040 - We need to talk about C-Reactive Protein (CRP) a bit more

As promised, here are the new data on systemic inflammation in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). - Jarred Younger

[youngerlab]

ERROR: The hs-CRP values I show in this video are in mg/L units (not mg/dL as I claimed). I will look over the videos and see if I need to remove them or reupload with notes added. For now, just note that all values I mention are actually mg/L, which is what you are most likely to see from your clinic or hospital anyway. Sorry for the mixup! - Jarred Younger

[zhiroslav]

It is what it is.
Thank you very much for your work and research.

[Frunobulax]

I really love your videos. Most researchers are terrified of talking about conjectures just in case they might turn out to be wrong. It's very refreshing to hear you speculate on some theories. Keep it up please!
As to CRP, I wonder if it could be an early predictor to later chronic diseases. There are a lot of slow developing chronic diseases that we miss because we look at the wrong parameters, and we classify people as "healthy" although some blood values are already far in the red. (IMO "healthy" is much, much more than "symptom free".) Take for example fasting insulin and/or the HOMA score which are excellent predictors of later T2D, but they're missed in practice because hardly anyone measures fasting insulin. (Everyone looks only at blood glucose which is often lags decades behind insulin.)
So, if we had time, then I'd take 1000 "healthy controls", partition them by CRP, observe them for 10 years and see which kind of chronic diseases they develop. My conjecture would be that those with high CRP have a much higher risk of developing ME/CFS or Fibromyalgia.

[lego]

Dr. Younger, this explanation tracks for what I've experienced. I have severe ME/CFS, and 90% plus homebound. Lots of fibromyalgia as well. I take a large battery of blood testing 3 times per year for my fatigue specialist in Marietta, GA. It's generally about 22 vials of blood per visit. On days when I've taken those blood tests and I've been VERY weak, extreme brain fog, my vision is poor, my coordination is poor (I have to use a walker to avoid falls that day), my CRP level is upward of 7. It has been as low as 3.9 on a good day. I've used NSAIDs on the days when it's that bad, and I have to say that NSAIDs might help a little with the headaches, but not with anything else. So, I'm hopeful that there will be other (more affective) treatments found that address the neuro- and bodily inflammation. Thank you SO much for everything you do. Follow-up question: My mother is looking into how to help financially with your research. What is the best way for her to do that?

[josemontilla-ps]

It'd be nice if more attention was paid to hormones. My sister has been very severe for 12 years and we observed early on that menstrual cycle drives her inflammation. In a matter of 24h from LH spike lots of her symptoms shift every month. Only PEM presentation is so consistent in time domain.

[Angela-zjsx]

Thank you for all the work you and your team do to find solutions.

[sherryl]

10:13 "...C-RP is elevated during or after the pandemic..."

Just a thought, isn't there a link between chronic stress and chronic inflammation? Environmental stresses and psychological illnesses like anxiety and depression can be inflammatory. If so, then I'm curious if cortisol has a correlation with C-RP. However, cortisol levels can likewise vary even on hourly basis, but, at least, it can be measured at home using saliva tests. Thoughts?

[sweetiepienumber]

Good information. Keep hope alive! Thanks again.

[selahr.]

I have Lupus, Chronic Inflammatory Demyelinating Polyneuropathy, Fibromyalgia, and CFS. My Sed Rate and CRP are monitored every 4-6 months since 2017. These levels have been much higher, and more continually so, since the CFS symptoms started around 2020. For me, the Sed Rate stays higher when my experience of negative symptoms have been more consistently worse (ie feeling sicker most days of the week for several weeks/months). My CRP has more variability, and seems to fluctuate the most when I’m feeling flares starting or stopping (ie new levels/degrees of sickness/disability on top of the chronic background levels going on). It’s like my Sed Rate is measuring the amount of wood burning in a fire and my CRP is measuring how much lighter fluid (increase) or water (decrease) is being applied to the existing fire. I think both are important to track.

[kathleensomerville]

From Australia, my CRP which should have been between 2- 3. I was seriously ill with diverticultus with a CRP if 248 I nearly died. 1 year later admitted to hospital with a CRP 75 antibiotics drip 3 days. 3 years later CRP 9. Still very ill with my bowel disease.

[homomorphic]

"I can't just show these data in a paper, it merely serves as an input to develop a hypothesis".

Wish 80% of other medical researchers would think this way :-)

[nurmihusa]

The standard American diet is highly inflammatory. I think most people live with level of inflammation that affects their lives but are not aware how it’s affecting their lives. When Covid hit - it hit most strongly the people who already had high levels of inflammation owing to diet and various medical conditions. I read a few studies that suggested that people who normally - because of diet and supplementation, etc. have very low levels of inflammation - experienced the virus very mildly if at all - or being infectious but not symptomatic.

[kjetil_]

thank you for your work! people like you give me hope. :)

[babybubble]

Dr. Younger, would you mind sharing when the results of the PET study are expected to come out? Is it going to happen this year?

[RowOfMushyTiT]

CRP is too broad - we need commercial tests for individual interleukins. Psoriatic Arthritis has the same problem - often low CRP, low TNF, but raised IL-23/IL17. Another problem is raised CRP is used as a metric to select patients for clinical trials (since they want a number to treat). Subsequently, doctors are biased by those results into thinking CRP has to be high to indicate PsA (while this is only true <50%). So it becomes a self-fulfilling prophecy. We have to be very careful in choosing a metric which might actually condemn half the people with the disease. ME/CFS might fall into the same CRP trap.
Also we need immune repertoire sequencing to easily identify/exclude autoimmune diseases. Celiac for example get's diagnosed on a few well-characterized antibodies and the rest gets put into a basket of 'Non-Celiac Gluten Sensitivity' simply because those additional antibodies were never characterized.

[jewelleryaddict]

Astralagus and panax gensing. 3 types MG. Vitamin D with k2. Lions mane, 3 other mushrooms. phosphidityl serine. Coq10. Reservetrol. All help but no cure. Have diagnosis of fms and cfs now for 30 years. Have my own study published in Journal of Musculoskeletal Pain years ago. Keep the study going, wish they did more when i first got this was called fibrositis.

[carolynwestwood]

Thank you for keeping us all updated with your research. 🙏

[kendrazoa]

please also collect vaccination history (dates and number of boosters) for each person to use in analysis. thanks.

[Masbrovids]

How about mitochondira and supplement like dribose or coq10

[homomorphic]

My hypothesis as to why the "normal" group is so high, is because they aren't normal. People become adapted to low level chronic pain, to the point where they don't even notice it. Women are also known to have a higher pain tolerance than men, so it might be interesting to compare the CRP of men who identify as not having pain and the women who identify as not having pain. If the pain tolerance is a factor, then (for a sufficiently large and random populations) the men should have lower CRP (because they have a lower pain tolerance, if higher CRP is causing pain, then the men will select out of the control at lower CRP levels)