CRP, C-Reactive Protein Elevation: Causes and Diagnosis

8 MINUTES

What is CRP, C-reactive protein, and why is it important?

CRP stands for C-reactive protein, which is a substance produced by the liver in response to inflammation. It is one of the acute phase proteins, which are a group of proteins that are produced in response to inflammation or infection.

CRP is an important marker of inflammation in the body, and its levels can be used to diagnose and monitor a wide range of conditions that involve inflammation, such as infections, autoimmune diseases, and cardiovascular disease.

In addition to its diagnostic and monitoring uses, CRP can also be used to assess the risk of developing certain health conditions, such as heart disease. Studies have shown that individuals with high levels of CRP may have an increased risk of developing cardiovascular disease, even in the absence of traditional risk factors such as high blood pressure or high cholesterol.

Overall, CRP is an important marker of inflammation in the body and can provide valuable information about a patient’s health status and risk of developing certain diseases.

How is CRP measured, and what are normal levels?

CRP levels can be measured through a blood test called a CRP test. The test measures the level of CRP in the blood, and the results are reported in milligrams per liter (mg/L).

In healthy individuals, CRP levels are typically low, usually less than 10 mg/L. However, CRP levels can increase rapidly and dramatically in response to inflammation, and levels as high as 100 mg/L or more can be seen in severe cases of inflammation or infection.

The interpretation of CRP levels depends on the context in which they are measured. For example, in an otherwise healthy individual with no signs of infection or inflammation, a CRP level above the normal range may indicate an increased risk of developing certain diseases, such as cardiovascular disease. In contrast, in a patient with a known infection or inflammatory condition, an elevated CRP level may indicate the severity of the condition or the response to treatment.

CRP levels can also be influenced by other factors, such as smoking, obesity, and certain medications. Therefore, the interpretation of CRP levels should be done in consultation with a healthcare provider who can take into account the individual’s medical history and other relevant factors.

What are the possible causes of elevated CRP levels?

Elevated CRP levels can be caused by a variety of conditions that involve inflammation or tissue damage in the body. Some possible causes of elevated CRP levels include:

  1. Infections: Bacterial, viral, or fungal infections can cause a rapid increase in CRP levels.
  2. Autoimmune diseases: Conditions such as rheumatoid arthritis, lupus, and psoriasis can cause chronic inflammation and elevated CRP levels.
  3. Cardiovascular disease: Atherosclerosis, or hardening of the arteries, can cause inflammation in the blood vessels, leading to elevated CRP levels.
  4. Cancer: Some types of cancer, such as lymphoma and leukemia, can cause elevated CRP levels.
  5. Trauma or injury: Tissue damage from an injury or surgery can cause inflammation and elevated CRP levels.
  6. Chronic obstructive pulmonary disease (COPD): Inflammation in the lungs from COPD can cause elevated CRP levels.
  7. Obesity: Being overweight or obese can cause chronic low-grade inflammation in the body, leading to elevated CRP levels.
  8. Smoking: Smoking can cause inflammation in the lungs and throughout the body, leading to elevated CRP levels.

CRP and fever

C-reactive protein (CRP) levels can increase in response to inflammation in the body, including inflammation caused by an infection. Fever is a common symptom of many infections, and it can be associated with elevated CRP levels.

When the body is fighting an infection, immune cells release cytokines, which can cause inflammation and trigger the liver to produce CRP. CRP levels can rise rapidly in response to an infection, often within a few hours.

In clinical practice, measuring CRP levels can be helpful in diagnosing and monitoring infectious diseases. For example, in patients with suspected bacterial infections, elevated CRP levels may indicate the presence of an infection and help guide treatment decisions.

Elevated CRP levels are not specific to infections and can also be caused by other conditions, such as autoimmune diseases or tissue injury. Other clinical factors, such as the presence of other symptoms or findings on physical exam, may be needed to determine the underlying cause of elevated CRP levels.

CRP in cancer

C-reactive protein (CRP) levels can be elevated in some cancer patients, particularly in those with advanced or metastatic disease. This is because cancer can trigger an inflammatory response in the body, leading to elevated CRP levels.

In addition, some cancer treatments, such as chemotherapy or radiation therapy, can also cause inflammation and lead to elevated CRP levels.

Research has shown that elevated CRP levels may be associated with poorer outcomes in cancer patients, such as decreased survival and increased risk of complications. However, the relationship between CRP levels and cancer is complex, and more research is needed to fully understand the role of CRP in cancer.

In clinical practice, measuring CRP levels can be helpful in monitoring cancer patients and assessing their response to treatment. For example, if CRP levels decrease during treatment, it may indicate that the treatment is effectively reducing inflammation and tumor burden. On the other hand, if CRP levels remain elevated or increase, it may suggest that the cancer is progressing or that the treatment is not effective.

Elevated CRP levels are not specific to cancer and can also be caused by other conditions. Other clinical factors, such as imaging studies or biopsy results, may be needed to determine the underlying cause of elevated CRP levels in cancer patients.

What are the implications of having high CRP levels?

High CRP levels can indicate the presence of inflammation in the body, which can have a number of implications for a person’s health.

In some cases, high CRP levels may be a sign of an underlying health condition that requires further evaluation and treatment. For example, high CRP levels in someone with no known underlying health conditions may indicate an increased risk of developing cardiovascular disease.

In other cases, high CRP levels may be a marker of disease activity in patients with known inflammatory or autoimmune conditions, such as rheumatoid arthritis or lupus. Monitoring CRP levels in these patients can help healthcare providers assess the effectiveness of treatment and adjust medications as needed.

While high CRP levels can be a sign of inflammation or disease, they are not always a cause for concern. In some cases, elevated CRP levels may be the result of lifestyle factors such as smoking or obesity, which can cause chronic low-grade inflammation in the body.

Ultimately, the implications of high CRP levels depend on the underlying cause and the context in which they are measured. Discuss your CRP levels with a healthcare provider who can help interpret the results and provide appropriate guidance and treatment.

How can I lower my CRP levels?

There are several lifestyle changes that can help lower CRP levels:

  1. Exercise regularly: Regular exercise has been shown to decrease inflammation in the body, including CRP levels. Aim for at least 150 minutes of moderate-intensity exercise per week.
  2. Maintain a healthy weight: Being overweight or obese can cause chronic low-grade inflammation in the body, leading to elevated CRP levels. Losing weight through a healthy diet and exercise can help reduce inflammation and lower CRP levels.
  3. Eat a healthy diet: A diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats has been shown to decrease inflammation in the body. Avoiding processed foods, sugar, and saturated and trans fats can also help lower CRP levels.
  4. Quit smoking: Smoking can cause inflammation in the body, leading to elevated CRP levels. Quitting smoking can help reduce inflammation and lower CRP levels.
  5. Manage stress: Chronic stress can lead to inflammation in the body, including elevated CRP levels.

In some cases, medication may be needed to lower CRP levels, especially in patients with underlying health conditions such as rheumatoid arthritis or inflammatory bowel disease. Work with a healthcare provider to develop a treatment plan that is appropriate for your specific situation.

Can CRP levels be used to monitor the effectiveness of treatment?

Yes, CRP levels can be used to monitor the effectiveness of treatment in some cases. In patients with inflammatory or autoimmune conditions such as rheumatoid arthritis or lupus, CRP levels may be used to track disease activity and assess the effectiveness of treatment.

For example, if a patient with rheumatoid arthritis starts a new medication, their healthcare provider may monitor their CRP levels over time to see if the medication is reducing inflammation in the body. If the CRP levels decrease, it may indicate that the medication is effective. On the other hand, if the CRP levels remain high or increase, it may indicate that the medication is not working as well as expected, and the healthcare provider may need to adjust the treatment plan.

Similarly, in patients with cardiovascular disease, monitoring CRP levels over time can help healthcare providers assess the effectiveness of lifestyle changes and medications in reducing inflammation and improving cardiovascular health.

CRP levels are just one tool that healthcare providers use to monitor disease activity and treatment effectiveness. Other factors, such as symptoms, imaging studies, and other laboratory tests, may also be taken into account.

C-reactive protein (CRP) versus erythrocyte sedimentation rate (ESR)

CRP testing and erythrocyte sedimentation rate (ESR) are both laboratory tests used to measure inflammation in the body, but they differ in several ways.

CRP testing measures the level of C-reactive protein (CRP) in the blood, which is produced by the liver in response to inflammation. The test is relatively simple and inexpensive, and results are typically available within hours.

ESR, on the other hand, measures the rate at which red blood cells settle to the bottom of a test tube over a certain period of time. Inflammation can cause red blood cells to clump together, which can make them settle faster and result in an elevated ESR. ESR testing is a more traditional and older method of assessing inflammation, and the test is typically done in a laboratory.

While both CRP and ESR are markers of inflammation, they have some differences in terms of sensitivity and specificity. CRP levels can increase more rapidly and dramatically in response to inflammation, making it a more sensitive marker of acute inflammation. ESR, on the other hand, is a more general marker of inflammation and may be elevated in a wider range of conditions.

In some cases, both CRP and ESR may be ordered together to provide a more complete picture of inflammation in the body. Healthcare providers may also use other inflammatory markers, such as interleukin-6 (IL-6), to assess inflammation in certain conditions.

How can I contact gastroenterologist Dr. Zavos for an appointment?

Dr. Chris Zavos is a board-certified gastroenterologist and hepatologist, located in Thessaloniki Greece, and specifically in Kalamaria suburb, about 7 kilometres (4 miles) southeast of downtown Thessaloniki. His private office is at: Fanariou 8 street (near Aigaiou and Adrianoupoleos avenues), Kalamaria (Thessaloniki), Greece.

Thessaloniki International Airport is only 10 km away from his private office in Kalamaria and can be reached by taxi within 13 minutes from the airport.

Dr. Chris Zavos performs endoscopies at Bioclinic private hospital in downtown Thessaloniki (Mitropoleos 86 street).

You can contact Dr. Zavos at phone numbers: (+30)-6976596988 and (+30)-2311283833, or you can email him at czavos@ymail.com. Dr. Zavos responds to Greek and English languages.

Last update: 13 April 2024, 10:57

DR. CHRIS ZAVOS, MD, PHD, FEBGH

Gastroenterologist - Hepatologist, Thessaloniki

PhD at Medical School, Aristotle University of Thessaloniki, Greece

PGDip at Universitair Medisch Centrum Utrecht, The Netherlands

Ex President, Hellenic H. pylori & Microbiota Study Group