C-reactive Protein Test (CRP) vs Erythrocyte Sedimentation Rate (ESR or sed rate)

Wow, so I feel like I'm doing all the research here. Although I haven't yet fully discussed the results of my CRP test with my holistic gastroenteroligist who says, "don't start up on meds," I have discussed it with my medical doctor who says, "start taking 1600 mg of Asacol, twice a day." I have an appointment with my holistic doctor to discuss this in more detail on Tuesday. Until then I am not taking my medical doctor's recommendation to start back on medication, and instead I've been doing research.

Before I took the CRP test, I was lead to believe by Tanya, the PA, that it was a more accurate test for Crohn's. So I was thrilled to hear that my CRP was normal!! Yay!!! Yes, that's right. It came back normal. Yet still my medical doctor is recommending that I go back on medication even though all other tests are normal. His reasoning is because some people cannot raise their CRP, and because mine was normal it must mean that I am one with this problem. Therefore, he wants to use the prior ESR test as the primary indicator of my Crohn's activity.

The problem I have with that, is that with my online research, the ESR can be elevated because of things like smoking, salts, temperature of the testing environment, and even being exposed to high altitudes. Additionally, the ESR rate doesn't respond quickly. and may not return to normal for weeks after there is an improvement in the condition.


Another thing that can raise the ESR is an elevation in red blood cells. Well, because I was anemic, I had been worked on raising my red blood cells, and my hemoglobin went from 10.9 to 11.9 so clearly my red blood cells increased.


Hmmmm.....


Now a little about the CRP rate. It elevates between 4-6 hours of a stimulus and returns within 3-7 days following the removal of the stimulus. Meaning, if I ate onions, and that is what caused inflammation, or if the high altitude of Vail was the cause, then once I stop, the CRP would be back to normal within one week. 


I was in Vail January 5 through 9, and I ate onions on January 8. My ESR was taken on 1-10. Whether the elevated rate was caused by the increase in elevation, the onions, or something else, it can take several weeks for the ESR to go back to normal.


My CRP test was taken January 16, eight days after I ate onions. This was ample time after these events for the results not to be affected by them.  


Study after study that I read about online indicates that the CRP is a better test of Crohn's than the ESR. It will be very interesting to hear what my holistic doctor has to say about all of this in detail. I'll update you.