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How Should High CRP And Low Hemoglobin Counts Be Managed?

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Posted on Mon, 18 Jul 2022
Question: Hi,
I got the following blood lab report. Need second and third opinions:

C-Reactive protien = 6.0 mg/L
Haemoglobin = 129 g/L
PSA = 0.01 ug/L (does that mean my testosterone will be very low too?) Is it also called undetectable PSA?)
GGT = 53 u/L
ALP = 119 u/L

Male, 35, diabetic, obese, hypertensive.
Thanks
doctor
Answered by Dr. Malik (1 hour later)
Brief Answer:
LAb results are suggestive Liver or Biliary tract injury

Detailed Answer:

Hello,

Your laboratory results show high CRP (normal below 3.0 mg/dL), low hemoglobin 129 g/l (reference 135 – 175 g/l) and slightly high gamma-glutamyltransferase - 53 u/L (reference 9–48 U/L) and increased alkaline phosphatase 119 u/L (reference 40–116 U/L). I am providing normal reference values because depending on the lab and the equipment used the values may be slightly different. If the reference values provided by your lab are different, please, provide me those values so that I can guide you better.

The lab results clearly suggestive of either liver damage from toxins (alcohol) or infections (hepatitis) or there is a disorder of the biliary system (gallbladder and bile ducts).
C-reactive protein (CRP) is an acute phase reactant produced by the liver. It is non-specific test. If there is an inflammatory process anywhere in the body CRP gets increased. It may also show the risk for the development of heart diseases (cardiovascular diseases).

Increased alkaline phosphatase mostly comes from disorders of the bone or liver or both organs. But increased gamma-glutamyltransferase along with ALP clearly shows hepatobiliary system disorder.

I would advise you to get complete liver function tests and differentiate whether it’s a liver parenchimal injury or disorders of the biliary system. High bilirubin level along with increased ALP shows whether it is biliary obstruction or liver parenchimal injury. Serum elevation of ALP and AST should show liver parenchimal injury.
Do not worry about PSA test. It is normal and has not associated with testosterone level.

Hope the information is helpful. Let me know if I can assist you further.
Thank you
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Malik (1 hour later)
Thanks. My HDL and other cholesterol is within range and all other tests are normal including LFT tests thats why I only listed the ones which are outside of range. I do not drink alcohol.

C-reactive protein is high but my doctor didn't say much about it or maybe he did not pay attention to it. Should I ask him again about this test? Is it something to worry?

Thanks
doctor
Answered by Dr. Malik (50 minutes later)
Brief Answer:
Information

Detailed Answer:

Hi,

If the other tests including LFTs are normal, please, do not worry about CRP.
Your CRP level is not so high. CRP above 10 mg/dL should be investigated. In mild inflammatory conditions CRP increases 10 to 50 mg/dL.

Majority of factors may cause slight increase (up to 10 mg/dL) of CRP such as consuming processed food, sedentary life-style, stress, tobacco or alcohol. As I told previously CRP also shows the risk for cardiovascular diseases. I would recommend you to try life style changes with exercises, weight loss and healthy diet to decrease CRP level. These life-style changes are also recommended to prevent cardiovascular diseases.

Hope I have answered your query. Let me know if I can assist you further.
Thank you
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Malik

Internal Medicine Specialist

Practicing since :2006

Answered : 353 Questions

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How Should High CRP And Low Hemoglobin Counts Be Managed?

Brief Answer: LAb results are suggestive Liver or Biliary tract injury Detailed Answer: Hello, Your laboratory results show high CRP (normal below 3.0 mg/dL), low hemoglobin 129 g/l (reference 135 – 175 g/l) and slightly high gamma-glutamyltransferase - 53 u/L (reference 9–48 U/L) and increased alkaline phosphatase 119 u/L (reference 40–116 U/L). I am providing normal reference values because depending on the lab and the equipment used the values may be slightly different. If the reference values provided by your lab are different, please, provide me those values so that I can guide you better. The lab results clearly suggestive of either liver damage from toxins (alcohol) or infections (hepatitis) or there is a disorder of the biliary system (gallbladder and bile ducts). C-reactive protein (CRP) is an acute phase reactant produced by the liver. It is non-specific test. If there is an inflammatory process anywhere in the body CRP gets increased. It may also show the risk for the development of heart diseases (cardiovascular diseases). Increased alkaline phosphatase mostly comes from disorders of the bone or liver or both organs. But increased gamma-glutamyltransferase along with ALP clearly shows hepatobiliary system disorder. I would advise you to get complete liver function tests and differentiate whether it’s a liver parenchimal injury or disorders of the biliary system. High bilirubin level along with increased ALP shows whether it is biliary obstruction or liver parenchimal injury. Serum elevation of ALP and AST should show liver parenchimal injury. Do not worry about PSA test. It is normal and has not associated with testosterone level. Hope the information is helpful. Let me know if I can assist you further. Thank you