Query about ESR please.

[Attic]

Hi everyone, can anyone please tell me if an ESR of 32 is classed as raised in a 74 year old Lady. Thank you Jenny x

[Koalajane]

I would say yes it is raised. My normal is under 10 but when mine was 28 the doctor said it was normal but my nurse said it isn’t is it as your normal is a lot lower. She looked at me and said”you are hurting aren’t you” bless her

[DorsetLady PMRGCAuk volunteer]

according to NHS -

What is normal range of ESR reading?

The following are considered normal ESR test results: 

Women under age 50 should have an ESR between 0 and 20 mm/hr. 

Women over age 50 should have an ESR between 0 and 30 mm/hr.

Men under age 50 should have an ESR between 0 and 15 mm/hr. 

Men over age 50 should have an ESR between 0 and 20 mm/hr.

But you should be aware that ESR can be raised for many reasons - you recently mentioned a case of shingles and a reoccurrence of PMR.

But it can be a myriad of things from a stubbed toe to after effects of operation -and most things in between.

Can I enquire why you are asking?

[Attic in reply to DorsetLady]

Hi DorsetLady. I went. to the Doctor with very swollen fingers which keep curling over and clicking when I pull them back into place. My hands have also gone purple. She said when I had a recent test for PMR my esr was normal at 32, and inferred that my swollen fingers may be caused by depression because I have multiple health issues. I find this very upsetting to be honest. She made me feel that it was all in my mind and was really quite unpleasant to me. She as agreed now to do another standard blood test. I fail to see how swollen fingers where you can't even get your Wedding Ring any lower than just below your finger nail are all in the mind. I think I should be having a test for some sort of Rheumatismbut she just doesn't want to know.I know it is not Pmr related but I posted on here because your help has been invaluable to me over the last seven years. Thank you

[DorsetLady PMRGCAuk volunteer in reply to Attic]

hi

Having a quick look online, I’m surprised GP didn’t consider Raynaud’s disease… that causes swollen fingers and purple patches . How are your toes?

Maybe have a look this -

nhs.uk/conditions/raynauds/

[Attic in reply to DorsetLady]

I have got Reynauds. I was diagnosed over 50 years ago, but have never had this before. She knows I have got Reynauds but she just didn't seem interested and said if my esr goes up anymore she supposes she will have to do something about it. Hey ho, this as really knocked the stuffing out of me.

I am considering changing Doctors.

Jenny x

[PMRpro Ambassador in reply to Attic]

"she supposes she will have to do something about it"

"I am considering changing Doctors."

I wouldn't be just considering it - you'd be struggling to get worse.

[Suffererc in reply to Attic]

what a very caring Doctor you have. Is she for real 😮

[PMRpro Ambassador in reply to Attic]

Well it IS PMR related because you have PMR and it is upsetting you. She is well out of order I'd say because while depression has been linked to swelling in very atypical case described as "rarest"

ncbi.nlm.nih.gov/pmc/articl...

the far more likely cause of pitting oedema in your case is PMR which can manifest as RS3PE syndrome. And "sausage fingers" is a typical presentation of some forms of inflammatory arthritis - and they can appear later after PMR as a precursor. That is usually because the PMR diagnosis was not correct but understandable if there were no other signs.

Is there another GP in the practice you could see? I would put in a complaint about her - because she needs to learn that chronic autoimmune disorders are NOT all in the mind and there is supposed to be more awareness of mental health problems whatever the underlying causes.

[Attic in reply to PMRpro]

Thank you PMRpro. I feel so much better now, what would I do without you all x

[PMRpro Ambassador in reply to Attic]

🥰

[PMRpro Ambassador]

I would class it as probably raised, yes, It's unlikely that you know what your personal normal is because so few people have them checked unless ill! The normal ranges are the levels found in 95% of a large population of nominally healthy people - and run from zero to 20 or 30 depending on the lab and as DL has explained. It isn't a range that is acceptable for an individual, it is a range into which your own personal normal should fit. Once you are treated properly, the inflammation should fall and with it the ESR so you may get to find out what your own normal is.

But it is a very non-specific marker, it can be raised by a whole range of things and if you recently had something else going on, as I know you do have from your other posts, even the stress of worrying can raise the ESR.

[Broseley]

Have you been doing something repetitive with your hands recently? The fingers getting stuck and clicking back is called trigger finger and is a symptom of arthritis. It was brought on in my case by using my phone a lot to read emails when I was on holiday for a month in New Zealand.It did clear up on its own but took about 9 months.

The purple fingers is Reynauds and I would say unrelated except for the autoimmune aspect.

[Attic in reply to Broseley]

Hi Broseley, I haven't been doing anything out of the ordinary, but thank you for replying to me.Jenny x

[Karendeena]

My GP says half of your age is ok, however the hospital labs say between 1 and 20 is normal. If you look up a woman over 50 it will say 1 to 30

[Attic in reply to Karendeena]

Thanks Ladies for taking the time to read and reply to my post. The Forum is a nice place to be, because we all understand what it is like to have such debilitating illnesses.Jenny x