CRP 6.6

Just had my very first CRP the other day out of the four years I have had UC. Paper showed results should be less than 10 and I came up with 6.6. Sorry but I haven't paid much attention to posts on CRP levels and their relationship to disease symptoms. The only symptom I really have anymore is going 3-5 times per day with solid stools containing no blood or mucus. Before UC I was only going an average of once per day, sometimes going twice and sometimes going zero. I'm trying to figure out what that normal CRP level means. Would it indicate that my UC inflammation is completely gone and now I need to figure out why I still go 3-5 times per day or could I still have colonic inflammation even though my CRP is in the normal range? Vitamin D level also came out at 43.1 which apparently is good. A bunch of other levels all came out in the normal range. The only thing off was my sodium level, which was only one point lower than the normal range.

IBS !

different labs have different ranges. my crp needs to be less than 1 for it to be considered normal. my worst was 27 but i definitely felt horrendous- worst pain of my life.

my crp always corresponds accurately with my inflammation but i know some members' crp doesn't elevate.

my gi doc tests it regularly every time i get blood work so i can see how it falls/rises.

For years my CRP was always less than .5, until I got UC. The only way for me to lower my CRP, which spiked to over 100 during my flare, was ending the flare.

And because remission does not mean "cure", I will always experience chronic inflammation even if it is below the surface during remission. That is why I am not surprised that my CRP will not return to the .5 level again.

But if you find something that really snuffs out CRP inflammation then please share it with us.

edit:
Actually I take that back. At the end of my last flare, when I really was taking anti-inflammatories like curcumin, E complex, etc. to help end the flare, then my CRP was around .3. But I don't take 30 pills/day any more.

Post Edited (IamCurious) : 7/26/2014 9:06:38 AM (GMT-6)

Be careful when reading info' provided by magazines like “Life Extension.”
The articles are written by the magazine's journalists, not researchers, for promotional purposes.

CRP is produced by the liver. It is a substance that binds to foreign and damaged cells, enhancing phagocytosis by macrophages. It reflects non-specific inflammatory/immune response.
There are always small amounts of CRP in the bloodstream. In an artificial, sterile world the level would theoretically be close to zero.

As Ambling said, I was trying to read between the lines with that website. I noticed it was laced with cherry picked facts. Still, it was a very interesting read. I recognized several things on their CRP lowering charts as being things which have some medical documentation as being effective for UC but was surprised that not one of the things mentioned specifically said that they would lower CRP levels of patients with IBD. I'm also still trying to figure out what a normal CRP range really is. I thought I was doing good with a 6.6 because it was quite a bit lower than their high range number of 10 and now I'm wondering if I am in the normal normal range or not. According to the linked website, if I had cancer, a CRP level of 6.6 would leave me with a pretty grim prognosis.

I was thinking of starting a new thread with another question but maybe I'll give it a try here first. What would a normal CRP level be for someone who had been diagnosed with UC but has since had surgery? I mean let's say for the sake of argument that surgery "cured" the person's UC. Even if it did, could your CRP levels still be high and cause other problems? I'm guessing the answer would be yes, it could. So, would it even be useful to have surgery for your UC if you have a high CRP level and that CRP level remained high after surgery?

Hi G in L-ville,

C-Reactive Protein can be reported as CRP level,
OR; High-Sensitivity CRP "CRP-HS"
Check your lab results then check out this article. I've copied & pasted the CRP relevant sections. It seems mostly understandable for the expert patient - which you may be :) Let me know if this helps.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308116/pdf/nihms348207.pdf

Biomarkers in Inflammatory Bowel Disease: Current Practices and Recent Advances
Heba N Iskandar and Matthew A Ciorba
Transl Res. 2012 April ; 159(4): 313–325.

C-Reactive Protein
C-reactive protein (CRP) is a protein produced by the liver in response to a variety of acute and chronic inflammatory conditions. Cytokines associated with active IBD [interleukin (IL)-6, tumor necrosis factor alpha (TNFα ) and IL-1β] stimulate increased production of CRP by hepatocytes over baseline levels which are typically less than 1mg/l.(16) During active IBD, levels can range from 5–200 mg/l depending on disease severity and the individual’s capacity to produce CRP. Such elevations of CRP are not specific to IBD as levels are also increased in various viral and bacterial infections, other autoimmune disorders, malignancy and other disorders resulting in tissue necrosis.(17) Positive features for CRP as a biomarker include that it is easily and reliably measured across diagnostic laboratories and has a short plasma half-life of ~19 hours which is determined by synthesis rather than degradation.(18)

Heterogeneity exists between individuals’ immune responses and elevations in CRP are more common in CD than in UC.(19) Potential explanations for this difference include the greater depth of inflammation and higher serum IL-6 found in CD verses UC.(20, 21) While most patients with active CD mount a CRP response, the level of CRP elevation varies both by individual and perhaps disease location. Florin et al found that ~10% of examined patients with active CD by clinical assessment were found to have a CRP of <10.(22) The phenotype of isolated ileal disease and low body mass index were found to be common in the low CRP producing group. However, analysis of a separate patient cohort did not confirm significance of this finding.(23) Gene polymorphisms have also been reported as an explanation for differences in CRP levels.

CRP in the Differentiation of IBD from non-inflammatory GI conditions
For most individuals, after abscess and infection are excluded, CRP has value as a biomarker in distinguishing active CD from functional bowel disorders.(31) Serum CRP has a lower sensitivity in UC, thus it cannot be relied upon solely to exclude the diagnosis of this disorder.(32)


CRP in Evaluating Patients with known IBD
CRP has the ability to distinguish active from quiescent IBD and trends with mucosal healing. A retrospective analysis of Mayo Clinic data showed moderate or greater clinical disease severity (OR 4.5), active disease on colonoscopy (OR 3.5) and severe inflammation on histology (OR 10.6) to associate with an elevated CRP.(33) In the same study, 51% of UC patients with active disease by colonoscopy had an elevated CRP. In a follow up investigation from the same group, quantitative assessment by CT-enterography correlated with CRP when perienteric inflammation was included, but not inflammation limited to the small bowel wall.(34) In patients with symptoms of active CD and an elevated CRP, 86% exhibited evidence of inflammation at colonoscopy.(33) This suggests that CRP is additive to clinical assessment in the ability to predict active mucosal inflammation. Across studies however, CRP is less sensitive and has a lower correlation with mucosal inflammation by endoscopy than the stool based biomarkers calprotectin and lactoferrin.(32) This is true in both UC and CD patients. In studies including CD patients, results were generally reported without distinguishing patients by disease location (ileal vs colonic vs ileocolonic); however, one study noted that abnormal small bowel radiographic findings did not associate with CRP elevation.(33)

In patients on concomitant immunosuppressive therapy for CD, elevated CRP (>5) or elevated platelet count (>298) at time of azathioprine withdrawal was predictive of future infliximab failure.(35) Though not highly sensitive, several studies have shown CRP elevations to be predictive of recurrence with CD.(36–38) A recent study identified CRP levels to associate with response to infliximab therapy in CD. Early normalization of CRP correlated with long-term response and a sustained increase of CRP levels in patients on infliximab correlated with a loss of response to therapy.(39) In contrast, evaluations of ESR have shown only mixed results with regards to its ability to predict relapse.(37, 40)

Gary, I had surgery as a kid and don't know what my CRP was when my UC was at its worst. In the 20 years since then my CRP's been checked many times by rheumatologists and is usually 'normal' and sometimes quite low.

Even when my skin and joints are obviously inflamed my CRP is almost always within range. The CRP has also come back normal when ESR was high or complements gauging inflammatory response were high. My doctors say it's a test with limited usefulness but order it anyway.

Thanks for the info everyone. I haven't had much time lately to check into anything but I will.

What were the units of measurements? mg/L or mg/dL? If it's the first one, then you may have cause for concern, arguably. If the latter, nothing to worry about.

emedicine.medscape.com/article/2094831-overview

hs-CRP test is what I always get. Probably no one gives a sh!t, but here's a graph of my CRP (mg/L) from August 2011 to March 2012. The spikes corresponded to acute flare-ups leading to hospitalisation. IV steroids brought the inflammation (and hence the CRP) right back down, but never for very long. Was on Remicade all this time, too - much good it did.

i.imgur.com/qX4Yc.jpg

Ever since surgery, my CRP has been knocking about at 7 or 8. But that might be due to residual inflammation from my retained rectum (what a phrase). Anyway, I'll probably drop dead from a heart attack at some point, but whatevers.

You have nothing to worry about Gary.
I think NCOT meant that if it was dL it could be a concern (meaning your reading was actually 66 mg/l).
Take a look at her chart with extended periods above 150mg/l ! Most Crohnies would kill for a reading of 6.6 ;-).

That's the trouble with magazines whose aim is to flog their supplements. They want to make out that normal people need all their supplements, and they do it by misleading everyone with unsubstantiated nonsense.

The best ways to lower CRP, by improving (moderating) immune function, are all free; sound sleep, fulfilling work, meditation, healthy diet, some exercise and good relationships – not to mention laughter, and oddly enough, some tears. And, holiday travel is great too. All these things calm and rejuvenate. Also note that as people age, their CRP naturally tends to rise. Can't live forever ... no matter what a magazine wants to tell you.

The heat woke me up (yeah, in England), couldn't get back to sleep and am typing on a tablet, so I'll probably make even less sense than usual <_<.

But yeah, ambling got what I was trying to say. dL= decilitre, which is one tenth of a litre (or liter for the Americans). If the milligrams part doesn't change, then mg/dL is 10x lower than mg/L.

Eg, 1 mg/dL = 10 mg/L
20 mg/dL = 200 mg/L
6.6 mg/dL = 66 mg/L

And so on.

Admittedly I had a brain fart earlier and thus made a dumb mistake. A reading of 6.6 mg/dL would be a definite cause for concern. You would have active inflammation without a doubt. But in terms of your UC, 6.6 mg/L ain't nothing to worry about - start to worry when it goes higher than 10.

In terms of assessing heart disease risk, the hs-CRP test is useless on its own. There are many causes of an elevated CRP and so it is not at all a specific prognostic for heart disease. Google CRP and read the wiki article on it. Unless you have been diagnosed with unstable angina or have other high risk factors for a heart attack, your CRP result is meaningless; and even then you would need other tests to confirm your risk. Mind, the way some folks go on about statins here, they would probably think a heart attack is benign by comparison.... *shakes head*

Well, it took me an eternity and a day to tap all that on a virtual keyboard... I'm going back to
bed, even if it is nearly time to get up :-/

Edit: sorry for the mistake in my first post, btw. Hate getting stuff wrong, but it's even more annoying when it's because I didn't stop to think. Okay, now I'm really, truly, off.

Post Edited (NiceCupOfTea) : 7/28/2014 2:49:03 AM (GMT-6)

Gary said...
The only symptom I really have anymore is going 3-5 times per day with solid stools containing no blood or mucus. Before UC I was only going an average of once per day, sometimes going twice and sometimes going zero.

Yes you are in remission but going 3-5 times per day indicates that you, like me and almost everyone else in “remission”, probably still have residual inflammation. I suspect we will always have it until a bona fide cure is found.

In the meantime your 6.6 CRP number reflects the inflammation brewing inside. My CRP is in a similar range and I believe is normal for someone in remission. I have been getting regular blood work for years and I want to reiterate that before my UC my CRP was always between .3 and .5. When in a flare my CRP spiked thru the roof.

Now if I did not have UC then I would be worried about my CRP that is over 3.0. That would indicate that I have inflammation somewhere in my body, perhaps in my arteries as a prelude to heart disease in the future.

One reason why statins are so effective at preventing heart disease isn't so much that they lower cholesterol, there are numerous examples of people with normal cholesterol levels who get heart attacks, but because statins significantly lower CRP and inflammation.

(In acknowledgment to Quincy I think that mesalamines also lower inflammation which may be why they help prevent bowel cancer.)

Post Edited (IamCurious) : 7/28/2014 5:58:30 AM (GMT-6)