I had my blood test done 2 days back for my RA. I noticed that my ESR count has gone up to 22mm/hr. My blood test taken 2 months back showed ESR to be 17mm/ hr. So now I am a bit confused as to what does this mean as far as my inflammation is concerned. Can anyone explain please.
Thanks.
ESR is one measure of possible inflammation in your body. It's not foolproof, but it's one of the signs doctors look for, because if your ESR is high, it's more likely you have some inflammation, though not necessarily RA. ESR isn't fixed and it's normal for levels to go up and down a bit, if you have a cold, for instance.
It's not possible to say precisely what your numbers mean without knowing the normal range for your lab. Look for a column or note that is labelled something like 'reference range' and then gives some figures, like 0-20. If your new result is a number higher than the top number in the range given, then it might mean that your result is now considered positive when maybe it was negative before. If the reference range IS 0-20, then note that your result is not much higher than that, and not much higher than before; many people with inflammatory arthritis get results much higher, into the 100s.
Also when flow mentions positive and negative this is just in reference to inflammation.
For example an ESR rate over 11 is a marker for non specific inflammation at my GP's.
So just going by this example amulla if you were at my doctors they would say you are showing signs of inflammation but not massively high.
The more sensitive test for inflammation is CRP.
To add to what Flow4 has said. I would try not to focus too much on the actual number as with many of these things the more important thing to look at is the trend over a longer period. You basically want your inflammation and ESR levels to be staying stable, or dropping to get into your normal band.
One odd result may not be significant, as could just be a cold or small infection somewhere. However if this trend continues over several blood tests then may be a sign that your treatment isn't working as well as it should.
The blood tests can be a mixed blessing. It's great that we're monitored but before getting these conditions our levels of this, that and the other could fluctuate all over the place & we'd never know ..... or worry!
As flow4 and helixhelix have said, peoples' inflammation levels will go up and down a bit for a whole range of non-serious reasons even in healthy people & that's true for us too.
You're right to question what these inflammatory markers are all about because RA, PsA etc. are inflammatory diseases and it's systemic (widespread) inflammation that causes all the trouble. So yes, getting our heads around it all does help.
I doubt that your rheumy will be jumping up and down about an ESR of 22. But he will be keeping an eye on the overall pattern over time. My inflammatory markers have always been a bit simple (rather like me), they go up, up, up when my disease is badly controlled and down, down, down when it's well-controlled. However many other people with PsA don't show inflammation in blood tests despite active disease. I understand that it is different with RA and that most RA-er's ESR / CRP will reflect what is happening fairly clearly(?)
I've still got a massive wad of blood test results from the first few years ... then I gave up because with doctors I trust I can just sit back and leave it all to them.
To me 20 is low I was extremely ill in 2010 my ESR was over 20 times 10. As I was said I was extremely ill and like you I though that when I went over 20 it was getting to high only to realise it can get a lot higher when you are really ill. I would not want to go back there. Kind regards.
Thank you all for your input. Helps to get a clearer picture and analyze things better. Although it still surprises me as to why my ESR has gone up while I have no kind of pain at all these days. The reference range for ESR is 2-30 and my ESR is 22😱. My CRP has been constant at 1 mg/L.
Thanks & cheers
So your results are still in the 'normal' range and won't be seen as a sign of inflammation. All sorts of things can cause ESR to rise that have nothing to do with RD: a virus or infection, an injury or shock, a change in meds, anaemia, pregnancy, even just getting older!
I have SLE & my sister has Fibromyalgia. Last year my sister and I both had Whooping cough & both our ESR levels were 14, because of that the GP's kept saying that it wasn't Whooping cough as our ESR's were too low, however we were both proved right by Public Health, so I think some doctors just use them as a guide but they aren't fool proof.
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