Q. I would like to get a proper diagnosis regarding my high hs-CRP.

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
Published on Apr 25, 2016 and last reviewed on: Oct 09, 2018

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 lower side. I am married for 11 years now. I am taking the diet similar to 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.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

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:

  • C-reactive protein (CRP) levels are a bit high indicating mild inflammation. This value is suggestive of high cardiac risk.
  • 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.
  • Serum iron levels are reduced in inflammation as they are used up to during cell damage reactions.
  • Vitamin B12 is dependent on multiple factors. May be inflammation, reduced absorption or varying regular activity could be the cause. No need to worry for now.
  • 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.
  • 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.
  • No other intestinal disease or malabsorption is indicated, as other values are normal.

Repeat the lipid profile and revert back to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist


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Hi doctor,

My LDL has gone up to 185. HbA1c is 5.9 and the mean plasma glucose 122.6. I do have sweet tooth, but no family history of diabetes. From last one year, I am going to gym for an hour daily in the morning. I have taken some whey protein and little worried about 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.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

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:

  • The abnormal lipid profile is in line with your prediabetes findings of increased glycosylated hemoglobin. This suggests unhealthy lifestyle in the past year rather than improvement when compared to your previous reports.
  • 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.
  • 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.
  • However, at present changing the lifestyle, being more active, cutting or quitting smoking along with weight reduction is must. Smoking will increase free radicals production in the body, which damages various organs including pancreas, reducing further insulin levels.
  • Make sure your body mass index is less than 25, preferably around 23 with more muscles.
  • At present, your ECG is normal and cardiac opinion is not necessary.
  • If you are not able to make suitable lifestyle modifications and lipid profile is the same after six months, then medications needs to be started. Once medications are started, it is more likely for lifetime.
  • You need to stop smoking and alcohol. Do muscle building exercises along with aerobics, protein rich diet and reduce fat intake.
  • 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.
  • Better food habits are most 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 to a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist


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Hello doctor,

Thanks for your prompt advice. My last one year 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 weight of 69 to 70 kg 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.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome back to icliniq.com.

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

Repeat the tests after six months and revert back to a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist



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