When it comes to your health, inflammation is a key topic because while your body needs some amount of inflammation—particularly to get you through stressful situations—too much inflammation over a long time can be harmful for your health.
Inflammation is your body’s way of reacting to stressful situations such as an acute injury (e.g., a cut on your finger) or infection (e.g., a flu virus) or a fight-or-flight situation (e.g., you’re being followed down the street late at night). When such situations occur, it’s normal for your body to experience inflammation as a protective, healing measure. As the stress subsides, your inflammation levels should also go down.
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Problems occur when you suffer from long-term, consistent stress which leads to chronic inflammation where the levels remain high for extended periods of time. Chronic inflammatory diseases—such as cardiovascular diabetes, obesity, some cancers and others—cause serious health problems, potentially leading to death.
What is CRP and Why Does it Matter?
The acronym CRP stands for C-reactive protein, a marker for inflammation in your body. Your liver manufactures CRP and pushes it out to the bloodstream in response to stress and the accompanying inflammation. With acute stressful situations, it’s not the body’s normal reaction that is concerning.
Where the tide turns though with CRP is when your blood levels become elevated with the protein, indicating your body has too much—potentially dangerous—inflammation, possibly even signaling a chronic inflammatory disease.
Fortunately, just like you can test your omega-3 EPA and DHA levels, or your cholesterol levels, there are blood tests available to identify your CRP levels. Your doctor can order a venous blood draw to be taken in their office or in an independent laboratory.
Testing your CRP Levels
There are two options for testing your CRP levels and you can talk to your doctor about whether either is appropriate for you. CRP tests are not just useful for identifying your risk of heart disease but can also help with other inflammation-related conditions such as autoimmune diseases, chronic diseases, infections and more.
- A CRP test is the standard test to measure the level of CRP in your blood. This test can identify inflammation levels in your body to help your doctor better assess your risk for heart disease, even though the CRP test is not actually testing for heart disease.
- A high-sensitivity CRP test, referred to as an hs-CRP test, is more sensitive than the standard CRP test in finding smaller increases in your CRP levels. An hs-CRP test is not recommended for everyone, and your doctor will determine if it is for you by evaluating your overall health, lifestyle choices, family history and risk of having a heart attack within the next 10 years.
What do Your CRP Test Results Mean?
This article places CRP test result levels into five categories, with some experts advising that 10 milligrams (mg) per deciliter (dL) is considered high. Here are the categories:
- Normal CRP levels are less than 0.3 mg/dL;
- Normal or Minor elevation (0.3 to 1.0 mg/dL) which could be associated with obesity, pregnancy, diabetes and/or other factors;
- Moderate elevation (1.0 to 10.0 mg/dL) potentially placing you at increased risk for autoimmune conditions, heart attack, respiratory infections and more;
- Marked elevation (more than 10.0 mg/dL) which could indicate acute bacterial or viral infections, systematic blood vessel inflammation or major injuries or traumas; and
- Severe elevation (more than 50.0 mg/dL) generally indicating a severe, acute bacterial infection.
Ways to Lower Your CRP Levels
It shouldn’t be surprising that those with chronic illnesses (especially those with which inflammation is associated)—including metabolic syndrome, obesity, diabetes, fatty acid liver, high blood pressure, high cholesterol, autoimmune diseases and some cancers—are at a higher risk of elevated CRP levels.
If your CRP test results come back with an elevated CRP blood level, there are things you can try to lower it, from medications to dietary supplements to lifestyle changes—many, if not all, of which are the kinds of treatments or modifications that are recommended for reducing inflammation and helping prevent or manage chronic illnesses.
This article on CRP is worth a read. As the article advises, most of the ways to lower your high CRP levels are centered around reducing your inflammation levels and focusing on the underlying causes of your inflammation, including managing any related chronic diseases.
Here are some of the recommendations:
Medications and Vitamins: Statins used to lower high cholesterol, and metformin to manage type 2 diabetes by keeping your blood glucose at acceptable levels are two prescription medication recommendations, but your doctor may have other suggestions based on your personal situation.
For example, non-steroidal anti-inflammatories (NSAIDs), work to reduce inflammation and pain. NSAIDs are either prescribed by your doctor (e.g., celecoxib) or purchased as over-the-counter medications (e.g., aspirin) but discuss with your doctor if these are long-term solutions as they may cause other problems, particularly in the gastrointestinal tract (stomach ulcers, bleeding, as examples). NSAIDs may also increase the risk of heart attacks, strokes, and potential kidney damage.
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On the other hand, fish oil (omega-3 EPA and DHA) supplements have a strong safety profile and when taken as recommended are generally safe. If you’re considering taking omega-3 EPA and DHA supplements in high doses, do so in consultation with your doctor, and even taking them in low doses should be part of your medical record. If you’ve heard that fish oil can increase the risk of bleeding, or increase the risk of AFib, we recommend you read two of our 2024 blogs here and here.
Fish oil prescription medications on the market are also considered to have a strong safety profile, and your doctor can determine whether you are a candidate for one of those options.
Lifestyle Changes: No surprises here: don’t smoke, reduce chronic stress, and if you choose to drink alcohol limit yourself to one drink for women or up to 2 drinks for men daily.
Eat smarter. Limit your refined carbs, fried foods, red meat, processed or fast foods, replacing them with healthy fats such as omega-3s EPA and DHA found in fatty fish such as salmon, sardines, tuna, and others, plant-based foods and whole grains. And yes, eat your fruits and vegetables. Exercise more. Current recommendations call for a minimum of 30 minutes per day, at least 5 days a week. Watch your weight—eating better and exercising regularly should help.
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Overview of Omega-3s and the Role in Heart Health
It’s omega-3’s role in heart health that first drew scientific attention to this essential nutrient, with researchers putting omega-3 EPA and DHA on the scientific and medical maps, so to speak, back in the late 1970s. Ground-breaking research from two Danish scientists, Jorn Dyerberg and Hans Bang, published their first study in 1978 in The Lancet on the “rethinking” of fats (including omega-3s) in the diet. Three studies published in the New England Journal of Medicine in the mid-1980s on omega-3s EPA and DHA and heart health, sparked decades of scientific examination and beneficial results in this area, catching the eyes of healthcare practitioners and consumers.
To date, omega-3 fatty acids have become the most researched nutrients in biology, with the number of studies on omega-3 rivaling that of statins and aspirin.
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That research has found that omega-3 EPA and DHA can lower blood triglyceride levels and blood pressure. In addition, these nutrients are known to stabilize the heart’s electrical system and quiet down the body’s inflammatory response, allowing it to recover more quickly from an initial inflammatory insult. Omega-3s can also make blood vessels less rigid, and more elastic and stretchier, reducing the chances of unwanted blood clots forming by helping ease normal blood flow to the tissues.
Can Omega-3s Lower Your CRP Levels?
It’s probable that omega-3s can help lower your CRP levels, likely based on their role as anti-inflammatory agents. And we’ve got some science to share in that regard.
This published study in the European Journal of Clinical Nutrition, found an inverse relationship between blood levels of omega-3 fatty acids and CRP in a healthy population. The study included 124 free-living adults (46 males, 78 females), divided into three tertiles (simply, groups), based on their CRP plasma levels: (<1.0, 1.0–3.0 and >3.0 mg/L). Body composition and anthropometric measurements were recorded.
hs-CRP was analyzed using immunoassays and fatty acids were measured by gas chromatography. The study authors reported that the highest hs-CRP level group (>3.0 mg/l) had significantly lower concentrations of total omega-3 EPA and DHA, compared to the other tertiles. The authors concluded these results provide “evidence that in healthy individuals, plasma omega-3 fatty acid concentration is inversely related to hs-CRP concentration, a surrogate marker of CVD risk.”
In reporting the results of this study, this post noted additional conclusions from the authors: “The importance of this study is that individuals with higher plasma hs-CRP (>3.0 mg/L)…have significantly lower plasma [omega-3] fatty acids” and that “this inverse correlation with hs-CRP…could represent a possible mechanism by which omega-3 fatty acids are involved in CVD risk reduction.”
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A recent study published in Frontiers in Nutrition determined that “omega-3 supplements significantly reduce CRP levels in participants with high initial CRP levels ≥4 mg/L.” The open-label randomized crossover trial included 49 individuals ages 55-80, who were current smokers or former smokers with ≥30 pack-years smoking history. They were randomized to receive 2.4 g EPA + 1.2 g DHA supplements for a 6-month period followed by 6 months observation, or the other way around. Over a 1-year period, blood samples were collected and were measured for CRP, plasma and red blood cell membrane levels of EPA, DHA and other fatty acids, and an inflammatory marker panel. Forty-one participants completed the trial (21 who began with the active arm; 20 who started in the control arm).
Here’s what the study found in regard specifically to omega-3s and CRP: the omega-3 supplements led to a significant decrease in plasma CRP, and CRP values at the end of the intervention relative to baseline was medium (Cohen’s d = 0.56). Further, the high-dose omega-3 supplements were well-tolerated, with only minor gastrointestinal symptoms in a subset of participants.
Other studies, too, found omega-3 showed promising effects on systematic inflammation by reducing CRP levels, such as this one in COVID-19 patients, and this meta-analysis of hemodialysis patients.
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Can Omega-3 Supplementation and Testing Help Keep CRP Levels in Check?
When talking about omega-3 EPA and DHA and lowering CRP levels, it’s not just testing your CRP level that counts. As we’ve discussed throughout this blog, there is a relationship between fish oil and your CRP levels.
But how much is “enough?” when it comes to omega-3 EPA and DHA and lowering CRP. At this point there is no definitive dose level for omega-3 specifically to reduce CRP levels. But there is an optimal level for omega-3 EPA and DHA in your red blood cells.
OmegaQuant offers at-home, simple finger-prick blood tests—known as Omega-3 Index tests—that measure the amount of EPA and DHA in your blood. As part of an overall healthy lifestyle, 8% is the targeted level for omega-3s EPA and DHA and that Omega-3 Index test results in the range of 8-12% may help to maintain, heart, brain, eye and joint health. Learn more here, here, here and here.
Summary
- Your CRP level is a biomarker of inflammation and chronic inflammation is problematic for your heart and can lead to other health issues.
- Science has demonstrated that omega-3 EPA and DHA (fish oil) is an important nutrient to support heart health, by lowering triglyceride levels, blood pressure and inflammation, including CRP levels.
- Testing is key to managing your CRP levels and your omega-3 EPA and DHA levels. Knowing your numbers allows you make dietary, exercise, lifestyle, medication and vitamin/supplement changes, as needed, to lower your CRP levels or raise your omega-3 EPA and DHA levels.
