hs-CRP

Date published: Nov. 25, 2020, Author: Bruno dos Santos

What are CRP and hs-CRP?

C-reactive protein (CRP) is a substance that the liver makes in response to inflammation. The C-reactive protein test measures the amount of this protein in the blood. The test can help to diagnose acute and chronic conditions that cause inflammation. A wide variety of inflammatory conditions can cause elevated CRP levels, including infection, organ and tissue injury, cancer, obesity, autoimmune conditions, pericarditis. Very high CRP levels (>350mg/L) are almost always a sign of a serious underlying medical condition, likely a severe infection or a poorly controlled autoimmune disease or severe tissue damage.

The high sensitivity CRP (hs-CRP) test is different from the CRP test. The hs-CRP test detects lower levels of CRP in the bloodstream (0-10mg/L), while the CRP test measures levels in the 10-1,000mg/L range. The hs-CRP test is used to evaluate chronic inflammation and a person's risk of developing diseases and conditions such as cardiovascular disease, atherosclerosis, diabetes and sedentary lifestyle.

There is currently no definitive standard for CRP blood levels, and guidelines vary. As a general rule, the following thresholds apply:

Normal levels are below 1 mg/L.
Slightly elevated levels (1 - 3 mg/L) indicate a moderate risk of developing cardiovascular disease and perhaps other diseases.
Moderately elevated levels (3 - 10 mg/L) are usually result from chronic conditions such as diabetes, hypertension, obesity, tobacco smoking and sedentary lifestyle.
Highly elevated levels (10 - 100 mg/L) are usually due to significant inflammation from an infectious or non-infectious cause.
Extremely high levels (above 100 mg/L) are almost always a sign of severe bacterial, fungal or viral infection, and sometimes cancer.

What are the most likely cause of elevated CRP?

A huge range of diseases and conditions can raise CRP levels, making the determination of the exact cause of its elevation almost impossible by looking at CRP levels alone. However, the causes fall into the following categories:

Viral, bacterial or fungal infection including COVID-19.
Injury, surgery or wound.
Cancer.
Chronic diseases: diabetes, obesity, hypertension, cardiovascular disease, arthritis, pericarditis and autoimmune diseases.
Lifestyle conditions: overweight, sedentary lifestyle.
Estrogen levels: Estrogen-based medications such as birth control pills and hormone replacement medications.
Pregnancy: especially during the later stages.

Intervention tips

You should consult a doctor and find out the cause if you have high levels of CRP (>10mg/L). For slightly (1-3mg/L) to moderately elevated levels (3-10mg/L), you should monitor it changes over time and potentially take actions to reduce the levels. There are many different supplements that can help reduce chronic inflammation and the commonly used supplements include curcumin contained in turmeric, alpha-lipoic acid, fish oil, ginger, resveratrol, spirulina, S-adenosylmethionine, zinc, green tea, frankincense, cat’s claw, capsaicin, andrographis and many others. Anti-inflammatory supplements do not work for everyone and you should find out which one(s) work the best for you. In almost all cases, supplements take time to reverse inflammation.

Medications may be needed to reduce inflammation in the body when it is highly elevated. Specific nonsteroidal anti-inflammatory drugs (NSAIDs) and some cholesterol-reducing medicines (statins) and may help lower CRP levels.