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Jupiter Trial and C-Reactive Protein

Answered on August 19, 2014
Created February 09, 2012 at 10:12 PM

Anyone read the Jupiter trial? http://www.nejm.org/doi/pdf/10.1056/NEJMoa0807646

I have a patient bring this study to my attention about the effectiveness of statin medications lowering C-reactive protein. His lipid panel is awesome all except he has a c-reactive protein measurement of 4 mg/dl. For this reason his medical doc wants him on statins. He's a big dude (6'8 and 310 lbs), well proportioned but between 20-30% body fat and a stout paleo eater. Low stress, and he works out 3-4x per week (strength and some cardio). Could his higher body fat % be the reason for the c-reative protein count? Any thoughts? One more thing, he has always had an awful time falling asleep, and staying asleep. We've tried many things (a la sleep/sugar/survival methods, plus other supplements) to no avail.

E8022f05c250e19a65b92207dd1630ca

(851)

on February 11, 2012
at 02:13 PM

6-7 months. He has dropped over 35 lbs in that time which is why I'm curious if his C-rect protein is high since he has lost quite a bit of weight and still holds quite a bit of body fat

E7adfe31507efb7c935f618a829f56d6

(1507)

on February 10, 2012
at 12:21 AM

Paleo with 20-30% body fat? has he tracked his diet? how long has he been paleo?

E8022f05c250e19a65b92207dd1630ca

(851)

on February 09, 2012
at 11:54 PM

Thanks for your input Rose. Like you, we are not terribly concerned about the reading, but really stumped about the cause. We will likely do another in 6 months to see what happens.

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3
3aea514b680d01bfd7573d74517946a7

(11996)

on February 09, 2012
at 11:03 PM

I had an elevated CRP on my last round of labs in June 2011, and my (now ex-) doctor was very concerned about it, despite the rest of my numbers being stellar. My new doctor, a more results-oriented person, apparently, told me she doesn't put much stock in a single CRP reading, or even several clustered within a short time period. In her experience, many things can produce an elevated reading, from bee stings to allergies to autoimmune flares.

Since statins have so many deleterious side effects, the benefits of reducing CRP (which is really just treating the symptom yet again, rather than the cause, whatever it may be) when the cause of that elevated number is not even known, seems like a bad bet to me. If I were the patient, I would wait six months and test again. And I would try to track down the cause of the inflammation, if the number is still high, rather than treat the number with a statin. At least, that's what I'm doing for myself.

Regarding the trial, I'm no expert, but a median follow-up period of less than two years seems underwhelming. I wouldn't expect there to be a lot of coronary incidents among any of the test populations within such a short follow-up time, but maybe I'm just unschooled in these things.

(Of course, all standard disclaimers apply: I'm not a doctor or a med student or physiologist, etc.) Good luck to him, and good for you for questioning

E8022f05c250e19a65b92207dd1630ca

(851)

on February 09, 2012
at 11:54 PM

Thanks for your input Rose. Like you, we are not terribly concerned about the reading, but really stumped about the cause. We will likely do another in 6 months to see what happens.

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