16:58]The bloating that shows up by mid-afternoon every day. The bowel movements that have been irregular for years, sometimes once a day, sometimes once every three days. The reflux that sits in the background after dinner, the cramping that comes and goes. None of it's bad enough to feel like an emergency, so you just kind of normalize it. And eventually you just stop bringing it up. A lot of what's being called IBS or functional bloating or sensitive stomach isn't just a body that's wired to be uncomfortable. The 2016 Lancet Gastroenterology and Hepatology review by Talley, Ford, and Holtmann mapped out the actual underlying ways that this happens. And Talley is one of the most respected names in this space. When he's co-authoring a review like this, the field listens. There's many different ways in which this happens. Here's a few of them. Low-grade chronic inflammation right there at the surface of the lining, immune activation, altered gut permeability, disruption of the gut microbiome, changes that happen after an infection, but they persist for years.

[00:17:58]The way in which they frame this is striking. The traditional concept of IBS as we know it, which is a disorder with no known underlying explanation, is outdated. They explicitly challenge this accepted view as IBS is an unexplained gut-brain disorder. Many of these symptoms are downstream of identifiable gut-immune disturbances. So, this is not just a body that's sensitive. And there's a reason why this really matters. Seeing this as chronic low-grade gut symptoms is, honestly, often the first place where chronic inflammation can surface because the gut is where so much of it starts. So, it might be daily bloating after ordinary food. It may be bowel patterns that are unpredictable for no clear reason. And it could be that reflux at the end of the day, cramping that's just, "Hey, this is my normal." But these are not normal. They're signals from your body that is most likely central to whole body inflammation. What I'm telling you is that your gut is not just sensitive, but that may be an inflammation story.

[00:18:56]So, digestive symptoms that you haven't really been paying that close attention to may actually be the signal of what's happening with your immune system. So, there we have it, folks. Five symptoms, five different ways that the same underlying signal, chronic low-grade inflammation, can show up differently inside your body. None of these on their own is a diagnosis, but two or three of them when you put it together in the same person, this is a pattern worth looking at, taking seriously. Now, here's the reason I want you thinking about this this way. Inflammation is the common ground underneath so many of the chronic conditions that modern medicine treats one organ system at a time. Brain fog, fatigue, joint stiffness, skin issues, digestive symptoms, they look like five totally different problems, yet they're one underlying story showing up in five different ways. If you know somebody who's been told, "Oh, it's just stress." or "You're just getting older."

[00:19:52]or "This is just how your stomach is."

[00:19:54]they need to see this video. Please share it with them. Sometimes the most useful thing that you can do is give a person a different way to listen to their own body. And if this video resonated with you and you want to go deeper, I'm offering a completely free inflammation phenotype workshop where I will walk you through exactly how inflammation works in your body, how it shows up in specific patterns, and how it impacts your story. And it's something you won't find anywhere else.

[00:20:19]This is not in my books, it's not here on YouTube. The link is in the description. Go there now and bring a pen. And with that in mind, five symptoms, one signal, your body is talking to you. I want you to listen, and I will see you next week.

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