Prevention is the Best Medicine – c-Reactive Protein to the Rescue

Prevention is better than correction in many areas of our lives. One life saving blood test that everyone should consider is the C-reactive protein (CRP) t…

I believe in preventive health care.  As a result I have additional tests done with my annual physical.  One life saving blood test that everyone should consider is the C-reactive protein (CRP) test.  CRP is a protein synthesized by your liver.  CRP is used as a marker for inflammation.

In 1930, Tillett and Francis in 1930 discovered a common factor, CRP, in a number of people with a variety of diseases.  It is not uncommon for CRP levels to increase 50,000 times more than normal in the presence of acute inflammation.   The rise in inflammation above normal limits can happen in as little as six hours and peaks after 48 hours.  As long as you have the cause of your inflammation, the level of CRP will remain elevated.

So, CRP can tell me if I have inflammation?   The basic answer is YES.  Bacterial infections cause CRP levels to rise higher than viral infections. There are many causes for inflammation, so the CRP test will not tell you the cause of the inflammation.  But, it does tell you that there is something wrong.  It is very useful in determining the presence of disease, its progress and the effectiveness of any treatments.

The role of inflammation as the genesis of disease is accepted by many in the medical field.  A highly sensitive CRP is used by many laboratories today to determine the level of CRP with greater accuracy.  The highly sensitive CRP can be used in the diagnosis of: inflammatory bowel disease, some forms of arthritis, autoimmune diseases, lupus, rheumatic fever, pneumonia, cancer, pelvic inflammatory disease, coronary heart disease, cardiovascular disease and others.

Since CRP is such a good marker for inflammation, it is also used to monitor healing after surgery, particularly organ transplants and burns.  It acts as an early detection system for possible infection.  A drop in CRP indicates that the cause of your inflammation is being treated properly.

Can you get a false positive with CRP?  Yes, there are some things that affect the accuracy of the CRP test.  High levels of CRP have been found in the later stages of pregnancy, with women using birth control pills and hormone replacement therapy, cases of severe stress, after strenuous exercise and with women using intrauterine devices (IUDs).  Additionally, higher levels of CRP have been observed in the obese.

There are two types of medicines affect the accuracy of CRP also.  Statin drugs – cholesterol lowering medications reduce the levels of CRP.   Corticosteroids – anti-inflammatory medicines containing the hormone cortisone have been shown to reduce CRP levels.

What do I have to do to get a CRP test?   The CRP test is a blood test.   It can be ordered by your doctor as part of a normal office visit or your annual physical.  There are some laboratories that will perform the CRP test for you without a doctor’s order.  Then the results go directly to you.  The cost is minimal – under $50.00.  There is no fasting or other requirement prior to taking the test.  It may be ordered periodically to check the progression of treatments that your doctor has ordered.

The results are easy to understand – the lower the better.  Levels below 1.0 mg/L are considered normal with no significant acute or chronic inflammation.  My last highly sensitive CRP test was 0.25 mg/L.   Levels between 1.0 mg/L and 3.0 mg/L are cautionary – you have an average risk of disease.  The test results indicate that inflammation is present at levels slightly above the average, but not to a level to become alarmed.  A level over 3.0 mg/L is an alarm for further investigation.

In 2003, the American Heart Association and the Centers for Disease Control and Prevention published a joint scientific report about using CRP as a marker of inflammation.  The report indicated a high correlation between CRP and coronary heart disease and stroke.

Obviously, you have a lot of chronic and acute levels of inflammation when you have coronary heart disease or a precursor condition to stroke.  I personally place more confidence in another blood test, the homocysteine level test, along with CRP, to isolate heart related inflammation.

Should I get my CRP tested?  I get one every year in conjunction with my annual physical.  Since CRP is a marker for inflammation, it is an excellent test to determine where you are today.  If you get the test this year and everything is OK, then getting the CRP test annually gives you a good indication of your health or disease progression.

If it continues to remain below 1.0 mg/L, then you can have some level of assurance that you are doing things to remain healthy.  If your CRP results increase over time, then it is something for you and your doctor to start other tests to determine the cause.  The good news is that you are on the front end of most diseases and treatments should work well.

I hear, more often than I want, that someone was just diagnosed with a tumor or some other very significant malady, and they must have surgery and they may not have long to live.  I shake my head and think that monitoring your health on a regular basis could have detected something when it was treatable before it became life threatening.  I use the CRP as my early warning system to something very life threatening in my life – cancer, coronary disease, etc.  It takes a long time for those kinds of diseases to become well established in your body.  The early detection, the better your chances of saving your life.  CRP won’t tell you what is causing the inflammation in your body, but it will tell you to look.