Blood Test Results.

[benjijen]

Hi there. Although I was diagnosed some 3 years or so ago I still don't understand the blood test results. Can anyone enlighten me on the main ones and what the results mean. I would really like to be able to judge if my inflammation is under control or not.

[Smiler53]

You need to look at ESR results for your inflammation level. Mine started around 55 and fluctuated for some time over the years while different meds were added. Last months blood test I was 17 which is brilliant, though it's taken quite a few years to get there. When I was first diagnosed, they told me that they would like to get it to 25, hope this helps.

[Hidden]

Hi benjijen,

I have put a link below to our article on the website about blood tests:

nras.org.uk/laboratory-test...

I hope this helps you

Best wishes

Beverley (NRAS Helpline)

[nomoreheels]

Do you mean the values benjijen? I hold my own drug monitoring record book for MTX & all the explanations of what the terms mean & their values are at the back of the book. If you have one maybe you'll find it in yours too? If not message me & I'll copy them.

[benjijen]

Thanks for you responses. I think what I need to know is what is classed as 'normal' for CRP and ESR results. I'm ok on the liver and kidney functions as I was having those tests before all this flared up. When I was on mtx a few years ago I did have a book but when I had to come off of it (after a few months!) I shredded it!

[nomoreheels in reply to benjijen]

All I can give you is what my hospitals labs use, do bear in mind yours may use a different test.

ESR normal values 1 - 7 mm/hr

CRP normal values < 6 mg/L

Hope this helps you.

[Cornishrex]

I'm no expert, but as I understand it, values under 20 are normal for esr and values under 3 are normal for crp. Those values change slightly depending on which laboratory is testing as they all have slightly different reference ranges.

I think that's just for ra purposes though. From my research, if you are looking at esr and crp for the purposes of assessing heart attack risk, you want to be below 1 for crp and optimally aiming for under 0.55 for men / 1 for women.

Personally, I've been on MTX for 6 weeks now, with "possible very early ra" picked up "within the window of opportunity". But my esr and crp scores were pretty low from the outset. Crp was 2.66 pre treatment. Esr 8. Since going on the MTX ive had my blood tested every 2 weeks, and the crp has been 0.4 / 0.6 / 0.4 since then, with esr remaining unchanged. Others on this website though have much higher readings. And a number here say that they don't believe that the crp / esr readings are indicative of the level of pain and inflammation you are really experiencing.

There is also debate over which of the two tests is more important than the other when assessing levels of inflammation. Most seem to say crp as its more sensitive and reacts more quickly to changing inflammation levels.

It's all pretty confusing. Honestly, I may be in denial as I'm not even convinced I've got it. I seem to have been convicted on the basis of a positive anti ccp / rf test rather than the level of inflammation shown in the crp / esr. I don't think my crp could get much lower though.

[Cornishrex]

Normal for crp might be 10 rather than 3. Maybe someone can correct me if I'm wrong on that number?

[nomoreheels in reply to Cornishrex]

Lower than 6 my lab tests Cornishrex, but as you say different labs .....

[farm123]

Reference range for CRP on my lab results is <4. Farm

[Cornishrex]

This isn't specific to ra but you might find the attached page which talks about crp levels interesting. It at least gives you an idea of optimal crp levels generally in life.

lef.org/Magazine/2006/5/rep...

[Hidden]

As the others said, "Normal" is different for every lab, the range should be on your results and if not, its possible to sometimes look up the lab on the net and see if they have an online site that tells you. Ive worked in several different labs where CRP has been <1 or <5, <6 and <8 so its important you know what your labs norm is.

The rest of my reply is a personal opinion and from experience only so u have to do your own researching but be careful of information that isnt from a highly regarded medical origin such as a hospital, accredited laboratory or an association such as NRAS etc as sometimes they get things wrong. Some of the other sites can be informative too but its probably best to check several more reputable sources as well.

I know its confusing but the testing for C-Reactive Protein thats released in the liver with our type of inflammation is called a CRP test - the more specific one to test for cardiac risk and stoke is called HsCRP and that stands for High sensitivity C-Reactive Protein which is obviously still based on c-reactive protein but in a slightly different way and shouldn't be confused with a plain CRP.

ESR is also an inflammatory marker but is less reliable and has low rises with things like a cold or minor infection. The reason most docs use it is that its cheaper but more and more they are using CRP or both. Mid range rises are more consistent with inflammation and very high (CRP >100 and ESR >80) are usually major infections.

[benjijen]

Thanks to all of you for your responses. The fact that labs are different from each other must cause confusion! My next test is now in January so I will be looking at it carefully now I've had to stop Humira. I'm feeling much worse and want to be 'armed' when I have my next hospital appointment in February.

[nomoreheels in reply to benjijen]

Sorry to hear that you're feeling worse having had to stop Humira benjijen. I'd ask if they'll give you the normal levels for each test when you they're taken next month then you're sure you'll read yours correctly. I can't compare mine I have taken here from those I had taken for the first 5 years of RD as they used completely different testing methods, far more comprehensive & my Consultant always went through the ones the lab asterisked (outside normal levels). I found it far better as we discussed the likely reasons why & the need for a change in meds or doses. Let us know now your February appointment goes.