Persistently elevated CRP-no symptoms

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Submitted by Dr T on February 27, 2014 – 7:30pm

I am a 58 yr old female -very active, all normal blood work and lipids, and don’t drink, smoke or do drugs. However, for the last 18 mo my CRP which has always been less than 1 , has gone from 3 to over 6. My PCP is very puzzled; my cardio( I had an AF ablation last Sept, and no AF since)says”most people don’t order that test!”, and isn’t the slightest concerned, even tho’ my Dad died at 58 of a sudden heart attack and stroke.My Mum also had breast cancer at 56 and died at 58, but the rest of her live was fit and healthy!We have a strong family history of cancer, and I’m really worried that I have some occult cancer lurking somewhere.The elevation seemed to come from nowhere, and was there before the AF. I had an ANA , SR and rheumatoid factor, as I have some arthritis and they were negative. However I have had the arthritis for over 5 yrs when the CRP was really low.  I do take HRT ( bioidentical), as I was having horrible hot flashes day and night, and that’s the only link I have come across, but the increase that may be attributed to that seems only minimal, nothing as high as 4 or 6.What else can I do to try and discover the cause of this? I also eat an anti-inflammatory diet, take fish oil, vit D , and am only 140llbs/5.6in. I have no apparent symptoms-it’s scary as it’s been high for so long. Can some folk simply produce more CRP as they age, without it being directly linked to chronic inflammation?Any guidance would be so much appreciated I feel like a walking time bomb!Thank-you so much for your time!

Hi Tina,

CRP is used mainly as a marker of inflammation. A level above 2.4 mg/l has been associated with an increased risk of a coronary event compared to levels below 1 mg/l. Recent research suggests that patients with elevated basal levels of CRP are at an increased risk of diabetes, hypertension and cardiovascular disease. A more sensitive CRP test, called a highly sensitive C-reactive protein (hs-CRP) assay, is available to determine heart disease risk.

Patients with a hs-CRP > 3.0 mg/L, are probably at a high risk for developing coronary artery disease if other risk factors are also present.
If you want to estimate your risk for heart disease, you may want to look here:

Since you seem to have an elevated hs-CRP, that does not seem to be explained by other risk factors, you should be evaluated for other problems such as autoimmune diseases, other infectious diseases or even cancer.

I personally don’t like to use tests that not specific like CRP – try to figure things out on the basis of the clinical information I get from my patient, not by a “shot in the dark”. You can calculate your cardiac risks here.

Hope this helps,
Dr T

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