Serum c reactive protein level query

[Red1973]

Had copy May blood test results .Serum c reactive protein level 11 mg/L ( range 0.00-7.00 mg/L)

Marked with ! but no contact yet from Dr to discuss .

Is this level normally acceptable

I wondered if the level was appropriate for someone who has arthritis and stenosis ( I also thought I had all signs of psoriatic arthritis last summer but dr said no and subsequent visit to rheumatologist last September was told test negative for RA.)

[MikeG1944]

I'd ring up the doc and ask them, however there's a lot if you Google it on the NHS and Patient sites, and 11 is not excessively high, and can be caused by any inflammatory condition, and also by stress on the day. An answer from the doc will put your mind at rest.

[Batty1]

I have very high C-reactive and ESR and I do have PSA .... FYI no blood test to determine PSA and most RA blood test are negative for those with it.

I been reading up on these 2 inflammation markers and it actually seems like a lot of things can cause them both to become elevated Arthritis is one but so can heart disease and stress.

What types of symptoms are you having!

[Red1973 in reply to Batty1]

Hi Batty1

First - thanks for your message -apologies for taking so long to reply- I had prepared responses in two occasions but lost them both after typing.

Problems started late 2018 - developed limp left leg and then had shooting pains mainly left leg but occasionally right and thought I had trapped nerve - even had pains at night whilst in bed. Left knee sore - then about 18 mtgs ago knee went stiff if sat for short period and found it more painful to walk with left leg. Also felt like I pulled muscle lower / mid back and very sore with movement- needed cane to walk at times.Saw Dr who gave me 100 codeine tablets and said I was too young ( mid 60’s ) for knee replacement.

Problems went on for months - left knee getting worse and back occasionally sore -felt really weird - tiredness etc-had several more visits to drs last summer with no progress until got referred to another more specialist local dr ( not consultant) who said my pain not severe enough to warrant knee op and I was too young but would do x ray “ just to check”.X ray came back showing severe osteoarthritis in left knee and weeks later ( Aug ) I was referred by local dr. to consultant- eventually seen Nov to be told I needed knee replacement- op scheduled Mar this year - cancelled week before because I covid,

Began to have similar problems right knee last summer - dr said it was because compensating for left.Had x ray for that Feb this year - moderate osteoarthritis.

Since Feb have lost lot of muscle around both knees.

Had back x ray last summer - showed some spondylitis . However was scheduled for new one in March - cancelled on day because of covid- eventually got it done May to be told I have stenosis in neck ands back - consultant wanted further scan which I had mid July - still awaiting consultant to come back although he had been on hols

Had some weird symptoms last few months.

Toenail problems last Nov/ Dec

Continually feeling tight around chest and ribs - had chest x ray may which was clear although I still feel tight and breathless for no apparent reason. Had appointment at chest pain clinic who think I have acid reflux.

Have had irregular bowels - had colonoscopy May 2019 show some diverticulosis.

Couple of months ago had subjuuctial haemorage ? right eye - took three weeks to clear - at same time had ear problem and blocked nose - thought it was blocked sinuses as also gaping for breathe at times but saw ent last week - who said he thought I had heartburn.He asked me what tablets I was taking when I said naproxen ( which I had been taking for over 18 mths since dr gave thenm for knee ) and back) he said they would give me heartburn.

Symptoms have gradually got worse/ more progressive- dr says bloods all ok but it had got to stage now where even last two weeks mobility has got worse and I smniw getting regular muscle spasms in neck and back and exercising becoming harder and harder.

Sorry forgot to mention that over last few months ability to walk has diminished. At start of covid I was going on walks for over half hour ( one mile etc)but began to experience pain towards end of walk / like foot drag and calves ankles began to stiffen.

Over weeks this stiffness began to come on earlier in walk and walks became shorter/ now even short walk or just walking in house can bring this on. Have read up and feels like footdrop - some times can lift foot up and then others I can’t .

As you can see various symptoms- when I queried some with local dr ( there are several drs in surgery ) I get told don’t look at Dr Google- I sure he thinks it all in my mind -,I know it isn’t ( I was relatively problem free until 2018)

Even my family tell me it’s just arthritis- everybody gets it - man up and carry on and do more exercise and walk more.

I seem to get tired so easily / not doing much and struggling to do a fraction of what I used to be able to . I was working full time until last year and part time until earlier this year- used to be up

6am every day full of energy. Now tire very easily.

Sorry to go on solongin response to you but it is difficult to explain all various symptoms ( I have probably missed some out!!) but even now having been awake short time my neck arms shoulders back very stiff and feel like in spasm.

Thanks again for your comment and sorry for delay in reply.

[Red1973 in reply to Batty1]

Hi Batty1

Sorry forgot to mention I have psoriasis flare ups also - tend to get it behind ears and lower back and groin areas although have recently had it on forehead and eye brows and did have it on hand last summer.

Saw dermatologist last Oct as I also had what I thought was psoriasis on arm last summer - arm was flaky and would not heal properly. Biopsy was taken and was found to be a basal cell carcinoma- had op to remove in Feb this year and everything seems to be ok with it since.

Thanks

[Batty1 in reply to Red1973]

Poor guy you have been through the wringer and sadly it sounds very familiar to me.

Have you ever had a thyroid and vitamin panel done? if not I highly suggest having them done. Thyroid test: TSH,FT3,FT4, T3 and antibodies and for Vitamins: Iron panel, B12 , D3 , folate and other Im sure I'm missing some.

It’s possible you could have psoriatic arthritis(PSA), which presents very similar to what you described. Their is no real test that can diagnose it you need a Rheumy that specializes in PSA that understands the disease or have good rapport with your current Rheumy to talk to him/her about PSA and is willing to consider it.

Anyone having Psoriasis can get psoriatic arthritis and it’s a debilitating disease.

[Red1973 in reply to Batty1]

Thanks for response.

After several requests eventually saw Rheumatologist last Sep after scan over two months earlier. He said my problems were musco skeletal and said bloods did not show Rheumatoid Arthritis and marked me forward for review three months (early Dec)When I had not been contacted by Christmas I contacted his dept was told they had long waiting list for review. End of Jan had letter ( which had been dictated late Dec )referring me back to dr / musco skeletal team as I had spondylitis as per scan.I did not even have face to face ( or even phone ) review in Dec.

Had last blood test at Drs May 2020

B12 / folate normal no action

Serum vitamin B12 336 ng/l ( range 145-910)

Serum folate 13.6 ug/l ( range 3-,20)

Serum ferritin 110 ug/l ( range 15- 200)

Thyroid function test - normal no action TFT results in euthyroid range

Serum free T4 level 14 pro/l ( range 7- 17)

Serum TSH level 1.11 mu/l (range 0.20- 4.50 )

I also had private ( finger prick at home and send blood off ) test a month ago for Active B12 and Thyroid which came back normal

( unfortunately I had used a handful on of Vitamin B12 tablets over couple of months before private test so it may have had slight impact on Active B12 result.

Going back to earlier I don’t have a Rheumatologist now and when seeing the one last September told him about my psoriasis and showed him

he dismissed me as not having it.

Thanks

[Batty1 in reply to Red1973]

Read this list of symptoms and see if you can pick out your xray diagnosis.

The complexity of life with psoriatic arthritis

There are five types of psoriatic arthritis.

1 That means that even those with no other diagnosis will experience varying symptoms and pain. And if that wasn’t confusing enough, each person may have multiple forms of psoriatic arthritis. Personally, I have three.

The five types are:

Asymmetric typically affects one side of the body and includes swelling and discomfort in the toes, fingers, hips, and knees.

Symmetric is similar to Asymmetric with the exception that it affects both sides.

Spondylitis is caused by inflammation between the vertebrae and causes pain and swelling in the back and neck along with hips, feet, and hands.

Distal affects the tips of fingers and toes and is often confused with osteoarthritis.

Arthritis mutilans causes damage to the ends of hands and feet. It may also shorten the length of a person’s toes and fingers because of bone loss.

Being dismissed by your Rheumy this could have a devastating effect kn your health.... you need a new Rheumy.