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R.A

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heather31241
heather31241

Hello all, i am very new to this forum. For more tan 1 year, i was diagnosed with R.A. Pills, pills pills.   Been on steroids for past 6 weeks, i dont feel much diffrence.  Saw consultant last week, he seems to think its polymialgoy Artheritis dont  know if its the correct spelling. I was told my ESR are high.

Could anyone on the forum tell me what is normal, low, or high ESR, also how do they calculate it.  Thank you

1 like, 7 replies

7 Replies

  • ptolemy
    ptolemy heather31241

    Posted

    On my blood test results it says that ESR should be 3-20mm/hour although some people may be slightly outside that range and be normal. I was 127 when diagnosed with PMR which is definitely outside the range! 
  • EileenH
    EileenH heather31241

    Posted

    A normal ESR is in the range 1 to about 30 - different hospitals have different figures. It tends to get higher as you get older but that isn't a hard and fast rule - I'm over 60 but my ESR is about 4, but it has never been any higher even when I could barely move because of the polymyalgia rheumatica. Some people can have levels that are anything from 40 to in the hundreds when they have polymyalgia.

    You say you have been on steroids for 6 weeks but don't feel any different - what dose are you on? The consultant obviously means polymyalgia - that just means many painful muscles - but I'm surprised if he said arteritis because that is a mixture of two illnesses that are related: giant cell arteritis (inflamed arteries) and polymyalgia rheumatica. Either way - if you are on a dose of 15mg/day of pred and you have experienced no improvement in 6 weeks I'm surprised he said polymyalgia. Polymyalgia rheumatica is the one arthritis/arteritis where the symptoms respond dramatically to a moderate dose of prednisolone (steroids).

    They measure your ESR by taking a sample of blood and putting it into a long very thin tube which is set up vertically. They then see how far the red blood cells settle in a given period of time - like the bits settle to the bottom of one of those snowstorm toys. The further it is, the higher the ESR is said to be. It is all due to proteins that the body makes when there is inflammation and which stick to the outside of the red blood cells and make them fall faster.

    • heather31241
      heather31241 EileenH

      Posted

      Thanks for your unput. the first time i went to clinic, after all the tests were done, was told i had RA. my meds are sulfuzaline, lefthnomide, co-codamol, tramadol.  I have to say they were not making any diffrence, i had a shot of steriod, helped for a while.things werent getting any better, affected my work. This time i was .told  i had Polymyalgia. Was given 5mg steriods, the usual..4,3,2,1dosage. through this process ,have developed more problems, not sure if they are related. My ESR level is 28 whatever that means.
    • EileenH
      EileenH heather31241

      Posted

      You mean you were put on a "fast taper"? From 5mg down to zero in a short time?

      If you have PMR no wonder you haven't had any relief! You need a dose of 15mg to start with and the taper runs over about 2 YEARS not weeks! Your ESR (an indicator of inflammation in the body) is at the high end of normal - but it does tend to increase with age and for a long time they said your acceptable ESR was up to (your age plus 10) divided by 2: so for a 60 year old you would have (60 + 10) is 70, divided by 2 is 35. 

      If you started on 5mg it might have had a bit of effect but as soon as you stopped the PMR would come back in full force - or worse because of the time that has elapsed.

      If you go to this link on this site:

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

      you will find some other links. The final one is a paper "Our approach to the diagnosis and management of PMR" which was written to assist GPs (and rheumatologists inexperienced in the modern management of PMR) look after their patients who they thought might have PMR. It explains in detail a reduction plan that reduces the risk of flares where you have 6 weeks at 15mg, 6 weeks at 12.5mg and then a year at 10mg pred before tapering to zero (hopefully). If you have a printer, take a copy of it to your GP, if not give him the reference so HE can look it up and maybe he will treat you on the basis of the PMR diagnosis but using a more appropriate way of using the pred.

    • EileenH
      EileenH

      Posted

      I should also have said - if they say the ESR is near enough normal that doesn't mean it isn't PMR. About one in six patients has an ESR that is "within normal range" . Mine is 4 - but I definitely have PMR.
  • frustrated61
    frustrated61 heather31241

    Posted

    Hi Heather ~

    Welcome!!  This place is full of knowledge.  I found solace in a few areas I'm dealing with.  The people here are pretty compasionate

    I'm sorry to hear you are not feeling any better after taking steroids for 6 weeks.  From the steroids point I can give you the experiences I've had.  First, if you're dealing with something like you are, it may take a while for your body to adjust to the steroids.  I'm not sure why you haven't felt any relief.  Have you spoked with the doctor about it?  It could be as easy as making a phone call and maybe they need to be adjusted.  Just a thought.

    I believe you are referring to the diagnosis of Polymyalgia Rheumatica. I truly sorry about this because being in constant pain changes you.  Try to get your doctor to understand that you are wanting to see improvement and that just may motivate him/her to step it up.

    You are in good hands with Eileen.  I hope you feel well soon.  We all deserve to

    Please keep in touch with everyone and let us know how you're feeling and doing.

    Warm regards,

    Frustrated

  • somersetsue
    somersetsue heather31241

    Posted

    My GP said Normal ESR is  1 - 16  BUT,  age divided by 2 is ok too! So me being age 60, ESR of 30 is ok. I'm told CRP is considered to be the more important indicator.
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