TLDR: What you need to know

• CRP (C-reactive protein) is a general indicator of inflammation in your body, and can be measured with a blood test you can ask your doctor for. We also include it in the Ray Wu MD program
• High CRP levels are associated with higher risk of heart disease, stroke, and other inflammatory conditions.
• A high CRP level is not a specific marker for any one condition but is a general signal that inflammation is present in the body. Being sick can also temporarily increase CRP.
• Lifestyle modifications, such as improving nutrition, exercise, and stress management, can lower CRP. -CRP can be a useful marker for monitoring if our lifestyle changes are effective.

Ray's Take

I think monitoring hs-CRP (hs stands for high sensitivity. Same thing as CRP) levels are interesting. The reason I say interesting, is because it is a non-specific measure of inflammation in your body.

Research dating back to the 2000s (linked below) has shown that high CRP increases your relative risk for heart attack and stroke. However, its also been shown through genetic studies that high CRP itself is not likely to be causal for heart disease. This means that CRP itself isn't the culprit. Rather, something else is going on, that is causing CRP to increase, which also increases your risk for disease.

So why test CRP? It's a simple test we can get with other metrics, and if your levels high, there are things we can do to try to decrease it. CRP can be decreased with nutrition, exercise, and other lifestyle factors such as managing stress.

What to do if you have a high CRP level

While high CRP may mean something related to cardiovascular disease, there are two more common causes.

First - you were sick or extremely stressed when you took the test. This can cause temporarily high levels. The only action item here is to wait until you are not sick, and then retest.

Second - you might have a reaction to a type of food you are eating, with the two most common cultprits being dairy and wheat. We recommend eliminating dairy or wheat for 2 months, and then retesting.

Besides the above, having a solid nutrition plan beyond just eliminating dairy/wheat is helpful, as is exercise and getting good sleep.

If everything has been tried, then we recommend adding some additional tests including fibrinogen, another non-specific marker for inflammation which is related to clotting.

Cool Knowledge for Normal People

This image from an article in "Hypertension" shows how CRP is produced by the liver and adipocytes (fat cells) in response to inflammation.

The presence of CRP in your blood indicates that your body is in a state of inflammation, which can be due to various reasons ranging from infections to chronic diseases.

While it seems that CRP itself doesn't cause diseases, high levels are often found in patients with conditions that involve inflammation, such as heart disease and autoimmune disorder and higher CRP levels predict heart attack/myocardial infarction (MI), stroke, peripheral arterial disease, sudden cardiac death, and all-cause mortality in healthy individuals with no history of cardiovascular disease.

Elevated CRP levels may not pinpoint the exact cause of inflammation but serve as a crucial indicator that something in the body needs attention.

Understanding your CRP levels can be a significant first step in taking charge of your health and preventing potential health issues related to chronic inflammation.

Optional Info for Nerding Out

From the New England Journal of Medicine:
C-Reactive Protein and the Prediction of Cardiovascular Events Among Those at Intermediate Risk
This study discusses the role of CRP in predicting cardiovascular events, providing insights into its value as a biomarker in clinical settings.

From the British Medical Journal (BMJ):
Association Between C Reactive Protein and Coronary Heart Disease: Mendelian Randomization Analysis
This research explores the genetic associations between CRP levels and coronary heart disease. It concludes that CRP is not causal for coronary artery disease

From Circulation:

Adjusted relative risks of future myocardial infarction associated with increasing quintiles of HSCRP (hs-CRP) among apparently healthy middle-aged men (left) and women (right). Risk estimates are adjusted for age, smoking status, body mass index (kg/m2), diabetes, history of hyperlipidemia, history of hypertension, exercise level, and family history of coronary disease.
High-Sensitivity C-Reactive Protein: Potential Adjunct for Global Risk Assessment in the Primary Prevention of Cardiovascular Disease