How to lower C-Reactive Protein (CRP) levels?

From the Guidelines

To lower C-reactive protein (CRP) levels, focus on anti-inflammatory lifestyle changes, such as regular exercise and a Mediterranean diet, as these have been shown to reduce CRP levels in studies like 1 and 1. The most effective approach to lowering CRP levels involves a combination of lifestyle modifications and, if necessary, medications. Key lifestyle changes include:

• Regular exercise, such as 30 minutes of moderate activity most days, which has been demonstrated to lower CRP levels in patients with rheumatoid arthritis 1
• Adopting a Mediterranean or anti-inflammatory diet rich in fruits, vegetables, whole grains, fatty fish, nuts, and olive oil, while limiting processed foods, red meat, and sugar, as this dietary pattern has been associated with reduced inflammation and lower CRP levels 1
• Losing weight if overweight, as fat tissue produces inflammatory substances that raise CRP
• Managing stress through meditation, yoga, or deep breathing exercises
• Ensuring 7-8 hours of quality sleep nightly
• Stopping smoking and limiting alcohol consumption to moderate levels

For medications, statins like atorvastatin (20-40mg daily) or rosuvastatin (10-20mg daily) can reduce CRP by 15-50%, as evidenced by studies such as 1. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin (81mg daily) may help temporarily. It's also important to note that certain nutrients, such as magnesium, vitamin C, and vitamin D, have been shown to have anti-inflammatory effects and may help lower CRP levels, as discussed in 1. If CRP remains elevated despite these measures, it's crucial to consult a healthcare provider to investigate underlying conditions such as infections, autoimmune disorders, or cardiovascular disease that might be causing inflammation. CRP is an acute phase protein produced by the liver in response to inflammation, and lowering it requires addressing the root causes of that inflammation in the body. Given the most recent and highest quality evidence, lifestyle modifications, particularly regular exercise and a Mediterranean diet, should be the primary approach to lowering CRP levels, with medications and nutrient supplementation considered as adjunctive therapies as needed.

From the FDA Drug Label

In adult patients with type 2 diabetes, and without clinically evident coronary heart disease, but with multiple risk factors for coronary heart disease such as retinopathy, albuminuria, smoking, or hypertension, atorvastatin calcium tablets are indicated to: Reduce the risk of myocardial infarction Reduce the risk of stroke

The text does not directly mention how to lower C-Reactive Protein (CRP) levels. Key points:

• The drug label discusses the use of atorvastatin for reducing the risk of myocardial infarction and stroke.
• It does not provide information on lowering CRP levels. 2

From the Research

Methods to Lower CRP Levels

To lower C-Reactive Protein (CRP) levels, several methods can be employed:

• Physical activity: Studies have shown that physical activity can reduce CRP levels 3, 4. Higher levels of physical activity and cardiorespiratory fitness are consistently associated with 6-35% lower CRP levels.
• Exercise training with weight loss: Exercise training with weight loss has been shown to lower serum CRP levels 5. A 2-month weight reduction program consisting of supervised aerobic exercises resulted in significant decreases in CRP levels.
• Combination of diet and exercise: Combined diet/exercise protocols have been shown to have significant anti-inflammatory effects, including reducing CRP levels 4.
• Pharmacological interventions: Certain medications, such as statins, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs), have been shown to reduce CRP levels 6.

Factors Influencing CRP Response

Several factors can influence the CRP response to physical activity and other interventions:

• Body composition: Studies have shown that body composition, such as percent body fat, can affect CRP levels 7.
• Sex: CRP levels can vary between men and women, with women generally having higher levels 7.
• Blood sample timing: The timing of blood sample collection can affect CRP levels 3.
• Diet: Diet can play a role in reducing CRP levels, particularly when combined with exercise 4.
• Smoking: Smoking can increase CRP levels, and quitting smoking may help reduce CRP levels 3.

Inconsistent Results

It's worth noting that not all studies have shown a significant reduction in CRP levels with physical activity or exercise training. A 12-month randomized controlled trial of exercise in men and women found no reduction in CRP levels 7. Further research is needed to fully understand the relationship between exercise and CRP levels.