CRP levels - what is "normal"?

[Mifford]

My latest blood tests came back with my CRP as "acceptable" at a level of 9. I can't remember what my own normal CRP level is but I'm pretty sure this is high for me and would indicate I'm flaring which ties in with how I feel at the moment.

It it did get me wondering what is viewed as a normal CRP level and at what point would it indicate a flare? I know everyone is different and this isn't for any treatment purpose and is just for my own interest but does anyone know what their own levels are like and what they would be when they are in a flare?

[PMRpro]

It depends on the lab to some extent and the units are also important - there can be factor of 10 difference which could mean if it is 1-10, then 9 is OK but if it is 0-1 9 certainly isn't OK!

Mine has never really budged, nor has my ESR. But what is more important is the lowest you get to with medication and feeling well - and then if it rises it suggests there is something going on. Yes there is a "normal range" but that is the normal range that 95% of the healthy population fall into. Your normal level may lie at the very bottom and your next door neighbour's at the very top - but if you had the same reading as him it wouldn't be your normal.

[Mifford in reply to PMRpro]

I've not looked at the test results to see what the ranges are for here but if 9 is "acceptable" I'm guessing over 10 is abnormal as my gps seem to put "acceptable" when the reading is borderline. I think for me it means I'm flaring and as I'm on methotrexate injections the rheumy nurses are monitoring my bloods so it'll be picked up if they aren't happy with it.

Interestingly when I saw the nurse for lessons on the injections she showed me all my readings on a graph on the computer. I get told my CRP and esr are always normal and there's no sign of inflammation which has always confused me when I've felt so awful. She showed me that every time I've felt bad and been begging for a steroid injection you can see my readings are high for me and it was such a relief to know I wasn't imagining it. Why the specialists can't read the info in the same way and on an individual basis I have no idea!

[PMRpro in reply to Mifford]

A few do - but it isn't something a lot of younger doctors understand, they don't know how normal ranges are established; you take readings from thousands of healthy people and plot a graph. You get the iconic "bell-shaped curve" and the normal range is what covers 95% of the population. That leaves the little triangles at each end - which are ALSO normal for the people they took them from. With a chronic illness you really do need to know what is YOUR normal. If your normal is 1 then 9 is mega raised. But how many of us had anything measured before we were ill? So you need to know what level leaves you feeling well and what level makes you ill. It really isn't rocket science - but it seems to be for some!

[Sara_A in reply to Mifford]

Oh also my crp has only ever been mildly raised even tho I have felt terrible. My rheumatologist said that u can have a normal crp with lupus as doesn't always cause inflammation. I think it's the esr that may be raised. I tend not to bother having my crp checked now when I feel bad as never shows much and rheumatologist said not to bother with it.

This is same with X-Ray's, I have awful pain in my thumbs and elbow but X-Ray's were fine he says again that's the lupus, and just cos u can't see anything on X-ray doesn't mean there is nothing wrong.

[Mifford in reply to Sara_A]

Mine's being done as part of my methotrexate checks - the day after they told me it was "acceptable" I flared with hands and feet swollen, tendons hurting everywhere, migraine I can't shift and sooooo tired but can't sleep. Had a horrible nightmare last night too which seems to happen when I'm flaring too. It's felt like it's been coming for a few weeks so at least my blood tests finally seem to be matching how I feel which makes a change

[Sara_A]

A normal crp is less than 5

[misty14]

Hi mifford

Lupus has a particular quirk that CRP is always normal despite inflammation. It's to do with the liver. If it's greatly raised then it means we have an infection. A normal CRP is less than 8 hence the note you got for your reading. Hope the Metho injections help you. X

[Mifford in reply to misty14]

Ahhh ok ... I replied above before I saw this so maybe my bloods still aren't in line with my symptoms then lol. Do feel like I've been fighting a cold off for a while so I'm guessing that'll be why then

[PMRpro in reply to Mifford]

Lupus.org says

"... However, for reasons that are not clear, CRP levels in individuals with lupus are only modestly elevated. "

So there can be SOME increase - but if it is HIGH then it suggests infection. If you have a slightly elevated CRP that correlates with YOU having a flare - it could well be a useful item.

[Mifford in reply to PMRpro]

Thank you - when it comes to thyroid stuff I could go on mastermind but lupus I'm learning all the time.

[PMRpro in reply to Mifford]

You do lupus - I'll do polymyalgia rheumatica.

Who else wants to join in? It would raised awareness alright!

[misty14 in reply to PMRpro]

Good way for us to meet each other too PMpro. X

[Mifford]

The gp gave me a copy of the results yesterday so I know what should be tested each time as the last blood tests forgot to retest my alt level after it had been raised on the previous test.

Anyway the reference range for this area is <5 and at least now I have a comparison point on my results. My tsh is back down to 0.6 thankfully - it had jumped to 2.6 which for me is well out of range so no idea what caused that blip but the increased thyroxine has fixed it so those symptoms are improving. Everything else is pretty much dead bang middle of the range - I know the nurse said they want to get my white cell count down with the methotrexate so if I get copies of my results going forward I can now compare them which helps me keep an eye on what's going on at least.

Oh except my only other one is a basophil count of 0 which make sure it bottom of the scale but no idea what that one means and I've not worried about looking it up yet as for some reason I'm assuming not having basophils sounds like a good thing but only because it's making me think basolisk from the Harry Potter films lolololol

[PMRpro in reply to Mifford]

"no idea what caused that blip but the increased thyroxine has fixed it " - the tsh was raised because you weren't on a high enough dose. tsh is thyroid stimulating hormone, when the body knows it hasn't got enough thyroxine available to it tries to stimulate more. Your body has registered the higher dose and so has stopped asking for more.

[Mifford in reply to PMRpro]

Sorry I didn't explain that right - I've been on a settled dose for about 3 years now after taking a long time to get it right and I stay in my target zone of between 0.2 and 0.8 but for some reason it went up to 2.6 and it's not been that high for well over 5 years now. It was more me wondering what has caused my body to reduce my thyroid function out of the blue to cause it. My guess would be that my body has attacked my thyroid again and hopefully it's a one off not to be repeated for another 5 years

[PMRpro in reply to Mifford]

That's probably about right - the disease activity does tend to vary over time. Sorry - I just read it literally...

[Mifford]

Actually I might have that the wrong way round and they want my white blood cell count to come up - I can't remember now. It must be one of "those" days as I just spent ages trying to wash the weird blue stuff off the tips of my fingers. It eventually came off under the hot tap and then realised it's not blue dye it's because my hands were cold 🙈🙈🙈

[Mifford]

Good news is that my CRP is down to 6 this week and my ALT level is also doing better than it was. My WBC is down from where it was 2 weeks ago but overall I'm guessing that the methotrexate injections are starting to kick in. Fingers crossed the results all keep heading in the right direction