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Crp and esr question

Hiya, looking for some advice really. About 3 years ago I was diagnosed with fibro, but over the last year my pain levels has increased to ab unbearable level, recent blood tests showed esr level at 89 and crp at 59. Issues with blood count and liver.  Obviously that's come at quite a shock to my doc and the tests are being repeated atm I saw a rheumatologist who said as I was showing no signs in inflammation when I saw him he will not diagnose me with ra. Is there anything else that could cause those results and be making me feel so poorly and in pain?

5 Replies

Unfortunately there are lots of things that can caused raised ESR and CRP.  They are a general measure of inflammation in your body, and aren't specific to inflammation caused by RA.  So you could have an infection, or another underlying disease rather than RA.  

Was your appointment with a rheumatologist recent?  If not then perhaps ask if you can be referred again.  But main thing is to keep on at your doctor to get to the bottom of it.  Hope you get answers soon.

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Have you had your vitamin d levels checked? 

I was diagnosed with RA last year and had no raised esr or crp or RF! 

It was all on an anti ccp. I had two wonderful months off the drugs and felt like I had my life back. After a weekend away I got a flare up and two weeks on its still going. Had a routine with my doc and it turned out that a vitamin d test I did over two months ago came back incredibly low, yet no one let me know!!! . I'm now on 10,000 units of vit d every day for 10 weeks. There is meant to be a connection with d deficiency and bone, muscle, joint pain, fatigue and depression. I'm hoping its all connected. However it takes a few months to get your levels back to normal, so I have a bit of a wait.  Worth checking possibly for you? 


Everything you have said above about your symptoms I had. I felt ill for such a long time, raised inflammation markers etc etc. By luck and the help of a very discerning Rheumatology nurse my bloods were tested which revealed low vitamin d levels. I have now finished the high loading dose of Vitamin D and am now on a maintenance dose - (about a year in now). I am feeling the best I have felt in years and believe that this went undiagnosed for a long time. My inflammation markers have come right down and I have so much more energy. I hope it does the same for you and that you will be feeling much better very soon. Best of luck - Pat


I think I'd want to know that spondyloarthritis had also been ruled out - particularly as many of the painful areas where enthesitis occurs (inflammation where tendon meets bone) overlap with the so-called fibro tender points. It it possible that your previous diagnosis of fibromyalgia (if based on tender points) was mistaking enthesitis inflammation for fibro tenderness - not all rheumatologists are particularly good at differentiating, and not all understand spondyloarthritis well - particularly when it happens in woman (as there is still a bit of a false belief that spondy is a mens disease, when in reality even though it is a bit more common in men, it is still fairly prevalent in women as well). You may want to have a chat with your GP about whether it would be useful to be referred to a different rheumatologist who has a special interest in spondyloarthritis, or to a spondyloarthritis clinic, instead of to a general rheumatologist. If you have any kind of back pain associated with your joint pain, then definitely push for a spondyloarthritis assessment.


Thanks for your replies. I think I was k ly diagnosed with fibromyalgia because there was no other explanation for the pain. I didn't have any tender points my pain has always be in my joints, knees shoulders etc. I had the results of the repeat tests today which show inflammation has increased

Esr- 90


Positive rheumatoid factor

Platelets are in the 700

Folate was low so she has done me a script for folic acid

Liver albumin was low globulin was high.

Im waiting for rheumatologist to get back to me as at the moment I'm only taking painkillers and narrower but I'm feeling so so poorly atm and I just want an answer and feel better :(


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