ESR and CRP

[Maur1]

Has anyone experienced a rise in CRP and ESR due to stress? Mine have both risen within the past 3 weeks and I am wondering if it was due to anxiety.

[DorsetLady PMRGCAuk volunteer]

Yes,

Both of mine were raised during a period when I was very stressed over my late husband health, and his numerous visits as an hospital inpatient.

No GCA symptoms presented themself at any time....so I knew (in hindsight) it was purely stress related!

Just have them monitored regularly, and if you have no return of symptoms, then you probably can assume it stress. However, it might be worth increasing your medication a little to get you through the stress....not something I would normally recommend, but it’s maybe worth discussing with doctor.

Mine went into a bit of a panic and increased mine although I felt fine, but with my history it was understandable, if unnecessary!

[Maur1 in reply to DorsetLady]

Thank you very much for your advice. Fortunately I have an appointment with Rheumatologist tomorrow and I hope he does not want to increase the Prednisolone. I wonder if a mild tranquilliser for. Few weeks would help.

[DorsetLady PMRGCAuk volunteer in reply to Maur1]

Is the stress likely to be resolved shortly, or is it a long term thing?

Please let us know outcome of appointment.

[Maur1 in reply to DorsetLady]

Hello Dorset Lady, I have not replied to you sooner as I was feeling low. I did not pursue a tranquiliser. My ESR and CRP increased further and Rheumatologist upped Prednisolone to 15mg which I am still on. I can't believe I was down to 2mg last September then got a chest infection and flare up and back up to 20mg then down to 8mg by March now up again. Rheumatologist wants me to take Methotrexate which I am reluctant to do after reading about side effects and having had enough side effects from Prednisolone and other medications since developing GCA.

[DorsetLady PMRGCAuk volunteer in reply to Maur1]

Hi

How are things at 15mg? Settled I hope.

Like you I would be reluctant to add another drug. Can you suggest to Rheumy that you continue with Pred alone....and maybe a slower taper. Don’t let him/her rush you, your body’s had enough to-ing and fro-ing - it now needs to settle down a bit.

[Maur1 in reply to DorsetLady]

Thanks for reply. My ESR and CRP are now within the normal range at 15mg although at the higher end. I still get toothache which has been one of my symptoms throughout. Been checked by dentist and teeth ok.

[DorsetLady PMRGCAuk volunteer in reply to Maur1]

That sounds about normal for bloods, but might be wise to monitor every month or so just to make sure they don’t rise....but as we always say symptoms are the key. Keep a log of teeth problems and see if it’s worse at any particular time - could well be stress.

Take care

[Maur1 in reply to DorsetLady]

Thank you. I'm having blood tests every 2 weeks to keep tabs on levels.

[Sandy1947 in reply to DorsetLady]

What are normal ESR and CRP levels?

[DorsetLady PMRGCAuk volunteer in reply to Sandy1947]

Hi Sandy,

Theses are a couple of articles I found on web -

Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease.

When your blood is placed in a tall, thin tube, red blood cells (erythrocytes) gradually settle to the bottom. Inflammation can cause the cells to clump. Because these clumps are denser than individual cells, they settle to the bottom more quickly.

The sed rate test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of your immune system.

Averages (based on 1996 study)

Age 20. Men 12, Women 18

Age 50. Men 14, Women 21

Age 90. Men 19, Women 23

Another study shows slightly difference values -

Age under 50. Men 0-15, Women 0-20

Age over 50. Men 0-20, Women 0-30

***********

CRP Reference Range

Adult: less than 8 mg/L

Up to 1 month: less than 6 mg/L

Most patients (90%) without organic disease have CRP levels less than 3mg/L and 99% have levels less than 10mg/L. Neonates are unable to induce CRP synthesis to the same extent and the neonatal reference range is lower.

Slightly higher CRP levels may be found in pregnancy, but any increase is usually within the reference range quoted.

The problem is, as individuals, we don't usually know what our normal is as it's not a test that is done when you don't have anything wrong. Some people's are a lot lower normally than the averages stated.

[Sandy1947 in reply to DorsetLady]

Thanks for all the details

[PMRpro Ambassador in reply to Sandy1947]

Just to add - the figures they quote are for the "normal range" found all across a very large population, tens of thousands. If you were to plot all the values on a graph you would get the famous bell-shaped curve so loved by statisticians. A small no of people have a low figure, a small number have a result at the high end of the range. And most people are somewhere in the middle.

That doesn't mean that because your reading is 18 it is normal for you - if your personal normal is 4 it is pretty raised. I have a normal of 4 - but while in hospital 6 years ago it bumbled along at 18 for several weeks. No-one turned a hair as it was still "within normal range" - but it very definitely isn't for me.

[SheffieldJane]

I think stress has a profound effect on inflammatory levels. If you are not experiencing a return of pain and stiffness though I should ask to stay at your present dose. In my view it would be more beneficial to do something more long lasting for the stress you are suffering, particularly if the situation cannot currently be resolved. I am thinking of things like yoga, mindfulness and perhaps some form of talking therapy. That way you are giving yourself a gift for life. A sedative is just going to numb things for a bit and not solve the situation, they bring problems of their own. My late husband’s mother got stuck on Valium for 10 years and she had real regrets about that.