Rheumatoid Arthritis And Crp Levels: Your Guide
- A blood test for C-reactive protein levels can help determine whether you have rheumatoid arthritis .
- If you have already been diagnosed with RA, CRP levels can indicate whether you are having a flare-up.
- Checking CRP levels also helps your doctor determine whether your RA treatment is effective.
- CRP levels are not the only test available for RA, and a normal CRP test result does not rule out an RA diagnosis.
Blood tests are never fun. And if youre not even sure what is being tested for, they can be frustrating, too. Knowing what youre being tested for and why can help you feel more in charge of your medical history. One blood test your doctor may order if you have rheumatoid arthritis, or if RA is suspected, is a C-reactive protein test. Heres what this test is for and what your results might mean.
How To Reduce Crp
The right foods help lower CRP and can help reduce the threat to your heart from high CRP levels. Dark, leafy greens like spinach, kale and collards fight inflammation, as do all types of berries, cherries, plums, onions, turmeric, red grapes and green tea. Salmon, sardines, mackerel, bananas, olive oil and flaxseed oil work, too, according to Harvard Health Publishing.
A study in the journal Current Atherosclerosis Reports in March 2019 points out that a plant-based diet that focuses on foods like whole grains, fruits and vegetables, nuts, legumes and oils can be especially beneficial. To tackle high CRP, you’ll also want to avoid sugars, soda, high-fructose juices, pasta, white bread and other refined grains.
A Nutrition, Metabolism and Cardiovascular Diseases study in June 2019 details how losing weight is also key to lowering CRP levels because excess weight breeds inflammation throughout the body.
“We now know that obesity is associated with increased inflammation,” Dr. Levin says. If you don’t have another cause of inflammation, and you have overweight or obesity even though you exercise, you should lose weight, she says. “Even if your cholesterol is not super high, obesity is a pro-inflammatory state.”
In fact, we know that half of all heart attack victims have normal cholesterol levels, according to the American College of Cardiology.
Drawbacks Of Crp Tests
Measuring CRP levels is not a perfect method for diagnosing RA or determining the effectiveness of a treatment. This is because CRP is not specific to RA. Elevated levels of CRP can indicate any type of infection or inflammatory condition.
On the other hand, some people with RA may have normal CRP levels. A study published in 2009 looked at databases of patients living with RA in Finland , and the United States over a period of 25 years.
Results showed that 44 to 58 percent of the patients, living in Finland and the United States, respectively, had normal CRP test results.
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What Is The Difference Between Crp And Hs
As youve no doubt guessed, the difference between CRP and hs-CRP is contained in the hs abbreviation high sensitivity.
Traditionally, CRP, or C-reactive protein, is measured down to concentrations of 3 to 5 mg/L hs-CRP is measured down to concentrations of approximately 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.
Crp Levels And The Diagnosis Of Rheumatoid Arthritis
No single test can confirm that you have RA. However, measuring levels of CRP in your blood can be part of a comprehensive diagnosis. A doctor can use your CRP levels to track the degree of inflammation over time.
If youre getting tested for RA, the doctor will likely order a standard CRP test rather than an hsCRP test.
To confirm a diagnosis of RA, the doctor will:
- analyze results from other lab tests, such as the rheumatoid factor antibody test and cyclic citrullinated peptide antibody test
- assess levels of morning stiffness and the amount of swelling and pain in your joints
- document the duration of your symptoms
- examine X-rays of the hands and feet to check for erosions or bone damage
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What Does It Mean To Have A High Crp
The Physicians Health Study found that among healthy adult men, those with a high level of CRP were three times more likely to have a heart attack than those with low levels of CRP. This was among men who had no previous history of heart disease.
According to the Cleveland Clinic, the Harvard Womens Health Study showed that high CRP levels were more predictive of coronary conditions and stroke in women than were high cholesterol levels.
Doctors may order this test in conjunction with other tests to assess a persons risk of heart disease or stroke. There is also new research that suggests CRP may be used as a predictor in health outcomes related to chronic obstructive pulmonary disease . Doctors may also order a CRP test to diagnose inflammatory autoimmune diseases, including:
How Do Doctors Use The Crp Test To Monitor Your Disease
As rheumatologists follow a patients progress through treatment, inflammation levels can tell them how active the disease is. The CRP gives you something to follow to see if the inflammation is high, says Dr. Kaplan. During flare-ups, CRP will be higher, so its a good gauge of whether your current treatment regimen is effective.
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What Conditions Affect Erthrocyte Sedimentation Rate And C
Since a large number of disparate conditions, such as obesity, can increase CRP production, it cannot be used to diagnose a specific disease such as rheumatoid arthritis. CRP is merely an indicator or biomarker of a disease process that is causing cell death due to inflammation. ESR rates can be affected by obesity as well as renal failure, aging, and female sex.
Today, a high-sensitivity CRP test, usually designated as hs-CRP, measures low levels of CRP using laser nephelometry.3,4 Several studies suggest that an elevated hs-CRP is predictive of coronary heart disease.14,15 Arterial damage results from white blood cell invasion and inflammation within the walls of coronary arteries. 14 A high hs-CRP, therefore, is a rough proxy for cardiovascular risk. The widespread use and publicity surrounding the association of hs-CRP with heart disease may have obscured its diagnostic role in pain and other non-cardiac conditions.6,9-13 If a pain patient has an elevated hs-CRP, it simply means that there is an active focus of inflammationbe it in the heart, CNS, or elsewhere in the bodyand efforts must be made to eliminate it.
How Is The Test Administered
No special preparation is necessary for this test. You may eat normally on the day of the test.
A nurse or other health practitioner draws blood from a vein, usually on the inside of your elbow or the back of your hand:
First, they clean the skin over the vein with antiseptic. Next, they wrap an elastic band around your arm, causing your veins to bulge out slightly. The practitioner then inserts a small needle into the vein and collects your blood in a sterile vial.
After the nurse or health practitioner collects your blood sample, they remove the elastic band around your arm and ask you to apply pressure to the puncture site with gauze. They may use tape or a bandage to hold the gauze in place.
A CRP test can be helpful in assessing a persons risk of heart disease, especially in combination with high cholesterol levels. The benefits of this test outweigh potential complications, especially for those at risk of heart disease or stroke and those recovering from recent heart procedures.
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What Is The Conventional Treatment Of Elevated C
Conventional physicians may prescribe the same drugs used to lower LDL cholesterol to also lower levels of CRP. In addition, they will typically recommend exercise and weight loss where appropriate, since both can help lower CRP levels. In general, conventional physicians recommend the same lifestyle changes shown to reduce heart disease diet, exercise, not smoking, drinking less alcohol, following a heart-healthy diet to lower elevated C-reactive protein levels.
Addressing Your Risk Factors
It is not known now much it helps to take steps aimed specifically at reducing your CRP levels.
Likewise, it is uncertain whether treatment aimed specifically at lowering CRP levels can reduce cardiovascular risk.
That aside, knowing your CRP levels are elevated should encourage you to take every opportunity to reduce your risk of heart disease.
Elevated CRP levels are almost always associated with other risk factors for heart disease, including:
- High blood pressure
- Metabolic syndrome
Talk to your healthcare provider about your heart disease risk factors and what can be done to address them and your CRP levels.
This may involve habit changes, weight loss efforts, and/or medication.
Clinical Study Of Esr
Many clinical reports detail high ESR levels in a variety of clinical conditions.1 After a literature review, I could not find any prior attempts to show whether pain treatment, per se, will lower an elevated ESR. To this end, I conducted a study of ESR levels in 50 consecutive pain patients referred to my pain clinic by their primary care providers.8 All patients had chronic pain conditions that were not adequately controlled by a daily morphine equivalent dosage of 20 to 40 mg. The causes of pain in these patients were spine ailments neuropathy headaches and miscellaneous . None had rheumatoid arthritis, temporal arteritis, or acute infection, which are well known to elevate the ESR.
Opioids administered at the time of referral included low dosages of hydrocodone, codeine, or oxycodone. Ten of the 50 patients had ESRs > 20 mm/h . Treatment in the first 90 days was simply to increase opioid dosages to a level that controlled the patient’s pain and enabled them to function and not be bed- or house-bound. With essentially no other treatment other than increased pain relief with opioids, 7 of the 10 patients with elevated ESRs returned to normal levels. The mean ESR was reduced from 33.9 mm/h to 10.5 mm/h . There was no obvious reason why the remaining 3 patients continued to have an elevated ESR. No attempt was made to determine whether one or more chronic, nonrheumatologic pain disorders had more frequent or higher ESRs.
High Crp And What It Means For Polymyalgia
C-reactive protein is a blood test marker that your doctor might test for if he or she suspects that you have an inflammation or a chronic inflammatory disease, such as polymyalgia rheumatica . Learn what the CRP test is and what its results could mean to you as a polymyalgia sufferer.
C-reactive protein is a blood test marker that your doctor might test for if he or she suspects that you have an inflammation or a chronic inflammatory disease, such as polymyalgia rheumatica . However, there are other diseases, such as lupus and rheumatoid arthritis in which a CRP test is also required for diagnosis.
An autoimmune disease develops when the immune system interprets our healthy cells to be foreign. Autoimmunity usually affects body tissues. There are about 80 autoimmune diseases. The most common are lupus, rheumatoid arthritis, psoriasis, anemia and polymyalgia rheumatica.
Polymyalgia is a common form of inflammatory disease in old people and usually mistaken for arthritis. However,there are also cases of patients with polymyalgia rheumatica who are younger than 50-years old.
PMR causes pain and stiffness in the shoulders and neck, hips and arms while affecting lining of joints. It can be diagnosed through blood tests such as red blood cell count, ESR and CRP test.
C-reactive protein is a substance generated by the liver when an inflammation exists. The C-reactive protein mixes with the blood. A high or positive result in the CRP test will tell of a systemic inflammation.
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What Does A High Crp Mean
A high C-Reactive Protein level in the blood is usually a sign of inflammation or bacterial infection because CRP is one of the most sensitive acute-phase reactants.
Elevated serum concentration of CRP is an unequivocal evidence of an active tissue damage process, but it is a nonspecific test that indicates only an inflammation.
CRP can increase dramatically in case of severe trauma, bacterial infection, inflammation, surgery, or neoplastic proliferation.
A high CRP may be a sign of the following diseases:
- Inflammatory bowel diseases .
- Pelvic inflammatory disease.
- Chronic inflammatory diseases .
- Bacterial infections .
Since CRP production is a non-specific response to tissue injury, it is recommended that results of the test should be correlated with clinical findings to arrive at the final diagnosis.
A high CRP value in a blood test means:
Other Blood Tests For Ra
Since CRP measurement is not the only indicator of RA, and normal CRP levels can be found in those with RA, other blood tests may be ordered at the same time if RA is suspected. Two other biomarkers erythrocyte sedimentation rate and rheumatoid factor are usually checked along with CRP.
RF tests measure a different kind of protein, and high levels of this protein are also a sign a person may have RA. ESR tests are another measure of inflammation. ESR is a less sensitive test than CRP and is not as useful a diagnostic marker, but since its easy to test for, its usually run at the same time as CRP. If all three levels are elevated, this is a stronger indication of RA although it is not definitive.
One myRAteam member told another about their test results: If plus your RF was positive, thats pretty strong evidence of definite RA. Even if all three levels are at normal rates, a diagnosis of RA can still be made if other symptoms are present. Conversely, elevated levels of all three do not mean a person has RA. Another member wrote, Just for the record, blood tests for RA are only part of the diagnosis puzzle. They are never enough alone to diagnose RA. Some folks actually have high RF levels, high anti-CCP, high CRP, and high ESR level, and definitely do NOT have RA.
Lab tests, therefore, are only one part of how RA is diagnosed.
Do you have questions about CRP levels? What was your path to RA diagnosis? Comment below or start a conversation on myRAteam.
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What Elevated Crp Levels Mean
When CRP levels remain elevated for a long time, it can be an indication that chronic inflammation of the blood vessels is present.
This type of low-grade inflammation contributes to the deposit of fat and other substances in the artery walls, a condition called atherosclerosis.
This is true even for those with elevated CRP levels who have no obvious signs of active inflammation.
It is now well-established that inflammation is an important contributor to atherosclerosis. Elevated CRP is also firmly associated with an increased risk of CAD.
What is not known is whether CRP itself actually contributes to CAD directly.
What Are The Risk Factors For High Levels Of C
Heart disease has an inflammatory component, which may be linked to high C-reactive protein levels. However, based on the current available data it cannot be considered an independent risk factor for cardiovascular disease.
Based on the review of the published data, the CDC and the American Heart Association have recommended the following guidelines for assessment of cardiovascular disease risk:
- CRP levels of 1 mg per liter or lower are considered low risk for cardiovascular disease.
- CRP levels of 1-3 mg per liter are considered moderate risk for cardiovascular disease.
- CRP levels greater than 3 mg per liter are considered high risk for cardiovascular disease.
- CRP levels greater than 10 mg per liter may suggest an acute coronary process, such as heart attack .
The known risk factors for cardiovascular disease are:
This may be possibly related to ongoing inflammatory atherosclerosis in these individuals because of their risk factors.
Despite these associations, research has not clearly and consistently established c-reactive protein as an independent risk factor for cardiovascular disease, as the data seem to be inconsistent from different studies. It has been proposed that elevated c-reactive protein is an independent predictor of atherosclerosis among healthy men and women.
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How Much Does The Test Cost
Many factors contribute to the cost of a CRP test, including the materials needed to carry out the test, the fee for the phlebotomist who draws your blood, the laboratorys fee for analyzing the sample, and the fee from your doctors office.
Your insurance coverage will determine your out-of-pocket cost. Insurance generally covers CRP testing, but depending on your policy, you might owe a deductible or a copay. If you are in doubt, check with your insurance provider.
If you are uninsured, then discuss the cost with your doctor or with the hospital or laboratory administrator. Some health care institutions have financial advocacy offices that can assist you with concerns about cost.