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HomeAnswersHematologyhigh hs-crpI would like to get a proper diagnosis regarding my high hs-CRP.

What could be the reason for a high hs-CRP and low iron?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At April 25, 2016
Reviewed AtApril 23, 2024

Patient's Query

Hi doctor,

I am suffering from iron depletion. My iron is low, but ferritin and hemoglobin are normal. My folic acid was 4 about a year ago. I took Folic acid tablets for two months and it is normal now. My vitamin D has improved after taking tablets. My vitamin B12 is also on the lower side. I am married for 11 years now. I am taking a diet similar to my wife, but her vitamin B12 is almost close to 900. My hs-CRP is high. I also get skin wounds regularly. I want to rule out whether I have celiac disease or dermatitis herpetiformis or any other underlying disease. I would like to get a proper diagnosis of the above conditions before going in for any medication.

Answered by Dr. Prakash. H. M.

Hi,

Welcome to icliniq.com.

Based on your query and after going through your reports (attachments removed to protect patient identity), my opinion is as follows:

  1. C-reactive protein (CRP) levels are a bit high indicating mild inflammation. This value is suggestive of high cardiac risk.
  2. Your cholesterol, LDL (low-density lipoprotein), and the ratios are also high indicating ongoing atherosclerosis inflammation, which is contributing possibly to high CRP, if no other causes like infection, inflammation, etc., are found.
  3. Serum iron levels are reduced in inflammation as they are used up during cell damage reactions.
  4. Vitamin B12 is dependent on multiple factors. Maybe inflammation, reduced absorption, or varying regular activity could be the cause. No need to worry for now.
  5. Control of diet, aerobic exercise, weight reduction, and fiber rich diet will control cholesterol level and hence CRP levels. Fibrates and statin treatment may be necessary.
  6. At present, iron and B12 therapy are not necessary. Repeat the test once your lipid profile is under control. If iron and B12 are still low, then we can start the treatment.
  7. No other intestinal disease or malabsorption is indicated, as other values are normal.

Patient's Query

Hi doctor,

Thank you for the reply,

My LDL has gone up to 185. HbA1c is 5.9 and the mean plasma glucose is 122.6. I do have a sweet tooth, but no family history of diabetes. For the last one year, I am going to the gym for an hour daily in the morning. I have taken some whey protein and little worried about the increase in creatinine 1.1. Since one year, I am smoking regularly around two to three cigarettes daily. So far I have no symptoms of any health issue. Please guide whether I should start medicine for LDL. Should I consult a cardiologist? Please find my latest report that I have attached.

Kindly compare my last report as well.

Thank you.

Answered by Dr. Prakash. H. M.

Hi,

Welcome back to icliniq.com.

I went through the report and also compared it with the previous report (attachment removed to protect patient identity). Based on your present query, my opinion is as follows:

  1. The abnormal lipid profile is in line with your prediabetes findings of increased glycosylated hemoglobin. This suggests an unhealthy lifestyle in the past year rather than improvement when compared to your previous reports.
  2. I am not sure about your weight, but weight reduction with more muscle gain is essential. There appears to be more fat, which is causing insulin resistance and abnormal lipid profile.
  3. If this continues the same without any lifestyle modifications, then there is a distinct possibility that you might end up as diabetic in the next two to three years.
  4. However, at present changing the lifestyle, being more active, cutting or quitting smoking along with weight reduction are must. Smoking will increase free radicals production in the body, which damages various organs including the pancreas, reducing further insulin levels.
  5. Make sure your body mass index is less than 25, preferably around 23 with more muscles.
  6. At present, your ECG (electrocardiography) is normal and a cardiac opinion is not necessary.
  7. If you are not able to make suitable lifestyle modifications and your lipid profile is the same after six months, then medications need to be started. Once medications are started, it is more likely for a lifetime.
  8. You need to stop smoking and alcohol. Do muscle-building exercises along with aerobics, a protein-rich diet, and reduce fat intake.
  9. If you are unable to achieve the normal range, then statin medications can be started after six months. At present, nothing to be alarmed about.
  10. Better food habits are essential. Do have an active life.

The Probable causes

1. Obesity. 2. Lifestyle.

Preventive measures

Weight reduction, exercises, good food habits along with cessation of smoking and alcohol.

Regarding follow up

Repeat tests after six months.

Patient's Query

Hello doctor,

Thanks for your prompt advice.

My last year's lifestyle has been very healthy; early to bed, early rise, only morning tea compared to five or six teas earlier, one-hour gym, breakfast with full sprouts and salads followed by seasonal juices every day. I have been maintaining a weight of 152 to 154 lbs against 72 to 73 a year back. My muscle mass has also increased and strengthened. I am feeling much fit and changes are visible. That is the reason I could not understand the test report.

Thank you.

Answered by Dr. Prakash. H. M.

Hi,

Welcome back to icliniq.com.

  1. Good to know, you are able to maintain a healthy lifestyle, except for smoking.
  2. Possible causes at present could be genetic makeup (family history of diabetes or abnormal lipid profile or history of myocardial infarction in the family or abnormal metabolism) or cigarette smoking.
  3. Rarely tests can be mixed up. If you are still in doubt then get a repeat lipid and glycosylated hemoglobin profile done.
  4. If the values still remain the same then further lifestyle modifications including stopping cigarettes would be necessary.
  5. If you can continue with a healthy lifestyle and repeat the test after six months and if it returns to normal then there will be no need for medication.
  6. I would advise you to continue lifestyle modification more strictly and medication can be resorted if laboratory values do not improve.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Prakash. H. M.
Dr. Prakash. H. M.

Hematology

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