Erythrocyte sedimentation rate in the blood. Prescribing a blood test for ESR and its interpretation

Content

If a serious illness is suspected, the patient is sent for a general capillary or venous blood test. If the results show an increased ESR, then most likely an inflammatory process has begun in the body. This nonspecific laboratory indicator helps the doctor decide on treatment tactics and prescribe the right drug.

What is ESR

Erythrocyte sedimentation rate, or ESR, is an important indicator in a blood test. It tells you how quickly red blood cells sink under the influence of gravity. The value should be measured in millimeters per hour (mm/h). During the study, red blood cells are kept in a special vertical tube. The laboratory technician measures the time it takes them to reach the bottom and then calculates the rate of subsidence.

In a healthy person, the level is low, but when inflammation has already begun in the body, the cells begin to stick together, become heavier and sink faster, which causes the ESR in the blood to increase. The specialist who refers the patient for examination can draw up a clinical picture of the disease based on the results and prescribe treatment. There are two ways to count blood cells - the Westergren method and the Panchenkov method.

ESR norm

The results may be different in children, men and women, and must be deciphered by a medical professional. It focuses on generally accepted indicators corresponding to the patient’s gender and age. Each category has its own ESR standard. If the analysis shows an excess, the doctor decides whether additional examinations are needed to clarify the disease.

ESR is higher than normal - what does it mean?

The process of increasing the number of red blood cells per unit of blood volume is called polycythymia. There are various reasons for increased ESR in the blood. The indicator begins to increase after a few days from the onset of the disease, and after 2 weeks it reaches its highest point, but there are exceptions. It all depends on the type of disease that precedes the increase in ESR. A change in the indicator may indicate the presence of:

• kidney pathologies;
• ARVI;
• rheumatoid arthritis;
• lymphomas;
• leukemia;
• diabetes mellitus;
• bacterial infection;
• rheumatism;
• hyperthyroidism and hypothyroidism;
• heart failure;
• other physiological disorders.

Deviation from the norm is often a consequence of stress, poor nutrition, and lack of vitamins in the body. Sometimes failure to comply with the rules for taking tests can increase the readings. To prevent this from happening, you need to give up food 3-4 hours in advance, alcoholic beverages and alcohol-containing medications 24 hours in advance, and eliminate anxiety. In addition, scientists have confirmed the fact that 5% of people on the planet have an ESR higher than normal from birth.

Increased ESR in the blood of women

The results of the analysis based on average data in the adult female population vary between 5-25 mm/h. There are many factors that can accelerate the sedimentation of red blood cells. Reasons for increased ESR in the blood in women:

• pregnancy;
• menstruation;
• postpartum period;
• preclimatic period.

A woman should alert her doctor if any of the conditions on the list are present. The conditions are not pathological, but at this time the concentration of plasma proteins in the blood increases. Due to monthly blood loss, hemoglobin decreases and anemia may develop. The same thing happens after childbirth, and while carrying a child, the mother gives him some of the vitamins, so the indicator becomes high.

In other cases, an approximate calculation by age is used:

1. from 4 to 15 mm/h – at 18-30 years old;
2. from 8 to 25 mm/h – in 30-60 years;
3. from 12 to 52 mm/h – at 60 years of age and older.

Increased ESR in a child

For newborn children, readings can be very low, this is not a deviation from the norm. As they grow older, they increase in size. An increased ESR in the blood of a child indicates that the inflammatory process is exacerbating, but sometimes the causes are sleep disturbances, stomach upset or teething. The following results are considered normal:

1. 0-1 year – 1-6 mm/h;
2. 1-7 years – 4-8 mm/h;
3. 7-12 years – 4-12 mm/h;
4. 12-18 years – 4-15 mm/h.

Increased ESR in the blood in men

In the analysis, the indicator for men is slightly different from that for women. The difference is about 1-10 units. Among the possible causes of increased ESR in the blood of men, doctors name:

• hepatitis;
• genitourinary system infections;
• heart attack;
• oncology;
• tuberculosis.

With age, the indicator changes: at 20-50 years old it is normal at 0-15 mm/h, and after 50 years the frame expands to 5-25 mm/h. The doctor must take into account medication intake, which also affects the analysis. A patient's lifestyle can tell a lot. Smoking and drinking alcohol often lead to exacerbation of chronic pulmonary and liver diseases: in such people, blood viscosity is reduced.

Increased ESR during pregnancy

When there is an increase in ESR during pregnancy, the gynecologist takes into account the patient’s complexion. For a thin woman, normal figures in the first and early second trimester are 20-62 mm/h, and at the end of the second and third – 35-80 mm/h, and for an expectant mother with a tendency to be overweight, the fluctuations are 18-46 mm/h and 30-72 mm/h. Anemia in pregnant women and chronic diseases also affect the results of the analysis.

Increased ESR - what to do

You should not immediately sound the alarm if the ESR in the blood is elevated: this fact in itself cannot indicate specific violations. The first thing to do when the erythrocyte sedimentation rate is elevated in the analysis is to seek clarification from your treating physician. When deciphering, the specialist interviews the patient for the presence of any symptoms that lead to an increase in the indicator.

For a patient who strictly complies with the conditions for taking the test, in the absence of obvious signs of disease in the form of elevated temperature, an additional examination is prescribed by other doctors using modern equipment. A high ESR in the blood is an indirect sign of serious illness and even a malignant tumor. If these cases are excluded, the drugs chosen correctly for treatment help reduce this value.

Thanks to advances in medicine and science, many today are treated in the early stages of their development. Due to this, the recovery rate among patients has significantly increased. With the introduction of new diagnostic techniques into medical practice, it is possible not only to make accurate diagnoses of many diseases, but also to identify the causes of their occurrence. Typically, the appearance of any disease in the body is primarily reflected in the composition of the blood. It is thanks to its analysis that it is possible to identify the factor causing the appearance of these changes.

One of these components of a person is his erythrocyte sedimentation rate or ESR. Based on this indicator, one can judge the appearance of current changes in the body. Today, ESR makes it possible to diagnose various pathologies in children and adults. ESR reacts to the appearance of various pathologies in the human body by increasing its value. This could be caused by various factors. The main task of the doctor is to determine these factors in order to prescribe appropriate treatment to the patient.

The abbreviation defines the concept interpreted as erythrocyte sedimentation rate. This indicator is detected at . After taking blood from a person, a test tube with this biomaterial is placed in a special installation, where this indicator is determined. In this case, special substances called anticoagulants act on blood cells. Under the influence of these connections they begin to fall down. The sedimentation time is recorded and based on it, doctors draw certain conclusions.

As a result of this separation, two layers become visible to the naked eye in a test tube: below and above. Experts measure the height of the resulting lower layer of plasma.

ESR is measured in millimeter values ​​per unit of time equal to an hour.

ESR is one of the first to respond to changes occurring in the body. As a result of increasing the ESR level, it is possible to identify the nature of the pathologies that have appeared in the body. They can be caused by agents of an oncological, rheumatological and infectious nature. Based on the level of ESR in the body, a preliminary diagnosis can be made, which in most cases is confirmed over time.

With the help of ESR, you can establish various types that are currently developing in the body. The geography of these diseases is different: from cardiac pathologies to malignant neoplasms.

Decoding the ESR indicator

ESR has a specific meaning, which differs between men and women. This indicator also depends on the age characteristics of the person.

Normal ESR in the blood:

• In a male body under 50 years of age, the normal ESR value is from 1 to 10 millimeters per hour.
• For men over fifty years of age, the ESR norm is measured from 2 to 20 millimeters per hour.
• For women under 30, this value is determined by an interval of 3 to 15 millimeters per hour.
• If a woman is in the age category from 30 to 60 years, then her normal ESR is in the range from 8 to 25 mm/h.
• The normal ESR indicator in women of more mature age is the limit from 12 to 53 mm/hour.
• An important value for the ESR indicator is in pregnant women. Already in the early stages of fetal development inside the mother’s body, the normal ESR value is the range from 25 to 45 mm/h.

This value remains at a certain level for quite a long time and persists even after childbirth. During the normal course of pregnancy, the ESR indicator does not go beyond the above limits.

The increase in ESR levels observed during pregnancy is associated with changes in the composition of the blood.

Usually the reason for this is an increase in protein mass, which is indicated by a percentage.Children have their own ESR norm. If a child is less than six months old from birth, then the normal ESR value for his body is measured in the range from 2 to 17 mm/h. The value of this indicator in infants is unstable and depends on various factors.

The main ones are:

• Diet
• Intake of vitamins into the body
• Baby development
• Activities of growth processes
• Presence of diseases

The child’s ESR should not worry parents, since the child’s body is growing and therefore this value may deviate from the norm.

Reasons for the increase

There are several reasons that cause an increase in the body's ESR. The main factor in increasing this indicator is an increase in the ratio of globulins to albumins in the blood. This occurs under the influence of microbes, fungi, and viruses that enter the body.

As a result of such unwanted penetration, the amount of globulins in the body that perform protective functions increases significantly. During this, the ESR value increases. An increase in rate, indicating the process of erythrocyte sedimentation, indicates in this case the onset of inflammation.

This situation manifests itself when a person is affected:

• Tuberculosis
• Osteomyelitis
• Arthritis
• Sore throat
• Pneumonia

The list of these diseases can still be expanded, but these pathologies are the most common when the ESR is elevated. With the treatment of these pathologies, the ESR gradually begins to decrease, which indicates the attenuation of the disease and a speedy recovery.

More information about the meaning of ESR can be found in the video.

In addition, an increase in ESR can be caused by the following reasons:

• An increase or decrease in the number of red blood cells
• Disruption of the process of formation of protein molecules in the liver
• Changing the ratio of the components of the internal environment of the body and many others.

ESR increases as a result of a person being affected by the following diseases:

• Stroke
• Heart attack
• Autoimmune diseases
• Malignant neoplasms
• Liver diseases
• Pathologies in the kidneys
• Various and so on.
• Even frequent blood transfusions can cause an increase in ESR in a person.

With various types of intoxication, ESR also increases. The loss of large volumes of blood can also be reflected in an increase in this indicator.

When receiving various injuries, as well as bone fractures, ESR increases.

If a person experiences a post-shock state, the sedimentation rate of red blood cells also increases.The condition, postpartum stage, menstrual cycle and old age lead to an increase in ESR.

Normalization of ESR in the blood

If an increased ESR value is detected in a patient, treatment aimed at reducing this factor is not prescribed. In most cases, it involves eliminating a set of factors that cause the appearance of values ​​that do not correspond to the norm. When an elevated ESR level is detected, the doctor tries to identify the factor leading to this value. After all, an increase in ESR only indicates the presence of changes in the body caused by various reasons that need to be established.

In order to accurately determine the nature of the pathologies that have arisen in the body, which are signaled by an increased level of ESR, a person is prescribed additional tests, based on the results of which certain conclusions can be drawn.

Only after the true causes have been established, a specific treatment is prescribed, aimed at eliminating existing pathologies and, as a result, reducing the level of ESR.

Doctors resort to comprehensive methods, on the basis of which the type of disease and the period of its course are established.

There are many ways to lower ESR in traditional medicine.Red beets are good in this case:

• It is necessary to boil a small amount of this vegetable for three hours and drink the resulting decoction in the amount of fifty milliliters every morning.
• This preventive treatment is safe and helps reduce ESR in the body.
• It is advisable to take this decoction before breakfast for seven days.
• The effect of this treatment is noticeable when you donate blood for the first time to determine ESR.

In children, ESR may be slightly higher than the norm. There is no need to panic, as the reasons may be the active growth of the child and the process of teething. An unbalanced diet that is poor in vitamins can also cause an increase in ESR in a baby. In this case, you just need to take care of a balanced diet, on which not only this indicator will depend, but also the overall well-being of the baby.

The ESR indicator is very important for the health of the body, since it is one of the first to respond to changes and development occurring in the body.

You should not be indifferent to this indicator and not attach importance to it. It is the ESR that first gives us a signal that something is going wrong in our body, and therefore it is worth undergoing a full examination to identify the reasons for its deviation from the normal value.

Erythrocyte sedimentation rate(ESR) is a laboratory analysis that allows you to evaluate the rate of separation of blood into plasma and red blood cells. The essence of the study: red blood cells are heavier than plasma and white blood cells, so under the influence of gravity they sink to the bottom of the test tube. In healthy people, red blood cell membranes have a negative charge and repel each other, which slows down the rate of sedimentation. But during illness, a number of changes occur in the blood:

Content increases fibrinogen, as well as alpha and gamma globulins and C-reactive protein. They accumulate on the surface of red blood cells and cause them to stick together in the form of coin columns;

Concentration decreases albumin, which prevents red blood cells from sticking together;

Violated blood electrolyte balance. This leads to a change in the charge of the red blood cells, causing them to stop repelling.

As a result, the red blood cells stick together. Clusters are heavier than individual red blood cells, they sink to the bottom faster, as a result of which erythrocyte sedimentation rate increases. There are four groups of diseases that cause an increase in ESR:

infections

malignant tumors

rheumatological (systemic) diseases

kidney disease

What you should know about ESR

The determination is not a specific analysis. ESR can increase in numerous diseases that cause quantitative and qualitative changes in plasma proteins.

In 2% of patients (even with serious diseases), the ESR level remains normal.

ESR increases not from the first hours, but on the 2nd day of the disease.

After illness, ESR remains elevated for several weeks, sometimes months. This indicates recovery.

Sometimes ESR rises to 100 mm/hour in healthy people.

ESR increases after eating to 25 mm/hour, so tests must be taken on an empty stomach.

If the temperature in the laboratory is above 24 degrees, then the process of red blood cell gluing is disrupted and the ESR decreases.

ESR is an integral part of the general blood test.

The essence of the method for determining the erythrocyte sedimentation rate? The World Health Organization (WHO) recommends the Westergren technique. It is used by modern laboratories to determine ESR. But in municipal clinics and hospitals they traditionally use the Panchenkov method. Westergren method. Mix 2 ml of venous blood and 0.5 ml of sodium citrate, an anticoagulant that prevents blood clotting. The mixture is drawn into a thin cylindrical tube to a level of 200 mm. The test tube is placed vertically in a stand. After an hour, the distance from the upper boundary of the plasma to the level of red blood cells is measured in millimeters. Automatic ESR meters are often used. Unit of measurement of ESR - mm/hour. Panchenkov's method. Capillary blood from a finger is examined. In a glass pipette with a diameter of 1 mm, draw up a solution of sodium citrate to the 50 mm mark. It is blown into a test tube. After this, blood is drawn twice with a pipette and blown into a test tube with sodium citrate. Thus, a ratio of anticoagulant to blood of 1:4 is obtained. This mixture is drawn into a glass capillary to a level of 100 mm and placed in a vertical position. The results are assessed after an hour, just like with the Westergren method.

The Westergren determination is considered a more sensitive method, so the ESR level is slightly higher than when examined by the Panchenkov method.

It must be remembered that uncomplicated viral infections do not cause an increase in ESR. This diagnostic sign helps determine that the disease is caused by bacteria. Therefore, when ESR increases, antibiotics are often prescribed. An erythrocyte sedimentation rate of 1-4 mm/h is considered slow. This reaction occurs when the level of fibrinogen, responsible for blood clotting, decreases. And also with an increase in the negative charge of red blood cells as a result of changes in the electrolyte balance of the blood. It should be noted that taking these drugs may cause a falsely low ESR result in bacterial infections and rheumatoid diseases.

• ESR - Erythrocyte sedimentation rate - the oldest test for identifying and monitoring the progress of infectious and inflammatory processes in the body

Synonym:

• ESR - erythrocyte sedimentation reaction

The phenomenon of erythrocyte sedimentation has been known since ancient times. Currently, determination of the rate of such sedimentation remains a popular laboratory test, presented as part of a complete blood count (CBC). However, an increased ESR in the blood of women is not always associated with the disease. Is it necessary to measure ESR? If yes, then for what?

ESR - why do red blood cells settle?

Normally, red blood cells - erythrocytes - carry a negative charge. According to the laws of physics, they, being equally charged, repel each other and “float” in the plasma without sticking together. When, under the influence of gravity, red blood cells “fall” down one by one, their sedimentation rate is low.

When the biochemical composition of blood plasma changes, more often when the normal balance between its protein fractions is disrupted, the negative charge of erythrocytes is neutralized. Positively charged proteins, like “bridges,” connect (aggregate) red blood cells with each other into “coin columns.”

Erythrocyte-protein conglomerates are much heavier than individual cells. Therefore, they settle down at a faster rate and the ESR increases.

• Fibrinogen is a marker of inflammatory and destructive processes. Produced in the liver. Its concentration in the blood increases significantly during acute inflammatory processes, as well as in response to the destruction and death (necrosis) of tissues.
• Globulins (including immunoglobulins) are high molecular weight proteins in blood plasma. Produced in the liver, as well as by the immune system. The concentration of immunoglobulins (antibodies) in the blood increases in response to infection.
• Mixed cryoglobulins - in particular, polyclonal Ig G antibodies and monoclonal antibodies Ig M and Ig G to the Fc fragment of Ig G. The combination of the latter is called rheumatoid factor.

Any physiological conditions, nutritional disorders or diseases associated with an increase in these or other proteins in the plasma are manifested by an increase in ESR.

The ESR norm is not the same for women and men. This is probably due to fewer red blood cells and more fibrinogen and globulins in women.

ESR - norm for women by age - table

How to calculate a woman’s individual ESR rate by age

To roughly calculate the individually acceptable limit of the upper norm of ESR in a woman, depending on her age, use the Miller formula:

ESR mm/hour = (woman’s age in years + 5): 2

The upper limit of the ESR norm is equal to the figure obtained by dividing the sum (woman's age plus five) by two.

Example:
(55 years + 5) : 2 = 30
The acceptable ESR limit for a 55-year-old woman is 30 mm/hour.

and that's why:

Firstly: ESR increases in many, very different diseases.

Secondly: In a number of diseases, ESR may remain normal.

Third: With age, ESR gradually (by about 0.8 mm/h every 5 years) increases. Therefore, in elderly patients, the diagnostic values ​​of a moderate increase in ESR have not been established.

Fourth: In 5-10% of healthy people, ESR can remain within 25-30 mm/hour for years (the so-called “soy disease”).

Fifth: ESR is influenced by the shape of red blood cells and their number in the blood.

Sixth: In addition to the protein composition of plasma, ESR depends on many of its other biochemical parameters - the amount of bile acids, electrolyte composition, viscosity, cholesterol-to-lecithin ratio, blood pH, etc.

Finally: The ESR norm is not the same in different measurement methods (read below).

Pathological causes of increased ESR in the blood of women

Despite the difficulty of interpretation, a pathological increase in ESR remains an objective criterion for inflammation, infection and necrosis.

Diseases affecting ESR levels

ESR in myocardial infarction

In some cases, diagnosing atypical forms of myocardial infarction - necrosis of the heart muscle due to impaired coronary blood flow - causes difficulties. Comprehensive clinical and laboratory studies, including dynamic monitoring of changes in ESR, help the doctor to recognize the disease in a timely manner and prescribe the correct treatment.

ESR during a heart attack increases after the disaster has occurred: 1-2 days after the temperature rises and the development of leukocytosis.

In other words, ESR begins to increase from the 3-4th day of illness. The peak of acceleration is expected approximately a week after the heart attack occurs. The ESR returns to normal gradually over the next few weeks.

What ELSE do ESR indicators in women depend on?

Moderate (up to 40-50 mm/hour) acceleration of ESR can periodically appear in completely healthy women. Such a physiological increase in ESR can be associated with menstruation, pregnancy, errors in diet (high-protein diet, abuse of fatty foods, overeating, alcohol), physical overload, excess body weight, stress, age-related changes in the body...

Increased ESR during pregnancy

In pregnant women, ESR accelerates: the longer the pregnancy, the higher the ESR.

From the third trimester, ESR can exceed the norm by 3 times and reach 45-50 mm/hour.

After childbirth, the ESR remains accelerated from three months to six months, then gradually decreases and returns to normal on its own.

What does high ESR in the blood mean?

How to assess a situation when, apart from an accelerated ESR, there are no other clinical signs of the disease, and the patient does not make any complaints? Let's look at a few examples:

ESR 20 in women - what does it mean?

An isolated increase in ESR up to 20 mm/hour, determined by the Panchenkov method (see below), can be considered a variant of the norm.

When measuring ESR according to Westergren, this indicator for women is the norm.

ESR 25, 30 in women - what does this mean?

In older women, these values ​​are more often regarded as a variant of the hole.

In young and middle-aged women - they may be a variant of the individual norm or indicate the approach of menstruation or pregnancy.

In other cases, an increase in ESR to 30 mm/hour reflects a certain tension of the immune system. All infectious processes or conditions after surgical interventions are associated with the mobilization of the immune system and increased production of protective proteins (immunoglobulin antibodies). Moreover, their maximum accumulation occurs by the 10th day from the onset of the disease and persists 2 or more weeks after recovery (remission). All this time, the ESR will be increased, although the acute stage of the disease (inflammation) has already resolved.

ESR 40 in women - what does this mean?

This acceleration of ESR is not easy to interpret. The best method for diagnosing a possible disease in this situation is a thorough history taking.

If there are no obvious pathological reasons for the increase in ESR (in history, currently), then it is not advisable to conduct complex additional studies. It is enough to do a few simple tests (for example,) or temporarily limit yourself to dynamic observation.

An ESR above 70-75 in a woman - what does this mean?

Such an increase in ESR already indicates a painful condition associated with inflammation, immune disorders, destruction of connective tissue, necrosis or malignancy:
- tuberculosis;
— subacute bacterial endocarditis (infection of the heart valves);
- polymyalgia rheumatica;
- exacerbation of rheumatoid arthritis;
- Crohn's disease, ulcerative colitis;
- temporal arteritis;
- acute renal or hepatic pathology;
- others

But, as a rule, these diseases are associated not only with high ESR - there are more modern and reliable methods for diagnosing them.

If no infectious or inflammatory process is detected, then such a significant acceleration of ESR (above 75 mm/hour) suggests a malignant tumor.

ESR above 100 mm/h – what to do? What does it indicate?

A significant increase in ESR in cancer patients may indicate metastasis—the spread of the tumor beyond the primary site.

The only case of diagnostic use of accelerated ESR (100 mm/hour and above) in oncology is the detection multiple myeloma(malignant bone marrow disease).

Very high ESR values ​​also occur in Hodgkin lymphomas.

Analysis of ESR in neoplasms is often used not for diagnosis, but for dynamic assessment of the effectiveness of treatment and monitoring the course of the disease.

What to do if the ESR in the blood is elevated?

If, upon detection of an accelerated ESR, the doctor decides to examine the patient in detail, then the following diagnostic tactics are recommended:

1. Careful medical history and screening tests: (complete blood count), UAM (general urinalysis), chest x-ray.

If the initial examination does not produce results, then the search for the cause of high ESR continues further:

2. The patient’s outpatient card is studied, the current ESR indicators are compared with the previous ones. ESR is also re-determined to exclude a false-positive result.

3. A blood test is performed to determine the concentration of proteins in the acute phase of inflammation:
— SRB,
- fibrinogen.

4. To exclude polyclonal gammopathy and myeloma, the concentration of immunoglobulins in the blood is determined (by electrophoresis).

If the cause of the elevated ESR is still not found, then it is recommended:

5. Monitoring ESR after 1-3 months.

6. Dynamic monitoring of the patient to detect (exclude) clinical manifestations of the suspected disease.

How to lower ESR in the blood of women and is it worth lowering?

Obviously, to normalize ESR, it is necessary to determine the source of dysproteinemia and eliminate it (i.e., detect and cure the disease or optimize nutrition and lifestyle). After eliminating the factor that accelerates ESR, blood counts will return to normal on their own.

Most often, the cause of an increase in ESR is diagnosed according to the plan described above. But sometimes, to clarify the nature of the disease and at the same time bring the elevated ESR back to normal, the treatment and diagnostic tactics “ex juvantibus” are used.

Algorithm for bringing ESR back to normal
ex juvantibus therapy

Principle of the method: verification of the suspected diagnosis by trial treatment.

1. First, the patient is prescribed broad-spectrum antibiotics. If the ESR does not decrease, then the reason for its acceleration is not an infection.

2. Then steroidal anti-inflammatory drugs are used (glucocorticoids: prednisolone, dexamethasone, etc.). If there is no positive result, then the reason for the acceleration of ESR is not inflammation (immune, autoimmune).

3. Having ruled out infection and inflammation, the patient is examined for oncology (malignant neoplasm).

This primitive-simplified approach in some cases helps to determine a controversial diagnosis.

Methods for determining ESR

ESR according to Panchenkov

Basis of the method:
The ability of red blood cells to settle to the bottom of a vessel under the influence of gravity.

How to do it:
Capillary blood thoroughly mixed with an anticoagulant (sodium citrate) is placed in a special graduated vessel “Panchenkov capillary” with a working scale of 100 mm and left for 1 hour.

The ESR value is taken to be the distance formed in an hour from the upper to the lower boundary of the plasma (to the surface with red blood).

Disadvantage of the method:
distortion of real results due to many non-specific factors.

• quality of anticoagulant,
• quality and accuracy of the inner diameter of the glass vessel,
• degree of cleanliness of the capillary vessel,
• adequacy of mixing blood with anticoagulant,
• air temperature in the laboratory,
• the adequacy of obtaining a blood sample from a finger prick,
• position of the rack with blood samples...

It is obvious that Panchenkov’s method of measuring ESR, ingenious for its time, is as simple (in execution) as it is inaccurate.

ESR according to Westergren

The principle of measuring ESR with this method is the same as that of the Panchenkov method. But for the study, pure venous blood and a capillary tube 200 mm long are used.

Determination of ESR by an automatic analyzer

The method involves calculating the kinetics of erythrocyte aggregation. An automatic hemoanalyzer repeatedly (1000 measurements in 20 seconds) records the optical density of the blood being tested. Then, using mathematical algorithms, it converts the results into Westergren ESR units (mm/hour).

Any method of measuring ESR has its advantages and disadvantages. To correctly evaluate the analysis, one must reliably know and take into account all the circumstances influencing its results.

Every day, more and more new ways to diagnose diseases appear in the world of medicine. Despite this, a general blood test is still the most important. This is the first study that doctors refer to for any complaints. In the general analysis, leukocytes, hemoglobin, platelets and other significant components are assessed. Along with them, one of the main indicators that helps assess the patient’s condition will be ESR.

What is ESR?

ESR is very important. Any deviation from normal indicators will indicate the presence of a certain inflammatory focus in a person’s body. In order to correctly determine the ESR level, the test must be taken in the morning, on an empty stomach. Otherwise, the results may be unreliable.

ESR shows us the degree to which red blood cells are deposited over a certain period of time.

This indicator is very sensitive; it usually reacts in the earliest stages of the disease, when there are no clinical symptoms yet. The level of ESR increases in infectious, rheumatological, and oncological diseases.

It happens that ESR can increase even under severe stress, physical fatigue, and dietary restrictions. But in this case, its increase is short-term.

Important! If the ESR level is high for a long time, you should be carefully examined to determine the cause.

How is ESR determined?

The technique by which analysis is most often performed is the Panchenkov method. Its essence is to mix capillary blood with sodium citrate (an anticoagulant), after which it will separate into two layers. The bottom layer will contain red blood cells, the top layer will contain plasma and white blood cells.

A number of factors can be identified that will influence the erythrocyte sedimentation rate:

• Red blood cell count. If their amount in the blood is reduced, then sedimentation will occur faster. Accordingly, if their content is increased, it means that they will settle more slowly.
• When an infection occurs, the immune system will respond by producing special antibodies, which causes the ESR to increase.
• With increased acidity of the blood, the ESR will also increase.

Normal ESR in the blood

• norm for men: 1-12 mm/h
• norm for women: 2-16 mm/h
• in pregnant women, ESR will always be elevated: up to 45 mm/h
• normal for children:
  • in the first days of life – 1 mm/h;
  • 0-6 months – 2-4 mm/h;
  • 6 months – 1 year – 4-9mm/h;
  • 1-10 years – 4-12 mm/h;
  • up to 18 years – 2-12 mm/h.

ESR: norm, reasons for increase (video)

After watching this video, you can get an idea of ​​what ESR is, get a little familiar with its norms and find out why it may be increased.

Reasons for decreased ESR

• Cholecystitis, liver diseases. As a result of these diseases, an increased amount of bile is produced.
• Increased number of red blood cells.
• Heart failure.
• Increased blood acidity.
• Deficiency of vitamins and minerals. May be low for vegans, in this case it is considered as a variant of the norm.
• Sickle cell anemia. Red blood cells have an irregular shape and, accordingly, settle more slowly.

Reasons for increasing ESR

These include:

• dietary restrictions, all kinds of diets and fasting;
• pregnancy;
• the presence of menstruation at the time of taking the analysis;
• allergies;
• the blood test was not taken on an empty stomach (you cannot eat 8 hours before donating blood);
• helminthiasis.

• Autoimmune diseases and collagenoses: systemic lupus erythematosus, vasculitis, rheumatism, scleroderma, dermatomyositis, periarteritis nodosa, rheumatoid polyarthritis, bronchial asthma, etc.
• Infectious diseases. Acute respiratory viral infections, bronchitis, sinusitis, pharyngitis, influenza, cystitis, pyelonephritis and others. All of these diseases cause a strong immune response and increased production of antibodies. And a high concentration of immunoglobulins in the blood increases ESR.
• Oncology.
• Pulmonary tuberculosis.
• Myocardial infarction. Damaged cardiac muscle tissue initiates an inflammatory response, resulting in increased fibrinogen synthesis, which leads to an increase in ESR.
• Endocrine diseases. Diabetes mellitus, hypothyroidism, hyperthyroidism.
• Kidney diseases – hydronephrosis, glomerulonephritis, urolithiasis.
• Conditions in which blood viscosity increases. Severe food poisoning, intestinal obstruction, blood transfusion.
• Injuries, burns.
• Diseases associated with metabolic disorders. Cystic fibrosis, obesity.

Increased ESR in the blood in women and men

• taking oral contraceptives;
• menstruation;
• period of pregnancy and breastfeeding;
• eating disorders. Women often abuse low-calorie diets.

In some men (about 5-8%), the ESR is slightly increased, this is also a variant of the norm. It may be a matter of lifestyle, abuse of bad habits, or simply personal characteristics.

Increased ESR in the blood of a child

• infectious diseases;
• allergies;
• severe intoxication of the body;
• injuries;
• impaired metabolism;
• worms.

Note! If the ESR is slightly increased, the reason may be different: lack of vitamins, teething, taking medications.

How to reduce ESR

In most cases, elimination of the inflammatory process in the body is required. To determine the exact diagnosis, additional studies are carried out. After this, the doctor makes his verdict and prescribes proper treatment. After the disease is cured, the ESR decreases.

Poor blood tests are often associated with liver problems. She may suffer due to poor nutrition, alcohol, excess weight, infectious and viral diseases. As a result, the liver does not have time to perform the function of cleansing the body of toxins, and they enter the bloodstream. As a result, the ESR may deviate from normal values. Then treatment measures should be aimed at eliminating this problem. You can take medications to support liver function, liver herbal teas.