When creating health goals, our desired outcomes are often to lose weight or feel more energized. Yet there may be another objective you want to focus on: reducing or preventing inflammation. Three out of every five people worldwide die of inflammatory diseases, making inflammation levels an important marker of health. To measure inflammation in the body, doctors turn to C-reactive protein (CRP) level tests. But how much CRP level is dangerous? And what does this test even look like?
Ahead, we’ll answer these two questions and provide some expert-endorsed ways to reduce CRP levels.
Understanding CRP
“C-reactive Protein is a biomarker that plays a critical role in assessing systemic inflammation,” says Darshan Shah, MD, the founder of Next Health. When the body experiences inflammation, it produces CRP in the liver and then releases it into the bloodstream. There’s always a small amount of CRP in the bloodstream, and we want that since normal CRP levels boost our immune system and help our bodies repair tissue.
Problems occur, however, when CRP levels rise above normal. Often, elevated CRP levels indicate that there’s an infection or inflammation present. High levels have been linked to many chronic conditions, such as obesity, diabetes, arthritis, allergies, chronic obstructive pulmonary disease (COPD), and multiple cardiovascular diseases.
These high levels are not just signs of different conditions or infections, they can also impact recovery and treatment in some cases. In one study with older patients who underwent surgery for cervical hip fractures, lower CRP levels were associated with a smoother recovery.
CRP test and results
When it comes to assessing CRP levels, the high-sensitivity C-reactive Protein (hsCRP) test is the gold standard. “Unlike regular CRP tests, the high-sensitivity version can detect even minor elevations in inflammation, helping clinicians identify risk at an earlier stage,” says Dr. Shah, “This is critical for preventative health, as it allows for early interventions through lifestyle changes, medications, or more in-depth investigations.”
There are three primary reasons a doctor orders a high-sensitivity CRP test:
Scan for inflammation flare-ups related to inflammatory or autoimmune conditions, like arthritis or lupus
Check if an anti-inflammatory medication is working
Assess someone’s risk of heart disease (and this one can only be done with a hsCRP test, not a regular CRP test)
When a doctor orders a CRP levels test, the process is similar to any other blood test: a blood sample is taken from your vein and assessed in a lab. Most people experience a prickling sensation, though others can feel some pain.
CRP levels alone cannot be used to diagnose a specific condition or to determine where inflammation exists in the body. That’s because your CRP level is a nonspecific marker of inflammation, and it’s not always due to something ominous. A toothache or common cold, for example, might be the cause of elevated CRP levels. Instead, this test is a team player alongside other diagnostic tools.
Interpreting CRP levels
In most healthy adults, less than 0.3 milligrams of CRP per deciliter of blood (mg/dL) is present. Defining this amount of CRP (or any amount) as “normal” is tricky, because “normal” varies based on a patient’s demographics and the lab where a test took place—but more on that below. Other CRP levels include minor elevation, moderate elevation, marked elevation, and severe elevation.
Here’s a rough idea of the range for each CRP level:
Normal levels: 0.3 mg/dL or less
Normal to minor elevation: 0.3 to 1 mg/dL
Moderate elevation: 1 to 10 mg/dL
Marked elevation: 10 to 50 mg/dL
Severe elevation: more than 50 mg/dL
But remember, each lab sets its own ranges for normal and elevated CRP levels, making the numbers above nothing more than an estimate. If undergoing a CRP levels test, confirm what constitutes normal or elevated with the lab where your CRP test is assessed or with your doctor.
Causes of elevated CRP levels
Each level is associated with different conditions and infections. Minor CRP elevation, for example, is often seen alongside:
Cigarette smoking
Common cold
Diabetes
Depression
Genetic polymorphisms, small changes in DNA
Gingivitis, gum inflammation
Obesity
Pregnancy
Periodontitis, gum disease
A sedentary lifestyle
Moderate elevation often correlates with systemic inflammation from an autoimmune condition, like rheumatoid arthritis or lupus. It can also be from myocardial infarction, pancreatitis, or bronchitis.
Marked elevation is associated with major trauma, acute bacterial infections, viral infections, or systemic vasculitis, a rare autoimmune disorder.
The last (but not least) level, severe elevation, correlates frequently with acute bacterial infections.
CRP levels and cardiovascular disease
One of the most interesting uses for high-sensitivity CRP tests is to assess someone’s risk for cardiovascular diseases. An elevated CRP level is a biomarker that can help predict future cardiac events, like heart attacks or strokes, and can provide a snapshot of someone’s risk of developing cardiovascular disease.
However a CRP level test is ordered for a specific individual: someone with a moderate risk for heart disease. If someone is already known to have a high risk, the CRP levels test won’t provide any new information. If someone has previously been assessed as low risk, a CRP test isn’t a standalone indicator of cardiovascular disease risk.
But for Goldilocks patients with moderate risk, a high-sensitivity CRP levels test can provide the information a doctor needs to create an effective cardiovascular disease prevention plan.
Special considerations
Many factors impact CRP levels, and not all are a cause for concern. To start, our demographics impact the “normal” and elevated CRP level ranges. Those who are biologically female have higher CRP levels than those who are biologically male—and CRP levels increase further if a woman is pregnant. Black Americans’ CRP levels also trend higher than other races and ethnic groups. CRP levels naturally increase with age as well.
Alongside demographic differences, individuals with certain medical conditions (i.e. the ones listed above) tend to have higher CRP levels. Minor elevation may be a cause for concern in a perfectly healthy 18-year-old guy, for example, but it wouldn’t be as concerning in a woman in her 50s with rheumatoid arthritis.
Strenuous exercise can also increase CRP levels temporarily, which could impact the results of a CRP levels test if taken right after a tough workout.
All this goes to show that CRP levels aren’t one-size-fits-all. To determine what is normal and elevated for you, it’s best to work with a medical professional who understands your medical history and any current conditions.
Reducing CRP levels
Your doctor ordered a high-sensitivity CRP levels test—and the results suggest your CRP level is higher than it should be. If this happens, there’s no need to panic. Lifestyle interventions and treatment for whatever is causing the inflammation in your body can help.
Maintaining a healthy diet
Keri Glassman, MS, an Integrative Registered Dietitian Nutritionist, says many dietary changes impact CRP levels. If she could provide only three tips to those struggling with elevated CRP, they would be:
Increase fiber: “Fiber has been shown in numerous studies to lower CRP,” Glassman says, “And fiber from food versus supplements has been shown to be more effective.” Common sources of fiber include lettuce, lentils, chickpeas, kiwis, apples, bananas, nuts, and quinoa.
Increase antioxidants: Glassman’s second recommendation is to increase the antioxidants in your diet. She advises that carotenoids in particular may be helpful at lowering CRP. While commonly (and correctly) associated with carrots, carotenoids can also be found in other orange and red fruits. Some leafy green veggies, including arugula, spinach, and kale, have high carotenoid concentrations too.
Increase whole foods: “Finally, if someone was eating a highly processed food diet, I would recommend modifying behavior to incorporate more whole real foods and reduce the highly packaged processed foods which are associated with higher CRP levels,” says Glassman.
These aren’t the only dietary changes that can help reduce CRP levels. Increasing the Vitamin D in your diet or trying intermittent fasting have both been associated with lowering CRP levels. But these three changes are a simple, effective place to start.
Exercise
Alongside diet, strapping on your sneakers for a run or HIIT session may lower CRP levels. A review of the literature on CRP levels and exercise suggests aerobic exercise, such as biking or jumping rope, may be the most effective type of workout to lower CRP levels.
One caveat? You’re probably not going to see much impact from walking or running once. To see marked changes to CRP levels, consistent workout sessions are required.
But this doesn’t mean you should move into the nearest gym and workout 24/7. Exercise addiction in men was correlated with elevated CRP levels. Instead, aim to hit the CDC’s activity guidelines: 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, plus at least two days of strength training.
Quitting smoking
Smoking impacts our health in various ways, including raising CRP levels. A 2023 study compared CRP levels in persistent smokers, one-time smokers, and non-smokers. On average, non-smokers had CRP levels around or below 1.0 mg/dL. One-time smokers had an average of 1.1 mg/dL. Persistent smokers CRP levels hovered around 1.3 mg/dL. Second-hand smoke, breathing in the smoke from others around you, is also associated with higher CRP levels.
The good news: when someone quits smoking or removes themselves from second-hand smoke, the lifestyle change reduces CRP levels. But as we all know, quitting is easier said than done.
To help, the U.S. government hosts an interactive website where you can build your own quitting plan. Your doctor can also be your partner-in-quitting, providing much-needed accountability and science-backed insight into how to stop smoking.
Managing stress
Believe it or not, some stress is actually healthy for us. When stress is operating business as usual, it creates some inflammation in the body, but that inflammation is countered by glucocorticoid signaling. If stress becomes chronic, glucocorticoid signaling’s anti-inflammatory benefits are impaired, leading to more inflammation (and thus higher CRP levels).
Chronic stress occurs when feelings of worry and tension don’t leave your body and brain after a stressor disappears. Getting stuck in traffic on the way to work, for example, would stress most of us out for thirty minutes. If it stresses you out the rest of the week, chronic stress may be at play.
Anyone with chronic stress can benefit from a cortisol detox, consisting of three customizable parts:
Dietary changes to reduce stress
Lifestyle changes, such as exercising more often or spending more time in nature
A toolbox of stress relief techniques for when external stressors pop up
Acupuncture
Many of the CRP reduction techniques we’ve discussed are lifestyle changes. But what if you already exercise regularly, have a good diet, don’t smoke, and manage stress but your CRP levels are elevated? In this case, acupuncture may be beneficial—though, it could be useful alongside lifestyle changes too.
Acupuncture has been shown to lower CRP levels in some studies, thanks to the practice’s ability to reduce physical pain and inflammation, especially for individuals whose symptoms are associated with a chronic condition like fibromyalgia.
If interested in acupuncture, it’s best to work with a qualified medical professional trained in the practice. During an appointment, they will insert small needles into the skin. Where those needles are inserted depends on your specific physical and mental health concerns.
Regular CRP test to monitor change
When CRP levels are elevated, a medical professional will first run additional tests to diagnose the underlying cause. After a diagnosis, they will provide individualized recommendations for medications, treatments, and lifestyle interventions (such as the ones listed above). All you have to worry about is following those directions and speaking up if you have any questions.
Typically, a doctor will also schedule regular check-up tests to monitor CRP levels. These regular tests can help determine if treatment is working and if modifications to treatment are necessary.
When to be concerned about CRP levels
When CRP levels are elevated, there may be cause for concern—if your doctor raises those concerns first. Reading and interpreting results from CRP-level tests is complicated, making it an excellent job for your doctor.
If your CRP levels are elevated, your doctor may order additional tests since CRP levels alone cannot pinpoint the cause of increased inflammation. From there, your doctor can curate the right treatment options for you.
Once a treatment plan has been made, a good doctor won’t ghost you. Instead, they will regularly monitor CRP levels and adjust your medications and lifestyle as necessary to get your CRP levels back to where they should be.
Frequently asked questions (FAQs)
What is an alarming/critical level of CRP?
An alarming or critical level of CRP is subjective. Your gender, race, pregnancy status, age, and even the lab where a CRP levels test is conducted all impact the classification of CRP levels. That said, levels above 10 ml/dL tend to be classified as marked or severe.
What level of C reactive protein is concerning?
C reactive protein (CRP) levels tend to be classified as normal when they are under 1 ml/dL. Above that may be cause for concern—if your doctor interprets the results as elevated for your specific circumstances. Unlike other markers of health, such as blood pressure or body temperature, there isn’t a set range for CRP levels. Instead, this is determined based on your medical history, gender, race, pregnancy status, age, and the lab where a CRP test was conducted.
What kind of inflammation causes high CRP?
Any inflammation causes higher than normal CRP levels. A high CRP level is an indicator of inflammation, but it cannot determine where in the body the inflammation exists or the underlying cause.
What infections cause high CRP?
Any infection that causes inflammation, from the common cold to acute bacterial infections, can cause CRP levels to rise. However, more severe infections (i.e. those acute bacterial infections) raise CRP levels significantly more than common colds and minor infections.
Final thoughts
Reducing inflammation is a worthy health goal. By monitoring CRP levels, you and your doctor can determine if you should take steps to reduce or prevent inflammation. In turn, lowering inflammation (and CRP levels) impacts a variety of health markers, from the strength of our immune system to our risk for cardiovascular disease.
If you believe you would benefit from checking your CRP levels, connect with a Parsley Health doctor. Our doctors can assess the full picture and order a high-sensitive CRP levels test if that is the right course of action for you.
