A Blood Test That Could Save Your Life: C-Reactive Protein
There are two very important blood tests that all people over the age of 35 should have done regularly. You would think that after years of research has demonstrated their importance, all doctors would routinely run these tests. Unfortunately, this is not the case. Very few doctors make it standard practice to order these tests despite extensive research supporting their importance.
Both tests reveal information about a person’s risk of heart disease. As most of us already know, heart disease is the number one killer of Americans. So doesn’t it make sense to use all the screening tools available to detect possible risk factors associated with heart disease?
Standard tests of assessing risk of heart disease are mainly limited to a cholesterol and triglyceride test. While it is known that cholesterol and triglycerides potentially affect heart and cardiovascular health, it is hardly the entire story.
Over the past ten years, a mountain of research has emerged pointing to other factors besides cholesterol and triglyercide levels that play heavily into cardiovascular risk. It is now believed that inflammation plays almost as an important of a role in heart disease as does elevated cholesterol.
In fact, there has been a huge storm of media attention over a recent study published in the prestigious New England Journal of Medicine, called the Jupiter study, which examined the benefits of using a cholesterol-lowering medication in people with normal cholesterol. Why would we give people with normal cholesterol a cholesterol medication? The answer is that the cholesterol-lowering medications called statins are also very effective at lowering inflammation in the blood vessels, which it turns out, may be as important as lowering cholesterol. In fact, many researchers have suggested that the ability of statin drugs to reduce risk of heart attack can be solely attributed to their anti-inflammatory effect, and not by their ability to lower cholesterol.
To further highlight this point, we can review the results of a study released about one year ago on a cholesterol-lowering drug called Zetia. This drug lowers cholesterol by reducing the amount that is normally absorbed in your intestines from the food you eat. The study found that although it was effective at lowering cholesterol levels, it was not effective at slowing the development of plaque formation and heart disease. Only statin medications, the ones that lower inflammation, have been shown to lower the risk of heart disease.
We are slowly moving away from the idea that cholesterol is the biggest evil when it comes to the progression of heart disease. The inflammation component is proving to be just as significant or maybe even more significant. So why aren’t doctors monitoring inflammation levels like they monitor cholesterol levels?
Unfortunately, there is no good answer to that question. A very simple, affordable test exists that very accurately can assess the amount of inflammation present in blood vessels. That test is called c-reactive protein.
C-reactive protein is a marker for inflammation everywhere in the body. To avoid getting information related to the inflammation in your bad knee, you have to ask your doctor for a cardiac specific c-reactive protein test often referred to as hs (highly sensitive) c-reactive protein. Every person should have this test done at least once a year in combination with their annual cholesterol check. Having elevated levels of c-reactive protein can quadruple your risk of developing heart stopping plaques.
If you have elevated levels of c-reactive protein, your doctor will try to convince you that the only way to reduce it is to use the statin medication called Crestor that was highlighted for its ability to lower c-reactive protein in the Jupiter study. Clearly, this is exactly what the pharmaceutical companies want. A side note: This “groundbreaking study,” which now justifies the use of statin medications in people with normal cholesterol levels, was funded by AstraZenica, the company that makes Crestor.
However, the idea that you must use statins to lower c-reactive protein couldn’t be further from the truth. Statin medications are dangerous and come with the risk of serious side effects. If you remember from my previous article on drug safety, the statin medication Lipitor ranked number five on the list of the top fifteen drugs that cause severe adverse reactions resulting in permanent injury or disability. Crestor, the drug used in the Jupiter study is considered more potent than Lipitor and is associated with a higher risk of side effects. The press forgot to mention that the participants taking Crestor were more likely to develop diabetes. Additionally, although it did lower the overall rate of heart attack better than a placebo, participants taking Crestor were more likely to suffer a fatal heart attack.
There are some very effective natural therapies to lower cardiac specific c-reactive protein and lower your risk of cardiovascular disease.
Diet and Nutrition
Food intake can play a significant role in how much inflammation is present in your body. Some foods like red meat, sugar, alcohol and trans fats directly increase inflammatory markers and put you at a greater risk for elevated levels of c-reactive protein.
It will not surprise you to learn what types of foods reduce inflammation and have been documented to lower c-reactive protein levels. Higher intakes of fruits and vegetables, particularly ones rich in certain compounds can reduce c-reactive protein levels.
In a recent study evaluating the data from 8,334 individuals, it was found that those who consumed the highest amount of flavonoids from fruits and vegetables had the lowest circulating levels of c-reactive protein. Flavonoids are naturally occurring plant compounds that have been correlated to numerous beneficial effects on health ranging from antioxidant to immune boosting. Green and brightly colored vegetables typically have the highest flavonoid concentration. In this particular study, the only fruit correlated with lower c-reactive protein levels was apples, but I suspect that other fruits high in flavonoids and antioxidants, such as blueberries, blackberries, goji berry, pomegranate, acai and noni, would all have similar effects. They probably were not consumed in high enough quantities to be reported by the participants in this particular study.
Another diet-centered study evaluated the effectiveness of carotenoid-rich fruits and vegetables and their ability to lower circulating levels of c-reactive protein. In this randomized four-week intervention trial, three groups were asked to consume different amounts of carotenoid-rich fruits and vegetables daily. Group 1 consumed only two servings per day, group 2 consumed five servings per day and group 3 consumed eight servings per day. After the four weeks, the group that consumed eight servings per day had significantly reduced levels of c-reactive protein compared to the low fruit and vegetable intake group.
High carotenoid vegetables used in the study included carrots, green beans, peas, broccoli, zucchini, tomatoes, kohlrabi, Brussels sprouts, red cabbage, cauliflower, spinach and radishes. Selected fruits included apples, pears, kiwis, bananas, peaches, nectarines, cherries, strawberries and red currants.
Omega-3 Fatty Acids
The omega-3 fatty acids found in fish oil have potent anti-inflammatory effects on the body and have been shown to specifically reduce the inflammation in the blood vessels associated with c-reactive protein.
In evaluating 269 patients referred for coronary angioplasty because of suspicion of coronary artery disease (age range between 58 and 62 years), C-reactive protein was significantly higher in patients with significant coronary artery stenosis compared with those with no significant angiographic changes. It was also observed that individuals with the lowest levels of c-reactive protein had the highest blood levels of DHA, an important omega-3 fatty acid found in fish and fish oil.
In a more observational study on 443 female Japanese students, it was observed that participants who consumed the highest levels of omega-3s from food had the lowest risk for having an elevated c-reactive protein.
Fish oil and omega-3 fatty acids also appear to have other beneficial effects on the cardiovascular system related to immune modulation, cell membrane health, and regulation of heart contractility and blood pressure.
Perhaps one of the most exciting new studies to be published on c-reactive protein involves the use of vitamin C. 396 healthy nonsmokers were evaluated to see if supplementation with 1,000 mg of vitamin C for two months could significantly lower c-reactive protein in those individuals who had elevated levels at baseline. The results were quite dramatic. Vitamin C was associated with 25.3% drop in c-reactive protein. Just as a comparison, Crestor in the Juipiter study reduced c-reactive protein by 37%. It would be interesting to see how higher levels of vitamin C supplementation might affect c-reactive protein levels.
Many people have heard about the health benefits of vitamin D. In the last 5-7 years we have seen a dramatic shift in the perceived importance of vitamin D supplementation and in the maintenance of adequate blood levels of this important nutrient. Clinical trials have shown the ability of vitamin D to significantly reduce c-reactive protein levels in sick individuals. It has also been demonstrated that people with low vitamin D status are more likely to have elevated levels of c-reactive protein. This is just one more reason to make sure you have your blood levels of vitamin D tested.
The Anti-Aging Bottom Line: More Americans die from heart disease than from any other cause, and research has that inflammation plays almost as an important of a role in the development of heart disease as does high cholesterol. If you are 35 or older, have your doctor perform a c-reactive protein test regularly so that you can be aware of and take steps to control inflammation before it leads to heart disease.
Read the next article in this series, Why You Need to Have Your Homocysteine Levels Checked, in which Dr. Passero discusses another important, but often overlooked, blood test that can help determine your risk for heart disease.
Dr. Passero completed four years of post-graduate medical education at the National College of Naturopathic Medicine in Portland, Oregon after receiving a Bachelor’s Degree in Environmental Biology from the University of Colorado. Dr. Passero has trained with some of the nation’s leading doctors in the field of natural medicine. In his practice, Dr. Passero focuses on restoring harmony to both the body and mind using advanced protocols that incorporate herbal therapy, homeopathy, vitamin therapy and nutritional programs. Through education and guidance patients are able to unlock the natural healing power contained within each one of us. For more information, visit his website, Green Healing Wellness, or follow him on Facebook.