Evidence Based

12 Hidden Causes of High C Reactive Protein (CRP)

Written by Biljana Novkovic, PhD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:
Jonathan Ritter
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology) | Written by Biljana Novkovic, PhD | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:

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Stress is a possible cause of high CRP levels

CRP is a marker of low-grade inflammation that links stress, emotional, and socioeconomic cues to physiological ones. Keep reading to find out about the main lifestyle, dietary, and hormonal causes of high CRP that are rarely talked about.

Lifestyle Causes of High CRP

1) Sleep Disturbances

There is an established, yet complex, relationship between CRP and sleep. Excess sleep, insufficient sleep, frequent napping, and infrequent napping have all been linked with elevated CRP, but these relationships depend on both night and daytime sleep patterns [1].

Insufficient sleep has been linked to inflammation. For example, CRP increases with both sleep deprivation and poor self-rated sleep quality in a dose-dependent manner [1].

Both total (88 hours) as well as partial (4.2 hours during 10 consecutive nights) sleep restriction significantly increased blood concentrations of CRP [2].

Sleep deprivation in pregnancy significantly increases CRP [3].

CRP concentration was elevated immediately after sleep restriction, and since this peptide has a half-life of 19h, this elevation was sustained after two days of recovery sleep [4].

On the other hand, several investigations have linked long sleep (≥9 hrs/night) with higher CRP in individuals with Obstructive Sleep Apnea and type 2 diabetes [1]. It could be that longer sleep time doesn’t cause higher CRP, but rather people with inflammation (and therefore higher CRP) need more sleep.

Elevated levels (>3.0mmol/l) of CRP were observed in both ≤6h and ≥10h sleep in aging men [5].

In men, long sleep duration and greater sleep disturbance were associated with raised CRP levels [6].

The relationship between daytime naps and CRP is also ambiguous. Self-reported nappers had increased CRP, and the authors suggested that frequent naps may actively elevate CRP, possibly via enhanced blood pressure upon waking [1].

On the other hand, a recent investigation focusing on young adults who nap infrequently reported IL-6, the precursor to CRP, increases following sleep deprivation but decreases after subsequent naps [1].

A study looked at sleep-wake concordance i.e. whether couples are awake or asleep at the same time throughout the night. Men and women with higher sleep-wake concordance also had lower CRP values [7].

Suboptimal sleep might be increasing your CRP. Excessive, irregular, and insufficient sleep have all been linked with high CRP levels and inflammation.

2) Smoking

Cigarette smoking increases CRP [8, 9].

CRP increases after smoking in chronic obstructive pulmonary disease patients. Increased CRP levels are a secondary effect of smoking and reflect tissue injury [10, 11].

3) Stress

CRP is elevated in chronic stress and may be the link between stress and low-grade inflammation-related diseases.

Psychological and social stress significantly impacts CRP [12]. In a study that examined job stress and CRP levels among Chinese workers, effort, overcommitment, and effort-reward imbalance were significantly correlated with higher CRP; and the reward was significantly related with lower CRP [13].

Positive engagement coping was associated with lower CRP in the context of interpersonal stress (e.g., arguments with parents or siblings, conflicts between adults in the home, friendships ended) or frequency of arguments with others reported in daily diaries [14].

A correlation was found between high CRP levels, chronic stress, and burnout experience in women with psoriasis [15].

Individuals with more children had significantly higher levels of CRP than individuals without children or than individuals with a low number of children. This association could reflect the known associations between high CRP and higher economic stress, exhaustion, episodic stress and chronic stress [16].

All kinds of chronic stress and exhaustion can increase your CRP levels, especially if you haven’t found a way to cope with daily stress in a positive way.

4) Socioeconomic Factors

CRP levels have been associated with many social and economic factors, which, in many cases, can be translated into chronic stress.

Children whose parents had less than a high school degree had 35% higher CRP than those with a college graduate parent; and, poor children had 24% higher CRP than those with high family income [17].

Children living in neighborhoods with high levels of poverty or crime had elevated CRP levels compared to children from other neighborhoods [18].

Furthermore, there was an association between childhood social isolation and CRP [19].

As neighborhood and family’s socioeconomic status (SES) increased, CRP decreased [20, 21, 22].

Being married is weakly associated with lower CRP level [23].

Both higher education and household income predicted lower CRP levels over the 13 years of a follow-up study [24].

In a Swiss sample, a linear association was found between education and CRP [25].

Depending on the study, associations with CRP and race were observed [26], or not found [27].

Several studies have demonstrated that women have higher levels of CRP compared to men [28].

Among heterosexuals, women had higher levels of CRP than men. However, sexual-minority men had higher levels of CRP than heterosexual men and sexual minority women. Lesbians had lower levels of CRP than heterosexual women [28, 29, 29].

Stress-related socioeconomic factors – such as low income, poverty, low education, social isolation, crime, and belonging to a minority group – have been linked with higher CRP levels.

5) Substance Abuse

CRP levels were higher in the presence of nicotine, alcohol, and cannabis use and nicotine dependence [30].

A U-shaped cross-sectional relationship between CRP and alcohol consumption is widely documented. Whereas alcohol in moderation is beneficial, alcohol users showing abuse or dependence have elevated CRP [30].

6) Altitude

While a short-term stay at moderate altitude (2,590 m) can decrease CRP levels [31], higher altitudes increase CRP and systemic inflammation.

Circulating CRP is upregulated in response to low pressure and low oxygen conditions at high altitude [32].

Hypoxia (decreased body oxygen) at high altitude was also associated with elevated CRP [33].

In a 2-week mountaineering expedition (at 3,200 – 3,616 m), participants had increased CRP concentrations [34].

High CRP is associated with neurological cognitions in high altitude, and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction [35].

Traveling to moderate altitutes may decrease CRP short-term, while very high altitudes increase CRP and whole-body inflammation both in the short and long run.

7) Extreme Cold

In temperatures below 0°C, CRP level increases with decreasing temperature. A reverse association, however, was observed above 0°C [36].

Dietary Causes of High CRP

8) Saturated Fatty Acids and Trans Fats

There is a potential positive association between saturated fatty acids (SFA) with CRP levels [37].

Lauric and myristic acids and high saturated/polyunsaturated fatty acid (SFA/PUFA) ratio are associated with elevated CRP concentrations in men [38].

A study of over 700 nurses showed that those with the highest trans fat consumption had blood levels of CRP that were 73% higher than those with the lowest consumption [39].

Eating a lot of saturated and trans fats may increase your CRP levels.

9) Vitamin Deficiency

Elevated CRP was associated with vitamin D deficiency in the city-dwelling elderly people.  [40].

High CRP levels were also linked with prenatal vitamin A deficiency. Similarly, children with lower retinol (vitamin A) levels were more likely to have high CRP levels in one study [41, 42].

The same may apply to adults as well. In sub-Saharan Africans, vitamin A-deficient people were at a much greater risk of high CRP [43].

Additionally, CRP levels were higher in both older people and young women with lower vitamin K levels [44, 45].

Vitamin D, vitamin A, and vitamin K deficiency may all increase your risk of high CRP levels.

Hormonal Causes of High CRP

10) High Leptin

Leptin, the “satiety hormone,” increases CRP production in the liver and blood vessels. High leptin levels are linked with obesity, overeating, and inflammation-related diseases [46].

People with high blood leptin and CRP are more likely to gain too much weight. Even when leptin is given to people as a medication, it increases blood CRP levels [47].

On the other hand, CRP can bind leptin in the blood. Therefore, high CRP levels can restrict leptin and cause leptin deficiency in the hypothalamus which, in turn, makes losing weight and fighting off infections a struggle [47].

11) High Estrogen

Oral estrogen therapy increased CRP levels in women. Additionally, postmenopausal women using hormone replacement therapy (HRT) have higher CRP levels [48, 49, 50].

Both leptin and estrogen may increase CRP levels. In turn, high CRP can lead to leptin deficiency and make it harder for you to lose weight.

12) High Cytokines

CRP production is regulated by interleukin-6 (IL- 6), interleukin-1b (IL-1β), IL-17 and tumor necrosis factor-α (TNF-α) [51, 52].

These cytokines can be produced in response to steroid hormones, thrombin, other cytokines, UV-light, neuropeptides, and bacteria [53].

Hormonal imbalances, inflammation, and bacterial infections raise your citokines. Increased citokines further raise your CRP and amplify inflammation.

What Now?

This post is the third in a four-part series about CRP. Read the other parts to learn about:

Irregular CRP Levels?

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Since CRP is a marker of chronic inflammation, it should come as no surprise that dietary and lifestyle factors that increase stress and worsen inflammation also raise CRP. Many of these factors are all too often overlooked.

Among the preventable causes of high CRP levels, poor sleep, chronic exhaustion, and smoking are the main lifestyle-related ones. Not sleeping enough, sleeping too much, and irregular, low-quality sleep all increase CRP; stressing about your income, relationships, or work has the same effect.

Additionally, spending time at very high altitudes or in extremely cold environments raises CRP, while short-term stays at moderate altitudes decrease it. Not getting enough sun (or dietary vitamin D) is another possible cause of high CRP.

Your diet can have a strong influence on your CRP levels. Diets high in saturated and trans fats and low in vitamins A and K increase CRP levels and inflammation.

Hormonal imbalances can also cause high CRP. High leptin and estrogen are among the potential culprits.

About the Author

Biljana Novkovic

Biljana Novkovic

Biljana received her PhD from Hokkaido University.
Before joining SelfHacked, she was a research scientist with extensive field and laboratory experience. She spent 4 years reviewing the scientific literature on supplements, lab tests and other areas of health sciences. She is passionate about releasing the most accurate science and health information available on topics, and she's meticulous when writing and reviewing articles to make sure the science is sound. She believes that SelfHacked has the best science that is also layperson-friendly on the web.

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