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  1. #1
    Dan J chinarider's Avatar
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    C Reactive Protein test & exercise= false positive?

    I wanted to see if any of you had any info or thoughts on this. My cholesterol levels have been somewhat high for a while- not terrible, but high. But my HDL has also been high, so I have good ratios. My Dr. wants to do the C Reactive Protein test. As I understand it, CRP is a marker for inflammation. If your arteries are inflamed as a result of atherosclerosis, the test will be positive. In studies involving large numbers of patients, CRP levels seem to be correlated with levels of cardiovascular risk. In fact, CRP seems to predict cardiovascular risk at least as well as cholesterol levels do.

    But any inflammation will cause high CRP levels. In fact, I also have some gout issues. My Dr. said the test wouldn't be valid if I recently had a gout attack, because that involves inflammation (A lot if you've never experienced it, you don't want to. It's no fun).

    I believe the training effect results, in part, from the training causing microscopic damage to muscle cells, which then heal stronger. See the problem-- training causes muscle inflammation. Will or could it cause a false positive on the CRP test? How long would one have to not ride to avoid this? I may have thought of this too late. MY appointment is a week from Wednesday, so I have to do the blood draw in the next few days to have the results back. We have a group ride Tuesdays. We normally ride pretty hard. We don't kill ourselves, but it is a hard ride. Should I skip it? Or if I ride it, but take Wednesday off, can I have the test done Thursday? Any thought would be appreciated. The doc wants this test to help decide whether I should go on a statin. I'd sure hate to get this recommendation as a result of a hard ride. Thanx.

    Dan
    1974 Stella 10 Speed
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    “The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.”
    Bertrand Russell

  2. #2
    Banned. The Weak Link's Avatar
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    According to my quick and dirty research, low levels of physical activity are more likely to generate a false positive.

  3. #3
    Dan J chinarider's Avatar
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    Quote Originally Posted by The Weak Link View Post
    According to my quick and dirty research, low levels of physical activity are more likely to generate a false positive.
    I did some quick & dirty research too. What I saw said strenuous exercise could cause mildly elevated CRP levels. Think I'll do the ride tomorrow, take Wednesday off & do the blood draw Thursday morning. If the levels are just a little high, I'm not going on a statin (unless my cholesterol has gone up; then I'll consider it). This may be one of the many cases of mainstream medicine not understanding the athletic patient.
    1974 Stella 10 Speed
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    “The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.”
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  4. #4
    Old Fogy
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    Do a search on statin drugs before you leap into this! The possible side effects are too much for me to risk it. I have two friends whose quality of life is greatly reduced because of the muscle damage caused by statin drugs.

  5. #5
    Don from Austin Texas
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    Quote Originally Posted by chinarider View Post
    I wanted to see if any of you had any info or thoughts on this. My cholesterol levels have been somewhat high for a while- not terrible, but high. But my HDL has also been high, so I have good ratios. My Dr. wants to do the C Reactive Protein test. As I understand it, CRP is a marker for inflammation. If your arteries are inflamed as a result of atherosclerosis, the test will be positive. In studies involving large numbers of patients, CRP levels seem to be correlated with levels of cardiovascular risk. In fact, CRP seems to predict cardiovascular risk at least as well as cholesterol levels do.

    But any inflammation will cause high CRP levels. In fact, I also have some gout issues. My Dr. said the test wouldn't be valid if I recently had a gout attack, because that involves inflammation (A lot if you've never experienced it, you don't want to. It's no fun).

    I believe the training effect results, in part, from the training causing microscopic damage to muscle cells, which then heal stronger. See the problem-- training causes muscle inflammation. Will or could it cause a false positive on the CRP test? How long would one have to not ride to avoid this? I may have thought of this too late. MY appointment is a week from Wednesday, so I have to do the blood draw in the next few days to have the results back. We have a group ride Tuesdays. We normally ride pretty hard. We don't kill ourselves, but it is a hard ride. Should I skip it? Or if I ride it, but take Wednesday off, can I have the test done Thursday? Any thought would be appreciated. The doc wants this test to help decide whether I should go on a statin. I'd sure hate to get this recommendation as a result of a hard ride. Thanx.

    Dan
    I wish I could help you regards the ride and its an effect on the CRP test. HOWEVER...I have some thoughts about a doctor talking to you about statins if your HDL/LDL ratios are good. i would get another opinion before doing the statins. I would also see if there were possible lifestyle changes to get the LDL down. Obviously the exercise is covered, but what about diet?

    FWIW, from what I have read the jury is out on how useful the CRP test is.

    Of course, any medical advice you get on this forum is probably worth about what you pay for it, but I would sure seek another opinion before getting on a pill regimen.

    Best of luck.

    Don in Austin

  6. #6
    Don from Austin Texas
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    Quote Originally Posted by chinarider View Post
    I did some quick & dirty research too. What I saw said strenuous exercise could cause mildly elevated CRP levels. Think I'll do the ride tomorrow, take Wednesday off & do the blood draw Thursday morning. If the levels are just a little high, I'm not going on a statin (unless my cholesterol has gone up; then I'll consider it). This may be one of the many cases of mainstream medicine not understanding the athletic patient.
    Mainstream medicine is very cynical about the patient's commitment to lifestyle changes. All too often mainstream medicine gives brief lip service to the lifestyle suggestions immediately followed by pulling out the prescription pad. It seems you are dedicated to the exercise part of the lifestyle approach. I have no way of knowing if your are careful about not eating bad fats, whether you are a non-smoker, whether you take in a generous amount of fiber etc. etc. There could be a lot to be done in this regards that your doctor isn't really addressing -- or perhaps not! I know that between exercise and dietary changes I dropped my LDL from 200 to 150 in six months, my triglycerides down to a third of what they were (don't remember the numbers). This was with no meds whatsoever.

    Don in Austin

  7. #7
    Dan J chinarider's Avatar
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    Quote Originally Posted by Don in Austin View Post
    I have some thoughts about a doctor talking to you about statins if your HDL/LDL ratios are good. i would get another opinion before doing the statins.
    Actually, my Dr. is pretty good about this. I had had some tests done related to the gout. He had some questions about some of the results, so he sent me to a hematologist (who is supposed to be really smart & up on things). It was he who suggested statins, but he seems to be of the school that thinks almost everyone over 40 should be on them. When I said this to the family doc, he said "I know" and made a face to indicate his disagreement. He then suggested the CRP test for added info. I got the impression a positive CRP would not by itself lead to his recommendation for statins, but to further testing.

    I would also see if there were possible lifestyle changes to get the LDL down. Obviously the exercise is covered, but what about diet?
    My diet has never been real bad, but I've made an extra effort since my last lipid panel (in January) to be good. I've been eating pretty clean with very little beef or pork, and a lot of fruits & veggies. Almost no junk food. Hopefully the LDL and triglycerides will be down, the HDL up & the CRP normal.
    1974 Stella 10 Speed
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  8. #8
    Dan J chinarider's Avatar
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    Quote Originally Posted by Don in Austin View Post
    I have no way of knowing if your are careful about not eating bad fats, whether you are a non-smoker, whether you take in a generous amount of fiber etc. etc.
    My diet is pretty good as indicated above (altho I'm not a diet nazi) including fiber & I'm a non smoker.
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  9. #9
    Don from Austin Texas
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    Quote Originally Posted by chinarider View Post
    Actually, my Dr. is pretty good about this. I had had some tests done related to the gout. He had some questions about some of the results, so he sent me to a hematologist (who is supposed to be really smart & up on things). It was he who suggested statins, but he seems to be of the school that thinks almost everyone over 40 should be on them. When I said this to the family doc, he said "I know" and made a face to indicate his disagreement. He then suggested the CRP test for added info. I got the impression a positive CRP would not by itself lead to his recommendation for statins, but to further testing.



    My diet has never been real bad, but I've made an extra effort since my last lipid panel (in January) to be good. I've been eating pretty clean with very little beef or pork, and a lot of fruits & veggies. Almost no junk food. Hopefully the LDL and triglycerides will be down, the HDL up & the CRP normal.
    Sounds like you are on the right track. Best of luck to you.

    Don in Austin

  10. #10
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    Statins for primary intervention is an outright fraud. I was on Pravachol for a few years before I realized that the trial report in the New England Journal of Med, on which I based my decision lied. They did not disclose that some thing like 40% of the cohort who already had symptoms of cardio issues: it was a secondary intervention intervention trial pawned off as primary.

    My primary care physician agrees.

    Check these out:

    http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm?chan=top+news_top+news+index_top+story

    http://www.businessweek.com/magazine/content/08_04/b4068052095204.htm

    http://blogs.wsj.com/informedreader/2008/01/18/drug-makers-latest-worry-statins/

    Also suggest you get a copy of:

    http://www.amazon.com/Overdosed-Amer...2415369&sr=8-1

    Before you make a decision.

    By the way, the reducing "inflammation" can also be accomplished it appears by getting one's Omega -6 mega three ratio closer to our historical average of 1/1 to 3/1 vice the 20/1 typical today. That might be treating the cause of the inflammation. However, it will not reduce cholesterol.

    It's not really understood why as many folks have cardio issues with low cholesterol as with high. It is known that strenuous exercise reduces the risk far more than any drug. The best reduction (at the most strenuous exercise levels) is 1/12 the risk.

    I showed the text/data to my doctor and he said he was ordering a copy.

    Al


  11. #11
    Dan J chinarider's Avatar
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    Got the results of my blood draw:
    Total cholesterol- 215 (217 in May; 253 Nov 08)
    HDL- 67 (63 May; 60 11/08)
    for Ratio of 3.2 (lowest risk according to the chart on the results)
    Triglycerides 119 (113 May; 192 11/08)
    LDL calculated-124 (131 May; 155 11/08)

    CRP was .68. According to the results on the chart anything less than 1 is low risk for cardiovascular disease. So, no Statins for me.

    My blood counts remain slightly low (this is why he sent me to the hematologist last winter). But I have no symptoms of anemia, so I'm not too worried about it. In fact, I think I'm going to cancel my appointment for next week since my health insurance sucks and doesn't cover office visits. Any thoughts are welcome.

    Dan
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    “The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.”
    Bertrand Russell

  12. #12
    Don from Austin Texas
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    Quote Originally Posted by chinarider View Post
    Got the results of my blood draw:
    Total cholesterol- 215 (217 in May; 253 Nov 08)
    HDL- 67 (63 May; 60 11/08)
    for Ratio of 3.2 (lowest risk according to the chart on the results)
    Triglycerides 119 (113 May; 192 11/08)
    LDL calculated-124 (131 May; 155 11/08)

    CRP was .68. According to the results on the chart anything less than 1 is low risk for cardiovascular disease. So, no Statins for me.

    My blood counts remain slightly low (this is why he sent me to the hematologist last winter). But I have no symptoms of anemia, so I'm not too worried about it. In fact, I think I'm going to cancel my appointment for next week since my health insurance sucks and doesn't cover office visits. Any thoughts are welcome.

    Dan
    The HDL kicks ass and that is what's important. Keep it up and just say no to the pills!

    Don in Austin

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