CRP and ESR testing, used alongside your history to investigate fatigue, joint pain and unexplained symptoms.
Referred by a GMC-registered GP, results reviewed by the same doctor
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Results explained in plain English, not just a number
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Inflammatory markers show that inflammation is present somewhere in the body. They do not show where, or why.
That limitation is the most important thing to understand before testing. A raised CRP is a prompt to look further, not a diagnosis. And a normal result does not exclude serious disease — several significant conditions run with entirely normal markers.
CRP (C-reactive protein) — made by the liver in response to inflammation. It rises within hours and falls within days, which makes it useful for tracking something active or resolving.
ESR (erythrocyte sedimentation rate) — how quickly red cells settle. It rises and falls more slowly than CRP, over weeks, so the two together indicate whether inflammation is recent or long-standing. ESR also rises naturally with age and in anaemia and pregnancy, so it is read in context rather than against a single cutoff.
Full blood count — the white cell pattern helps distinguish infection from other inflammation.
Ferritin — included deliberately, because ferritin is itself an inflammatory marker. Reading iron stores without knowing the CRP is how genuine iron deficiency gets missed, and this is the pairing that prevents it.
The rheumatology panel adds anti-CCP antibodies, rheumatoid factor and uric acid. Anti-CCP is considerably more specific for rheumatoid arthritis than rheumatoid factor, which is positive in a range of other conditions and in some healthy people — a distinction that causes a lot of unnecessary alarm.
One situation is genuinely urgent. Scalp tenderness, jaw pain when chewing, or new headache in someone over 50 raises the possibility of giant cell arteritis, where ESR is typically markedly raised. That combination needs same-day assessment, not a routine blood test — untreated it can cause sudden permanent blindness.
And a caution the other way: normal inflammatory markers are part of the picture in fibromyalgia, not a disappointment. They confirm the diagnosis rather than undermining it.
Included: C-reactive protein · erythrocyte sedimentation rate · full blood count · ferritin.
A rheumatology panel is available where inflammatory arthritis is suspected, adding anti-CCP antibodies, rheumatoid factor and uric acid — anti-CCP being considerably more specific for rheumatoid arthritis than rheumatoid factor alone.
1. Consultation. Because these markers are non-specific, the history is what makes them useful. Where the pain is, how long stiffness lasts, whether anything is swollen — that shapes what the number will mean.
2. Referral. To a Randox Health clinic. We commonly request thyroid function and ferritin alongside, as both mimic inflammatory symptoms.
3. The sample. A single blood draw, no fasting. Postpone testing for two weeks after any infection — recent illness raises both markers and makes the result uninterpretable.
4. Results review. A GP explains what a raised result narrows down and what it does not, and arranges rheumatology referral where the pattern warrants it.
No fasting required. Postpone testing for two weeks after any infection, as recent illness raises both markers and makes the result uninterpretable.
CRP and ESR detect inflammation anywhere in the body. Neither identifies where it is or what is causing it.
A raised result narrows the question and makes it more urgent. It does not answer it. Infection, autoimmune disease, injury, recent surgery, obesity and cancer all raise them, and so does a cold you had last week.
CRP rises within hours and falls within days. It reflects what is happening now, which makes it useful for tracking whether something is settling.
ESR rises and falls over weeks, and is affected by age, sex, anaemia and pregnancy independent of any inflammation. ESR rises with age in healthy people, so a mildly raised figure in someone in their seventies may mean nothing at all.
They are often ordered together because they can disagree usefully.
New headache, scalp tenderness, jaw pain when chewing or any visual change in someone over 50, with a markedly raised ESR, suggests giant cell arteritis.
That is a same-day emergency — untreated it can cause irreversible sight loss, and treatment is started before confirmation rather than after. If that describes you, contact your GP urgently or go to A&E rather than waiting for a results appointment.
Reassuring for many serious inflammatory conditions, but not exclusion.
Normal markers do not rule out cancer, early autoimmune disease, or lupus — which frequently shows a raised ESR with a normal CRP. And they are entirely normal in fibromyalgia, ME/CFS, and most chronic pain, which does not make those conditions any less real.
Normal inflammatory markers do not exclude serious disease. Some cancers, early rheumatoid arthritis and localised infection can all sit alongside normal results.
A convincing clinical picture beats a reassuring blood test, and should not be dismissed because of one.
Any recent infection raises CRP for days to weeks — which is why testing shortly after a cold produces an alarming result that means nothing. Postpone testing for two weeks after any infection.
Obesity raises CRP mildly and persistently, as do smoking, pregnancy and the combined pill.
This is not "an inflammation test" in the wellness sense. Panels marketed as measuring "chronic inflammation" to justify supplements or elimination diets are using a real test to support claims it cannot carry.
A mildly raised CRP in someone who feels well is far more likely to reflect weight or a recent virus than any condition a supplement will address.
CRP and ESR are among the cheapest and most routinely available NHS blood tests, and any GP will request them where symptoms warrant it.
If you have symptoms that concern you, that is the right route — partly because a raised result needs the examination and follow-up that comes with it.
Speed, when waiting for an appointment is the obstacle, and interpretation — because a raised marker with no explanation is a beginning rather than an answer, and needs someone to tell you what happens next.
It depends entirely on how much, and on how you feel.
A mildly raised CRP is extremely common and most often reflects a recent infection, or simply body weight. A markedly raised result with symptoms is a different matter and needs proper assessment.
The number alone does not settle it.
Almost always not. Infection is far and away the commonest cause, followed by autoimmune conditions and injury.
These tests are useless as a cancer screen — they miss cancers and flag people who do not have one.
Normal markers do not mean nothing is wrong.
Fibromyalgia, ME/CFS, thyroid disease, iron deficiency, sleep apnoea and depression all produce genuine, disabling symptoms with entirely normal inflammatory markers.
That is worth saying clearly, because "your bloods are normal" is too often where the conversation stops.
CRP rises within hours and falls within days — it reflects what is happening now.
ESR moves over weeks and is affected by age, sex, anaemia and pregnancy. ESR rises naturally with age, so a mildly raised result in an older person often means nothing.
Yes, substantially. CRP can stay raised for days to weeks after any infection.
Postpone testing for two weeks after an infection, or you will pay for a result that has to be repeated.
That combination needs urgent attention today, not a routine appointment.
Giant cell arteritis — particularly with scalp tenderness, jaw pain on chewing, or any change in vision — can cause permanent sight loss, and treatment is started before it is confirmed.
Contact your GP urgently or go to A&E.
No. No fasting and no other preparation.
If it is raised because of weight, yes — weight loss, exercise and stopping smoking all lower it, and cost nothing.
If it is raised because of a disease process, treating that disease is what lowers it. No supplement addresses the cause, whatever the marketing says.
A full blood count, ferritin, thyroid function and kidney and liver function, because the pattern across them is far more informative than an inflammatory marker on its own.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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