We’ve finally reached part 3 of this cholesterol series! In parts 1 and 2, we discussed how cholesterol became the go-to measure at every checkup, and then how cholesterol actually works in your body and why aiming to lower cholesterol with a low-fat diet and/or drugs rarely, if ever, leads to improved health.
In this third part, we’re going to talk about CRP. CRP is not cholesterol, but please hear me out, it’s relevant. A blood test for CRP levels is a better predicter of long-term health outcomes than cholesterol has even dreamed of being, and if you lower CRP, you will actually be improving your health. That’s two times the win right there over a cholesterol test.
In case you missed the first two installments in this series, you can catch up here and here. To just review very quickly, total cholesterol levels in your blood have some correlation to long-term negative health outcomes, especially heart disease. However, lowering your cholesterol level does not seem to improve health outcomes, especially in older people.
This seemingly paradoxical finding is easily explained by a better understanding of what cholesterol is doing in your body. Cholesterol is in your bloodstream as part of the healing process. Yes, having high levels of LDL cholesterol in your blood is an indicator that you are not in great health. You have some damage being done to cells that requires a lot of cholesterol in order to heal. So in that way, a cholesterol test is a good measure of your current health state.
Cholesterol fails to accurately predict long-term outcomes for a very simple reason: It is there to heal, so if it does its job, then your health should be improving, or at least staying the same, not declining. If you lower your cholesterol level with medications and do not address the damage that cholesterol was being produced to heal, then that damage will continue unabated and your lowered cholesterol will not produce better long-term health. Less cholesterol available will have made your health worse, because you were unable to heal as quickly as you could before. This is the simple reason why cholesterol levels tend to increase as we get older. We need cholesterol in order to heal.
The routine cholesterol test that your doctor gives you can indeed be a good indicator of our current health state, but now you can see why the advice that we’re then given based on the cholesterol test (do whatever it takes to lower that cholesterol) can actually make our health worse. Eating less cholesterol is pointless, it does not lower the level in your blood because you do not digest cholesterol. Taking cholesterol lowering meds can lower the cholesterol in your blood, but that does not equate to better health. It’s more likely to worsen your health because it’s slowing down your body’s natural healing process. So what can we do?
We do want to have a lower cholesterol level, because a naturally lower level means there’s not a lot of damage being done to our cells, aka we are relatively healthy. Yet, if we lower the levels manually, that will make us sicker. What we need to do is to stop thinking about cholesterol as the problem that needs fixing. It is a symptom. The problem is the damage that was initially done to our cells, which triggered the immune process in our body that then produced all that cholesterol in order to heal.
Cholesterol is not the problem. Damage and inflammation are the problem that cholesterol is working to heal. To be sure we’re improving our health, we need to pay more attention to that initial damage and inflammation.
There is a way to do that. Did you know that there’s a test for inflammation levels in your blood?
The test measures C-reactive protein (CRP). CRP is a reliable indicator of systemic inflammation, because CRP is a also a part of the immune process. When any cell is damaged, your liver produced CRP, which then binds to damaged cells and attracts other immune cells to come and fix the problem. Damage to cells is always followed by inflammation, which is then followed (hopefully) by the rest of the immune processes that lead to healing. CRP is part of initiating this whole immune system healing process.
Both cholesterol and CRP are part of the immune process. In isolation, neither of these necessarily mean that you will have worsening health long-term, as they are both healthy processes for your body. CRP attracts immune cells to come and repair the damaged cells. Cholesterol is the most important ingredient for cell repair, since it is literally the structure of the cell walls.
According to both WebMD and Harvard Health, only about 50% of people who suffer heart attacks have high LDL cholesterol levels. You couldn’t find something that correlated less if you tried. Measuring, monitoring, and trying to manipulate cholesterol levels has failed to improve our health outcomes. CRP could be the simple answer that replaces this cholesterol mess we’ve gotten ourselves into.
Here are two reasons that you should talk to your doctor about your CRP levels instead of your cholesterol levels.
1. CRP predicts cardiovascular disease better than cholesterol (or anything else).
Are we shocked? Probably not since we’ve seen just how unreliable cholesterol is as an indicator. CRP, on the other hand, is so highly predictive that some medical resources have started saying that it is actually a test of heart health.
It’s not, it’s just a test of inflammation.
CRP is highly correlated with heart disease because CRP is highly correlated with every disease. CRP shows us how much systemic inflammation we have. The only thing we know for sure from inflammation is that there has been damage done. Damage to cells results in inflammation, every time. It says nothing about the cause or origin of the inflammation. In this way, CRP is a predictor of overall health and cannot be used to pinpoint any specific disease. It is always found to be positively correlated with every illness, from Rheumatoid Arthritis to COVID-19.
CRP is more highly correlated with heart disease than cholesterol because CRP is one of the very first processes the immune system employs when damage has been done. A high level of CRP indicates that damage is currently being done, or is ongoing. Cholesterol is produced near the end of the immune processes, to rebuild the cells. So if you have a high level of cholesterol in your blood, that indicates some damage has been done, but it is currently being repaired. If you have a high level of CRP in your blood, that means that damage is being done that has not yet been repaired.
The fact that CRP is not specifically an indicator of heart disease doesn’t in any way lessen its importance as a health indicator. It is a predictor of the direction your overall health is moving in. What could be more important than that? Why would we aim to only prevent heart disease when we could be preventing every chronic illness all at once?
The good news is that when CRP levels lower, it indicates that your overall health is improving. All disease risk is decreasing and any current disease is improving, not just heart disease.
2. Your doctor cannot give you a medication for CRP levels, but diet and lifestyle has been shown to improve it greatly.
When you get your cholesterol tested and it’s high, you will be given a pill to lower it, because diet makes no difference. The pill will likely lower your cholesterol, but will it improve your health? Probably not. If your cholesterol level has lowered, you cannot be sure why it has lowered, and if you have not lowered it by first also lowering the amount of damage being done (that the cholesterol is there to fix), then lowering cholesterol will not improve your health, it will worsen it.
A CRP test is exactly the opposite. CRP is a proven indicator of long-term health that your doctor will not give you a pill to fix. Certain medications have been shown to lower CRP levels in some people, but since CRP is the first step in a healthy process, lowering it with medications has unsurprisingly never been shown to improve any health outcomes. For this reason, medication is not prescribed to lower CRP, but you can reduce it with changes in your diet and lifestyle, and doing so will have an unquestionably positive outcome for your health. CRP is one of the first steps of the immune process. If your CRP is lowered, that proves there is less damage happening. There are no other steps in between to confound the connection there.
The way to lower CRP is to lessen the amount of damage being done to our cells. Just like cholesterol, CRP is not the problem. Unlike cholesterol, there is no CRP in the food that we eat, so we don’t get senseless advice like “just don’t eat it”. Also unlike cholesterol, when we see improved CRP levels, we can be 100% confident that we are improving our health.
Again, it’s important to remember that CRP is highly correlated with every kind of ill health. For this reason, it’s recommended to test CRP at least twice, about 2 weeks apart the first time, because it can fluctuate. Your CRP could be high because of an injury or acute illness that you will quickly recover from. Literally any damage to any cell will result in inflammation and an increase in CRP production. A single high result does not predict long-term health deterioration, but if the high level persists, that is proof that your body is sustaining ongoing damage.
In 2002, The New England Journal of Medicine published a study that really drives home the point that you should be working to improve your CRP level, not your cholesterol level. The study followed almost 28,000 healthy women for 8 years, assessing both their LDL cholesterol levels and their CRP levels. They found that cardiovascular risk was significantly greater for people with low LDL cholesterol and high CRP levels than in those with low CRP and high LDL cholesterol. Now you know why this was the obvious outcome. CRP indicates that damage is being done. LDL cholesterol indicates that damage is being healed. Lower cholesterol only, and you will be left with damage that isn’t being healed. Lower CRP, and you will also lower the need for any LDL cholesterol.
Lifestyle changes can improve your overall wellness and lower your CRP naturally. A good way to start is by eating things that digest more easily in your body. Cook all of your vegetables. Limit your sugar intake as much as possible. Replace processed oils (those made from seeds, legumes, or grains) with natural oils (from fruits, like coconut, olive, and avocado). Eat more natural fats. These small changes will start to remove some of the ongoing causes of the damage that increases both CRP and cholesterol levels in our blood.
CRP is usually part of the routine blood panel at every health checkup. Most doctors just don’t point out the results to you, because they don’t have anything to give you to fix it. Now that you know it’s the measure that matters the most to your long-term health, go ahead and ask them to show you your CRP results every time! You can take control of this measure, and by extension, your cholesterol levels, your heart health, and every other future chronic health concern. If your CRP levels are falling, your health is improving. All of it. It really is that simple.
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