Inflammation Level

[linziej]

Hi

Could someone tell me what is a normal inflammation level. I had bloods taken again and after th hour despite being on steroids that said it was high.

Thanks

[Matilda_1922]

I think below 2

[linziej]

Oh right. After 45 minutes mine was at 66.

[nomoreheels]

It depends on the lab where your bloods are tested so never completely accurate from lab to lab but as an example mine are as below

ESR normal values are 1 - 7

CRP normal values are < 6

I don't quite understand what you mean by "after 45 minutes", could you elaborate?

[linziej in reply to nomoreheels]

Hi

The inflammation blood test I get has to be checked after an hour. My blood is taken and after an hour they go back and look at it. Something to do with it dropping to the bottom. I left after 45 minutes and it was sitting at 66. It was my 3 month review at the biologics to see if treatment has worked.

[nomoreheels in reply to linziej]

Ah, I didn't realise it was biologics monitoring. Although I know inflammation bloods are quick response we don't usually have the results so quickly when they're a part of DMARD drug monitoring bloods. I guess you had them done & waited for your results?

[linziej in reply to nomoreheels]

Erythrocyte sedimentation rate (ESR)

A blood sample is taken and put in a tube that contains a chemical to stop the blood from clotting. The tube is left to stand upright. The red blood cells (erythrocytes) gradually fall to the bottom of the tube (as a sediment). The clear liquid plasma is left at the top. The ESR measures the rate at which the red blood cells separate from the plasma and fall to the bottom of a test tube. The rate is measured in millimetres per hour (mm/hr). This is easy to measure as there will be a number of millimetres of clear liquid at the top of the red blood after one hour.

[linziej in reply to linziej]

Hope that explains it better.

[nomoreheels in reply to linziej]

Yes, I know how it works, but as I said we don't get results back so quickly normally. Thanks though.

[linziej in reply to nomoreheels]

Oh right. I have always got my results back on the day.

[nomoreheels in reply to linziej]

Even with DMARDs? Here in the UK I've only had DMARD drug monitoring bloods done at my GP Practice & whilst they usually have them back the following day I only get them the following visit. I used to have DM bloods taken at hospital when I lived abroad but a week prior to my 3 monthly Consultant appointment. Confusing eh?! 😳

[linziej in reply to nomoreheels]

Oh right. Usually my esr is done at the biological nurse app. But has been done at Gp too. I have had 4 different biologics but don't seem to work. Away to try one called Goluminab ( I think). Thank you for your replies.

[nomoreheels in reply to linziej]

I hope you find one that works soon, seems like you have a particularly resilient form of RD, I'm sorry.

Just a tip, if you want to add something to a previous reply that you've written (like you have below) there's a downward arrow next to the Like button, tap or click on that & it'll give you options - Edit, Delete or Report. Select Edit & it lets you add to your reply, makes things easier all round. 😉

[8080 in reply to nomoreheels]

Thanks for that info, nomoreheels.

[linziej in reply to nomoreheels]

I am in the uk. In the north of Scotland.

[nomoreheels in reply to linziej]

Our replies crossed! There are two tests used for ESR, the Westergren method, which most labs use, & the Wintrobe method, the less sensitive of the two. I hadn't realised you were at hospital having your biologics review with your biologics nurse. Seems pretty high though?

[helixhelix]

What's more useful sometimes than the actual number is the trends. Some people have naturally high or low results, and they are said to increase with age too, and so the generalisations given to be "normal" are completely unhelpful. So 30 or 40 can be completely ok for one person, but for others would be complete agony.

You might find it helpful to track your results over time and look at how they go up, or down, with the different drugs.

[Gnarli]

I wonder why they don't standardise tests and treatments. I've never had an ESR test mine seem to be only CRP. At the last rheumy nurse appointment on Thursday the CRP was 25. So the MTX has been increased again and the threat of "adding something else in" if inflammation levels don't drop. The fun just never stops does It?

[DelicateInput in reply to Gnarli]

All sorts of things push ESR up: various illnesses in the body such as a cold or throat infection or chronic sinusitis; overweight; diet (high fried fat/meat diet), inactivity; age.

As helixhelix says, it is the trend that is important. However, high inflammation levels are not healthy. It is best to try to determine the cause and eliminate that. You will then have a clearer picture of how bad the RA is - in most people it is a combination of the other things I have mentioned and RA is only a contributory factor. Not really very reliable at all.

[Gnarli in reply to DelicateInput]

Thank you. Gosh, having this is like sitting for an exam

[Mandalou in reply to Gnarli]

Hi Buttonhater

My GP who I have my 8 weekly blood tests with for my Etanercept won't do regular ESR they say that it is not an accurate measure of specific inflammation. I think it's probably to do with money being spent on what they see as unecessary tests.

They say CRP is the one to use.

I wish they would do ESR though as I get all my results via their patient online access system and its amazing you can plot graphs and look back at all your records and I still have my sky high ESR readings from when I was diagnosed.

Plus I'm convinced that sometimes I'm flaring and my CRP doesn't elevate much since I've been on Biologics in which case it would be nice to see what my ESR is.

I'm convinced that my Biologic takes away the swelling but still leaves me with pain , sort of invisible flares.

But anyway, poor you! That's a high CRP, and urrgh more Mthx, I hope it drops soon and you get more control.

Best wishes

Mx

[Gnarli in reply to Mandalou]

Hi Mandalou. Thanks for responding with the helpful info. Know your enemy eh? I must be one of the lucky ones, fingers crossed, and haven't had side effects and don't feel too bad either. Strange disease this

Jan

[nomoreheels in reply to Gnarli]

The CRP test is the more used of the two generally because it's the one which indicates acute inflammation, what's happening now (within the last 12 hours to be precise) & so it can be acted on by increasing doses, adding or changing meds if it's unusually or consistently high. You'll likely have had ESR taken when you were first diagnosed as it usually forms the screening Rheumys do at your diagnostic appointment, you may not have been aware though. Some Rheumys like to have the two taken more regularly for patient & drug recording purposes, I always have both taken, I guess it depends on the Rheumys preference & I guess cost can have an affect too. ESR differs from CRP in that it's more useful to track chronic or long term inflammation but it can also be affected by non-inflammatory factors. So, for example, if you have anaemia or have problems with your kidneys that could cause a raised ESR. Hope this helps explain the two a bit more Jan?

[Gnarli in reply to nomoreheels]

Thank you for such a comprehensive response

[nomoreheels in reply to Gnarli]

You're welcome Jan, I hope you could understand it! ☺️

[sparklyshazza]

Infections steroids and other things can affect yr inflammatory markers..its not all about the RA....

[linziej in reply to sparklyshazza]

Hi

Unfortunately my inflammation makers won't come down. Very difficult trying to get a treatment that works. Been seen every once so hopefully the new treatment works. I had fluid on the lung last year due to high inflammation levels so have been on prednisolone for a year. So hoping the next biologics works.

[Gnarli in reply to linziej]

Bless you. I hope you find something to help you very soon

Jan

[linziej in reply to Gnarli]

I hope so. Looking at alternative treatments now. I'm only 39 and have had it since 22. Six replacement/ fusions later still can't get control of it.

[Simba1992 in reply to linziej]

Have you tried dietary modifications?

[linziej in reply to Simba1992]

Hi

I'm looking at that now. Any advice is greatly received.

Thanks

[Simba1992 in reply to linziej]

You can always start with eliminating gluten, dairy and sugar. Just by doing this often makes a difference in 2-3 weeks then I would order Tom O ' Bryons book " The autoimmune Fix". You find it on amazon. The book explaines in a very comprahensive way the relationship between gut health and AI diseases. It is a overview of the newest research in the field and also helps you to get started with an antiinflammatory elimination diet. Good luck.xx Simba

[Gnarli in reply to linziej]

What can I say? If I was in your position I'd be prepared to try absolutely anything, short of murder. Huge gentle hugs coming at you if you want them

Jan

[DelicateInput]

Depends on the lab, but most say between 0 and 15; some say between 0 and 20.

Above 40 is very abnormal.

[linziej in reply to DelicateInput]

Thank you for that.😀

[Simba1992]

Thank you northside2😊I have heard of Amy Meyers and am glad you have found her book!There is so much we can learn about our bodies and how AI affects it and how this really helps us to find ways to support and make our healthy immune system stronger😊👍🏻