From the Research
Elevated blood protein levels can result from various conditions including infections, inflammation, certain cancers, and autoimmune disorders, with the most recent evidence suggesting that rheumatoid arthritis is a significant contributor to this condition 1.
Causes of Elevated Blood Protein
The causes of elevated blood protein levels are diverse and can be attributed to several factors, including:
- Infections, which trigger increased production of immunoglobulins and acute phase reactants as part of the immune response
- Chronic inflammatory conditions like rheumatoid arthritis or inflammatory bowel disease, which can cause persistent protein elevation
- Certain cancers, such as multiple myeloma, which can lead to significantly elevated protein levels due to excessive production of monoclonal immunoglobulins
- Liver diseases like cirrhosis, which may elevate blood proteins by reducing the liver's ability to regulate protein metabolism
- Dehydration, which can cause falsely elevated readings due to concentrated blood volume
- Autoimmune disorders, which trigger antibody production that increases total protein levels
- Certain medications, particularly corticosteroids and some antibiotics, which may also affect protein levels
Diagnosis and Treatment
When elevated blood protein is detected, further testing is typically needed to determine the specific proteins involved and the underlying cause, which might include protein electrophoresis, immunofixation, or specific antibody tests depending on clinical suspicion. Treatment always targets the underlying condition rather than the protein elevation itself, with methotrexate being a commonly used and effective treatment for rheumatoid arthritis, as evidenced by recent studies 2, 1. Some key points to consider in the treatment of rheumatoid arthritis with methotrexate include:
- Methotrexate is generally well-tolerated, but has important, albeit uncommon, potential side-effects including a risk of liver toxicity and cytopenias
- More active monitoring in patients with fatty liver disease may be appropriate
- More rapid dose escalation and use of subcutaneous therapy may provide even greater success
- Methotrexate has been shown to have off-target benefits, such as a reduction in cardiovascular disease risk, although these studies may suffer from confounding.