Blood Test Results

Hello everybody

I have had PMR for 2 years

Steroids now down to 1mg from 25mg

Blood test every 6 weeks. GP says they are normal. But what is normal

Should I be asking about levels of something or other

Thanks

[PMRpro Ambassador]

The blood tests they are talking about are probably ESR (erythrocyte sedimentation rate) and CRP (c-reactive protein).

When there is inflammation present in the body the liver produces proteins in response, one of them is CRP and so it is usually raised when there is inflammation (not always though). These proteins stick to the outside of the red blood cells - and make them slippier as a result. The ESR is measured by putting whole blood into a tall vertical tube and measuring how fast the red blood cells sink to the bottom - so if they are slippier they sink faster. So if there is inflammation - they fall further in the same time.

They are both very non-specific - they can be raised for all sorts of reasons. A cold is enough, even pregnancy though I doubt we are interested in that!

While you have the symptoms well under control with pred they should be within the normal range - ESR should be somewhere under 20, but that is the maximum it should be and YOUR personal normal may be much lower, the lowest level it gets to on the higher doses of pred is a good guide.

Does that help? Ask if you don't understand anything

You have done very well to get to 1mg in 2 years - but don't assume it has gone yet. Some people are fine on 1mg but they need that 1mg for some time. But very very good luck in getting to zero!

[Hidden in reply to PMRpro]

Thank you for reply

I now know what to ask

[piglette]

Hi Brohule, I always ask for the actual blood test results. I used to get printouts from the surgery but now I can go on line and see them. The printouts give a “Normal” range. I can even get graphs of tests over time on line which is interesting.

[Hidden in reply to piglette]

Thank you

[DorsetLady PMRGCAuk volunteer]

Hi,

I found this earlier in the year, unfortunately can’t remember source!

ESR

Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease.

When your blood is placed in a tall, thin tube, red blood cells (erythrocytes) gradually settle to the bottom. Inflammation can cause the cells to clump. Because these clumps are denser than individual cells, they settle to the bottom more quickly.

The sed rate test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of your immune system.

Averages (based on 1996 study)

Age 20. Men 12, Women 18

Age 50. Men 14, Women 21

Age 90. Men 19, Women 23

Another study shows slightly difference values -

Age under 50. Men 0-15, Women 0-20

Age over 50. Men 0-20, Women 0-30

Trouble is, as individuals, we don't usually know what our normal is as it's not a test that is done when you don't have anything wrong. Some people's are a lot lower normally than the averages stated.

CRP - this is from Southend NHS Trust

Adult: less than 8 mg/L

Up to 1 month: less than 6 mg/L

Most patients (90%) without organic disease have CRP levels less than 3mg/L and 99% have levels less than 10mg/L. Neonates are unable to induce CRP synthesis to the same extent and the neonatal reference range is lower.

Slightly higher CRP levels may be found in pregnancy, but any increase is usually within the reference range quoted.