What Is C Reactive Protein (CRP and hs-CRP)?

by Marcelle Pick, OB/GYN NP

Inflammation is a quickly becoming recognized in conventional medicine as a key component of serious health problems, including heart disease, diabetes, and osteoporosis. Inflammation is the body’s response to infection. Acute inflammation occurs almost immediately after trauma — from a cut or break, to a heart attack. Chronic inflammation is an ongoing process by which tissue breaks down and is repaired over and over, causing scarring or even tissue destruction. Chronic inflammation is common with autoimmune disorders, when the immune system attacks itself.

Detecting inflammation can be tricky, but a marker called C-reactive protein (CRP), is released into the bloodstream by the liver when inflammation is present, and can be revealed in blood tests. Although doctors and scientists are still uncertain about the specifics around when the test should be done or who should have it, most clinicians use CRP tests to monitor acute inflammation or disorders specifically linked to inflammation, such as inflammatory bowel disease or arthritis.

Cardiovascular risk and CRP

Many things can contribute to low-grade inflammation, including stress levels, nutrition, and environmental exposures. The problem occurs when these ongoing factors create inflammation in the body that potentially leads to serious conditions such as cancer and heart disease.

In 2003, the American Heart Association and Centers for Disease Control and Prevention (AHA/CDC) published their recommendations on the clinical use of CRP testing. They established levels of cardiovascular risk by assigning CRP values as follows:

Low risk: less than 1.0 mg/L
Average risk: 1.0-3.0 mg/L
High risk: above 3.0 mg/L

But the AHA/CDC also said that these values are only useful as an independent marker for risk of cardiovascular disease and should not be used as a screening tool or to track treatment. It is my experience as a functional medicine practitioner that CRP is a very important marker, especially for preventative intervention. When I have a patient whose CRP is over 1 mg/L, I recommend lifestyle changes to help manage and reduce inflammation. I also recommend an hs-CRP test, or high-sensitivity CRP. This test in my opinion is critical to help determine more accurate CRP levels.

A recent worldwide study revealed that people with high levels of hs-CRP benefit from the use of a common statin drug that can help reduce the risk of heart attack or stroke. My hope is that this study will encourage all practitioners to test for hs-CRP, but instead of simply writing a prescription for a statin, actually investigate and address the underlying causes of inflammation.

If CRP or hs-CRP is elevated, there are many things that we can do to help temper inflammation and the risk of inflammation-related disease before beginning a lifelong course of prescription medication. The first place I check is the digestive system, the seat of a healthy immune system. Simple changes in diet can improve digestion and change CRP levels for the better. There are also anti-inflammatory spices that can be used in cooking, such as turmeric, ginger, and other Indian spices that may help reduce CRP.

Although this is a fairly new path in conventional medicine, inflammation has always been considered a high priority in my practice. For more information about inflammation and natural approaches for reducing it, see my many articles in our Inflammation section.