C-Reative Protein test

I tried looking this topic up on the board but there were over 1,000 posts so forgive me if I ask this again. Does anyone know if your C-reative protein count goes up or down depending on disease activity? I know that for Lupus this test means nothing as far as disease activity but I was wondering what is the general thought on it for Sclero.
Thank you
Anoush

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I thought if it was elevated it indicated inflammation somewhere in the body...such as in the arteries of your heart? Sorry I can't be more specific than this....this is all I remember from a previous doctor visit.

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Thank you jjrtuffy, That is about the only thing I know about it. The higher it is the greater your chance of some cardiac event in the future. They use it also for people who they suspect have had a heart attack. My other doctors used to run an ESR to check for inflammation at times it was near normal and other times really high. But my Rhuem and Primary have been using the C-Reactive test instead.
Anoush

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Hi, Anoush,

For years my CRP and sed rate were running 2 to 3 times the normal maximum. Then I started taking 6 capsules of fish oil daily, and a small dose of alpha lipoic acid for a few months and many (most) of the telangiectasias I had developed on my face and body disappeared. The CRP went down some also. So after a few months, I reduced the fish oil to 4 capsules daily, and my neurologist had me increase the alpha lipoic acid to 600 mg daily. But I've noticed that if I run out of them the telangiectasias on my face re-appear. It's like the blood vessels become inflamed again. And I know that CRP and sed rate have to do with inflammation. Last spring, I realized that my blood tests indicated that the fish oil was helping raise my good LDL but also raising my unhealthy HDL and cholesterol. So I decided to switch to a purified omega 3 that was 70% omega 3. Fish oil is usually only about 35% Omega 3. That way I'd be getting less total bad oils (including Omega 6 which can increase inflammation) in the capsule. After being on that for a few months, I had my lipids retested. Lo and behold, by CRP and sed rate were down into the normal range for the first time in at least 7 years!

70% or higher Omega3 is very hard to find, but it's out there. Now I've even found one that is 90% Omega 3. You have to read the ingredient labels carefully to determine the actual percentage of Omega 3, because the front labels can be very misleading.

Scleroderma does not tend to have as MUCH inflammation as some of the other autoimmune diseases, but nevertheless some of the research I have read does indicate that in the areas where collagen deposits the actual deposition is preceded by signs of inflammation, which may activate the cascade of events. So I suspect that keeping the inflammation down might be one of the ways the disease might be slowed. In my case the disease is moving ever so slowly with still no skin hardening, so maybe I'm doing something right. I hope so.

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What brand and dose of omega are you using.

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Also what brand of alpha lipoic acid- brand?

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Sorry Anoush, I don't know much about CRP. I have seen it on my blood requistion forms so I know it's something rheumatologists check for commonly. I've also seen ESR/sed rate.

This discussion is interesting. I have actually read and been told different things about inflammation in scleroderma. My first rheumatologist told me that inflammation preceded fibrosis and therefore they were always monitoring for inflammation. If the sed rate was very high, then it would be a cue to start prescribing steroids and hopefully slow down or prevent fibrosis. This made sense to me at the time, but now I've also heard that scleroderma generally has very low levels of inflammation, or potentially not an elevated sed rate at all.

I told my new rheumatologist what the old one (who retired) had said about monitoring me for inflammation and she said that she saw no need because she wasn't expecting to find any inflammation. She said that treatment decisions would be made based on symptoms and evidence of organ involvement, not blood work.

As well, there are many people who eat an anti-inflammatory diet, taking anti-inflammatory supplements (curcumin, for example), fish oil, etc. in an attempt to reduce it as much as possible and therefore slow progression of the disease. Presumably this would not be so widespread if it wasn't helpful, at least for some people.

I wonder if there's a difference between limited and diffuse scleroderma as regards inflammation.

I know I sometimes FEEL that I am inflamed with sore muscles, painful joints, a bit of swelling, burning sensations, etc. However all of those things could be attributable to other processes too. I've had my ESR checked several times and it's always been normal despite symptoms.

I know many of you do have inflammation and respond well to things like dietary changes or Prednisone use. Just curious how this fits into the theory of what the disease is. The other connective tissue diseases (lupus, RA, etc.) clearly have inflammation as a major symptom/feature. But I thought that scleroderma was a bit different.

Zoe

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Sorry It's taken me a bit to reply to all of your great replies but I have the virus from hell LOL. This is interesting Zoe. I have had a high sed rate when I am actually feeling well and a elevated C-reactive when I have been sick and not sick and even low readings on both. That is an interesting train of thought though about fibrosis and inflammation, I am convinced Daisy that Omega 3's helped my kidney function improve, although can't say I have noticed any change in my spots with it. My c-reactive protein which my primary ran for what reason I have no idea since I told him I was actually feeling pretty good that day, he was concerned about me saying my Raynauds was acting up. Of course it is it's freezing outside! Anyway it was low, not normal just lower than before but hey that's good news he said I probably will never have a heart attack never mind the grade II diastolic dysfunction or the 2 differant types of arrhythmias I have LOL. Interesting my Alkaline Phosphate was a little high but my liver function tests were okay. I swear sometimes I feel like I am going coo-coo from all this. I try not to pay to much attention to blood work either. I go more on how I feel and can generally tell if something is not right. I don't mean to sound sarcastic towards my doctor I think he is wonderful but sometimes I think they tend to get off track or perhaps not really listen. I don't know but it would be interesting to see if anyone else has had a flucuating c-reactive protein test and if it corresponded with how they were feeling.
Anoush

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Chosen: I take GNC's 600mg alpha lipoic acid (their brand).

It was also at GNC that I found the Nordic Natural's Ultimate Omega which is 70%, but unfortunately extremely expensive. So recently I found out that GNC has GNC "Triple Strength Fish Oil" which claims to have 900 mg total omega 3 in a single enteric coated tablet.

Each capsule is listed to contain:
EPA (eicosapentaenoic Acid) (Omega 3) 647 mg
DHA (Docosahexaenoic Acid (Omega 3) 253 mg

So thats a total of 900 mg of Omega 3. The capsules look to be about 1000 mg capsules, so that's about 90% Omega 3. Impressive. And It's MUCH less expensive that the Nordic Naturals Ultimate Omega. I do wish this one said it was molecularly distilled, and it doesn't, but they must be using some type of distillation to get it to the 90% level. They do say it is "regularly tested (using AOAC international protocols) for potency and purity by an independent, FDA-registered laboratory and found to be free of detectable levels of mercury, cadmium, lead and PCBs"

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Thanks! Been taking Nordic naturals but didn't know about all the other, they r expensive. Will check out!

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I have high CRP most of the time. Two heart Dr's that I have had said they do not consider CRP as a heart factor. I just had a 2 way heart by pass 9 weeks ago. My cholestoral (sp) has always been great. I never weigh over 110 pounds so that was not a factor. I feel the CRP is what caused my blockage.
Carol

HAPPY HOLIDAY TO EVERYONE. MAY YOUR NEW YEAR BE A HEALTHY YEAR.

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Anoush,

This article indicates that CRP tends to be elevated in scleroderma when the IL-6 increases: http://www.ncbi.nlm.nih.gov/pubmed/20883364 .

Lots of scleroderma specialists use the 6 minute walk test as a prognostic indicator. This article: http://www.ncbi.nlm.nih.gov/pubmed/19487260 indicates that "C-reactive protein (CRP) was the only independent variable associated with abnormal 6MWT." It also says, "calcinosis was the only independent factor associated in multivariate analyses with a trend for an association for CRP."

In this study: http://www.ncbi.nlm.nih.gov/pubmed/18271801 , they found a relation between elevated CRP and antimitochondrial antibody in patients with systemic sclerosis.

So these and other studies seem to indicate that CRP has a relationship with certain other markers of disease activity in scleroderma.

Now look at this study: http://www.ncbi.nlm.nih.gov/pubmed/17911482 . This study showed that treatment with statin medications lowered the CRP. And along with that came "statin-mediated improvements in the endothelial function of SSc patients as well as immunomodulating effects. Statins may thus prove to be an invaluable addition to the therapy of the vasculopathy of SSc."

This elevated CRP and lipids was why my doctor placed me on statins, but it was purified omega 3 that finally got my CRP down into the normal range, as I explained previously. The statins alone (at least not the done the doc had me on) were not doing the job. Hope this helps!

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Thank you Daisy, Those articles really answered my question. Mine has been high at times and that is when my doctor told me the disease is active. I've been taking the Omega 3 for the past 3 months, although it's not the purified form you are taking and my C-reactive is lower than it was at the beginning of the year. That would be wonderful if it is has a positve affect for keeping this disease quiet. It's so funny I started taking it only to keep my heart healthy and it may have had other beneficial affects. My personality is Hope for he best but expect the worse LOL. However I am going to keep a positive attituded about the whole thing and keep taking the Omega 3. Thanks again.
Anoush

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Good going, Anoush. We'll hang in there together! Just keep working to get that CRP down. I was really impressed with how well the purified Omega 3 worked to get my CRP down, when for years it had been 2 to 3 times the normal maximum despite the pravastatin. Look for the 70% to 90% Omega 3. It's hard to find and relatively expensive when compared to regular fish oil, but worth every penny, I think.

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Okay, Thank you :)
Anoush

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Thanks so much Daisy Do. You always have the greatest information

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