Blood Tests (CRP ESR) Levels: Whats Normal?

Hello all hope the wet and windy weather is not causing havoc with everyones RA or PsA.

After years still dont know what each of these markers mean or whats normal.
My bloods book says these markers should be below a certain figure (cant remember what or find book due to mtx brain fog).

My bloods move either side of markers, the arthitis feels no different, in fact I feel its spreading... So are we all different and the figures in my bloods book are just a generic guide???

Luckily or not I have a high pain thresh hold, which may not help with dealing with my Rhuemy nurse as I (and all of us with RA PsA) tend to be stoical about our disease.

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15 Replies

  • Hi there,
    I'm pretty sure that the figures for ESR are just a generic guide. Mine states that the normal range for ESR is between 0 - 20 (might be 1 - 20 but 20 is the max.) Other sources of information simply say that every individual has their own 'normal' ESR level. I think it was Tilda who recently posted a formula for working out what the average person's ESR 'should' be - half your age + 5 or something like that. Anyway, from what I've heard on here over the past 5 months, anything over 30 or so is considered high and, for some people, the high 20s are cause for concern.

    Unlike you, I think I am someone whose ESR reflects how they feel (definitely not true for everyone). Mine lingers around 70 & I haven't really had any real reprieve from active inflammatory arthritis since being diagnosed in June. For 3 months I was on steroids, however - they made me feel better and my ESR quickly went down to 4! Came of them - instantly up to 77!

    As for CRP, I think it is a more sensitive indicator of inflammation but the same general principles apply. Have you googled these things? Unlike a lot of info. on the 'net, there are some very clear explanations of ESR & CRP available.

    Totally agree with you about stoicism - almost essential for daily life, hopeless strategy with Rheumy nurses!

    Christina x
  • Hi There.
    I was given a sheet by my Rheumy nurse regarding the levels for blood tests, was given this fact sheet at an arthritis workshop that my Rheumy department organised last year. I hope these are of some use as a guideline .however, I am aware that some lab department blood limits can differ .

    Hb F 11.5-16 M 13.0-17
    Wcc 4-11
    Neut 2.5-7.5
    Platelets 150-400
    MCV 80-100
    Urea 3.8-8.3
    Creat 70-110
    ALT 10-40
    Alk phos 75-160
    PV 1.5-1.72
    CRP <8
    ESR F <15 M <12

    I have never had my ESR taken as my rheumy department don't use this but my CRP hangs around 20 with some blips of 33. The lowest my PV has ever been was 1.74 but usually hovers around 1.80-1.84. I know my nurse uses this reading, the CRP and DAS reading when deciding on giving a Depo steroid Injection or change of medication in conjunction with my Consultant

    Really hope this helps in some small way. Might be worth asking your nurse for your local hospitals labs blood levels.

    Rainie xx
  • Apparently some labs use slightly different measurements so may not be exactly the same as others, which means that the generic guides you get for levels could be misleading. And people also do vary loads.

    So best thing is to keep track of your own readings so you can see how they change (or not) over time. I'm one of the people who seems to have a very, very stable ESR & CRP so for me anything over about 10 awful! And at my very worst, when I could hardly move, it reached 21.... And I have to keep reminding my consultant this otherwise she says I'm fine, when I'm not. Polly
  • Mine has hovered between 15 and 28.and dr sed mine should be 0 to 7.last weeks blood test come back at 19 so I'm very pleased as on week 7 on mtx so hoping it means its helping me.but I felt so much pain even at 15 a few mths rheumo nurse said our main aim in giving you mtx is to get ur inflammation down,so this week I have been happy xx
  • The biggest issue with measuring the inflammatory markers like ESR and CRP is that while in some people, changes can be a guide to inflammation in your body, in a lot of folk they just aren't. There are actually only a couple of diseases where raised ESR is part of the diagnosis (polymyalgia rheumatica and giant cell arteritis).

    ESR normal ranges vary considerably with age too - as you get older, the "normal" can get a lot higher. So for young folk up to 10 is normal, but for a 50 year old up to 20 or even higher would be considered normal. CRP doesn't vary with age, with anything over 10 being considered a bit high, but again, its not specific to RA flares so doesn't always mean anything, and could be something else going on in your body that it totally unrelated. I really don't get why most doctors seem fixated on ESR levels when they are such a poor measure of inflammation generally, because it is possible to have massive inflammation going on and completely normal ESR and CRP.

    Having said all that, if you are someone who does show changes in either ESR or CRP, then it can be just one of the things that can be used to see if inflammation is getting better or worse. In that case, its not really the actual numbers that count, but whether they are going up or down.
  • What were your levels. Mine were ESR 30 and CRP 18. And I am 45. I believe that I have both those diseases and they have given multiple other diagnosis. But I think they are wrong
  • As has already been said these markers can vary depending on what else is going on in the body. Many things can alter readings such as: age, Infection, pregnancy, contraceptive pill etc. etc.
    Plus we have the physiological effect, we see high markers and automatically feel more pain, our brains deceiving us!

    So please don't get to hung up on these readings.

    I always get quite annoyed when doctors/nurses tell us how we are based on these markers. I have A.S (Ankylosing Spondylitis with Enthesitis) as well as other conditions and my levels are always relatively low ESR <5 - 12 which most would consider as NO inflammation, CRP around 12 -18 yet I can be in a terrible flare unable to straighten my body, move my neck or walk due to severe pain.

    I also have low WCC, Hb, Creat, if my doctor paid to much attention to these I'd be in hospital or constantly on iron tablets, although he does monitor my kidney function carefully and my bloods are still done 4 wkly after 15yrs on these meds.

    So please listen to your body not what's written on a lab report.

    Beth xx
  • i would think 20 was an abnormal reading for esr...i would be in a terrible amount of pain if it was this high...mine is ok at about 7to 10. x
  • I'm mid-50's and my doctors say that up to 24 is normal for my age, and don't take any notice of it up to that level. When you consider some folk can have readings of 60 or more, a reading in the 20's would really depend on what else was going on or obvious before it was seen as significant.
  • Im 47 my range came back at 20.... sometime I feel as stiff as a robot... even hurts to blink my eyes... the test for RH was very low... but I'm suffering...
  • I agree it is confusing - I've just had a problem with my wrist and my CRP was 28 but both the hospital and my doctor said that as I have RA it was 'only slightly raised' - but my highest previous reading was 16 but that was before I started on MTX....
  • Hi Farjer121 and all

    As has been mentioned it can often be important to focus more on how you are actually feeling rather than what the blood test results are suggesting, but the test results can be a useful tool. There is a good website we often signpost people to to find out more about blood tests, and results, called 'Lab Tests Online':

    They have a section on the different reference ranges used by different labs and I have quoted below a good explanation taken from the site: "Whether or not your test result is within the laboratory reference range, the result must be considered within the context of your personal circumstances, and with the benefit of your doctor's knowledge of your past medical history, current medication and the results of any other investigations."

    I hope that helps to clear things up!

    Kind regards

    Sarah Kate
  • Dear All,

    Thank you all so so much for your contributions to this topic... Sarah Kate, yes I will look at the site you have suggested above.

    It seems I should look at my numbers in the context of how I feel and as being specific to me and past history.

    So, I`ll just have to remind my Rheumy Nurse, although my numbers are low I am in alot of pain and have always been and stop being stoical when it comes to meetings with consultants and nurses.

    Thank you all again and good health during the winter ahead.

    Best Regards,

  • I,ve just received my blood test results back and the doctor said they were ok,butmy esr levels were 65 how can this be ok?.
  • I just got my ESR results at 90 and CRP at 28 and in a lot of pain.doctors have advise I go in and speak about results.


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