What is ESR and what values are considered normal
In a test tube with blood, red blood cells gradually fall down, and transparent plasma remains on top. The height of this column per hour is the ESR, it is measured in millimeters per hour. The approximate norm for men is up to 15 mm/h, for women - up to 20 mm/h, with age the permissible values are higher. Measurement methods in different laboratories differ, so it is correct to compare results only within one technique. A slight deviation from the upper limit while feeling well almost never means illness.
- Unit of measurement: millimeters per hour
- The norm is higher for women than for men
- Values naturally increase with age
- The results of different methods are not directly compared
- A slight excess often does not matter
Frequent reasons for increase
The most common cause is a common infection: from sore throat and pneumonia to urinary tract infection. At the same time, ESR increases more slowly than C-reactive protein and remains elevated for several weeks after recovery. The second group is autoimmune and rheumatic diseases, in which the indicator remains high for a long time. The third is anemia, in which subsidence is accelerated mechanically. In addition, kidney disease with protein loss, thyroid disease, tumors, as well as surgery and trauma increase ESR.
- Bacterial and viral infections
- Rheumatoid arthritis and other autoimmune diseases
- Anemia
- Protein-losing kidney disease
- Oncological diseases, including blood
- Injuries, surgeries, burns
- Chronic inflammatory processes
When a high ESR means nothing
There are many situations when the indicator increases without illness. In pregnant women, ESR naturally increases from the second trimester and can reach values that are frightening when looking at the form. An increase occurs with obesity, taking certain medications, including hormonal contraceptives, as well as in older people without any pathology. Finally, the result is influenced by the technique: long-term sample storage, temperature in the laboratory, tilt of the tripod. If you feel good and other indicators are normal, it is wiser to simply retake the test in two to three weeks.
- Pregnancy and postpartum period
- Menstruation
- Obesity
- Old age
- Taking hormonal contraceptives
- Technical errors when performing the analysis
What examinations are prescribed?
First, the doctor clarifies the complaints and examines the patient: temperature, lymph nodes, joints, skin, tonsils, abdomen. Then it evaluates the complete blood count - hemoglobin, leukocytes and leukocyte formula, platelets. C-reactive protein responds to inflammation faster and more accurately, so it is studied in parallel. Ferritin and iron are checked to rule out anemia, and rheumatoid factor and antinuclear antibodies are checked to evaluate autoimmune causes. Additionally, a general urine test, chest x-ray and abdominal ultrasound are performed. The scope of research is determined by the clinical picture, and not by the number itself.
- General blood test with leukemia formula
- C-reactive protein quantitative
- Ferritin and iron
- Rheumatoid factor, antinuclear antibodies
- General urine test
- Chest X-ray
- Ultrasound of the abdominal cavity and lymph nodes
What should the patient do?
Do not try to “lower ESR” - this is an indicator, not a disease, and there are no special drugs for it. If you recently had a cold, sore throat or other inflammation, it is logical to retake the test after two to three weeks: most often the values return to normal on their own. If the indicator remains high and there are no complaints, the doctor prescribes a phased examination, and not the entire possible list at once. If a high ESR is combined with weight loss, prolonged fever, night sweats or enlarged lymph nodes, you need to be examined without delay.
- Don’t treat the number, but look for the cause
- Retake the test 2–3 weeks after infection
- Donate blood in the morning on an empty stomach, in a calm state
- Tell your doctor about your pregnancy and medications you are taking.
- If you have alarming symptoms, get examined without delay
- Observe the indicator in dynamics, and not based on one result