Assessing for Inflammation in Depression

Assessing for Inflammation in Depression

CRP or C-reactive protein is a protein made by the liver in response to inflammation in the body; it plays a role in the body’s inflammatory response and acts as a measure of the body’s inflammation. hs-CRP, or high sensitivity CRP is a more sensitive way to evaluate for inflammation. This is important in psychiatry because inflammation can sometimes worsen or even cause depression. An elevated hs-CRP gives us hints about which medications and/or supplements may be helpful in treating depression that may have an inflammatory component.

Is hs-CRP worth checking in all ages of patients with depressive symptoms?

There is evidence that higher levels of hs-CRP correlate with depression across all age groups and is implicated in treatment resistant depression.

What cutoff is used when considering hs-CRP in depression?

Levels over 2mg/dl are often used and would indicate that various interventions may be helpful. Some consider anything over 1mg/dl as worth intervening on but the evidence isn’t as clear at that level.

Which medications are considered if hs-CRP is elevated and thought to play role in the patients depression?

We often look to medications that have some role in dopamine modulation including:

  • Wellbutrin (bupropion)
  • Nortriptyline (a Tricyclic antidepressant)
  • Abilify (aripiprazole)

Which supplements may be beneficial if hs-CRP is elevated and thought to play role in the patients depression?

  1. L-methylfolate 15mg/day: For more information on l-methylfolate, click here.
  2. NAC, or N-acetylcysteine 1200mg BID: click here for more on dosing and other benefits to NAC.
  3. Omega 3 Fatty Acids (fish oil): click here for the best brands and related dosing.

Which lifestyle changes have been shown to improve inflammatory markers including hs-CRP?

  • An anti-inflammatory diet can yield major benefits. Look here for our post on an anti-inflammatory diet also called the few foods diet. Also look into the Mediterranean diet.
  • 4x per week Aerobic Exercise, of moderate intensity and lasting 45 minutes has been shown to lower inflammation.
  • Mindfulness including meditation and yoga have been shown to lower inflammation in general. Here is information on mindfulness including what it helps and how to go about trying it out.

Have you been assessed for inflammation?

Our team can perform the needed tests to see if inflammation is causing your depression. Schedule an appointment today.

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David Danish MD

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