Do you have low inflammatory markers even when you ar... - NRAS

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Do you have low inflammatory markers even when you are obviously flaring or suffering active RD?

Brushwork profile image
13 Replies

It is becoming obvious that this is not rare.

If you answered yes to the above: would you share your usual diet with us? E.g. I am vegan... I am interested to know if our diet plays a part in our blood markers (while it doesn't stop the RA).

This is just personal interest... I am not supporting any eating plan/diet or anything else, just plain curious. As many of you know, I have experimented with eating plans and can say they don't work for me. Also I have read that a vegan or vegetarian lifestyle can lead to reduced levels of CRP and I wonder if this is feeding the many claims (artificial - in my view) that diet plays a part in disease activity. While such lifestyles and eating plans may reduce blood inflammation it really does not reduce internal joint and organ inflammation.

Maybe it is time to look at this? Not in terms of a cure, but in terms of the problems associated with blood inflammatory markers being unreliable for diagnosis. A specialist nurse, when I was explaining my problems, told me 'well your bloods are fine' , as if to dismiss my claims of disease activity!

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Brushwork profile image
Brushwork
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13 Replies
helixhelix profile image
helixhelix

Professor Tim Spector (my hero....think he’s brilliant) has done a lot of proper science on nutrition, including the study in link below.

Some of his main points in much of his work is how individual we are in our reactions to nutrition, how we individually process food, but also how incredibly important it is for health. So it is logical that food can influence inflammation and low grade inflammatory conditions. RA though is a deeper condition.

I have a pretty good diet, mainly plants and fish. With small amounts of everything else and no highly processed food at all. I always have low inflammation levels. But I always did....on diagnosis with something like 27 swollen joints my ESR got up to 21 😂 And at that time I was living on ready meals, cigarettes, coffee and doughnuts!

kcl.ac.uk/news/landmark-stu...

I really recommend his books for people interested in food

Brushwork profile image
Brushwork in reply to helixhelix

Really interesting. I will read it. My CRP was 6 and ESR only 12 while an MRI showed widespread and deep inflammation. The Rheumy said she’d expect CRP to be in 30’s with this level of inflammation.

Thank you

Brychni profile image
Brychni in reply to Brushwork

Agree with janmary below - as soon as my Doppler scan result came back proving visual evidence of inflammation in the synovium ( or whatever it's called) rheumatology were no longer interested in blood tests. It's only my GP who hasn't figured out yet that the fortnightly blood tests are to monitor for side effects of mtx who keeps saying 'your inflammation levels are normal'. I finally told him a couple of weeks ago that they always have been.

I think with diet it might be what you don't eat that has a greater effect; avoiding things which have been proven to cause inflammation like sugar which is the biggest culprit. Trouble is it's in everything and people mistakenly think that honey for example might be better somehow but it's even worse than can sugar. Here is an interesting article about how different sugars are processed by the body.

bbcgoodfood.com/howto/guide...

New evidence about vitamin D is also interesting as it is also antinflammatory. I've been taking a high dose for several years now and I can't even remember why - probably migraines and I wonder if it is this that keeps my inflammation levels low?

As I was diagnosed with undifferentiated Inflammatory Arthritis it's difficult to make a judgement as it could be RA, PsA or something else which I can't remember! Anyway PsA as you know doesn't have the same blood markers but does cause inflammation in the synovium and is treated with methotrexate so in my case it doesn't really matter.

From everything I have read though and with every day that goes by I think it is more likely RA.

I've also been going on abut exercise for a long time and even though I find it harder and harder I still make myself do it. Stretches at home and an hour with the dog every day in the woods, a run usually every other day but that's becoming less and less appealing. They say exercise is also powerfully anti inflammatory so I will carry on. For me it feels like a flushing through of the body and I have a feeling it helps with processing side effects of medication.

I'm aware that unless the meds start working soon I probably will not be able to run any more so I am already adapting to doing more aerobic stuff at home.

janmary profile image
janmary

My blood markets are never high, even when in an obvious flare with hot swollen hands , feet. Etc I’m not vegetarian , but would say I have a Mediterranean type food intake- loads of fruit veg fish nuts. Very little meat . Cook everything from scratch . With COVID restrictions the low inflammation markers seem to ‘mean’ more to the rheum staff than physical exam etc than when there were f2f appointments .

Brychni profile image
Brychni

Hi - this was supposed to be a reply to you - sorry about duplicating:

Agree with janmary below - as soon as my Doppler scan result came back proving visual evidence of inflammation in the synovium ( or whatever it's called) rheumatology were no longer interested in blood tests. It's only my GP who hasn't figured out yet that the fortnightly blood tests are to monitor for side effects of mtx who keeps saying 'your inflammation levels are normal'. I finally told him a couple of weeks ago that they always have been.

I think with diet it might be what you don't eat that has a greater effect; avoiding things which have been proven to cause inflammation like sugar which is the biggest culprit. Trouble is it's in everything and people mistakenly think that honey for example might be better somehow but it's even worse than can sugar. Here is an interesting article about how different sugars are processed by the body.

bbcgoodfood.com/howto/guide...

New evidence about vitamin D is also interesting as it is also antinflammatory. I've been taking a high dose for several years now and I can't even remember why - probably migraines and I wonder if it is this that keeps my inflammation levels low?

As I was diagnosed with undifferentiated Inflammatory Arthritis it's difficult to make a judgement as it could be RA, PsA or something else which I can't remember! Anyway PsA as you know doesn't have the same blood markers but does cause inflammation in the synovium and is treated with methotrexate so in my case it doesn't really matter.

From everything I have read though and with every day that goes by I think it is more likely RA.

I've also been going on abut exercise for a long time and even though I find it harder and harder I still make myself do it. Stretches at home and an hour with the dog every day in the woods, a run usually every other day but that's becoming less and less appealing. They say exercise is also powerfully anti inflammatory so I will carry on. For me it feels like a flushing through of the body and I have a feeling it helps with processing side effects of medication.

I'm aware that unless the meds start working soon I probably will not be able to run any more so I am already adapting to doing more aerobic stuff at home.

Brychni profile image
Brychni

healthunlocked.com/api/redi...

JenniferW profile image
JenniferW

Hi BrushworkI have severe RA but with low inflammatory markers, you would barely know I had an autoimmune condition from my blood tests. My rheumy had to take scans and rely on DAS scores to get me funded for biologics.

I agree with you that the current blood tests aren't that helpful, I think they are missing something important in the process. Unless I have misunderstood the blood tests, I don't think they measure things like T cell activity or cytokine levels ( I have no idea if this would be feasible to do).

I just have a normal balanced diet with probably too much sugar and cake.

I do eat quite a nutritious range of food with meat, fish, eggs, fruit, veg and dairy so get most of my vitamins and minerals.

Hope this helps

Jenny

Brushwork profile image
Brushwork in reply to JenniferW

Thank you. It is curious, and we seem to have varied diets, so that doesn’t seem relevant. More questions

bpeal1 profile image
bpeal1

My CRP always hovers around 1. I try to eat a balanced diet but probably eat too much cake and chocolate (especially when I’m feeling tired). Thankfully my rheumatologist always goes on physical examination of joints and how I say I’m feeling rather than blood tests.

Mmrr profile image
Mmrr

I'm seronegative with low inflammatory markers too. I had one spike in CRP around 2 years after diagnosis.My bloods give no indication that I have RA.

Previously fit and healthy I gained 5 stone in weight after becoming unwell, mainly due to an insatiable appetite at that time which has never been explained.

I've now taken that weight off and eat a healthy diet of home made food with lots of vegetables, fruit and a little meat.

Sugar does not bode well with me, giving me almost immediate micro ulcers in my mouth.

Creakywrists profile image
Creakywrists

I also have very low inflammatory markers. Very early on when every joint hurt and I was almost immobile with a consistently raised temperature my ESR hit 80 but at the same time my CRP was only 13. Since then my CRP has remained under 5 and if my ESR goes above 15 I’m struggling !For the best part of a year we’ve had a series of locum GPs and I’m very matter of fact when I tell them that I don’t really show inflammation in my blood results, which they seemed to accept, as has our new permanent GP. I think it’s possibly on my hospital record certainly the rheumy nurses know.

My diet now is healthy omnivore. I have red meat once a week max, mostly white meat or meat substitutes the rest of the time, along with tinned or white fish. I eat my five a day as a minimum, low sugar, very low salt, high vitamin D supplementation (but below the 4000iU a day maximum). Very little processed foods or food substances generally, although I will occasionally chuck a sweetex in a hot drink. In the past, I ate a huge amount of processed food every day, drank loads of pop, and near enough chainsmoked. My RD has been worse than ever since I cleaned up my act 5 years ago, but the highest crp I’ve ever had during a flare is 12. My ESR is always normal, my crp generally below 3.0 even with swollen joints. My working diagnosis is likely PsA, which is notorious for being completely seroneg, including inflammatory markers. When my symptoms began, I was around 14 or 15, very physically fit and sporty, and living in a cook-from-scratch, no junk household. We weren’t even allowed ketchcup unless we went out for a special occasion!! 🙈

ketiv74 profile image
ketiv74

I am sero positive, diagnosed 2 yrs back. I am mostly Vegetarian, occasionally eat chicken & eggs but no other meat. Currently on Mtx 15 mg inj and recently added HCQ. When diagnosed both my Anti CCP, ESR & CRP & RF were moderate -high. But everything was brought under control by Mtx , and since then all markers are in normal range in every blood test (which occurs every 3-4 mths). However I have had mini flares since Aug last year, which were helped by short course of steroids, but because they kept repeating every few weeks, now my Rheumy has added HCQ. None of my blood test showed elevated inflammation markers during last 6 -7 months.I would like mention though, I have noticed that fasting or liquid diet helps bringing down the flare. Unfortunately that can't be long term solution, or may be it is for more disciplined people.

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