High ESR

[Mrs_Tumnus]

Hi,

I was looking for some advice.

My ESR was slightly elevated in 2020 -

Range - 2-16 - my reading 18

Yesterday

Range - 2-16 - my reading 24

I haven't had the ESR tested in between.

I have had sore joints for years, especially hands and feet. They feel stiff and sore to bend or straighten out. Last month, my ring finger swelled at the knuckle spontaneously. I hadn't hurt it any way, but it felt broken to move. The selling went down over a couple of days and it hasn't happened since, but I do feel stiff as I always do.

I have hypothyroidism (mild) and I take 50mcg. I put the stiffness down to my thyroid, but could it be rheumatoid? I also have a strange symptom of facial flushing. Random hot patches on my face, akin to being slapped. I have tried to see if this is due to alcohol or certain foods, but there is no link or pattern.

The GP has called me in regarding the ESR and I shall see him next week.

Any advice would be appreciated.

[Hidden]

Morning, I would ask to be tested for RA at your appt. It’s a simple blood test that can indicate RA. If you start the conversation s/he will be on the lookout for symptoms/ markers and may refer you to a Rheumatologist after further investigation.

CRP (rather than ESR) is the more accepted measure, so ask for that to be checked alongside Rheumatoid Factor. Hope all goes well.

[katieoxo60]

Think you need to address this with your GP , raised ESR is not usually a good sign but it generally indicates some kind of upset in the body but that could merely be a current infection. In your case it as been up on more than one occassion so needs investigation is my opinion. Best Wishes

[nomoreheels]

Hiya Mrs_Tumnus, welcome to the NRAS site. Your GP may suspect something is awry with arranging another appointment. He may wish to examine your joints too.

In diagnosing rheumatoid conditions what is of more relevance is another inflammatory marker, CRP (which is acute or current inflammation) whereas ESR is chronic or long term inflammation). Both are non-specific, just an indication that you have some inflammatory response, which may include an infection of some sort. If on examination he detects inflammation of joints (usually seen early on in small joints such as hands or feet) he may suggest he orders more bloods to include both ESR & CRP plus RF (Rheumatoid Factor). What is useful to know is that none of these necessarily mean you have rheumatoid, only that it's possible. Another blood test checking for antibodies is anti-CCP. This is more sensitive but often GP's leave the taking of that to a Rheumatologist.

What may be of interest is if you have one autoimmune condition it often follows you get another. That may be worth considering if your GP sits on the fence in referring you to a Rheumatologist.

For now maybe a look here would be of further help nras.org.uk If you have anything else you'd like to know just ask, there's always someone who will relate.

[bienassis]

I agree with Criplady - that is sensible advice. Thyroid problems can be a precursor of Rheumatoid Disease. Not always the case of course - but simple tests will put your mind at rest. I had Hyperthyroidism when very young which after surgery was fine for many years. In my 60s I was diagnosed with Hypothyroidism. The Rheumatoid disease popped up in between!

When I was first diagnosed with the rheumatoid problem, the ESR test was the only one used, but as time has passed the CRP is now the favoured inflammatory marker for rheumatoid disease.

I wish you the best of luck.

[Mrs_Tumnus]

Thank you so much for the replies.

My rheumatoid factor was tested back in April. It was marked as normal.

Rheumatoid factor < 10 kiu/L range 0 - 14

CRP 5

Serum calcium 2.29 mmol/L range 2.20 - 2.60

Serum ferritin 25 ug/L range 5 - 85

Serum albumin 37 g/z range 35 - 50

Serum adjusted calcium 2.37 mmol/L range 2.20 - 2.60

Serum inorganic phosphate 0.98 mmol/L range 0.80 - 1.50

Serum alkaline phosphatase 80 iu/L range 30 - 130

Does this mean that I do not have rheumatoid arthritis and the ESR is more likely to be linked to the thyroid issue?

[nomoreheels in reply to Mrs_Tumnus]

As with most things RD-related unfortunately the answer isn’t as simple as the question. Given your RF value back in April it might help to have a read of this creakyjoints.org/symptoms/w... Please bear in mind it's an American website (as are the accompanying links) but I chose it because I believe it's better than most at explaining seronegative RD, that is if you are repeat tested & your RF is a similar value.

Can I ask what your GP's thoughts were with the results of the normal blood panel you provided above? Were your joints tender at the time & did he examine those & others? If so what were his thoughts/findings?

[Hidden in reply to Mrs_Tumnus]

To add to nomoreheels' response:

- nras.org.uk/resource/seropo...

[Hidden]

Sero-negative RA is a possibility. Many on here have it and had a difficult journey getting appropriate treatment.

[Luisa1987]

hi I wouldn't read too much into a raised esr I have systemic lupus which is an autoimmune disease similar to RA and my esr is always in the hundreds last month 126! I do take prednisolone to help with the inflammation but the most important thing they look at is CRP .

[Hidden]

Dear Mrs_Tumnas,

Your symptoms could be linked to any number of conditions. It is definitely worth speaking to your GP and asking for a referral to a rheumatology unit as well as investigative tests to be run.

Below are some resources which may be of help:

- nras.org.uk/resource/what-i... This article talks about what RA is and how it is diagnosed.

- nras.org.uk/resource/making...

- nras.org.uk/resource/unders...

- versusarthritis.org/about-a... I give this link, as the rashes you describe on your face are typically more associated with this condition.

I hope you find this information useful, sorry there is not much more help we can offer. I wish you all the best. Should you require any additional information or support please contact our helpline on 0800 298 7650 (Mon-Fri, 9.30am-4.30pm) or email us at [e-mail]

Wishing you all the best,

Hannah - NRAS Information and support coordinator.

[Chockyuk]

Hi

I have seropositive RA. My CRP is never that bad, but my ESR is regularly in the mid 100’s, despite taking Mthx, Sulphasalazine and having steroid injections. A normal ESR for me is around 50! My Rheumatologist recently referred me to a Haematologist to check for blood cancer as it’s so high, but thankfully it he diagnosed severe inflammation and nothing malignant. I’m sure your GP will get to the bottom of it for you, and as others have said, there are many factors involved with a higher than normal ESR. Try not to worry too much.

x