What is the normal esr level and what esr measurement is considered high please?
ESR : What is the normal esr level and what esr... - PMRGCAuk
ESR
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Tayzee
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For years across the world the normal range for ESR has been said to be 0-20 for men and 0-30 for women. However, that is the range found in a large population of people (usually 10,000 apparently healthy subjects are used to obtain such figures) and which includes 95% of them. It isn't a range that is normal for any single person and you can have a reading that is outside that range and still be perfectly normal for YOU.
If the reading is above 20 is is probably suggesting there is some infection or inflammation somewhere but it will rise with just a common cold and very high levels can be found of both ESR and CRP (which contributes to the ESR rising) in chest infections. But in the case of PMR/GCA up to 1 in 5 patients have ESR levels that remain below the top of the range - but that doesn't mean it isn't raised for you. Mine trundled along at 16-18 when I was having a major flare - but no-one noticed as that is still firmly "within normal range". My personal normal is in low single figures.
Thanks... my last esr test was 39 but I’m having pains again and think it may have gone up again so I’m having a blood test weds to see 🧐 my go doesn’t do my crp levels only esr... does that matter?
Not really, as one study found that ESR works well, possibly better, for monitoring PMR. My CRP only moved up once - when I was having a bad episode of atrial fibrillation.
But 39 is raised for anyone - and should have suggested that maybe a slightly higher dose of pred be tried to see if it brought it down.
I had started on 20mg which was fab! Felt amazing and level went down to 12... so reduced gradually and got to 9mg with no pains but on retest was 39 so went up to 10mg which I am on now ... but I think it will need to increase as pains are back again ... 😩
That shows you should be aiming for an ESR of 12 - and possibly less but if it starts to rise and that rise continues it is telling you that the pred dose is now too low. You are not heading relentlessly to zero, you are looking for the lowest dose that controls the inflammation and keeps the blood tests steady. It's impossible to say what dose you need, it might be 10mg but you have first to clear out the accumulated inflammation. How did you drop from 15 to 10mg and how often did you go down the dose?
A good way to approach this sort of thing where you have overshot is to take the dose where the flare happened plus 5mg for up to about 10 days - in your case 14mg. Then go back to the dose above where you flared, though if I were you I would try 11mg first if you are sore now at 10mg. You need at least a month at that dose to be sure it is still enough. A good approach is also to test every month BEFORE starting a new taper. If the ESR starts to creep up, don't do the next reduction step, wait it out another month.
I went from 20-15-12.5-10-9 mg from starting in Dec ... First done 2 weekly now monthly and interim blood tests to check before altering the dose .... so pretty much what you said really so just see what the latest level is next week and take it from there I guess..
How far was 2-weekly? Two weeks is rarely long enough to see what is happening, especially if you are going 2.5mg at a time. The recommended approach is the reduction step shouldn't be more than 10% of the current dose - at from 15mg that should mean 1mg at a time. Reducing more than 1mg per month is predictive of a relapse.
1 month each between 10-9-8-9-10mg and been on 10 a month now .... 2 weekly was at higher dosage...
i found your information on the ESR very interesting. My dr. said my esr was in normal range but am not sure it was ever looked at before. I have very controlled asthma, but if i do have a flare up my Dr. always puts me on prednisone. when she did this last fall i told her I felt so good, it was the first time in months that I didn't hurt everywhere., that is when she first thought that I could have PMR. It took a couple of months to get in with a rheumatologist and he confirmed the diagnosis. My main problem now is the fatigue.
I'm 99% sure that my rheumatologist prefers the CRP test as it's more sensitive for diagnosis.
Except it isn't necessarily - my CRP only rose in respone to a severe episode of atrial fibrillation and was back to normal the following week. My ESR does increase, but remains "within normal range". A study did conclude that ESR can be better for monitoring relapses of PMR even if less reliable in diagnosis
ncbi.nlm.nih.gov/pmc/articl...
I live and learn 🙂.
Which is more than a lot of doctors seem to want to do! 
When I was teaching and a child asked me a question that I couldn't answer/wasn't sure, I'd say so and tell him I'd find out or look it up that evening (rather than give the wrong or misleading answer) and report back the next day. I was teaching 10 subjects in primary school and acknowledged I wasn't an expert at everything. This could apply to doctors who are dismissive of patients concerns and send them away confused or dissatisfied.
Couldn't agree more. One of the doctors in our practice failed to identify PMR in me for 5 years - the one who did know what it was was a woman who worked part time and had had 2 maternity leave periods so I had never seen her. Apparently she later taught the other GP how to use google to look up symptoms and they both happily used it even when a patient was there. I don't mind you don't know - but I DO expect you to make some effort to know how to find out.
Both were tested early days, but after about a year - ESR only.
Other way round for me. 😏
Which is why they need to do both at first and decide which is more reliable for THIS patient.
Yep. Treat the individual and don't clump us all under one umbrella, please.
Plus everyone is different when it comes to tapering and side effects - and everything else ... We are NOT machines with a common repair manual !
Different patients, different doctors, different ways.
My ESR has pretty much always been in the ‘Normal’ Range but my CRP has been Up n Down, my understanding is that a lot of Consultants prefer the CRP Level, when l lived in Wales ESR was never done by GP only at the Hospital - occasionally my GP here does an ESR for me but invariably it’s OK - Normal ESR 0-15mm/h
It must feel good to be in the 'normal' range.😂😂😂
There seems to be no single path to recovery as we all seem to react so differently which makes it so much harder to deal with... it’s very interesting to hear everyone’s journeys...
The highest my ESR has been is 412. My GP said I should be in the Guinness Book of Records!
Wow! Do you remember what other symptoms you had at that time?
One reason I ask is that when my ESR reading came back as 130, a GP from my usually inert practice rang me in a right flap and ordered me to immediately dial 999 for an ambulance!
They needed to rule out GCA, but when I got to hospital, because I had a fever and those blood readings, they deemed it a "fever of unknown origin" and had me on an assortment of intravenous antibiotics until the rheumatologist turned up and rescued me, several days later.
I had just had a new hip and the surgeon would not let me go home. Whenever it goes over 100 the surgery normally calls me and says come in and talk to us. They had me tested for cancer at one point but found nothing. Now they just shrug and say it is just me.
Ignoring the fact that GCA causes fever ....
They pursued 3 possible diagnoses in parallel:
1. PMR-GCA - rushed to hospital bc of possibility of the latter
2. Covid19, because they were Kovid Krazy in June 2020. They triaged me into the Covid section of A&E without my realising, and then had to to give me my own suite for nearly a week
3. Fever of unknown origin, let's try all the antibiotics. In hospital 2 extra days bc of iatrogenic reactions.
Turned out to be "just" common or garden PMR. This was actually the assessment of a doctor from the general pool who came to A&E soon after I arrived. The A&E doctors, nurses and orderlies all "knew" I had Covid though - hysterical atmosphere.
You aren't the only person with PMR/GCA to have had a similar experience. It is understandable though I suppose.
Seems to depend on who you talk to - my gp panicked when my blood tests showed readings above 80 but when I saw the rheumatologist he said he had seen much higher!
Interesting, same for me. The rheumatologist was really laid back about the high ESR, and the temperature I'd been running. Inflammation alone will do that, she said.
My normal ESR is 9 so if I go into the 20 s I know it is high
Another thing I've learnt from ppl on here, everytime I've had blood results back and dr has just said they are still to high or higher than last time, I've never thought to ask how high is high? and what is the normal range? but I will be on monday when I have my weekly phone call and pred check
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