Results ESR/serum c : Hi, the post is not allowing... - LUPUS UK


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Results ESR/serum c

Lisas_tired profile image

Hi, the post is not allowing me to post results again 🤦🏼‍♀️ after I typed it all out too!!!!

Basically waiting for rheumatoid appointment, in the meanwhile, had these results along with full blood count, I don’t understand why my serum c is high but ESR is low???

Serum c.... 11... range <5

ESR .... 5mm range (0-20)

I thought these both indicating inflammatory in the joints???

Thanks xx

12 Replies
Hidden profile image

Hi there. The CRP and ESR are both very non specific measures of inflammation.

There is a more specific version of ESR called Plasma Viscocity (PV) which is more reliable but not all areas use it as it’s more expensive. So ESR will tend to be higher the older you are, and your normal will depend on your weight and gender too.

Normal range in some labs is 0-10 but other 0-20. It is good to know your baseline but each of us will have a different normal depending on us and on these factors.

So I really would not read too much into it as it’s a very old fashioned test of how quickly the sediment settles in your blood sample. It tends to be used to assess an individual’s trends rather than everyone who has inflammation will have a high ESR. Some people’s never change, some are always low where others like mine are always high.

It rises and falls quite slowly so you could flare up quickly but have a low ESR still and it can remain high even though you might be through a flare already so be feeling fine.

0-5 CRP range is really only useful for those who don’t have any systemic inflammatory disease - as a measure of cardiovascular risk. Many labs state a more useful 0-10 as their range - in which case yours is only very slightly elevated.

CRP rises and falls throughout the day and is a very immediate measure of inflammation - so is good for RA flares but not always useful if you have more systemic connective tissue diseases.

For example I have quite RA-like bloods and my PV was so consistently high that my rheum didn’t bother testing it but my CRP was 17 at the last clinic 6 weeks ago. However it was described as “mildly raised” by my new neurologist - where my PV or ESF is usually soaring. When I had pneumonia and pancreatitis my CRP was over 150.

So I know that my CRP of 17 is actually quite raised for me given I had no viruses or infection when it was tested by rheum.

But for those looking at it without knowing my normal on steroids was 2.5 - they think it’s not very significant as assume that if it was high it would be 150 which they can see on my history!

Sorry to be a bit garbled but I seem to be flaring a bit and my brain and fingers are fudge! I hope this reassures you a little though.

Basically it’s your symptoms that should count and these 2 measures are actually showing quite different aspects of the inflammatory process. Both look normal/low to me but then it depends on what your normal range is - not mine!

Lisas_tired profile image
Lisas_tired in reply to Hidden

Ahhh Thankyou for explaining how it works, that’s a great help!!! I just wasn’t feeling too good at all & my body seemed so weak & sensitive to touch, even my eyes flared up (dry & itchy) I seem to feel a lot better now (after nearly a month) but these episodes are happening more frequent & lasting longer each time!!!

Hopefully will get some answers soon & thanks again xxxx

I assume you mean CRP, c-reactive protein, as opposed to protein C which is a totally different substance. As TT says, they are very non-specific indicators of inflammation SOMEWHERE in the body. The ESR rises with all sorts of things from a cold to pregnancy and also the blood having been taken too long before they do the test! The CRP is supposed to be a bit more specific in that it isn't affected by things like that and also doesn't rise with age which the ESR is said to do,

This version of the CRP test, where it is raised above the range they quote, is done by one technique, the version TT mentions is a separate test (called hs-CRP, high specificity) and only applies to people whose CRP is in the normal range. It may indicate cardiac problems.

In some illnesses the CRP is more likely to rise and show inflammation than the ESR. CRP is particularly likely to rise in chest problems - nothing to do with joints at all. So really - there is something going on somewhere but probably not desperately active at present.

Lisas_tired profile image
Lisas_tired in reply to PMRpro

Ohhh yes, I did mean CRP.... so I realise, we are none the wiser 🙄🤦🏼‍♀️

Thank you also for the explanation, I haven’t spoke to my doctor regarding them, I just collected my results, receptionist just told me ‘all normal’....... of course they did!!!!!

PMRpro profile image
PMRpro in reply to Lisas_tired

And when did that receptionist get their medical qualis????

The fact that some tests are "in normal range" does provide information too though - it isn't a case you have to have abnormal results to get information really. It narrows down what they need to investigate and they are basic info tests which a GP can have done before the rheumy gets involved and they don't have to work from nothing for that first appointment.

But it is good you have your results - because there are doctors who manage to miss the not normal results or who decide they are lab errors! Someone was saying the other day they had had loads of very low results that the doctor had dismissed as lab errors - but in the end it turned out they had a severe immunodeficiency and those results were always going to be low. You can have one abnormal result - that must be checked by repeating it. The more times that is done, the less likely it is that the lab made a mistake. If a blood result looks dodgy most clinical scientists in the lab would check it from the same sample. If it came out OK they would assume there was maybe a fault first time round - and check it again before reporting it.

It really does pay to keep an eye on your results - and keep a record. Our hospital notes here where I live also plot results on a graph so you can identify trends. And if you have copies - they are less likely to get lost...

Lisas_tired profile image
Lisas_tired in reply to PMRpro

Yes I definately agree with keeping an eye on our own records!! Always get a print out & compare them... don’t we just love our receptionist 😂😂

You can only know if your results are hi/lo when you have something to compare with.

What is lo for you, might be normal for me.

Don't worry, if there is anything to be concerned about, whoever ordered the tests would contact you.

Hope your appointment comes through soon.

Yes absolutely, Thankyou, appointment is 22nd Oct :)))

I feel that for me, even my results are only on 12.. this is high so god knows how I would manage if they were a lot higher or into their hundreds!

I also judge it on if I can go to the gym, as I’m a big fan of this, as soon as I don’t want to go, I know there’s an issue 🤦🏼‍♀️ xx

Take it easy...stress is the WORST thing for any AI disease. No one ever eased their symptoms by worrying about them.

When you think about it...getting in a tizzy just upsets you & you are the only one to suffer!

I really do know how hard it is not to worry, I've had plenty of practice, but I have realised if I take my mind off "me" .....listen to music, chat on the phone bake a cake....anything but sitting thinking how bad things are I can relax just enough....until I see my doctor or nurse to try to sort things.

I know I sound like PollyAnna....but it works for a lot of people.

I just spent 40 minutes waiting to get a blood test. The hospital's brand new computer system has packed the poor phlebotomists are having to write everything by transfer to the system when (IF) it starts working again. Naturally not a manager to be seen!

Omg 40 minutes 😫😫😫

I agree totally, stress is what causes all these flare up for me usually!!! I try & do a lot of things (when the energy levels allow it) just to take my mind of it all.

Everything is just so time consuming & it’s the not knowing etc.... Thankyou xxx take care x

That is so right.....everything takes sooooooo long. Changing the bedsheets fills up a whole morning! Struggling with onn/ off fitted sheets is a real challenge!

I have just bought a heated airer.....much easier than trying to put sheets on the washing line. I washed two sheets, 4 Pillow cases + duvet cover...all dried & In airing cupboard in under three that is a stress reliever! No damp sheets cluttering up utility room.

Then spent the afternoon on the sofa watching a DVD...pacing effort is a bonus.

Ahhhhh sofa days 😍😍😍😍 I’ve them xxxx

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