ESR and CRP

Should my bloods show a level of 29 I'd probably be hospitalized as my blood inflammation markers are 4 and 2 respectively and throughout all the years with PMR/GCA my levels have never budged from my 'normal'.  However, someone sitting next to me would find a level of 29 perfectly acceptable and someone else across the room would be told 'a little on the high side but ok' whereas the next person might be immeditately summoned to his/her doctor for investigation.

The truth of the matter is that the norm is normal to only one person - you.  There are calculations which can be done which will show a range of 'normal' parameters but they are based on the blood test results of normal people anyway.  Good perhaps as a guidance but not much more.

Around 20% of patients have no inflammation markers anyway.  I've always had to go by symptoms alone.

Normal ranges are worked out by taking the readings obtained for the population as a whole based on thousands of readings from across a representative population - supposedly healthy. Of course, as we age our general level of inflammation in the body tends to increase, and so the ESR will also increase. ESR also rises in response to colds, other viral infections, trauma - and even pregnancy! All things people might not have been aware of when the blood sample was taken. Is that general level of inflammation I mentioned "normal"? In a sense it is - older people just "are so" some would say and unless it is dramatically raised it is accepted. Younger women should have a lower reading - I don't actually know for sure if they do, I've never seen ESR divided up into age groups. As I said, men are a bit different, lower and, according to the NIH in the USA, the general figures using the Westergren method (the original method) are:

Men under 50 years old: less than 15 mm/hr

Men over 50 years old: less than 20 mm/hr

Women under 50 years old: less than 20 mm/hr

Women over 50 years old: less than 30 mm/hr

Mine has never gone above 7, it is mostly 4. Some people just don't develop this inflammatory response and they presumably skewed the results a bit. And of course - you can't say that at 49 and 360 days 20 is the top but at 50 and 5 days 30 is suddenly OK (but some people appear to think so).

What really matters is what YOUR personal normal is - but to know that you would have had to have regular readings taken over years. I think it is pretty fair to say that your normal is probably the lowest reading you can achieve whilst on pred - I don't know how acceptable that is to biochemical medicine or haematology specialists who do the test.

It is a VERY unreliable test and really shouldn't still be in use - but old habits die hard. 

ESR and CRP are general tests that show if there is inflammation in the body. There are many causes. They are not specific for a specific illness or problem.

The numbers given in EileenH comments below are accurate in that  the "normal" tends to increase with age. A laboratory report should list the normal parameters in that lab, if they are not listed don't be afraid to ask what they are.

Once you go on Prednisone you would like to see a good drop in ESR and CRP in 30 days. That is if you are dealing with only PMR. There could be other inflammatory processes going on in your body that ought to be addressed such as gingivitis that would keep  the ESR and CRP modestly elevated.

Average age of someone getting PMR is 70 years. If you are near that age I would think that  a ESR of 29 is within the accepted limits.

Charlie44644

Charlie44644