Do You Have Hidden Heart Disease? A Simple Blood Marker That Your Doctor is Probably Not Ordering

Most doctors keep annual bloodwork to a minimal Complete Blood Count (CBC), Lipid Panel & Urinalysis.

Unfortunately, we are now realizing that these routine panels tell us very little about oxidative stress, inflammation & heart disease risk.

Making matters worse, routine treatments like statins may not actually work at preventing heart disease.

A marker called high sensitivity C-Reactive Protein (hs-CRP) is being included in routine blood analysis more and more frequently.

hsCRP, an inflammatory marker that is produced by the liver, is one of the best and most predictive inflammatory markers since it takes into account the status of a number of other inflammatory markers. hsCRP is unique in that it is not only a marker of inflammation, but it itself causes damage to the blood vessel lining. It is both a marker and a risk factor for heart disease when levels rise over 2.0 mg/L.

hs-CRP is raised from a culmination of other inflammatory markers that travel to the liver creating this one deep marker. These individual markers are the interleukin-6 (IL-6), interleukin-1B, and tumor necrosis factor alpha (TNF-alpha). Together these three markers are what trigger the production of hs-CRP in the liver.

Functions of hsCRP:

hsCRP acts to increase oxidative stress and autoimmune dysfunction, both of which can harm vascular cell walls. The marker is also an indirect indicator of general oxidative stress.

Main Potential Causes of High hsCRP:

hsCRP can be caused by any ordinary infection such as sore throat, strep, pneumonia, chronic bronchitis, colitis, and sinusitis.

One of the most common infections that causes hsCRP is a periodontal infection. Inflammation of the gums from forgetting to brush and floss can lead to an increased risk of heart disease (1).

When infection and other sources of chronic inflammation have been ruled out, hsCRP can signal the presence of inflammation in the vascular walls.

Other Potential Causes of Elevated hsCRP:

  • Increased levels of heavy metals such as lead or mercury
  • Certain medications
  • Alcohol use
  • Depression
  • High intake of refined carbohydrates, sugars and sweets
  • Lack of sleep
  • Obesity
  • Smoking
  • High intake of saturated fat
  • High intake of trans fat
  • H. pylori infection
  • Rheumatoid arthritis
  • Chronic obstructive pulmonary disease
  • Lupus

Other Signs of Vascular Inflammation:

  • High iron and ferritin levels
    • Important fact: According to The Journal of Nutrition, for each 10 ug/L increase in ferritin, the risk of atherosclerosis in the carotid arteries rises by 3%, correlated with IL-6 and hs-CRP levels (2).
  • High uric acid levels
  • High IL-6, IL-1, IL-18
  • High TNF-alpha
  • High platelets

Nutraceutical Support:

Omega 3 Fatty Acids:

The anti-inflammatory effect of omega 3 fatty acids from fish, flax, nuts, and grassfed beef is well-known.

As omega 3 levels go up, levels of hs-CRP reduce (3). Likewise, as omega 3 levels go down, hs-CRP levels rise (4).

  • Plant sterols:  Plant sterols are fatty substances often derived from soy (like beta-sitosterol) that can help inhibit cholesterol absorption and support healthy LDL and HDL levels. When taken alongside omega 3’s, the European Journal of Clinical Nutrition found that hs-CRP may drop as much as 39% (5).

Vitamin D3:

Vitamin D has been shown to help lower hsCRP and IL-6 is is one of the most commonly deficient vitamins for individuals living north of Florida.

Unbeknownst to many, vitamin D is a very powerful anti-inflammatory hormone and is important for hormone and gut health.

Glutathione:

Glutathione is the body’s major antioxidant and immune modulator that it makes on its own. It also helps to flush harmful heavy metals and other toxins from the body, thereby reducing systemic inflammation, oxidative stress, and hs-CRP.

The problem is, stress from a toxic environment full of heavy metals, pesticides, and other unpleasantries will often deplete glutathione levels.

Taking substances like selenium, alpha-lipoic acid, N-acetyl cysteine, & whey protein can help support glutathione production in the body.

  • Important Note: Alpha-lipoic acid and N-acetyl cysteine  not only support glutathione production but also help recycle existing glutathione levels.

Coenzyme Q10:

Coenzyme Q10 (also called CoQ10 or Ubiquinol) inhibits the inflammatory marker TNF-alpha, and improves activity of Vitamin E which has also been shown to lower hs-CRP and IL-6 levels (678).

Active Botanicals:

Flavonoids:

Flavonoids are powerful plant chemicals known for a variety of health benefits. Flavonoids from soy, berries, green tea, dark chocolate, grape seed extract all have research supporting an ability to reduce oxidative stress and support heart health.

Lutein:

Lutein, a substance found in egg yolks and dark, leafy green vegetables, especially spinach, has also been shown to reduce levels of hsCRP

Lycopene:

Lycopene is highly prevalent in watermelon and tomatoes. It’s known for it’s ability to support prostate health in men, but for our purposes here, lycopene has been shown to reduce the inflammatory marker TNF-alpha as much as 34% (9) and potentially reduce the risk of cardiovascular disease (10).

Turmeric:

This yellow Indian spice contains an active ingredient known as curcumin. Curcumin is a well-known anti-inflammatory chemical and a natural COX/LOX inhibitor. (COX/LOX are fancy names for inflammatory pathways targeted by drugs like Ibuprofen, Celebrex, as well as other anti-inflammatory drugs.)

Mediterranean Style Diet:

The mediterranean diet is almost defined as being the complete opposite of the Standard American Diet.

  • Standard American Diet:
    • High in refined sugars, bleached grains, saturated fatty acids, trans fatty acids, and processed palm and canola oils.
    • Low in fruits, vegetables, and fatty fish.
  • Mediterranean Diet:
    • High in vegetables, fruits, whole grains, nuts and olive oil
    • Low in red meat and refined sugars.

The Journal of the American Medical Association reported in 2004 that a mediterranean diet significantly reduces hs-CRP levels.

Getting Tested for hsCRP

Next time your doctor wants to order blood work, request that he or she add hs-CRP to the list of markers. I run it on most of my patients.

The reason for this may not seem necessary, however, often times such markers are important to add to a physician’s list because they cater to your needs as a patient. Sometimes you may not “feel” improvements, and with functional nutrition which makes it difficult to gauge success and failure. However, inflammatory markers such as hs-CRP can be useful benchmarks to measure how well a natural approach is working. This is why alternative health professionals like myself routinely measure hs-CRP as a general marker of health. We then look to identify and address the cause of high hs-CRP when we see unhealthy levels above 2.0 mg/L.

hsCRP is a “quiet” marker and so levels can be high without you even knowing. If your doctor isn’t testing for it, then you don’t know.

For a comprehensive resource, pick up a copy of What Your Doctor May Not Be Telling You About Heart Disease, by Mark Houston, MD.

 

14 Comments

  1. Matt July 31, 2012 at 7:11 am - Reply

    This is a good post, but the best way to prevent heart disease is to increase your cholesterol intake. Yes, it sounds counterintuitive, but it’s the truth; not only is cholesterol good for you, not getting enough increases your risk of heart disease. I learned this from reading “The Great Cholesterol Lie,” a comprehensive book debunking myths about cholesterol. If you’re interested, check out my blog for my review.

  2. […] few weeks back, I introduced you to high sensitivity C-Reactive Protein (hs-CRP), which is one of the best markers of hidden heart disease, inflammation and infection. I recommend […]

  3. […] few weeks back, I introduced you to high sensitivity C-Reactive Protein (hs-CRP), which is one of the best markers of hidden heart disease, inflammation and infection. I recommend […]

  4. sladja April 29, 2013 at 9:57 pm - Reply

    Dear Sir,my hs-CRP is 25 and for 7 years it never been lower than 11 so I don’t know what to do any more cause I don’t have any autoimmune disease but I have flu symptoms every 2-3 months and no doctor can’t figure out what is wrong with me..
    I have high cholesterol and triglyceride but I don’t have any cardiovascular disease cause I was with cardiologist who did some tests.What may cause high hs- CRP?
    Thank you for your article..

    • hs-CRP is a non-specific marker of inflammation caused by a number of things discussed in the article…any infection, periodontal disease, as well as:

      Increased levels of heavy metals such as lead or mercury
      Certain medications
      Alcohol use
      Depression
      High intake of refined carbohydrates, sugars and sweets
      Lack of sleep
      Obesity
      Smoking
      High intake of saturated fat
      High intake of trans fat
      H. pylori infection
      Rheumatoid arthritis
      Chronic obstructive pulmonary disease
      Lupus

      Any one or combination of this could contribute. In some individuals, their CRP can naturally run just a little higher and if you’ve ruled out other causes of inflammation, it is possible that your “normal” is just naturally a little higher than the average. But if you’re getting constant flu symptoms, etc, I would suggest working with a functional medicine doctor to identify a any functional deficits. A traditional cardiologist may just have ruled out any existing disease, a functional medicine oriented doctor will look at the chance of future cardiovascular disease and see where you are along a spectrum of function, not a black/white diagnosis.

      http://www.functionalmedicine.org/practitioner_search.aspx?id=117

  5. […] Do You Have Hidden Heart Disease? […]

  6. Careseng Health – Do You Have Hidden Heart Disease? A Simple Blood Marker That Your Doctor is Probably Not Ordering August 27, 2013 at 11:29 am - Reply

    […] This post is originally from Dr Rinehart’s blog. […]

  7. […] heart disease mortality – with LDL particle number, other markers such as lipoprotein(a) and hs-CRP, as well as risk ratios such as Total Cholesterol:HDL, and Triglyercide:HDL gaining more […]

  8. Why Does Heart Disease Run in My Family? Why You Should Care About Homocysteine, Folic Acid and the MTHFR Gene Mutation - Primal Docs March 11, 2014 at 11:38 am - Reply

    […] few weeks back, I introduced you to high sensitivity C-Reactive Protein (hs-CRP), which is one of the best markers of hidden heart disease, inflammation and infection. I recommend […]

  9. Edward July 15, 2015 at 4:43 pm - Reply

    I just recently been diagnosed with HS-CRP at 8.7 which is high my appointment for the cardiologist is not till October 13 2015 which is 3 months away as well as Ruthmatoligist appointment to check for arthritis and I was wondering if there was anything that I can do to help lower these levels before my actual appointment any information would definitely be grateful

    • Alexander J. Rinehart, DC, MS, CNS July 17, 2015 at 10:49 am - Reply

      Hi Edward, thanks for reaching out. I am unable to provide specific clinical advice, but the article outlines some potential strategies in the “Nutraceutical Support” section.

  10. Kelsey August 20, 2015 at 10:34 am - Reply

    Dr. Rinehart, i just learned that my CRP is 7.65. I’m 42, female, 207 lbs (actively working on losing), vegetarian for many years, eat a healthy diet, exercise 30-60 minutes most days, cholesterol is 176, LDL 102, HDL 51. I take 50k units of Vit D prescription for low levels, and was on birth control for the past year. I stopped birth control meds recently after reading this can impact CRP significantly. My question is, do you think this high CRP level be primarily associated with my weight and the pill? Or is there another obvious possibility? I’ve always had great numbers and will be working on reducing my CRP before my next test in a month. I’ve already added many steps from your article, but am wondering if losing weight and going off the pill will be the most impactful, based on my already acceptable diet and exercise routine.

    • Alexander Rinehart, DC, MS, CNS August 22, 2015 at 10:32 am - Reply

      Hi Kelsey, As a chiropractor I cannot comment with regards to the birth control. Generally speaking, it is possible that excess weight plays a role. But it is not always just one thing, as it may still be just one piece of the puzzle.

  11. stacey January 21, 2017 at 3:57 pm - Reply

    My hs-CRP is 38.5 my doctor is doing nothing what should I do?

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