DEAR DR. DONOHUE: Please tell me about CRP. I have a high reading of 5.5. – T.V.

CRP – C-reactive protein – is an old blood test put to a new use. Almost since Hippocrates, the CRP blood test has been used to detect inflammation. Infections – even a common cold – or illnesses where inflammation is a hallmark, like rheumatoid arthritis, elevate the blood level of CRP.

Now the test is used to detect risk for heart disease that comes from clogged heart arteries and risk for stroke that comes from clogged brain arteries. It was only recently that inflammation was recognized as part of the artery-clogging phenomenon.

Inflamed arteries encourage the buildup of plaque. Plaque is gunk composed of cholesterol, triglycerides, blood proteins and blood platelets. It clings to artery walls and eventually obstructs blood flow through them.

A high CRP reading is additional evidence that all is not well with arteries and that a person could be in danger of having a heart attack or a stroke. The CRP test currently in use is a refinement of the old test. Its official name is hs-CRP – high-sensitivity C-reactive protein. (This is a bit of information you can discard.)

A CRP value less than 1 mg/L indicates a low risk for heart attack and stroke; one between 1 and 2.9, an intermediate risk; and a value of 3 or more, a high risk. For reliability, two tests should be obtained and the values averaged. The tests ought to be taken two weeks apart.

What to do with someone whose only sign of artery disease is a high CRP level is a matter of dispute. You should do all those things that people at risk for heart attacks and strokes must do – control blood pressure, lower blood cholesterol, don’t smoke, lose weight if indicated, perhaps take a daily aspirin (if the doctor agrees) and begin an exercise program (again with the doctor’s consent).

The coronary artery disease pamphlet gives detailed information on how to keep arteries free of plaque. Readers can order a copy by writing: Dr. Donohue – No. 101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: I was a bed-wetter until I was in my teens. I am 71, and way back then one didn’t visit doctors for such things. I solved the problem myself. For me, before wetting the bed, I always dreamed of going to the toilet to void. Every bed-wetter I have talked to through the years says this was true for them too. So during the day, when I went to the bathroom to void, I would pinch myself. Lo and behold, I would do the same when asleep and dreaming of voiding. The pinch always woke me up, and the problem was solved. – B.B.

Thank you for a clever approach to a problem that causes many children much grief. I don’t know if it will work for everyone, but it’s worth a try. I also don’t know if every bed-wetter dreams about urinating before actually urinating while asleep.

DEAR DR. DONOHUE: Does taking elk antler capsules have any health benefits? – Anon.

I have no idea. I don’t imagine elk are in favor of this practice.

DEAR DR. DONOHUE: Why don’t you recommend a salt substitute for people with a potassium deficiency? My doctor told me to use a salt substitute to solve the problem. I did, and since that time my potassium blood tests have always been fine. – A.G.

I don’t know why I haven’t mentioned potassium chloride, the stuff chiefly used by people on a low-salt (sodium chloride) diet. It is a good substitute for salt, and it would be a good way for people who are low on potassium to correct the deficit. People on water pills – diuretics – often develop a potassium deficiency, since most water pills rid the body of that mineral while ridding it of fluid overload.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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