Diagnosis of a patient begins with laboratory examinations, and a complete blood count (CBC) is a must on the list. It allows you to determine the number of red blood cells and their main characteristics.
ESR (this indicator stands for erythrocyte sedimentation rate) is a basic parameter, it allows you to diagnose the presence or absence of an inflammatory process, and after a course of therapy, check how effective it was.
Along with it, the term ROE is used in medicine – the erythrocyte sedimentation reaction. These concepts are identical. The blood that, after being drawn from the patient, is placed in a test tube or high capillary, gravity acts.
Under this influence, it is divided into several layers. Heavy and large erythrocytes settle to the very bottom. If this happens quickly, inflammation occurs in the body. It changes in millimeters per hour (mm/h).
Important: Constantly high rates are a consequence of chronic inflammation. But sometimes, with acute inflammation, an increase is not observed.
Determination of the erythrocyte sedimentation rate is a mandatory parameter of the general blood test. Although ESR will not help determine an accurate diagnosis, it will give some hints – especially when combined with the results of other studies.
- What value of ESR is considered the norm?
- ESR rate in children
- When does ESR level rise?
- Diseases in which ESR increases
- When the reasons for the increase are not established
- What does a low ESR level mean?
- False positive ESR tests
- Methods for determining ESR in blood
- Features of preparation for analysis
- How to lower ESR in the blood?
What value of ESR is considered the norm?
Chronic disease can also affect the deviation of the result from the conditional norm, but is not pathological.
The ESR rate differs among people of different sex, age and even physique.
For women, due to the characteristics of the body, this rate is higher than for men – it is associated with more frequent blood renewal, as well as a number of hormonal changes that the female body regularly undergoes.
An increase in ESR in pregnant women from 4 months of age is normal and does not require additional diagnostics.
This table illustrates the normal ESR count of an adult.
Men; Women; Pregnant women
|ESR rate||8 -10 mm/h||10 – 18 mm/h||The norm is to increase the result to 45 mm/h. This figure is higher if there is a lack of hemoglobin.|
The determination of indicators and their interpretation should also be carried out taking into account the age of the patient.
Floor; Up to 20 years old; Range from 20 to 55 years old; Over 55 years old
|Gender||Before 20 years||Range 20 to 55||Older than 55 years|
|Men||12, mm/h||14, mm/h||32, mm/h|
|Women||20, mm/h||21, mm/h||23, mm/h|
In pregnant women, there is a dependence of the acceleration of red blood cells on the physique.
In thin people in the first half of pregnancy, ROE reaches 21-62 mm/h, in the second – 40-65 mm/h.
For the full – 18-48 mm/h and 30-70 mm/h, respectively. The norm is any indicator in the specified range.
Important: In women taking oral hormonal contraceptives, the erythrocyte sedimentation rate is always higher.
ESR rate in children
ESR in children during the period of infectious diseases (intestinal infections, respiratory tract diseases) increases by 2-3 days of illness and reaches 28-30 mm/h.
In infants, the change in this indicator depends on teething, the mother’s diet (with breastfeeding), the presence of helminths, vitamin deficiency, and also when taking certain medications.
Below are the average erythrocyte sedimentation rates for children.
|Age of child||ESR rate, mm/h|
|Teens||10 for boys, 15 for girls|
If the ESR level is increased by 2-3 units, this is a variant of the norm. Additional examination is required if the indicator exceeds the norm by 10 or more units.
Important: In the morning, the ESR indicator is always higher – it is important to consider this when interpreting the analysis results.
When does ESR level rise?
With inflammation, the level of proteins in the blood increases, so red blood cells settle faster. If all indicators are normal, except for the erythrocyte sedimentation reaction, then there is no serious cause for concern. After a few days, you can retake blood and compare the results.
The most likely reasons for the increase in ESR:
- Inflammation of the respiratory system, genitourinary system (including sexually transmitted diseases), fungal infections – almost 40% of cases,
- Oncological processes – about 23%,
- Rheumatic and autoimmune diseases, including allergies – 17%,
- Endocrine and gastroenterological diseases – 8%,
- Kidney disease – 3%.
Inflammation of the genitourinary system
Important: An increase in ROE up to 38-40 mm/h in children and up to 100 mm/h in adults is critical. This ROE value indicates serious inflammation, kidney problems, and the onset of oncology. Such a patient needs additional examination – special analyzes of urine, blood, ultrasound or MRI, consultations of several specialized specialists.
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Diseases in which ESR increases
A temporary increase is observed after acute conditions, accompanied by a large loss of fluid and an increase in blood viscosity (diarrhea, vomiting, severe blood loss).
For a longer time, the ROE value grows in some diseases:
- Endocrine system pathologies – diabetes, cystic fibrosis, obesity,
- Diseases of the liver and biliary tract, including hepatitis, cholecystitis,
- Diseases that are accompanied by tissue destruction,
- With a heart attack and stroke (it rises a few days after the onset of the disease),
- Blood diseases
- Infectious of any etiology.
Important: Bacterial infections cause an increase in ESR by 2-10 times. With viral, it increases slightly – by several units. In a man aged 31, an increase to 17-20 mm/h indicates the viral nature of the disease, up to 58-60 – bacterial.
When the reasons for the increase are not established
In this case, the patient needs a more thorough examination. More detailed blood tests are prescribed, during which the average volume of erythrocytes, the number of leukocytes and lymphocytes, and the leukocyte formula are determined.
It is also worth taking a blood test for tumor markers, urine analysis.
During these examinations, it is important to take into account the initial state of the body:
- Previously diagnosed infections
- The presence of chronic diseases.
What does a low ESR level mean?
A decrease is typical for such conditions:
- Blood viscosity,
- Muscular atrophy
- Epilepsy and some nervous diseases,
- Long-term use of drugs based on calcium, mercury,
- For some types of anemia.
It is important to take into account how low the ESR indicator is. A value of 4 mm/h is the norm for a small child, but for a woman over the age of 20 it is an alarming symptom.
Important: Low speed is the norm for those who adhere to vegetarian (no meat) and vegan (no animal products).
False positive ESR tests
A false positive is a temporary increase that does not depend on pathological processes in the body, provoked by some drugs, age or metabolic characteristics.
When the result is false positive:
- In elderly patients,
- If you are overweight,
- After vaccination against hepatitis B,
- With anemia,
- If the patient has impaired renal function, diseases of the urinary system,
- While taking vitamin A,
- In case of violation of the algorithm for blood sampling and analysis, as well as in violation of the purity of the used capillary.
If you suspect a false positive result, you should retake the test again after 7-10 days.
In cases where the test result is false positive, the patient does not require additional examination and treatment.
Methods for determining ESR in blood
There are several research techniques, the results of which differ by 1-3 units. The most common is the Panchenkov analysis.
For it, blood is taken from a finger, mixed with sodium citrate in a 4: 1 ratio and placed in a narrow high capillary.
In international laboratory practice, the study of erythrocyte sedimentation rate is carried out according to the Westergren method. For this, venous blood is used.
The Westergren method is the same as the previous method, only a higher capillary is used. This method is more accurate.
The Wintrob assay is used with anticoagulants. A portion of blood is mixed with an anticoagulant and placed in a special tube.
This technique is effective for readings below 60-66 mm/h.
At a higher speed, it clogs up and gives an unreliable result.
Features of preparation for analysis
For maximum reliability of the result, blood sampling must be carried out correctly:
- The patient should not eat at least 4 hours before the procedure – after a rich and fatty breakfast, the ROE indicator will be falsely increased.
- It is necessary to make a deep puncture (when taking blood from a finger) so that you do not have to squeeze out the blood – when pressing, a significant part of the erythrocytes is destroyed.
- Make sure that no air bubbles get into the blood.
How to lower ESR in the blood?
You should not take medications on your own to lower this indicator. If necessary, they will be prescribed by the attending physician. It is important to remember that simply decreasing the rate does not eliminate the root cause of the increase.
Since such test results are often associated with a low level of hemoglobin, a weakened state, the patient is prescribed iron preparations, B vitamins, folic acid.
Corticosteroids are prescribed if you have rheumatic disease.
Independently, the patient can use folk methods to strengthen the immune system and cleanse the blood from the waste products of pathogens. This will improve the general condition, support the body and improve blood composition.
For this purpose are used:
- Beet juice (100-150 ml on an empty stomach before breakfast),
- Tea with lemon,
- Honey (1-2 teaspoons a day, diluted in a glass of warm tea or water),
- Infusions of chamomile and linden (1 tablespoon per glass of boiling water, drink this volume during the day in several doses).