ESR is Borderline - Need another blood test. Confused!

[shuk]

Hey Everyone,

I had a blood test end of Dec due to chronic migraines - It looked at all the main things as I have not had a blood test since I was a Child.

I'm 32 now -

The blood test come back ok except for the ESR rate. The doc told me it 21. According to my age and the sum that's done to calculate a person's ESR, my age should be 21 max.

So she said it's bordrline so I got to go back at the end of the month.

I have never heard of this before. Am a bit worried because when you google esr rate, you are faced with a load of horrible illnesses.

Was wondering if anyone can shed any light as it's been on my mind...

Thanks

[PMRpro Ambassador]

Your GP is talking rubbish. The ESR is a general indicator of the presence of inflammation in the body and can be affected by a whole range of things - including colds, injury and pregnancy! The "calculation" she's mentioned is no longer taken much notice of - it allows my ESR to be something like 35 but it is now realised that doesn't follow at all and the "normal range" is said to be 0-20. Or thereabouts. And even if it were, to say that 20 is fine but 21 is not is also rubbish.

The "normal range" is a statistical grouping. You take samples from thousands of apparently healthy people and measure the value. Then you draw a graph - usually it makes the famous "bell-shaped" graph - and calculate the values that cover 95% of the population and call it the "normal range". That still leaves 2.5% at each end of the graph who aren't included. So you could be in that 2.5%.

ESR is not diagnostic, it is a sign post that you add to all the clinical findings (symptoms). It also requires the sample to be taken and analysed within 4 hours or the result is inaccurate. You take a long glass tube and fill it with whole blood (the plasma and the blood cells mixed) before standing it vertically for an hour. At the end of the hour you look to see how far to top of the red blood cells has settled - like sand in a bucket. In your case it was 21mm - so your ESR is 21. A millimetre is a small amount, you cannot say an ESR is perfectly accurate on that basis. If they'd looked a minute earlier it might have been at the level you'd say was 20.

And finally - given your age, are you on the pill? That alone is enough to raise your ESR. Read the summary on this page: ncbi.nlm.nih.gov/pmc/articl...

So whether it is the pill or a cold - far more likely than you having any of the nasty things you found online!

[PMRpixie]

Mine was 98! Now since on prednisone is 38. Is the main indicator of inflammation. I didn't know it had any relationship to head aches? I have had headaches most of my life. No one has figured why or what to do besides pain meds. They say they are tension headaches. I'm a nurse so know all the answers to that but one can only do so much about ones surrounding influences. Totally frustrated.

Take care!

[David-F in reply to PMRpixie]

I have a long unexplained history of headaches - tried everything without success. I developed classic pmr symptoms last summer but with normal esr and crp. GP eventually gave me a trial of 15mg pred and pmr symptoms disappeared in 3 days. Head pain (frontal, occipital and tender scalp) remain though, and now under rheumy reducing to 7.5mg so he can try to understand the head pain (on 10mg now and no pmr symptoms). I also have a crusting nasal lesion on my septum (inside my nose) which was inconclusive inflammation. Wegeners is a possibility but all autoimmune tests are negative. Im sure I have some sort of autoimmune condition which is giving me the head pain - I have tried everything to reduce them (diet lifestyle etc) but the pmr link is the first concrete indicator. Its easy to be dismissed by the medical fraternity as an over anxious patient who reads too much, but my advice is to read up and keep asking questions if you are concerned. If you arent then an esr of 21 in itself is nothing to worry about