Posted , 10 users are following.
I live in a jurisdiction which only allows one of these tests to be done at the same time. My GP has always used ESR, but locum used CRP, and said rheumatologists recommend this measure be used in PMR. And what are the healthy levels for these tests? Internet and Dr Google just confusing me today!
0 likes, 16 replies
We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.
Twopies Anhaga
Posted
Well, throughout this pmr journey, my crp had been perfect...right from the get-go. So for me, crp would not have been an indicator. I'm certainly no authority, this just has been my experience.
Anhaga Twopies
Posted
I hadn't had CRP done since used at original diagnosis over two years ago - and it has crept up in two readings three months apart although not as high as at beginning of PMR journey. The locum was concerned and told me to increase pred to 5mg! I didn't; compromised with 3mg as I had been feeling a bit rotten, and that has helped me feel better.
eddylynn36538 Anhaga
Posted
My internest always uses the crp number while rheumatologist uses esr. Both numbers show up from single blood work. My crp is normal but my esr was 48. My rheumy said the inflammation is still there but as I wasn't suffering much pain ( a little in shoulders when I wake up) I didn't have to go back up unless it became a problem. I had been on 7mg pred for a month and she said to stay there for another couple of months before trying to reduce. My gp lets my rheumy decide. Very happy with all my doctors.
amkoffee Anhaga
Posted
I had an elevated ESR for two years before any pain set in. At the same time I was running a low-grade fever in the mornings. My doctor had no idea why I was running this elevated ESR or the low grade fever but assumed it was probably because of my lower back issues. Then when the pain came my doctor did the blood test and this time my ESR was higher than it has ever been and my CRP was also elevated. So take this information anyway you want.
Anhaga amkoffee
Posted
Thanks Amkoffee. I'm going to see if there's a way to work around this lack of proper testing. Pretty bad when a system becomes so tied up in money-saving knots patients have to try to figure out workarounds, but I should be grateful the system is there.
EileenH Anhaga
Posted
Depends on the patient - some people find one is raised, others it is the other, some people have both and some have neither. What show up best for you? Which of course means you need to have both done at some point to find out.
ESR is affected by more extraneous things and if the test can't be done promptly within 4 hours of taking the blood sample there may be errors. The acceptable range is 1-20, anything above that is indicative of the presence of inflammation somewhere. It used to be said up to 35 was OK - and they used an equation to work it out according to age up to age 55. Then it stayed the same. But now they realise that those higher figures were not "normal ageing" - there was undiagnosed inflammation.
CRP is one of the proteins that contributes to the reading you get for ESR (erythrocyte sedimentation rate) - the rate at which RBCs settle in a vertical tube of whole blood. If blood proteins are raised - the cells settle faster and the ESR is raised.
Every lab has its own figure for normal CRP depending on their technique and the units. You should find it in brackets after the result on the sheet. They should be low though, under 1 or under 10 are usual levels (factor of 10 in the units).
Twopies EileenH
Posted
Anhaga EileenH
Posted
Maybe we can get around this by doctor ordering the tests on different sheets and I going in on different days? I live so near the hospital it would be easy enough to do.
Anhaga Twopies
Posted
Yes, Twopies I think it's been decided that it isn't normal for older people to have higher inflammatory markers. As at any age higher numbers indicate inflammation is present and older people just happen to have more inflammation, doesn't mean that inflammation isn't a problem. The first doctor I went to with the ongoing pain, my old GP having retired literally days before I became an interesting and needy patient, thought my inflammation markers weren't significant. She also said that my iron was normal, when in fact ferritin level was barely registering. It was a new doctor who saw these as red flags.
BettyE Anhaga
Posted
I'm amazed that you can only have one test at a time. Does that apply across the board?
I recently asked by 'phone to have ESR and CRP added to my routine U+Es as I was having more pain than usual and wondered about the possibility of a return of PMR.
When I arrived I found that my GP had added several others: LFT, Bone Group, ( what's that? ), FBC and others that I cannot now remember as they say in Confession. All ok and pain resolved but surely that is more efficient than having to repeat tests one at a time. I'm in Norfolk UK.
Anhaga BettyE
Posted
Betty, yes, this must be one of the stupider ways "they" try to save money. For example I could only get an annual Vitamin D test although the first one showed I was at some risk of toxicity if the level was going too high. Not having regular tests meant I had no way of knowing if the level at the first test was marginally safe or if I was trending upwards because of increased supplementation and had to have a mid-year test done privately. I don't live in the UK but in a different country which claims to have universal health care.
EileenH BettyE
Posted
Anhaga BettyE
Posted
Betty, I get more than one test at a time, I misunderstood your statement. I just can't get tests which allegedly measure the same thing at one time. I was getting random glucose, ferritin, CBC, and ESR done at one time. Vitamin D is allowed once a year. Either, but not both, CRP or ESR.
BettyE Anhaga
Posted
BettyE EileenH
Posted
Thank you, Eileen.
As you know, I had "amazing bone density" four and a half years ago according to my hip replacement surgeon. Good to know I must still be replacing it.
In case this is of interest to anyone, I was unable to take Alendronic Acid and had eight years of Pred. altogether. The only supplement I had was Calceos.
EileenH BettyE
Posted