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C-Reactive Protein — Should You Get it Tested?

Posted Jun 02 2009 4:30pm

Heart Attack If you ask your primary care doctor to check your C-reactive protein (CRP), there is a high likelihood you will be told it is not necessary.  Even though we know that CRP is a risk factor for heart disease 1 and more and more doctors are testing CRP levels in patients who they consider to be at high risk, testing CRP is not yet recommended for routine lab testing.

If you ask me, it’s time that changed. At LMI, we do screen routinely for CRP.  Let me tell you why.

First of all, we know heart disease doesn’t occur just due to high cholesterol. We now know that the biggest contributor to heart disease is inflammation.  In fact, some people have heart attacks that didn’t even have high cholesterol.

The body produces higher CRP in response to inflammation, so it is called a biomarker of inflammation.  For example, when atherosclerosis (plaque build-up inside the walls of arteries) starts to damage blood vessels around the heart, they become inflamed. This triggers CRP production.

Since increased inflammation plays a role in a number of other diseases, CRP is being studied to see if it is tied to any other disease risks, and indeed it is. Research has now tied CRP to:

  • Cancer. A recent Danish study found that people with levels of CRP higher than 3 mg/L were about 30% more likely to be diagnosed with cancer than those whose levels were less than 1 mg/L. 3
  • Macular degeneration. High blood levels of CRP have also been linked to an increased risk for age-related macular degeneration according to a report in the Archives of Ophthalmology. 4
  • Cognitive decline and dementia.  Data from the Honolulu-Asia Aging Study (HAAS), a longitudinal community-based study of Japanese American men, found that those with the highest quartile of high-sensitivity CRP had significantly more cognitive decline than those in the lowest quartile. 5

To me, the evidence is not only clear, it grows stronger every year. That’s why, even though we are sometimes criticized for routinely checking CRP levels, all these studies seem to show that it does correlate with many diseases. And that’s why, in my opinion, it should probably be routinely checked.

The only problem with CRP is that it could elevate even in response to say a cold or flu.  However, in the absence of this type of illness or other infection, CRP is one way to tell if the body is experiencing chronic inflammation and putting you at greater risk for not just heart disease, but other chronic disease as well.

It’s easy and inexpensive to test for CRP. A simple blood test called the high-sensitivity C-reactive protein (hs-CRP) test does not even require fasting. It measures CRP levels in milligrams per liter of blood. A level of 0 mg/L is the goal. Anything between 0 and 3 is worth improving but is not considered serious. Anything above 3 however, is serious — it at least doubles your risk for a heart attack. 2

So, what if your CRP levels are high? How do you get them down?   You need to address all the usual sources of inflammation — insulin resistance, low thyroid levels, being overweight, etc.  In addition, switch to a low glycemic index diet, and increase your intake of antioxidant-rich foods, vegetables, beans and some fruits, such as berries.  And by all means, if you smoke, redouble your efforts to quit.

In addition, studies have shown that statin drugs will lower CRP; however a recent study showed that vitamin C was even more effective than statins, and you know from my past articles, that I believe in using statins only when absolutely necessary and keeping dosages as low as possible due to potential side effects, especially on brain health.

A study published in the journal, Free Radical Biology and Medicine found that vitamin C lowered CRP by 0.25 mg/L, while previous studies found that statins lowered levels by about 0.2 mg/L. 6 The dosage of vitamin C that lowered the CRP was 1000 mg.

So, to summarize, I believe that CRP is a good indicator of inflammation in the body; just make sure you aren’t sick with a cold or flu or any other infection when you have the testing done.  If CRP is elevated, it is showing you have hidden sources of inflammation in the body.  The best approach for lowering it is to first tackle lifestyle factors like smoking, and metabolic imbalances like insulin resistance, while improving your diet.

And if you don’t want to waste any time trying to get it down, 1000 mg of vitamin C may also help.  In fact, the lead author of the vitamin C study expressed that she believed vitamin C may be the wiser course of action for those who have elevated CRP but do not happen to have elevated LDL cholesterol. 7 I couldn’t agree more!

References

    1. Circulation. 2008 Nov 25;118(22):2243-51.
    2. Cleveland Clinic, http://my.clevelandclinic.org/heart/news/hot/crp.aspx, accessed May 22, 2009.
    3. J Clin Oncol. 2009 Mar 16.
    4. Arch Ophthalmol. 2007;125(10):1396-1401.
    5. Doi:10.1016/j.neurobiolaging.2008.01.008.
    6. J.Free Rad Biomed. Jan 2009. 46(1):70-77.
    7. http://www.medicalnewstoday.com/articles/129322.php.

      [ Ed. Note: James LaValle is the founding Director of the LaValle Metabolic Institute, one of the largest integrative medicine practices in the country.  Dr. LaValle is the author of The Metabolic Code Diet: Unleashing the Power of Your Metabolism for Lasting Weight Loss and Vitality and the Executive Editor of THB’s The Healing Prescription.  To learn more, click here.]

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