# Low calprotectin



## zHassanz

Does low calprotectin mean that a flare is over and one is supposed to be in remission?

I have been having lots of complications -gases, bloating, abdominal pain and constipation- and my doctor suggested that I should do a calprotectin test to see whether the disease is active or not.

I got the test results and I have not seen my doctor yet, but calprotectin is fairly low. My doctor has been playing on the line that I'm 'imagining' all these symptoms and he was trying to prove that using this test. I'm currently feeling lost and very anxious about what the hell is going on with my body, can anyone help with this?


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## smt

What are the FC levels, if we may know?


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## GABoy

Interesting you should ask about this. I was having major symptoms this past summer. I was in the hospital in July. All imaging was normal. They ran a calprotectin on me in September and it was 47. Eventually, my abdominal symptoms calmed down. Perianal are always bad. About a week ago, i started with severe RLQ pain. Calprotectin levels were 311. 

I'm not sure what to make of the test. I know I was flaring when it was 47. I know I'm flaring now at 311. So, FWIW, that's my experience.


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## zHassanz

smt said:


> What are the FC levels, if we may know?


It's 28, and it's supposed to be negative up to 50.


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## smt

28 is quite low and perfectly normal. Any other labs done?


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## zHassanz

GABoy said:


> Interesting you should ask about this. I was having major symptoms this past summer. I was in the hospital in July. All imaging was normal. They ran a calprotectin on me in September and it was 47. Eventually, my abdominal symptoms calmed down. Perianal are always bad. About a week ago, i started with severe RLQ pain. Calprotectin levels were 311.
> 
> I'm not sure what to make of the test. I know I was flaring when it was 47. I know I'm flaring now at 311. So, FWIW, that's my experience.


I remember having it 270 when I was first diagnosed and it dropped dramatically to 80 after a couple of days on prednisone and pentasa, but I just thought that the meds were super effective. Sounds like it's not a good indicator at the end.


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## zHassanz

smt said:


> 28 is quite low and perfectly normal. Any other labs done?


No, nothing. 

What are other tests that I should do?


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## Clash

FC has been a great indicator but that being said he had a normal fc last summer and a colonoscopy a couple weeks later showed pristine bowel but when biopsies came back there was inflammation at the cellular level, so still active disease.

Before that my son had a baseline established during a hospital visit when MRE, colonoscopy an FC all correlated. The FC result was in the 300s, imaging and scope showed simmering inflammation. At his worst by scope his FC result was 1700.

Like any other test there is no 100% accuracy.

I hope your symptoms resolve soon.


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## smt

zHassanz said:


> No, nothing.
> 
> What are other tests that I should do?


Unfortunately, there is no easy answer. One can test for blood inflammatory markers but they are not 100% accurate.

The FC test has a good sensitivity and specificity. See for instance, this:

http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-12-5

2 weeks back I argued about the usefulness or otherwise of CRP in ruling out IBD cases, and there were many interesting and excellent posts in response to that. 

http://www.crohnsforum.com/showthread.php?t=76692


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## Catherine

zHassanz said:


> I remember having it 270 when I was first diagnosed and it dropped dramatically to 80 after a couple of days on prednisone and pentasa, but I just thought that the meds were super effective. Sounds like it's not a good indicator at the end.


It could mean your faecal calprotectin levels are quite low when you flare.  What were your symptoms like when it was 270?


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## GABoy

smt said:


> Unfortunately, there is no easy answer. One can test for blood inflammatory markers but they are not 100% accurate.
> 
> 
> 
> The FC test has a good sensitivity and specificity. See for instance, this:
> 
> 
> 
> http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-12-5
> 
> 
> 
> 2 weeks back I argued about the usefulness or otherwise of CRP in ruling out IBD cases, and there were many interesting and excellent posts in response to that.
> 
> 
> 
> http://www.crohnsforum.com/showthread.php?t=76692



Yeah, I have never produced CRP. Even in my worst flares, my CRP is normal.


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## zHassanz

Catherine said:


> It could mean your faecal calprotectin levels are quite low when you flare.  What were your symptoms like when it was 270?


I never had symptoms as severe as everyone usually states over here; stuff like blood in stool or uncontrollable diarrhea, but when I was first diagnosed I wasn't able to tolerate any food, I was bloated all the time and mostly constipated and started losing weight like crazy in a couple of weeks.

Actually I'm kind of having the same symptoms right now, but with this very low calprotectin level. :/


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## zHassanz

smt said:


> Unfortunately, there is no easy answer. One can test for blood inflammatory markers but they are not 100% accurate.
> 
> The FC test has a good sensitivity and specificity. See for instance, this:
> 
> http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-12-5
> 
> 2 weeks back I argued about the usefulness or otherwise of CRP in ruling out IBD cases, and there were many interesting and excellent posts in response to that.
> 
> http://www.crohnsforum.com/showthread.php?t=76692


I had a CRP test a couple of weeks ago and the results came out as normal.

This is starting to sound like I don't have Crohn's at all. :|


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## zHassanz

Clash said:


> FC has been a great indicator but that being said he had a normal fc last summer and a colonoscopy a couple weeks later showed pristine bowel but when biopsies came back there was inflammation at the cellular level, so still active disease.
> 
> Before that my son had a baseline established during a hospital visit when MRE, colonoscopy an FC all correlated. The FC result was in the 300s, imaging and scope showed simmering inflammation. At his worst by scope his FC result was 1700.
> 
> Like any other test there is no 100% accuracy.
> 
> I hope your symptoms resolve soon.


I was just hoping for it to be at least 70 or something to alarm my doctor. I know that the accuracy is not 100% but what I got is totally off charts when it comes to an inflammation and the symptoms I'm having are totally unbearable. 

There might not be an inflammation, but I'm sure something is wrong with my GI. This is really frustrating!! 

Thanks for your wishes, though.


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## smt

zHassanz said:


> I had a CRP test a couple of weeks ago and the results came out as normal.
> 
> This is starting to sound like I don't have Crohn's at all. :|


What was the exact value of your CRP in mg/l or mg/dl?


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## zHassanz

smt said:


> What was the exact value of your CRP in mg/l or mg/dl?


It was 0.4 mg/L.


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## smt

Other inflammatory markers, such as ESR, and other bloods, if any?

My CRP was 0.36 mg/l.


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## zHassanz

smt said:


> Other inflammatory markers, such as ESR, and other bloods, if any?
> 
> My CRP was 0.36 mg/l.


Oh, yeah I have done that recently: ESR was 3 mm/hr first hour and 8 mm/hr second hour.

My liver profile: ALT was 17 and AST 12.


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## smt

These are excellent results. zHassanz, I am sorry for people like us, who have baffling cases. My heart goes out to you.

My ESR was 4 mm/hr. All other bloods were normal. If your Hb, and CBC were normal as well, I do not know what more can be said to the physician. I request other members to share their suggestions.

I am going for dinner, hope to be back.


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## zHassanz

smt said:


> These are excellent results. zHassanz, I am sorry for people like us, who have baffling cases. My heart goes out to you.
> 
> My ESR was 4 mm/hr. All other bloods were normal. If your Hb, and CBC were normal as well, I do not know what more can be said to the physician. I request other members to share their suggestions.
> 
> I am going for dinner, hope to be back.


Yeah, my Hb and CBC are all within normal range.

I'm suspecting that a parasite or a fungal infection is causing these symptoms since this is the only logical explanation. *Sigh* I'm really getting tired of having to live with all of this trouble.

Thanks for your kind feelings, and I hope you enjoy your meal.


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## aypues

zHassanz said:


> Yeah, my Hb and CBC are all within normal range.
> 
> I'm suspecting that a parasite or a fungal infection is causing these symptoms since this is the only logical explanation. *Sigh* I'm really getting tired of having to live with all of this trouble.
> 
> Thanks for your kind feelings, and I hope you enjoy your meal.


It might be a bacterial overgrowth. I had some bacterium that is normal in some people but if you have symptoms they treat it with flagyl. I was having a lot of unformed stools, very weird consistency like sludge or a gel. The flagyl cleared it right up!

The other cause of your symptoms may be regular old irritable bowel, which is quite common and can be mistaken for Crohn's symptoms, but it sounds like you are in remission with such a low fecal calprotectin. 

For me I dont have a lot of symptoms but I am really diseased - It's so weird! My FC is like 850! We followed up with MRE and found the strictures everywhere and it's a mess.


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## zHassanz

aypues said:


> It might be a bacterial overgrowth. I had some bacterium that is normal in some people but if you have symptoms they treat it with flagyl. I was having a lot of unformed stools, very weird consistency like sludge or a gel. The flagyl cleared it right up!
> 
> The other cause of your symptoms may be regular old irritable bowel, which is quite common and can be mistaken for Crohn's symptoms, but it sounds like you are in remission with such a low fecal calprotectin.
> 
> For me I dont have a lot of symptoms but I am really diseased - It's so weird! My FC is like 850! We followed up with MRE and found the strictures everywhere and it's a mess.


Well, it turned out that I have Crohn's in my stomach, and that's why the Calprotectin level was low. According to my doctor the lower the infection is in your GIT, the higher the Calprotectin level.

I'm really sorry that you have all those strictures, and I hope it'll be sorted out soon.


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