Log in
22,642 members18,036 posts


Further to a post I made a few weeks ago regarding my daughter's health, we have recently had the results of some blood tests which state that she is severely anaemic, and had a positive ESA result. does anyone know what this is/means? I have googled it but it really confused me and I am no further forward with getting a diagnosis for her. We are waiting for an appointment with a private rheumatologist as we don't seem to be getting anywhere with the NHS.

7 Replies

Hi jobriggs

Do you mean ESR which is an inflammatory marker in the blood?.

So sorry your having to see a private Rheumy and trying to get help for your daughter. Really stress ful time for you. X


Hi Misty

Thanks for the reply. our GP said ESA but whether he actually meant to say ESR I,m not sure. Her ESR level was at 29 a few months ago, it is so confusing,


That needs clarifying jobriggs as its important especially as high last time. I'm glad the anemia can be treated as that can make you feel very poorly. Good luck. X

1 like

I agree ESR is an indicator of active inflammation. For women under 50 its under 20 I think. The only ESA I can think of is an artificial agent used to help renal anaemia, which your daughter hasn't been given.

1 like

The problem with lupus as I found out is it is very difficult to diagnose. I had it for 5 or 6 years before being diagnosed which is an average amount of time. ESR can be raised for other reasons so I suspect further tests will be needed before getting the final diagnosis


Many thanks every one. My daughter is being sent for yet more blood tests as she is very aneamic. She has also been off college since Wednesday due to the pain she is in. We really need to get to the bottom of all this as soon as possible so that she can have a future. I recently read somewhere (can't remember where) that a Lupus patient had started with foot pain, I think it was Plantar fasciitius, my daughter was diagnosed with that problem at the age of nine


ESA blood, or ESO test may be to distinguish between different anaemias. This may shed some light:

How is it used?

When is it requested?

What does the test result mean?

Is there anything else I should know?

How is it used?

The test is used to:

detect and measure the severity of anaemia (too few red blood cells) or polycythaemia (too many red blood cells),

monitor the response to treatment, and

help make decisions about blood transfusions.

It is not usually used to screen for polycythaemia (too many red blood cells), as the haematocrit - another routine part of a full blood count - is a more accurate test for this.

^ Back to top

When is it requested?

Haemoglobin measurement is part of the full blood count (FBC) (which is requested for many different reasons), especially when your doctor suspects anaemia, and sometimes as part of a general health screen). It is often requested before operations to make sure you are fit for surgery and do not require a transfusion. The test is also repeated when monitoring bleeding or response to treatment of various anaemias.

^ Back to top

What does the test result mean?

Looking for reference ranges?

Normal values in an adult are approximately 120 to 180 g/L (12 to 18 g/dL) of blood but are influenced by the age, sex and ethnic origin in the person. Above-normal haemoglobin levels may be the result of:


excess production of red blood cells in the bone marrow,

severe lung disease, or

several other conditions.

Below-normal haemoglobin levels may be the result of:

iron deficiency

vitamin deficiencies e.g. vitamin B12


kidney disease

inflammatory disorders such as rheumatoid arthritis or infections

haemolysis (accelerated loss of red blood cells through destruction)

inherited haemoglobin defects such as thalassaemia or sickle cell anaemia

cirrhosis of the liver (during which the liver becomes scarred),

bone marrow failure

cancers that affect the bone marrow


^ Back to top

Is there anything else I should know?

Haemoglobin concentration decreases slightly during normal pregnancy.

Haemoglobin levels peak around 8 a.m. and are lowest around 8 p.m. each day.

Heavy smokers have higher haemoglobin levels than non-smokers.

Living in high altitudes increases haemoglobin values. This is your body's response to the decreased oxygen available at these heights.

Haemoglobin levels are slightly lower in older men and women and in children.


You may also like...