The Good News and the Bad News About a Sophisticated Blood Test

About five months ago, when I had a physical exam, most everything seemed to come out well…except for one test that suggested something might be amiss. It was a test I hadn’t had, or even heard of, before--something known as a c-reactive protein (CRP) test.

This is a test, my doctor explained, that tests for “inflammation” usually associated with heart problems. I didn’t like the idea of “inflammation,” since it seems to be behind so many chronic diseases.

A normal reading, according to the printup of my tests, was less than 1 mg/L. My reading was 5. The chart showing my reading indicated that a reading of over 10 was cause for alarm. But what about a reading between 1 and 10?

My doctor didn’t seem very concerned. She suggested I come back for another test in six months, but didn’t offer any suggestions as to what I might do to counter the reading. Or if I should do anything.

When I went online, several sites suggested that any reading over more than 3 put me at “highest risk.”

Risk for what? Well, there the experts seem uncertain. An article on WebMD cited a study that suggested the CRP reading was more predictive of heart problems than cholesterol readings. There are also connections to macular degeneration and colon cancer.

I had a check-in with a nutritionist in I’ve previously consulted with, in early March, and she said she didn’t care for the reading. She recommended a combination of enzymes, along with CoQ-10. She told me to take the supplements for two months, and have the test again. (The WebMD article suggests taking aspirin and/or statins.)

I just had the test, and lo and behold, the reading was 0.2. It seems like quite a dramatic change. Now I wonder, was either the first test, or this test, improperly measured? Or was I missing certain nutrients from my diet that the enzymes and CoQ10 suddenly provided? Is the test really all that significant?

In that same WebMD article, I see there is something called an ultra-sensitive CRP, which provides even more insights into potential heart problems.

I guess I’m happy that my number improved. I'm also glad that statins never became an issue. It just seems that making sense out of these supposedly ever-more-sophisticated tests is difficult to do--for professionals and patients. I can’t wait for genetic testing.

Comments

[Ron]

What a dilemma-and which test result is “true.”

I was a research scientist for many years operating a laboratory where we had to run duplicate test samples to obtain consistent results with low error rates. Usually multiple control samples were run to assure consistency. It is always troubling to get back test results from medical check-ups. The test results are based on a single sample with faith placed in the quality and efficiency of an unknown laboratory. Were appropriate controls run, the instruments calibrated correctly, the samples handled according to established protocols etc.? There is another issue; the actual error rate of the test itself. I always ask my physician what the error rate is for any given test (or look it up myself), and then we discuss the “range” of a particular result. If we feel there is a questionable trend, I ask that the test be repeated.

Test result numbers are not absolute. I have had my cholesterol tests range from 250 to 190 over five days. (My cholesterol is generally high). In addition, my father died from prostrate cancer several years ago. Early on in his disease, an orchidectomy was performed to reduce his serum testosterone levels. Shortly after his surgery, laboratory tests indicated spiked levels of testosterone. An investigation initiated by my complete disbelief in the laboratory tests revealed that blood samples had been mixed up in the hospital pathology lab.

My advice is to always question laboratory tests, good or bad, and try to obtain information of ranges and error rates.

Dave, I enjoy your site and thank you for your insights and dedication to health issues.