Is a 28.3 CRP level really awful?

September 3, 2009 9:46 PM

My blood work came back with a C Reactive Protein level of 28.3 mg/L. Normal range is <6.3. Should I be freaking out as much as I am?

I was having hip pain after starting a new running regimin a few months ago. It got really bad, I saw my primary care doctor and she sent me off to physical therapy and eventually to a orthopedist who specializes in sports medicine and ordered x-rays. Apart from some calcification in my hip and apparent weakness in my affected side, there doesn't seem to anything obviously wrong. She also ordered some bloodwork at the same time which showed borderline high triglycerides, too low HDL cholesterol but total cholesterol is average. But the CRP level is quite elevated (28.3).

Doc is sending me to see a rheumatologist next as she thinks the high CRP level indicates inflammation that could be the explanation for the hip pain but might be indicative of something more.

But of course now I read about elevated CRP levels and how it's associated with cardiovascular risk and that along with my somewhat problematic cholesterol levels has me a little freaked out. I do plan on calling her back to get a better explanation of the CRP thing but does this sound plausible that the CRP levels would just be from a hip injury?

41, female, mostly healthy.

posted by otherwordlyglow to health & fitness (7 comments total)

From what i read here, it looks like your Doc is barking up the right tree.

Don't sweat it unless the rheumatologist rules out an inflammation. Even then, don't sweat it.

IANAD.
posted by Xoebe at 9:59 PM on September 3

Never freak out after one test. Freak out after two or three tests. False positives happen. Assays aren't perfect. Lab techs screw up. Results get switched. Wait for some follow up tests before you get too worried.

Also, stop reading medical sites until you have a diagnosis. They're pure anxiety-porn.
posted by dephlogisticated at 10:19 PM on September 3 [4 favorites has favorites]

It's funny, I just had a round of blood tests the other day. My CRP was a bit elevated but so was my ALT and AST (liver enzymes), so of course, I head right for the interwebs and do a search.

The first pagehit for "liver high ast alt" showed me a list of possible causes. Here's a few:
• Viral hepatitis
• A fatty liver
• Drug/medication-induced liver disease
• Liver tumors
• Heart failure
• Strenuous exercise

As I'm running down the list, my heart is beating faster and faster. I'm sweating, my lips are quivering. I'm starting to panic! It's A TUMAH!
Then I remember 2 things: a) I'm on a medication that's metabolized by the liver and b) I had gone on a 40 mile bike ride the day before the blood test. Strenuous exercise indeed. So, there's an explanation. Plus, my doc and I will chat about this sometime soon, to be sure.

The really funny thing is that i do this EVERY YEAR after my yearly physical.

The lesson here is: step away from the internets, ma'am; your blood pressure will thank you.
posted by Cat Pie Hurts at 10:39 PM on September 3

I have lupus and whenever my CRP comes back high it has coincided with a flare; that is, I had some sort of inflammation/joint pain at the time. A rheumatologist is the logical next step, he or she will check for arthritis and other auto-immune causes for your hip pain. It could easily be nothing, but it's best to be sure. Don't panic or worry in the meantime.
posted by Oriole Adams at 12:55 AM on September 4

CRP, ESR tests correlate with inflammation. They are incredibly, INCREDIBLY non-specific in all but a few conditions. Your CRP will be elevated if you break a bone, it will be elevated if you get the flu, it will be elevated if you have a stroke, it will be elevated if you have a bleeding ulcer.

I can't speculate on why your CRP is elevated (I am not your doctor, you are not my patient, this is just medical education), but it could be absolutely anything, yes, including just your hip.

(The association with heart disease is really more from chronic elevations of CRP, not one time when someone has an acute symptom.)
posted by gramcracker at 5:18 AM on September 4 [2 favorites has favorites]

The big move in big pharma in the past decade or so was to start bundling cardiovascular and inflammation as targets. And every time you turn around, something else has been learned that makes this make sense.

Here's the key phrase from wikipedia: "CRP rises up to 50,000-fold in acute inflammation."

As far as I know, it is not generally believed that inflammation from a joint injury, arthritis or other IL-6 inducing events is a risk factor for a heart attack.

The hip pain that is keeping you benched is your real problem here.
posted by Kid Charlemagne at 7:28 AM on September 4

Rationally, I know I'm freaking out without reason and I know I should stay away from the Google. Appointment is made with rheumatologist and an additional call is in to my primary care doc for further explanation of labs.
posted by otherwordlyglow at 10:19 AM on September 4