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Creatine Kinase (Blood)

 Website: Creatine Kinase (Blood) - Health Encyclopedia - University of Rochester Medical Center

Does this test have other names?

Creatine phosphokinase, CK, CPK

What is this test?

This test measures the amount of an enzyme called creatine kinase (CK) in your blood.

CK is a type of protein. The muscle cells in your body need CK to function. Levels of CK can rise after a heart attack, skeletal muscle injury, or strenuous exercise. They can also go up after drinking too much alcohol or from taking certain medicines or supplements.

CK is made up of 3 enzyme forms. These are CK-MB, CK-MM, and CK-BB. CK-MB is the substance that rises if your heart muscle is damaged. CK-MM rises with other muscle damage. CK-BB is found mostly in the brain. If this test shows that your CK levels are high, you may have muscle or heart damage.

Why do I need this test?

Your healthcare provider may order this test if you may have muscle damage or injury. But because levels of this protein may not peak for up to 2 days after certain injuries, you may need to have this test several times to see if your heart or other muscles have been damaged.

You may also need this test if you have chest pain or weakness and your healthcare provider wants to see t if you've had a heart attack.

If you are taking statin medicines and have unusual muscle cramping and pain or muscle weakness, your healthcare provider may also order a CK test. Statin medicines are used to treat high cholesterol. They sometimes cause serious muscle injury. In very rare cases, they can even lead to a rapid, life-threatening muscle breakdown.

What other tests might I have along with this test?

Your healthcare provider may order other tests to find out if you have had muscle injury or a heart attack. If you have had a heart attack, your healthcare provider may order a blood test to look for high levels of cardiac troponin. This is another protein found in your heart. Cardiac troponin has replaced CK-MB as the test of choice to find out if you’ve had a heart attack. This is because cardiac troponin is more sensitive and more specific.

Or the healthcare provider may order tests to see how you are recovering. These tests include:

• Other blood tests

• Electrocardiogram (ECG) to measure the electrical activity of your heart

Because levels of CK may rise if you have a thyroid problem, alcohol abuse, or kidney failure, your healthcare provider may also order tests to look for these diseases.

What do my test results mean?

Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

The normal range for general CK varies by age and gender. Race is also known to affect CK levels. 

How is this test done?

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

Does this test pose any risks?

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

What might affect my test results?

Strenuous exercise, recent surgery, and certain medicines may make your CK levels higher than normal.

African Americans naturally have higher levels of CK. Some people with a muscular build also have higher levels of CK.

How do I get ready for this test?

You don't need to prepare for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use. 

Medical Reviewers:

• Chad Haldeman-Englert MD
• Kenny Turley PA-C
• Maryann Foley RN BSN

What is high-sensitivity C-reactive protein? Can you lower it with food?

 Website: What is high-sensitivity C-reactive protein? Can you lower it with food? - Pritikin Weight Loss Resort

In several studies, the Pritikin Eating Plan combined with regular exercise has proven remarkably effective in lowering high-sensitivity C-reactive protein, often abbreviated as hs-CRP.

Within three weeks of eating and exercising Pritikin style, scientists at UCLA documented that hs-CRP levels fell on average 39% in men,1 45% in women,2 and 41% in children.3

The Pritikin Eating Plan focuses on whole foods naturally rich in fiber and low in salt and sugar, such as fresh fruit, fresh vegetables, and whole grains, and lean sources of protein like beans/legumes, fish, white poultry, egg whites, and nonfat dairy foods.

Biomarker of cardiovascular disease risk

In recent years, hs-CRP has been endorsed by several public health organizations4,5,6 as a biomarker of cardiovascular disease risk.

What is hs-CRP?

High-sensitivity C-reactive protein is produced by the body when blood-vessel walls are inflamed. The higher your levels of hs-CRP, the higher your levels of inflammation tend to be.

But before we go any further, it’s important to distinguish between acute inflammation and chronic inflammation.

Acute inflammation

Inflammation can be a very good thing. Think of inflammation like a burner on a gas stove. When you suffer an injury, like a cut on your finger, your body turns up the flame. Your immune system sends in an army of white blood cells that fight infection and promote healing. This is called local or acute inflammation.

Chronic inflammation

But problems can occur for the arteries and heart when your body keeps that burner going.

This low, steady burn, known as chronic inflammation, is not caused by a single injury, like a close encounter with a paring knife. Rather, it’s the result of constant injury to the inner walls of our arteries, and it’s brought on by lifestyle factors like poor food choices that lead to excess bad cholesterol in the blood, excess blood glucose, and high blood pressure.

Chronic inflammation in the arteries creates a breeding ground for the formation of fatty streaks, which can eventually lead to cholesterol-rich plaques and ultimately, heart attacks and strokes.

Many other diseases are also linked with chronic inflammation, and include arthritis, autoimmune diseases, cancer, diabetes, and pulmonary diseases.

Lowering hs-CRP

That’s why it’s so critical to focus on lowering inflammatory markers like high-sensitivity C-reactive protein.

Your hs-CRP score | What to aim for

A large clinical trial demonstrated significantly less cardiovascular risk for patients with hs-CRP scores that were less than 2.0 mg/L.7

General guidelines for hs-CRP scores:

• Low risk of cardiovascular disease: Less than 1.0 mg/L
• Average risk: 1.0 to 3.0 mg/L
• High risk: Above 3.0 mg/L

Above 10 mg/mL usually indicates acute inflammation.

What is the difference between CRP and hs-CRP?

As you’ve no doubt guessed, the difference between CRP and hs-CRP is contained in the “hs” abbreviation – “high sensitivity.”

Traditionally, CRP, or C-reactive protein, is measured down to concentrations of 3 to 5 mg/L; hs-CRP is measured down to concentrations of approximately 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.

Other markers of chronic inflammation

Other markers of chronic inflammation include noxious chemicals released by both white blood cells and fat cells. They’re called inflammatory cytokines.

In a 2013 study on overweight and normal-weight children at the Pritikin Longevity Center, scientists at UCLA found that within two weeks, levels of inflammatory cytokines dropped markedly.8 Similar results published in several studies over the past decade have been observed in adults attending the Pritikin Longevity Center.

What is high-sensitivity C-reactive protein? How to lower hs-CRP | Bottom Line

When we exercise regularly and eat well, focusing on heart-healthy whole foods as the Pritikin Eating Plan does, we’re not only taking good care of our hearts; we’re taking good care of all kinds of lesser-known but incredibly important heart-protective systems within us, like our ability to prevent chronic inflammation.

What Is a C-Reactive Protein Test?

 Website: C-Reactive Protein (CRP) Test: High vs. Low Levels, Normal Range (webmd.com)

If you have high cholesterol, you've probably been told to lower the LDL number from your blood test. LDL is the "bad cholesterol," the type that contributes to plaque that can clog your arteries. This can lead to a heart attack or stroke.

But that's only part of the story. Research shows that only 50% of people who suffered heart attacks had high LDL levels. So, many doctors use another test called the C-reactive protein test to help figure out who’s at risk.

C-reactive protein (CRP) is produced by the liver. Its level rises when there is inflammation in your body. LDL cholesterol not only coats the walls of your arteries, but it also damages them. This damage causes inflammation that the body tries to heal by sending a "response team" of proteins called "acute phase reactants." CRP is one of these proteins.

One study found that testing for CRP levels is a better indicator of cardiovascular disease (CVD) than the LDL test. But, it's important to know that a CRP test is not a test for heart disease. It's a test for inflammation in the body.

The test is also used for people suffering from autoimmune diseases like lupus and rheumatoid arthritis. They also cause inflammation. A doctor might test someone with either condition to see if anti-inflammatory medication is working, though the CRP test cannot determine where the inflammation is taking place.

A variation of the CRP test, the high-sensitivity CRP (hs-CRP), is used to check for cardiovascular disease.

It’s a simple blood test. A sample is drawn from a vein, most likely in your arm. No special preparation is needed (like fasting) and the test is not painful beyond a sting on the arm from where needle is inserted. The test may be affected by medications you take, so ask your doctor if you need to cut back beforehand. The blood sample is tested at a lab.

Here are what the results mean:

• hs-CRP level of lower than 1.0 mg/L -- low risk of CVD (heart disease)
• hs-CRP level of 1.0 mg/L and 3.0 mg/L -- moderate risk of CVD
• hs-CRP level of more than 3.0 mg/L -- high risk of CVD

A high level could also be a sign of cancer, infection, inflammatory bowel disease, lupus, rheumatoid arthritis, tuberculosis, or another disease. It could also be high because you're in the second half of your pregnancy or you are using birth control pills.

The hs-CRP test is most useful for people who have a 10%-20% chance of having a heart attack within the next 10 years. The test is not helpful for people with a higher or lower risk.

Because your CRP level can vary, the test should be done two times (2 weeks apart) to determine your risk of heart disease. It’s also important to remember that you could have a high reading without necessarily having heart disease. So, it's important to check your LDL levels as well to get a full picture of your CVD risk.

Fortunately, the same statin medications that lower LDL have also been shown to lower CRP levels. In addition to any medicine, you should make some lifestyle changes (cut down on fatty foods, stop smoking, and start exercising) at the same time.

High-sensitivity C-reactive Protein (hs-CRP)

 Website: High-sensitivity C-reactive Protein (hs-CRP) | Lab Tests Online

What is being tested?

C-reactive protein (CRP) is a protein that increases in the blood with inflammation and infection as well as following a heart attack, surgery, or trauma. Studies have suggested that a persistent low level of inflammation plays a major role in atherosclerosis, the narrowing of blood vessels due to build-up of cholesterol and other lipids, which is often associated with cardiovascular disease (CVD). The hs-CRP test accurately measures low levels of CRP to identify low but persistent levels of inflammation and thus helps predict a person's risk of developing CVD.

There are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:

• The standard CRP test measures markedly high levels of the protein to detect diseases that cause significant inflammation. It measures CRP in the range from 10 to 1000 mg/L. This test may be used to detect inflammation (see the article C-Reactive Protein).
• The hs-CRP test accurately detects lower levels of the protein than the standard CRP test. It measures CRP in the range from 0.5 to 10 mg/L. This test is used to evaluate individuals for risk of CVD.

CVD causes more deaths in the U.S. each year than any other cause, according to the American Heart Association. A number of risk factors, such as family history, high cholesterol, high blood pressure, being overweight or diabetic, have been linked to the development of CVD, but a significant number of people who have few or no identified risk factors will also develop CVD. This fact has lead researchers to look for additional risk factors that might be either causing CVD or that could be used to determine lifestyle changes and/or treatments that could reduce a person's risk.

High-sensitivity CRP is one of a growing number of cardiac risk markers that are used to help determine a person's risk. Some studies have shown that measuring CRP with a highly sensitive assay can help identify the risk level for CVD in apparently healthy people. This more sensitive test can measure CRP levels that are within the higher end of the reference range. These normal but slightly high levels of CRP in otherwise healthy individuals can predict the future risk of a heart attack, stroke, sudden cardiac death, and peripheral arterial disease, even when cholesterol levels are within an acceptable range.

hs-CRP could be a marker not only in apparently healthy people, recent studies have shown. Adults with congenital heart disease (ACHD) with elevated CRP have worse functional status and exercise capacity, greater risk for death, or non-elective cardiovascular hospitalization.

12+ Ways To Lower C Reactive Protein (CRP)

 Website: 12+ Ways To Lower C Reactive Protein (CRP) - SelfHacked

Written by Biljana Novkovic, PhD | Last updated: April 30, 2020

CRP is a marker of low-grade inflammation and stress that increases your risk of heart diseases. Read on to find out about the different lifestyle and dietary strategies that can help keep your CRP levels at bay.

Ways To Lower C Reactive Protein (CRP)

1) Address Any Underlying Health Conditions

CRP’s job is to increase in response to infection, tissue damage and inflammation. So it doesn’t come as a surprise that many different conditions can increase CRP.

That’s why if your CRP is elevated, the most important thing is to work with your doctor to find out what’s increasing your CRP and to treat any underlying conditions.

Discuss the additional lifestyle changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!

2) Exercise

Regular physical activity can help decrease CRP [1, 2, 3].

In a meta-analysis of 20 studies involving 1,400 people with heart disease, CRP levels decreased after exercise. People who were worse off when they started saw greater reductions in CRP [4].

The amount of exercise needed to lower CRP levels is relatively modest. Scientists have made an estimate that the total energy expenditure needed was 368 – 1,050 calories/week [5].

However, CRP levels can also increase after exercise when the exercise is stressful and causes tissue damage. CRP levels, in this case, will depend on the duration, intensity, type of exercise, and the distance traveled by an individual. CRP increases more in exercises with more distance traveled (endurance exercise) [2].

The exercise of all-out intensity and relatively short duration, no matter what type, does not elicit a significant change in CRP for the 1-hour to 5-hour period of rest following the exercise [6].

One study found that after a marathon (42.195 Km) CRP levels were unchanged, they increased by 3.4X the next day, and after four days were back to original levels [7].

On the other hand, the CRP level after an ultra-marathon (200 km) increased 40 times and it remained at the same level up to six days after the race [7].

3) Weight Loss

In those who are overweight and obese, weight loss and fat reduction were reduced CRP levels [1, 8].

One study found that the odds of achieving desirable CRP levels more than doubled with 5% loss of total body weight and fat mass [8].

Some studies suggest that total, rather than regional, fat loss are better predictors of change in inflammatory burden [8].

Other studies, however, indicate that fat stored in the abdomen and thigh muscles are associated with higher levels of CRP independent of total fat mass, suggesting that greater reduction of fat in these regions may be associated with greater improvement in CRP levels [8].

4) Balanced Diet

Healthier diets are independently associated with lower CRP levels, suggesting that diet is associated with systemic inflammation [9].

Diets high in fiber and rich in fruits and vegetables are associated with lower CRP levels, while a Western diet and diets high in fat, sugar, and refined grains can increase CRP [9].

High dietary fiber intake, in particular, has been associated with lower CRP levels [10, 11].

In one study, participants received a 45% fat 1,000 Kcal Mediterranean-like meal (monounsaturated 61% of fat) or a Western-like meal (saturated 57% of fat). The Mediterranean-like meal resulted in a decrease in CRP 2 hours after eating [12].

5) Alcohol in Moderation

Light alcohol intake (1 glass/day), rather than abstention or abuse, has been associated with lower CRP levels [1, 13, 14].

In one study, moderate wine consumers had significantly lower levels of CRP than women who drank no or little wine [15].

Combined consumption of white wine and extra-virgin olive oil also decreased CRP in chronic kidney disease patients [16].

However, the association between alcohol and CRP concentration appears to be mediated primarily by the alcohol itself and not dependent on the type of alcoholic beverage consumed [17].

Remember that alcohol in excess can have many negative health effects! Discuss your alcohol consumption with your doctor.

6) Yoga, Tai Chi, Qigong, and Meditation

Yoga, Tai Chi, and Qi Gong are exercise therapies that integrate moderate physical activity, deep breathing, and meditation to promote stress reduction and relaxation, which can beneficially influence the immune system and overall health [18, 19].

Studies suggest that 7 to 16 weeks (1 – 3 hrs weekly) of these “mind-body therapies” can cause significant improvements in CRP levels [18].

People who do them longer and persistently may reap better effects. When long-term expert hatha yoga practitioners and novices were compared in a study, expert practitioners had lower CRP levels [20].

However, even shorter interventions seem to be beneficial.

In one study, an 8-week regimen of yoga in addition to standard medical therapy significantly reduced CRP levels in patients with heart failure [21].

In another study, a gentle form of tai chi in patients with type 2 diabetes who were also obese decreased CRP levels [22].

Similarly, a decrease in CRP was also observed in older depressed participants receiving an SSRI (escitalopram) when they also practiced tai chi [23].

In two studies with cancer patients, medical qigong lowered CRP levels, reduced the side effects of cancer, and improved the quality of life [24, 25].

A practice of mindfulness in faculty members of Ohio State University who had elevated CRP helped decrease their CRP levels. Although not statistically significant, at 2-months the CRP level was on average 1 mg/ml lower – a change that may have clinical significance [26].

In people with inflammatory bowel disease (IBD), attending a workshop for breathing, movement, and meditation significantly helped decrease CRP by week 26 [27].

Both walking meditation and walking exercise may reduce CRP levels in depressed seniors [28].

7) Sexual Activity

In one study, men who were sexually active with a partner (more than once a month) were less likely to be in a higher CRP category five years later than men who weren’t. Yet, a higher frequency of sex (i.e., 2 – 3 times a month or once a week or more) was not related to CRP in men [29].

Women with sexual partners had significantly lower CRP at midcycle, and higher CRP at other phases; in contrast, sexually-abstinent women had little cycle-related change in CRP [30].

8) Optimism

In a study with over 6.8k people, inflammatory markers including CRP were increased in those prone to pessimism [31].

In another study, lower self-rated health was associated with elevated CRP even among apparently healthy individuals (over 13.7k participants) [32].

Finally, in a third study, poor self-rated health was significantly associated with elevated CRP levels in over 11k women [33].

9) Vitamin A, C, D, K Sufficiency

Vitamins are nutrients our bodies need but can’t produce themselves that are important for health and proper body function. When there is not enough of certain vitamins, our body starts functioning suboptimally. Some deficiencies can even have serious health consequences.

Blood vitamin C concentrations were found to be associated with lower CRP levels in both men and women, primarily among non-smokers, non-overweight women and postmenopausal women [34].

Supplementation with Vit C + Calcium + Iron reduced CRP and oral pathogens in a rural population with periodontitis [35].

In another study, elevated CRP was associated with vitamin D deficiency in the urban elderly [36].

Elevated CRP was associated with vitamin A deficiency in multiple studies (mainly in developing countries) [37, 38, 39].

Finally, CRP was elevated in vitamin K deficiency in both seniors and young adult women [40, 41].

10) Coffee and Green Tea

Research suggests that there’s a link between higher coffee consumption and lower CRP [42, 43].

Coffee consumption was associated with lower CRP in a study of overweight/obese postmenopausal women [44].

One study found that CRP was progressively lower with increasing levels of coffee consumption in men, but not in women [45].

Another study in Japanese women found significantly lower levels of CRP in the group of > or = 1 cup/day compared to that of < 1 cup/day [46].

Additionally, studies have found that green tea extract reduces inflammatory biomarkers including CRP [47].

Green tea consumption in a multi-ethnic Asian population was associated with lower CRP concentrations [48].

In another study, green tea catechins in the blood were shown to be weakly to moderately associated with lower CRP [49].

However, NOTE THAT one study showed that hot tea consumers had lower CRP compared to non-consumers of both sexes, whereas iced tea consumers had significantly higher CRP [50].

11) Cannabis

In a survey of over 10.8k adults aged 20 – 59, recently active cannabis smokers had generally lower CRP levels compared to US community residents of the same age who had never smoked cannabis [51].

Another study found that the prevalence of elevated CRP (> 0.5 mg/dl) was significantly higher among non-marijuana users than among past, current light or heavy users (over 9k people) [52].

12) Supplements

Discuss the following supplements with your doctor. Research suggests they may help decrease CRP levels:

• Fiber [53, 54, 55]
• Cocoa and dark chocolate [56, 57, 58, 59]
• Folate [1, 60, 61, 62]
• Magnesium [63, 64]
• Omega-3 [65, 2, 66, 67]
• Vitamin E [68, 69, 70]

Remember, always speak to your doctor before taking any supplements, because they may interfere with your health condition or your treatment/medications!

About the Author

Biljana Novkovic

PHD

Biljana received her PhD from Hokkaido University.

Before joining SelfHacked, she was a research scientist with extensive field and laboratory experience. She spent 4 years reviewing the scientific literature on supplements, lab tests and other areas of health sciences. She is passionate about releasing the most accurate science and health information available on topics, and she's meticulous when writing and reviewing articles to make sure the science is sound. She believes that SelfHacked has the best science that is also layperson-friendly on the web.