ESR and CRP

Posted , 6 users are following.

I have read recently that an ESR rate of 29 is perfectly "normal" for a woman.

I find this rather high.  Comments, please!

0 likes, 8 replies

8 Replies

  • Posted

    It'll depend on who you are, where you are and which side of the fence you are sitting.

    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.

  • Posted

    At birth your ESR is less than 1. It increases with age and for most ages it was accepted that you could work out the appropriate ESR by taking either (age/2)for men or for women it was (age + 10) divided by 2. That means that at 55-ish you were looking at 30-ish for a woman. The "normal range" for ESR has been taken as up to 30 for a long time but in recent years the "formula" has been discredited. I suspect that this particular piece of information has not reached all doctors!

    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. 

  • Posted

    Constance,

    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

  • Posted

    I started off with Poly diagnosis and an ESR level of 38, Doc was alarmed and asked how much Alcohol I drank , I replied about two weekly and he said it was too high , he thought I meant Bottles but enlightened him to the facy that I meant glasses. Wine that is. However I took this on board and avoided any Alcohol for 1year, my ESR came down gradually with preds and he said about 15 ESR is within the normal range, I am 12 at this time but I think it fluctuates.I think all Docs differ. Good luck with this
    • Posted

      In that case I'm glad my ESR doesn't do anything! However - I think he is wrong: "Low to moderate alcohol consumption was related to lower levels of inflammation markers " and the same is to be found in other research papers. I'm left to wonder how he would react to the locals here! Did the doctor in question come from rather further east than Dover? I was treated as an alcoholic by a consultant of middle-east extraction a few years - had nothing to do with the diagnosis which he didn't manage to get right either. My GP fell off his seat laughing when I told him but that consultant caused a large waste of money for the NHS by getting it wrong and ordering a load of tests that were not needed and I have no doubt it it in my UK hospital notes which I object to.
    • Posted

      H a Ha Eileen we live and learn , or rather dont, It was scary when he first said it but know he likes to socialise himself, he really is very good and thorough he diagnosed me with Poly on my second visit and within 3 days i had a blood test and was on pred,.Thanks for all you info as it has been really helpful, now on 2 and getting a few twinges etc but will stay with it not sure really how to taper to nil and think perhaps back to docs for that, what do u think please, Hope to be at that stage in couple months fingers crossed.
    • Posted

      There is a slow reduction method on the thread that has the links to other forums, in posts 4 and 5.

      https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316

      I and a lot of others have used it successfully and it should also work to reduce 1/2mg at a time from 2 providing you start with 1 day new 7 days old dose - possibly even more days between. It's 25% drop each time so is pretty big.

      Be very vigilant though - you don't want to joint the band who were fine at 1mg and stopped pred only to develop a flare a couple of months later. Doctors will try to tell you that dose can't be doing anything so just stop - some nurses however have also experienced it being different!

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