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Inflammation

Blood Testing for Systemic Immune-Inflammation Index (SII)

The Systemic Immune-Inflammation Index (SII) is a composite blood marker that blends information from three circulating cell types: neutrophils, lymphocytes, and platelets. All three are born in the bone marrow and constantly patrol the bloodstream. Neutrophils are front-line defenders (innate immune cells), lymphocytes coordinate targeted defense and memory (adaptive immune cells), and platelets (thrombocytes) help with clotting and signal at sites of injury. At home blood testing is available in select states. See FAQs below

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Key Benefits

  • Understand your body’s inflammation-immune balance using a single index from blood counts.
  • Spot early immune activation or stress that standard symptoms or vitals might miss.
  • Clarify unexplained fatigue, pain, or recurring infections by flagging systemic inflammatory drivers.
  • Guide risk stratification in heart disease and stroke alongside cholesterol, CRP, and blood pressure.
  • Inform cancer prognosis when combined with tumor features, stage, and treatment plans.
  • Track treatment response or flare risk in autoimmune and chronic inflammatory conditions.
  • Monitor recovery after infections, surgery, or injury by following SII trends over time.
  • Best interpreted with a full blood count, CRP/ESR, and your symptoms.

What is a Systemic Immune-Inflammation Index (SII) blood test?

The Systemic Immune-Inflammation Index (SII) is a composite blood marker that blends information from three circulating cell types: neutrophils, lymphocytes, and platelets. All three are born in the bone marrow and constantly patrol the bloodstream. Neutrophils are front-line defenders (innate immune cells), lymphocytes coordinate targeted defense and memory (adaptive immune cells), and platelets (thrombocytes) help with clotting and signal at sites of injury. SII is not a single substance; it is an index built from the relative presence of these cells to summarize the body’s immune–inflammatory posture.

SII reflects how “activated” the body’s inflammation is and how robust its immune reserve appears at the same time. Higher neutrophils and platelets point to acute inflammatory drive and pro-clotting signals, while lower lymphocytes suggest reduced adaptive immune bandwidth. By integrating these opposing forces—innate activation and thrombosis on one side, adaptive surveillance on the other—SII offers a snapshot of systemic immune stress. It captures how the body is responding to challenges such as infection, injury, or physiological strain, distilling complex cellular dynamics into a single, intuitive measure of immune–inflammatory balance.

Why is a Systemic Immune-Inflammation Index (SII) blood test important?

The Systemic Immune-Inflammation Index (SII) captures how “hot” the body’s inflammatory and clotting systems are relative to immune surveillance. It integrates three common blood counts—neutrophils and platelets (front-line inflammation and clotting) and lymphocytes (adaptive immunity)—into a single signal. In healthy adults, SII tends to cluster in the lower-to-middle part of a lab’s reference band; sustained extremes often point to physiology under strain.

When the index is low, it usually reflects less innate inflammatory drive or fewer circulating neutrophils and/or platelets. If driven by neutropenia or marrow suppression, people may notice frequent infections, mouth sores, or slow wound healing; if platelets are also low, easy bruising or nosebleeds can appear. A low result can also come from lymphocyte predominance (common in some viral illnesses) without true immune weakness. Children naturally have different white cell balances that can lower SII, and pregnancy-related shifts are interpreted with pregnancy-specific expectations.

When the index is high, it signals neutrophil- and platelet-driven activation with relative lymphocyte drop—typical of acute infections, tissue injury, chronic inflammatory disease, or metabolic stress. Symptoms may include fever, fatigue, body aches, or flares of underlying conditions. Biologically, this state activates the endothelium, promotes clotting, strains the heart and vessels, and can worsen insulin resistance; older adults more often show higher baselines.

Big picture: SII sits at the crossroads of immunity and hemostasis. Tracked with related markers (CRP, neutrophil-to-lymphocyte ratio, platelet metrics), it helps gauge systemic inflammation and forecast risks across cardiovascular disease, cancer outcomes, sepsis, and recovery from major illness or surgery.

What insights will I get?

The Systemic Immune-Inflammation Index (SII) is calculated from a standard CBC as platelets × neutrophils ÷ lymphocytes. It integrates how activated your innate immunity and clotting are relative to adaptive immune capacity. Because inflammatory tone shapes vascular health, energy use, and infection control, SII signals whole-system stress.

Low values usually reflect fewer neutrophils and platelets and/or more lymphocytes, indicating low inflammatory tone with preserved adaptive surveillance. When due to true neutropenia or thrombocytopenia, they can signal marrow suppression, viral infection, autoimmune destruction, or drugs, with system-level risks of infection or bleeding. Children often sit lower.

Being in range suggests balanced innate–adaptive immunity and controlled platelet activity, supporting stable endothelium, efficient metabolism, and resilient responses to routine stressors. In population studies, prognosis tends to be best when SII lies in the lower-to-mid part of reference intervals.

High values usually reflect neutrophil-driven inflammation, platelet activation, and relative lymphopenia—the classic acute-stress pattern from cytokines and stress hormones. This milieu is pro-thrombotic and endothelium-activating, with reduced immune diversity and greater vulnerability during infections or cardiovascular stress. Values run higher with aging, in males, and during pregnancy.

Notes: SII is derived from CBC counts that vary with acute illness, time of day, exercise, smoking, and medications (corticosteroids raise it; cytotoxic therapies lower it). Iron deficiency can raise platelets. A single value reflects the moment; trends and context matter.

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Frequently Asked Questions About

What is Systemic Immune-Inflammation Index (SII) testing?

SII testing calculates platelets × neutrophils ÷ lymphocytes from a CBC with differential to estimate systemic inflammatory load and immune balance.

Why should I test Systemic Immune-Inflammation Index (SII)?

Testing SII helps you monitor low-grade inflammation, recovery capacity, and cardiometabolic context, and see how sleep, stress, training, and nutrition affect immune activity.

How often should I test Systemic Immune-Inflammation Index (SII)?

Establish a baseline when you feel well, then retest periodically to track trends or after changes in training, illness, sleep, stress, or nutrition.

What can affect my Systemic Immune-Inflammation Index (SII)?

SII is influenced by acute infections, chronic inflammatory conditions, adiposity, smoking exposure, sleep loss, psychological stress, heavy training, medications, menstrual phase, pregnancy, and altitude.

Are there any preparations needed before Systemic Immune-Inflammation Index (SII) testing?

SII is derived from a standard CBC with differential and typically requires no special preparation. For comparability, try to test at a consistent time of day and in similar conditions.

What states are Superpower’s at-home blood testing available in?

Superpower currently offers at-home blood testing in the following states: Alabama, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin.

We’re actively expanding nationwide, with new states being added regularly. If your state isn’t listed yet, stay tuned.

What happens if my Systemic Immune-Inflammation Index (SII) is outside the optimal range?

Review recent illness, training load, sleep, stress, and medications. Consider retesting after recovery or lifestyle adjustments and compare with related markers like hs-CRP, ferritin, and the CBC components.

Can lifestyle changes affect my Systemic Immune-Inflammation Index (SII)?

Yes. Weight management, anti-inflammatory nutrition, consistent physical activity, better sleep, stress reduction, and avoiding tobacco can improve SII.

How do I interpret my Systemic Immune-Inflammation Index (SII) results?

Interpret SII relative to your baseline and trends over time, together with symptoms or recent stressors, and alongside hs-CRP, ferritin, and the neutrophil, lymphocyte, and platelet counts.

Is Systemic Immune-Inflammation Index (SII) testing right for me?

SII testing is useful for anyone interested in monitoring inflammation, recovery, and immune balance over time and in understanding how daily habits influence these patterns.

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