I am worried about my high ESR levels. What action should I take?

Question

I had my first blood test 3 years ago, which revelaed a very high ESR level of 78. Since then, I have had more blood tests to keep an eye on my ESR levels, but they are always between 53 and 78. My chest Xray has come back clear to rule out TB. As I have no symptoms of illness, my doctor feels that there isnt much more he can advise me on. I am worried about the things I have found on the internet about the causes of high ESR (artheritis), but my doctor feels at the age of 26 I shoud not worry about this. I am curious to know if others have had ESR readings this high, and what was causing it. What should I do (or say to my GP) to find the cause?

Answer 1

ESR is helpful in diagnosing two specific inflammatory diseases, temporal arteritis and polymyalgia rheumatica. A high ESR is one of the main test results used to support the diagnosis. It is also used to monitor disease activity and response to therapy in both of these diseases.

Moderately elevated ESR occurs with inflammation, but also with anemia, infection, pregnancy, and old age.

A very high ESR usually has an obvious cause, such as a marked increase in globulins that can be due to a severe infection. The doctor will use other follow-up tests, such as cultures, depending on the patient’s symptoms. Persons with multiple myeloma or Waldenstrom’s macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammation. As noted before, polymyalgia rheumatica and temporal arteritis may also have very high ESRs.

A rising ESR can mean an increase in inflammation or a poor response to a therapy; a decreasing ESR can mean a good response.

Although a low ESR is not usually important, it can be seen with polycythemia (a condition where a patient makes too many red blood cells), with extreme leukocytosis (patient has too many white blood cells), and with some protein abnormalities. Some changes in red cell shape (such as sickle cells in sickle cell anemia) also lower the ESR.

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Is there anything else I should know?
ESR and C-reactive protein (CRP) are both markers of inflammation. Generally, ESR does not change as rapidly as does CRP, either at the start of inflammation or as it goes away. CRP is not affected by as many other factors as is ESR, making it a better marker of inflammation. However, because ESR is an easily performed test, many doctors still use ESR as an initial test when they think a patient has inflammation.

If the ESR is elevated, it is typically a result of globulins or fibrinogens. Your doctor may then order a fibrinogen level (a clotting protein that is another marker of inflammation) and a serum protein electrophoresis to determine which of these (or both) is causing the elevated ESR.
Females tend to have higher ESR, and menstruation and pregnancy can cause temporary elevations.

In a pediatric setting, the ESR test is used for the diagnosis and monitoring of children with rheumatoid arthritis or Kawasaki’s Disease.

Drugs such as dextran, methyldopa (Aldomet), oral contraceptives, penicillamine procainamide, theophylline, and vitamin A can increase ESR, while aspirin, cortisone, and quinine may decrease it.

Answer 2

Esr Levels

Answer 3

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Answer 6

Pls do help me the doctor diagnosed me of rheumatoid arthritis I got a higher level of ESR my knee is swelling and also my meta tarsals of my feet both of them ...my doctor tried to make an infusion I mean a aspiration on my but so sad I'm so much afraid I refused ....I told him if its possible to give me some medicine for me and he give me celebres 200 mg twice a day and also cipromax 500 mg twice a day....and it relieves gradual and now I want is what food I should take.........

Answer 7

High Esr

Answer 8

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