Ladd McNamara, M.D discusses the future of medicine both as it relates to health, supplementation, and how health professionals are finding new ways to increase income in an ever evolving world!

Understanding C Reactive Proteing (CRP) on Your Lab Report

artery CRP homocysteine oxidized LDL Ladd McNamara 2

A high-sensitivity C Reactive Protein (CRP) blood test is one of those critical tests that should be viewed in combination with a full lipid panel (one that includes Oxidized LDL Cholesterol), and homocysteine.  However, what is it, and how do you interpret your results?

C Reactive Protein (CRP) is a protein produced by the liver, and is used as a blood marker to indicate the relative level of inflammation in the body, particularly the blood.  Any condition that involves inflammation will elevate CRP.   Arthritis, autoimmune diseases, cancer, tissue injury, infection, and particularly active damage and development of atherosclerosis will all increase CRP levels.   Inflammatory molecules, including cytokines, trigger the liver to create C Reactive Protein and fibrinogen.

Because various diseases and conditions can cause the elevation of CRP, just having an elevated CRP does not necessarily let you know what is causing the inflammation.  That is why the CRP needs to be viewed in combination with homocysteine and Oxidized LDL-to-HDL ratio in order to understand whether the inflammation may be an indicator of active arteriosclerosis or something else.   (It is possible to have an autoimmune disease or arthritis and ALSO have active arteriosclerosis.)

On a Cardiac Panel, the CRP must be viewed as a rough indication of how much inflammation is going on in the body.  In a person without an inflammatory disease, cancer, or infection, then the CRP should give pause to whether it is an indication of arterial damage.   If the patient has diabetes, then it is most likely an indication of arterial damage, as diabetes leads to arterial damage via oxidative damage.

Oxidation leads to inflammation.  Homocysteine damages arteries via oxidiative damage, leading to inflammation.   Homocysteine also oxidizes LDL cholesterol, which leads to more inflammation.  Oxidized LDL getting under the lining of the arteries (under the endothelium) through gashes caused by homocysteine triggers an inflammatory response by monocytes (macrophages) that release hydrogen peroxide …leading to more inflammation, and more CRP.

As the macrophages attempt to gobble up damaged oxidized LDL, the macrophages become so full of “LDL goo” that it appears under the microscope that the cells are full of foam, and thus these cells are called “Foam Cells.”  The foam cells cannot contain all the LDL goo, and it spills the partially digested fatty-waxy substance within the arterial wall … leading to more inflammation, and even more elevation of CRP.

The waxy-fatty substance becomes calcified and smooth muscles migrate into this damaged inflammed area under the lining of the artery.  This is arterial plaque!  This is the process of the number one killer of both men and women.   It is clear that following your CRP levels is helpful in determining how much inflammation is underway, and how rapidly arterial plaque may be forming.

The development of arterial plaque

Again, I stress, this must be viewed in light of the level of OXIDIZED LDL, Oxidized LDL-to-HDL ratio, and homocysteine.   If either of these are significantly elevated then a high CRP is indicative of arterial damage, because these are the substances that lead to damage of the arteries and resultant inflammation.   (If your lab does not check oxidized LDL, please contact Molly Fini at to get these tests, and more, at the best price.  It’s that critical.)

Here’s how you can interpret your CRP Levels, and what you can do about it.


High-Sensitivity C Reactive Protein

< 1.0           Ideal

1.0 – 1.9     Acceptable

2.0 – 2.5    Borderline Elevated Risk

2.6 – 3.0    Elevated Risk

3.1 – 4.0    High Risk

> 4.0         Very High Risk


If your CRP is elevated, and it is suspected that it is due to arterial inflammation (because your homocysteine and oxidized LDL is elevated) then take action to reduce your homocysteine and oxidized LDL.   Since oxidation is the problem, anti-oxidants are the answer!   As you reduce oxidation, inflammation will reduce and it will reflect in a lower CRP level.  (Remember, you are not treating a lab test, you will be changing the inflammatory process that is ravaging your cells, arteries, and organs.)

Consider taking the following (or at least start with some of the basics):

A full-spectrum multi-antioxidant regimen, multi-mineral formulation (in chelated form for optimal absorption)

The Multi-Antioxidant formulation should have at least 1000 mcg of Folic Acid, as well as generous doses of Vit B6 and Vit B12

Make sure you’re taking at least 400 IU of the natural vitamin E (d-alpha tocopherol with the gamma tocopherol, as well as delta)

Avoid vitamin E with both D and L alpha tocopherol without any gamma tocopherol!

If your oxidized LDL cholesterol-to-HDL cholesterol remains elevated, double or triple your NATURAL vitamin E!


Also take:

Fish Oil, that is purified through a double-distillation process.

Additional calcium and magnesium

Vitamin D, at least 4000 IU per day, and as much as 10,000 IU’day

Grape Seed Extract, at least 200 mg/day, and as much as 800 mg/day

Resveratrol, at least 30 mg/day, and as much as 250 mg/day

Olive Fruit Extract, at least 30 mg/day, and as much 100 mg/day

Alpha Lipoic Acid, at least 200 mg/day, if not 400 mg/day

Choline (which converts to Betaine in the body), at least 375 mg, if not 750 mg/day

If your homocysteine persists above 8.0 after taking 750 mg of Choline, take additional Betaine (a.k.a., TMG)

Co-Enzyme Q10, at least 100 mg per day, if not 300 mg per day


Certainly, there are many different antioxidants that help maintain health and reduce the incidence of disease.  Start with something.  Add antioxidants that can help target your particular health concern, and recheck your blood work.  If the levels are improving, but not quite in healthy to low-risk ranges, then increase the antioxidants, or find out what nutrients would work.   It is my suggestion to avoid cholesterol-lowering statin drugs.  You can make most of the necessary changes with eating right, exercise, losing weight, taking supplements, sleeping well, and reducing stress.

Good health!

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