Chances are you just had a recent stool test and your calprotectin levels came back elevated. In todays article, you will learn more about the Fecal Calprotectin test, some of the reasons why you Calprotectin is elevated , why you need to monitor your calprotectin levels when you have gut inflammation and how to lower calprotectin levels if your are elevated.
What is Calprotectin?
Calprotectin is a type of protein that is found within white blood cells specifically in neutrophils and I will explain why that’s important in just a moment.
Essentially, Calprotectin (1) it a test marker that differentiates Irritable Bowel Syndrome (IBS) from Inflammatory Bowel Disease (IBD) (2). The higher the level of fecal calprotectin the more gut inflammation present in your intestines.
Several studies have demonstrated the diagnostic accuracy of fecal calprotectin in differentiating between IBD and IBS. Elevated fecal Calprotectin levels (>50-100 µg/g) are highly suggestive of active Inflammatory Bowel Disease, while normal or low levels (<50 µg/g) are more indicative of functional bowel disorders like IBS.(3)
Conditions That Cause and Elevated Calprotectin
Elevated levels of fecal calprotectin are indicative of gut inflammation and can be associated with various conditions. Some common conditions that may cause an elevated fecal calprotectin level include:
1. Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis, which are chronic autoimmune inflammatory disorders of the digestive tract, commonly lead to elevated fecal calprotectin levels. Monitoring fecal calprotectin is a useful tool in assessing disease activity and determining response to treatment in patients with Inflammatory bowel disease (IBD).
2. Irritable Bowel Syndrome (IBS): While IBS is a functional gastrointestinal disorder characterized by abdominal pain and changes in bowel habits, some individuals with IBS may also exhibit low-grade gut inflammation in their intestines. Elevated fecal calprotectin levels in IBS patients suggest the presence of mucosal inflammation despite the absence of structural abnormalities identified via traditional diagnostic tests.
3. Gastrointestinal Infections: Infections caused by bacteria, viruses, or parasites can trigger an inflammatory response in the gut, leading to increased production of calprotectin. Elevated fecal calprotectin levels in the context of acute gastrointestinal infections indicate ongoing inflammation and can aid in diagnosing and monitoring the resolution of the infection.
4. Celiac Disease: Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, resulting in damage to the small intestine. In individuals with untreated celiac disease, gut inflammation can elevate fecal calprotectin levels. Monitoring fecal calprotectin can help assess the effectiveness of a gluten-free diet in managing celiac disease.
5. Infectious Colitis: Inflammation of the colon due to bacterial or parasitic infections, such as Clostridium difficile colitis or parasitic colitis, can cause elevated fecal calprotectin levels. Testing fecal calprotectin in patients with suspected infectious colitis helps differentiate between inflammatory and non-inflammatory causes of diarrhea and guide appropriate treatment.
6. Gastrointestinal Disorders: Other gastrointestinal conditions, including microscopic colitis, diverticulitis, and colorectal cancer, can also lead to elevated fecal calprotectin levels. Monitoring fecal calprotectin can aid in the evaluation and management of these disorders by assessing the degree of inflammation and response to therapy.
7. Non-Gastrointestinal Conditions: In some cases, elevated fecal calprotectin levels may be observed in conditions outside the gastrointestinal tract, such as systemic inflammatory disorders or infections that induce systemic inflammation. Considering the specificity of calprotectin to the gut, interpretation of elevated levels in non-gastrointestinal conditions requires careful clinical evaluation.
It’s important to note that fecal calprotectin is a sensitive but non-specific marker of gut inflammation, and an elevated level should prompt further evaluation by healthcare professionals to determine the underlying cause. Additional tests, imaging studies, endoscopic procedures, and clinical assessments are often needed to establish a definitive diagnosis and guide appropriate treatment based on the individual’s medical history and symptoms.
Monitoring Fecal Calprotectin Levels
Monitoring fecal calprotectin levels can provide valuable information for the assessment and management of various gastrointestinal conditions. Here are some reasons why monitoring fecal calprotectin is important.
1. Assessment of Disease Activity: Fecal calprotectin levels correlate with the degree of intestinal gut inflammation in conditions such as inflammatory bowel disease (IBD). Monitoring calprotectin levels over time can help healthcare providers assess the level of disease activity and response to treatment. A decrease in fecal calprotectin levels may indicate that the inflammation is improving, while persistently high levels might suggest active disease that requires additional interventions.
2. Guiding Treatment Decisions: Fecal calprotectin levels can help guide treatment decisions in patients with IBD and other inflammatory gastrointestinal conditions. Changes in calprotectin levels can aid in determining the effectiveness of medication regimens, adjusting treatment strategies, or initiating escalation of therapy when necessary.
3.Differentiating Inflammatory from Non-Inflammatory Conditions: Fecal calprotectin testing can help differentiate between inflammatory conditions (such as Inflammatory bowel disease ) and non-inflammatory disorders (such as irritable bowel syndrome). Elevated calprotectin levels are more suggestive of an inflammatory process, prompting further evaluation and management tailored to the underlying pathology.
4.Monitoring Post-Treatment Response: Following treatment initiation, monitoring fecal calprotectin levels can assess the response to therapy and help determine whether the treatment is effective in reducing inflammation. Serial monitoring of calprotectin levels can guide adjustments in treatment plans to optimize patient outcomes.
5.Predicting Disease Relapse: In patients with Inflammatory bowel disease (IBD) and other chronic inflammatory conditions, monitoring fecal calprotectin levels can help predict the risk of disease relapse. Elevated calprotectin levels may indicate an increased likelihood of disease activity, allowing for early intervention to prevent a flare-up or worsening of symptoms.
6.Non-Invasive Monitoring Tool: Fecal calprotectin testing is non-invasive and easily performed, making it a convenient tool for monitoring gastrointestinal inflammation compared to invasive procedures like endoscopy. It provides a quantitative measure of intestinal inflammation without the need for repeated invasive tests, especially in patients requiring long-term disease management.
7. Improving Patient Management: By monitoring fecal calprotectin levels, healthcare providers can individualize patient management strategies, optimize treatment plans, prevent complications, and promote better outcomes in patients with various gastrointestinal conditions associated with inflammation.
Overall, monitoring fecal calprotectin can help healthcare providers make informed clinical decisions, tailor treatment strategies, and improve the overall management of patients with inflammatory gastrointestinal disorders. It is important to discuss the interpretation of fecal calprotectin results with healthcare professionals to ensure appropriate follow-up and management based on individual patient characteristics and clinical context.
Endoscopy VS Fecal Calprotectin test
Physicians use many kinds of tests to monitor what’s going on side the digestive tract. Unlike an endoscopy, the fecal calprotectin test is a non-invasive test, you don’t need to be put to sleep, and you don’t need to take medications it’s a test that can be done using a take-home stool test.
Another benefit of the fecal calprotectin test is that unlike an endoscopy which can only be done 1-2x year a fecal Calprotectin test can be done as frequently as needed to monitor progress. Endoscopies on the other hand are more invasive. This is why more and more doctors are turning to fecal Calprotectin test as a way to monitor inflammation in the digestive tract.
I use the Fecal Calprotectin test to diagnose, monitor disease activity, and guide the treatment process to prevent a relapse in my patients with Inflammatory bowel disease (IBD).
Histamine Intolerance and Elevated Fecal Calprotectin
Studies have shown that keeping track of the level of fecal Calprotectin in stool is useful in the management of IBD.
When I say IBD or Inflammatory Bowel Disease, I’m talking about Celiac Disease, Crohn’s disease, or Ulcerative Colitis, these are all inflammatory bowel disorders that you would see an elevated calprotectin level.
Many times, when we talk about gut inflammation and the health of the gut barrier, we are often interested in knowing what’s happening in the mucosal layer of the intestines.
When you have gut inflammation a few things happen. You get an increase in the number of White blood cells (neutrophils) in the area and that’s because in the early stages of tissue damage, and oxidative stress, Neutrophils will migrate to the area of tissue injury.
Recently it’s also been shown that Neutrophils release histamine. (4)(5) which may also explain why people with elevated Calprotectin experience symptoms like abdominal cramps, diarrhea, excessive gas, and heartburn(6)
So, there you go. Now you know why Your calprotectin test is elevated. We know that there is an Inflammatory bowel disorder but now we need to know more about the reasons and what’s causing the inflammation.
How To Lower Elevated Calprotectin Levels- 5 Supplements That Can Help
While dietary and lifestyle changes are crucial for managing inflammation and calprotectin levels, some supplements may support gut health and potentially help lower inflammation.
Here are five supplements that have been studied and have been shown to lower Calprotectin Levels
- Curcumin: This active compound in turmeric has potent anti-inflammatory properties. Studies suggest that curcumin may help reduce inflammation in the gastrointestinal tract and has a positive effect on conditions like IBD. I like this liposomal Curcumin for elevated calprotectin.
- Omega-3 Fatty Acids: Found in fish oil, omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) have anti-inflammatory properties and may help lower levels of inflammatory markers, including calprotectin.
- Probiotics: Certain strains of probiotics can support gut health and may help reduce inflammation. Strains like Lactobacillus and Bifidobacterium have been studied for their potential benefits in inflammatory bowel diseases and can help lower calprotectin levels.
- Glutamine: An amino acid that serves as a fuel source for intestinal cells, L-glutamine has been shown to help maintain gut barrier function. Studies have shown L-Glutamine supplementation can help reduce Calprotectin (*),(*).
- Zinc: This essential mineral plays a role in immune function and has also been shown to lower Calprotectin levels. Zinc supplementation has been explored in multiple studies for its ability to support gut permeability (Leaky Gut) and reduce markers of inflammation (*).
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