Tired But Normal Test Reports? Hidden Inflammation May Be The Reason

Across India’s clinics, doctors are seeing a puzzling trend: people walk in feeling constantly tired, achy, or ‘just not themselves,’ yet their test reports come back perfectly normal. For many, the frustration of having no clear answers only adds to the stress. What often hides behind these vague symptoms is something called chronic, low-grade inflammation — a silent process that quietly disrupts the body without showing the dramatic signs we usually associate with illness, like fever or swelling.

We spoke to Dr Sarat CV Talluri, Senior Consultant- Internal Medicine, Arete Hospitals, Hyderabad, who explained the causes of inflammation without fever.

What Makes This Inflammation Different?

"Unlike the inflammation caused by infections, which shows fever, redness, and swelling, subclinical inflammation happens quietly. It impacts cells, changing metabolism, hormone levels, and immune function without obvious external signs. Over time, this silent stress may manifest as ongoing fatigue, stiffness in the joints, digestive issues, mental confusion, and initial symptoms of long-term diseases like diabetes, heart disease, or liver disease," explained Dr Talluri.

Also Read: You Don’t Work Out, But You’re Always Sore: What Your Body Could Be Telling You

Key Triggers Behind Hidden Inflammation

Multiple factors drive this growing issue in India. 

1. Diet and Lifestyle

• Excessive consumption of processed foods, sugars, trans fats, and low fibre dysregulates the gut and feeds inflammation.
• Long hours of sitting, extended work schedules, and screen time blunt the body’s natural repair systems.

2. Stress and Sleep

• Chronic stress keeps cortisol levels elevated, pushing the body into a constant low-grade inflammatory state.
• Poor or interrupted sleep diminishes tissue repair, compromises immunity, and aggravates inflammation.

3. Environmental Factors

Air pollution, indoor smoke, chemical exposure, and workplace toxins also contribute to fueling inflammatory pathways.

A prominent perspective published in Nature Medicine highlights how modern lifestyle factors—like poor diet, physical inactivity, pollution, and chronic stress—drive systemic chronic inflammation (“SCI”), a subtle yet harmful state that contributes to diseases, such as heart disease, diabetes, fatty liver, and more.

Why It’s Hard to Detect

The difficulty with subclinical inflammation is that its signs are often subtle and easily overlooked. Constant fatigue despite enough rest, mild joint discomfort, digestive changes, brain fog, and unexpected weight fluctuations are common indicators. Many mistake these symptoms for stress or aging, unaware they could be signs of hidden inflammation in the body.

"Detecting subclinical inflammation is not straightforward. Routine tests may appear normal. Physicians look for particular markers, like C-reactive protein, and examine daily lifestyles—diet, sleep, tension, and activity to figure out the sources of the problem rather than simply treating the symptoms," added Dr Talluri. 

Also Read: The Cardiac Impact Of Autoimmune Diseases: What Lupus, RA, And Psoriasis Can Do To The Heart

How to Manage Low-Grade Inflammation

Managing low-grade inflammation requires several approaches. 

• Diet is key: eating whole, minimally processed foods, vegetables, fruits, nuts, seeds, and omega-3-rich items helps limit inflammatory triggers. Cutting back on fried foods, refined sugar, and sweetened drinks supports healthy metabolism. 
• Staying active is equally important: Even moderate exercise, such as walking, stretching, yoga, or resistance training improves circulation, lowers inflammation, and enhances energy.
• Stress control is vital: )Mindfulness, meditation, breathing exercises, or recreational activities stabilize hormones and reduce inflammation. A fixed sleep routine, reduced screen time at night, and a peaceful environment enable repair and preserve immunity. In addition to those with early metabolic issues or increased risks, physicians can recommend certain supplements or medications.

Why Early Recognition Matters

Early recognition is essential. Low-grade inflammation left unchecked can progress over years, increasing the risk of chronic diseases that are harder to reverse. Paying attention to persistent fatigue, mild aches, digestive issues, or cognitive sluggishness is not trivial; these are signals that the body needs attention and adjustment. Making lifestyle changes and keeping up with regular medical check-ups can help lower inflammation and support overall well-being.

Bottomline

Dr Talluri concluded, "This silent inflammation is hitting more Indians than we know — too often ignored since it doesn't induce fever or overt signs. Identifying the problem, improving lifestyle, and visiting a physician when symptoms endure are essential steps. Adults who feel ongoing fatigue, discomfort, or subtle health changes despite normal test results should seek professional evaluation. With careful management, inflammation can be reduced, organ function preserved, and overall energy and health restored."