CRP & ESR

[Dypdi]

Does anyone know the recommended amount of ESR & CRP in your blood tests? Mine seems to vary quite a lot. The last time, 2 months ago, the CRP was 9, now it is 12. The ESR was last time 'just normal' whatever that is? This time it is 8.

From this test, the DR's comment was 'no further action required'. I did not speak with them but thought I might get more info from yourselves.

I have GCA (confirmed by autopsy) & PMR since Jan 17, started on 70mg preds and twice put back up and one time back to 60mg. I am now down to 6mg and hoping to drop to 5.5mg over the next few days. I do have lots of aches and pains etc which the rheumatologist (back in Jan) felt was arthritis returning after the preds had suppressed the pains for the past couple of years.

During all this time, I have had a dose of pneumonia, shingles and a massive pulmonary embolism, gall stones in bile duct (have no gall bladder) So not doing so bad. Before all this, I was an active hill walker.

Di

[jinasc]

Biopsy not Autopsy - just in case people think a ghost is writing.

Now you say Jan 17 was it this year the GCA came along?

I am unsure as I looked at your profile which is sparse and could do with you adding more to it.

ESR and CRP are markers to say something is going on. I had GCA and after a visit to GP, who diagnosed me with Jaundice (which was correct). He knocked on my door two days later at 8.30am, my blood test had come back and the ESR was 241................he had clean forgotten than he had seen me and diagnosed me the previous two days amd was worried that the GCA had caused the problem. We laughed and I gave him a cup of tea and half my bacon sandwich.

Markers go up and down, symptoms win every time.

[Dypdi in reply to jinasc]

Thank you so much, GCA was 10 days after PMR but Jan 17.

[Dypdi in reply to jinasc]

I should have made clear, Jan 2017.

[piglette]

I hope you did not really mean that your GCA was confirmed by autopsy!

CRP should normally be 5 or under and ESR 30 or under, although it does seem to vary and I have seen 20 or under recommended. It also varies a bit with age. ESR increases a bit.

[Dypdi in reply to piglette]

Thank you so much, I was not worried but just needed to know. Thank you

[DorsetLady PMRGCAuk volunteer]

The problem 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.

From Patient uk 2018-

ESR: the normal range is 0-22 mm/hour for men and 0-29 mm/hour for women.

CRP: most people without any underlying health problem have a CRP level less than 3 mg/L and nearly always less than 10 mg/L.

[Dypdi in reply to DorsetLady]

Thank you so much. I really appreciate it. I have made notes of it all!

[DorsetLady PMRGCAuk volunteer in reply to Dypdi]

You must remember a few things -

That during PMR and GCA, the inflammation will usually make your markers to be higher (although for some people it doesn't rise).

The steroids will also dampen down those figures artificially.

Both ESR and CRP markers can rise for all sorts of reasons - any time your body needs to repair itself - from a stubbed toe, to a cold/virus, to much more serious illness.

So as jinasc says always take note of symptoms, rather than just markers alone although some like to know what they just for interest.

[alvertta in reply to Dypdi]

July 6 2020, My CRP was 7 and I lost half sight in my right eye Opthamologist said he would never have been concerned about 7. But when we looked at my optic nerve it was white. Totally blocked. Should be pink. So. You can never tell. My ESR was 22 on the day my sight failed. Within range. Drat.

[Hidden in reply to alvertta]

I am so sorry to hear that. Hope you are adjusting to lack of sight.

[alvertta in reply to Hidden]

Getting there. I find the dark edges distracting and need to buy new glasses w no frames. That’s life. A big lesson.

[Dypdi in reply to alvertta]

Well done. Hard going.

x

Di

[PMRpro Ambassador]

If you get a print-out of your results from the doctor you should see the result and in brackets after the number the range that applies to your lab. And a note of whether it is abnormal or not.

Generally, ESR should be between 1 and 20, sometimes 30, and CRP under 1 or under 10 depending on the units your lab uses.

The ESR "normal range" is determined by taking samples from thousands of apparently healthy patients, 10 thousand is usual. And the range is the variable levels that are found in 95% of those samples. Being slightly outside either end of the range is not the end of the world - but it depends on your personal normal. My personal ESR is low single figures so one showing at 18 is very raised for me, it is still within normal range according to the lab.

But what is far more of interest is the trend. An apparently raised value of either with no symptoms of PMR or GCA means not a lot. They are both very non-specific indicators of inflammation - anything from illness to accident can raise either, CRP can even rise as a result of stress. It will also go up as the result of a chest infection. But if a raised value is seen without accompanying symptoms it should be checked the following week to see if it is continuing to rise. Only then should an increase of the dose be decided upon.

[Hidden in reply to PMRpro]

Thank you. I was hoping to go down. I do not have any infections just ached and pains. They can wear off during the day. I try to keep active. I may delay the going down for a couple of weeks. Family coming this weekend so will be distracted.

[PMRpro Ambassador in reply to Hidden]

Would definitely wait until you have recovered from the visitors!!!

[Dypdi in reply to PMRpro]

Thank you so much, now waiting for visit.

[TheMoaningViolet]

The widely used rule calculating normal maximum ESR values in adults (98% confidence limit) is given by a formula devised in 1983 from a study of ≈1000 individuals over the age of 20: The normal values of ESR in men is age (in years) divided by 2; for women, the normal value is age (in years) plus 10, divided by 2.

I copied the above from a website, but my husband told me the formula when my PMR symptoms started in order to demostrate that my ESR may not be as high as it seemed for my age.

So, using this formula, my maximum normal ESR is 31-32 which is higher than the stated normal range.

[PMRpro Ambassador in reply to TheMoaningViolet]

In the meantime many experts think it doesn't make that much difference with age - that the increase is seen because of undiagnosed subclinical inflammatory disorders.

[TheMoaningViolet in reply to PMRpro]

That's interesting and not surprising.

[PMRpro Ambassador in reply to TheMoaningViolet]

Think how many of us were told we were just "older" - but really had PMR!!!!

[alvertta in reply to PMRpro]

Yup.

[Telian]

Sincere hope it wasn’t an Autopsy!

[PMRpro Ambassador in reply to Telian]

But the pathologist knows ALL the answers and does EVERYTHING. But it is too late ...

[Telian in reply to PMRpro]

Too true......

[Dypdi in reply to Telian]

I got the opsy right!!!! Blame my increasing age!!!

[Telian in reply to Dypdi]

You’re not alone - I see that many consultants I just call them ologies!

[navejasjoe]

My wife has been told that the standards are: For ESR it is less than 20; For CRP it is less than 8

Joe