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

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.

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.  You can get your oxidized LDL status tested with a “Triple Marker Test” through Shiel Lab in New York.

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.)

Considerations

(See Medical Disclaimer Below)

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

The Multi-Antioxidant formulation should have at least 600 mcg of folic acid (or 1000 mcg of L-5-methyl-tetra-hydro-folate), as well as generous doses of Vit B6 and Vit B12

Make sure you’re taking at least 300 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 consider:

Fish Oil

Additional calcium and magnesium

Vitamin D

Grape Seed Extract

Resveratrol

Olive Fruit Extract

Alpha Lipoic Acid

Choline (which converts to Betaine in the body)

If your homocysteine persists above 8.0 after taking 750 mg of choline, consider taking betaine (a.k.a., TMG)

Co-Enzyme Q10

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.

Medical Disclaimer- Everything on this website, and in this article, is not to be interpreted as, or substituted for, medical advice.  It is for informational purposes only, to be used to faciliate a conversation with your health care provider.  Please consult with your own personal health care provider before embarking on a supplement program.   The information on this website is not meant to take place of the information and recommendations you receive from your personal physician or other licensed health care provider, as the information and considerations offered on this website may not apply to your health condition and needs.   Do not use any information on this website for the use of diagnosing, treating, or managing your care without a thorough discussion with your health care provider.   Do not stop, start, or change any medication without consulting with your physician.   If you have, or suspect that you have, a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website.  Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

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Medical Disclaimer

Information on this web site is provided for informational purposes only. The information is a result of years of practice experience and study by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this website for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this web site. Information provided on this web site and the use of any products or services purchased from this website (or as a result of information provided this website) by you DOES NOT create a doctor-patient relationship between you and any of the physicians or authors affiliated with this website. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.