C-Reactive Protein (CRP)

This measures the level of c-reactive protein (CRP) in a sample of your blood. CRP is a protein that your liver makes. Normally, you have low levels of c-reactive protein in your blood. In cases of Inflammation, your liver releases more CRP into your bloodstream. High levels of CRP may mean you have a serious health condition that causes inflammation.

Inflammation is your body’s way of protecting your tissues and helping them heal from an injury, infection, or other disease. Inflammation can be acute (sudden) and temporary. This type of inflammation is usually helpful. For example, if you cut your skin, it may turn red, swell, and hurt for a few days. Those are signs of inflammation. Inflammation can also happen inside your body.

If inflammation lasts too long, it can damage healthy tissues. This is called chronic (long-term) inflammation. Chronic infections, certain autoimmune disorders, and other diseases can cause harmful chronic inflammation. Chronic inflammation can also happen if your tissues are repeatedly injured or irritated, for example from smoking or chemicals in the environment.

A CRP test can show whether you have inflammation in your body and how much. But the test can’t show what’s causing the inflammation or which part of your body is inflamed.

Other names: c-reactive protein, serum

What is it used for?

A CRP test may be used to help find or monitor inflammation in acute or chronic conditions, including:

Infections from bacteria or viruses

Inflammatory bowel disease, disorders of the intestines that include Crohn’s disease and ulcerative colitis

Autoimmune disorders, such as lupus, rheumatoid arthritis, and vasculitis

Lung diseases, such as asthma

Your health care provider may use a CRP test to see if treatments for chronic inflammation are working or to make treatment decisions if you have sepsis. Sepsis is your body’s extreme response to an infection that spreads to your blood. It’s a life-threatening medical emergency.

Why do I need a CRP test?

You may need this test if you have symptoms of a bacterial infection, such as:

Fever or chills

Rapid heart rate

Rapid breathing

Nausea and vomiting

You may also need a CRP test if your provider thinks you may have a chronic condition that causes inflammation. The symptoms will depend on the condition.

If you’ve already been diagnosed with an infection or a chronic disease that causes inflammation, you may need this test to monitor your condition and treatment. CRP levels rise and fall depending on how much inflammation is in your body. If your CRP levels fall, it’s a sign that your treatment for inflammation is working or you’re healing on your own.

What happens during a CRP test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This process usually takes less than five minutes.

What do the results mean?

Your CRP test results tell you how much inflammation you have in your body. But your test results can’t tell you what’s causing the inflammation. To make a diagnosis, your provider will look at your CRP results along with the results of other tests, your symptoms, and medical history.

In general, healthy people have very low amounts of CRP in their blood. Any increases above normal mean you have inflammation in your body. But labs measure CRP levels in different ways, and they define “normal” CRP ranges differently, so it’s best to ask your provider what your results mean.

Is there anything else I need to know about a CRP test?

A CRP test is sometimes confused with a high-sensitivity-(hs) CRP test. They both measure CRP, but they are used for different conditions. An hs-CRP test measures very tiny increases in your CRP levels. It is used to estimate your risk of heart disease.

Erythrocyte Sedimentation Rate

ESR is a blood test that that can show if you have inflammation in your body by measuring rate of red blood cells sedimentation.

Inflammation is your immune system’s response to injury, infection, and many types of conditions, including immune system disorders, certain cancers, and blood disorders.

Erythrocytes are red blood cells. To do an ESR test, a sample of your blood is sent to a lab. A health care professional places the sample in a tall, thin test tube – Westerngren and wintobe tubes- and measures how quickly the red blood cells settle or sink to the bottom of the tube.

Normally, red blood cells sink slowly. But inflammation makes red blood cells stick together in clumps. These clumps of cells are heavier than single cells, so they sink faster.

If an ESR test shows that your red blood cells sink faster than normal, it may mean you have a medical condition causing inflammation. The speed of your test result is a sign of how much inflammation you have.

Faster ESR rates mean higher levels of inflammation. But an ESR test alone cannot diagnose what condition is causing the inflammation.

Other names: ESR, SED rate sedimentation rate; Westergren sedimentation rate

What is it used for?

An ESR test can be used with other tests to help diagnose conditions that cause inflammation. It can also be used to help monitor these conditions. Many types of conditions cause inflammation, including arthritis, vasculitis, infection, and inflammatory bowel disease. An ESR may also be used to monitor an existing condition.

Why do I need an ESR?

Your health care provider may order an ESR if you have symptoms of a condition that causes inflammation. Your symptoms will depend on the condition you may have, but they may include:
Headaches
Unexplained fever
Weight loss
Joint stiffness
Neck or shoulder pain
Loss of appetite
Anemia

What happens during an ESR?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial.

You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Are there any risks to the test?

There is very little risk to having an ESR. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Your provider will use the results of your ESR test along with your medical history, symptoms, and other test results to make a diagnosis. An ESR test alone cannot diagnose conditions that cause inflammation.

A HIGH ESR test result may be from a condition that causes inflammation, such as:
Arteritis
Arthritis
Systemic vasculitis
Polymyalgia rheumatica
Inflammatory bowel disease
Kidney disease
Infection
Rheumatoid arthritis and other autoimmune diseases
Heart disease
Certain cancers

A LOW ESR test result means your red blood cells sank more slowly than normal. This may be caused by conditions such as:
A blood disorder, such as:
Polycythemia
Sickle cell disease (SCD)
Leukocytosis, a very high white blood cell count (WBC)
Heart failure
Certain kidney and liver problems

If your ESR results are not normal, it doesn’t always mean you have a medical condition that needs treatment.

Pregnancy, a menstrual cycle, aging, obesity, drinking alcohol regularly, and exercise can affect ESR results.

Certain medicines and supplements may also affect your results, so be sure to tell your provider about any medicines or supplements you are taking.

Is there anything else I need to know about an ESR?

Because an ESR can’t diagnose a specific disease, your provider may order other tests at the same time. Also, it’s possible to have a condition that causes inflammation and still have a normal ESR result.

C-reactive protein (CRP) test is commonly done with an ESR to provide more information.