Soe is measured in. ESR in a blood test - the norm and deviations

A complete blood count is a very important study that helps the doctor identify some deviations from the norm for a healthy person. It shows several very important parameters, among which the ESR indicator is important. If everything is in order with a person’s health, soy in the blood is within the normal range. In adults and children, normal values ​​differ.

What is SOE?

Red blood cells are blood cells that perform a very important function in the body. These particles transport oxygen in human blood. ESR (erythrocyte sedimentation rate) is an indicator that is determined by conducting a study of a general blood test. Its deviations do not always unambiguously indicate that a person has some kind of disease or inflammatory process.

If the ESR exceeds the norm, you need to pay attention to other analysis data that can confirm the presence of the disease. If all other characteristics are normal, it is worth conducting additional studies. An increase or decrease in this characteristic is a signal for a doctor that he cannot ignore. Timely adoption of measures will help maintain human health.

Physiological limits of normal in women

For a healthy woman, there are their own criteria and the norm of soy in the blood. The erythrocyte sedimentation rate depends on the state of health and age. So, if the girl is not in a state of pregnancy, then this indicator should be in the range from 3 to 15 mm / h. Compared with men, their ESR should be in the range of 2 to 10 mm / h. After 60 years, in women and men, the norm of this indicator is the same - 15-20 mm / h.

For pregnant women, an increased ESR is very often characteristic, the indicator sometimes reaches 25 mm / h. Anemia often occurs in women in position, as a result of which blood thinning and an increase in the erythrocyte sedimentation rate are observed. Due to the individual characteristics of the organism, such characteristics may be different for each individual person.

How is a blood test done?

First, the patient will need to donate blood. It is optimal to do this in the morning and on an empty stomach in order to prevent the deviation of the indicator due to the presence of other factors. Biological material is sent for research, which is carried out by a specially trained laboratory assistant, or it is done automatically using a special device. Only a few drops of liquid are required for the study.

The erythrocyte sedimentation rate is determined using a special test, which with a high degree of probability will give the real indicator of soy in human blood. The study of biological material is a simple process, it takes about an hour to complete. The liquid is placed in a test tube, and the laboratory assistant monitors how quickly the erythrocytes settle to its bottom. Blood plasma itself has a slightly lower density than red blood cells, which is why they sink to the bottom.

It is very important not to get hung up on this parameter, it will only tell you what to pay attention to. The effectiveness of the study increases in conjunction with other diagnostics, which can tell more about a person's condition. The whole research process has three phases, the longest of them is the second, which lasts 40 minutes. The first and third stages take 10 minutes each. During this time, red blood cells sink to the bottom, settle and turn into a clot.

The indicator of the result of the study was obtained as a result of simple mathematical operations. The distance that the red blood cells descended is divided by the time spent on this operation. The unit of measure is mm/h. The decoding of the received data is carried out by a specialist who must take into account all related characteristics. The more pronounced the deviation of the ESR from the norm of a healthy person, the more dangerous and longer the inflammatory process in the body.

Why does the level of ESR in the blood rise?

The erythrocyte sedimentation rate indicates that not everything is in order with blood circulation, or vice versa. Sometimes elevated ESR levels are due to special causes, such as pregnancy or the consequences of surgery. If there are inflammatory processes or oncological diseases in the body, then the ESR level will be somewhat overestimated. Normal ESR data for different categories of people are different. If the score is high, then:

1. The density of erythrocytes is reduced.
2. There is a large amount of alkali in the blood.
3. The level of albumin content decreases.

All these factors are the result of blood thinning. But other points also influence the acceleration of erythrocyte sedimentation, for example, malnutrition, if there is a lack of vitamins and minerals in the body. In an infant, ESR increases during teething. Other causes may be hormonal disorders, pregnancy, fever, blood cancer, tuberculosis. This phenomenon often occurs due to chronic diseases in the active phase.

Causes of low ESR

Doctors say that more dangerous is an increased erythrocyte sedimentation rate. But do not forget about the lower bounds of this parameter. The reason for the decrease in the level of ESR can be the following diseases or pathologies:

1. Polycythemia. The blood becomes very viscous, and the ESR is minimal.
2. Diseases of the liver and kidneys. This lowers the level of fibrinogen in the blood.
3. Some cardiac pathologies.

Fasting, chronic circulatory failure, viral hepatitis, taking certain medications (calcium chloride, salicylates) can lower ESR. In epilepsy and neurosis, there is also a low erythrocyte sedimentation rate. But all this is revealed in the process of a comprehensive analysis of many characteristics of a person's state of health, therefore, when prescribing treatment, the doctor must rely not only on the ESR.

Treatment for elevated ESR in the blood

An elevated ESR does not clearly indicate pathologies. Treatment is prescribed to lower it to normal. There is no single algorithm for getting rid of this phenomenon. First of all, the reason for the increase in ESR is revealed. This may require more than one laboratory study. If, as a result, a person does not have other symptoms of diseases or inflammation, then treatment is not prescribed.

If the reason is clear, the doctor will prescribe an appropriate course of treatment, during which it will be necessary to periodically take a general blood test and observe the ESR. The closer this indicator is to the norm, the more correct and effective the treatment is. Soy in human blood is an important indicator, but this parameter must be monitored, especially if a person is at risk.

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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• WBC (white blood cells - white blood cells) - the absolute content of leukocytes.
• RBC (red blood cells - red blood cells) - the absolute content of red blood cells.
• HGB (Hb, hemoglobin) - the concentration of hemoglobin in whole blood.
• HCT (hematocrit) - hematocrit - the ratio of the volume of formed elements to blood plasma.
• PLT (platelets - platelets) - the absolute content of platelets.

Erythrocyte indices (MCV, MCH, MCHC):

• MCV - the average volume of an erythrocyte in cubic micrometers (µm) or femtoliters (fl).
• MCH is the average content of hemoglobin in an individual erythrocyte.
• MCHC - the average concentration of hemoglobin in the erythrocyte.

Platelet indices (MPV, PDW, PCT):

• MPV (mean platelet volume) - the average platelet volume.
• PDW is the relative width of platelet distribution by volume.
• PCT (platelet crit) - thrombocrit.

• LYM% (LY%) (lymphocyte) - relative (%) content of lymphocytes.
• LYM# (LY#) (lymphocyte) - absolute content of lymphocytes.
• MXD% - relative (%) content of a mixture of monocytes, basophils and eosinophils.
• MXD# - absolute content of a mixture of monocytes, basophils and eosinophils.
• NEUT% (NE%) (neutrophils) - relative (%) content of neutrophils.
• NEUT# (NE#) (neutrophils) - absolute content of neutrophils.
• MON% (MO%) (monocyte) - relative (%) content of monocytes.
• MON# (MO#) (monocyte) - absolute content of monocytes.
• EO% - relative (%) content of eosinophils.
• EO# - absolute content of eosinophils.
• BA% - relative (%) content of basophils.
• BA# - absolute content of basophils.
• IMM% - relative (%) content of immature granulocytes.
• IMM# - absolute content of immature granulocytes.
• ATL% - relative (%) content of atypical lymphocytes.
• ATL# - absolute content of atypical lymphocytes.
• GR% - relative (%) content of granulocytes.
• GR# - absolute content of granulocytes.

• RBC/HCT - mean volume of erythrocytes.
• HGB/RBC - the average content of hemoglobin in an erythrocyte.
• HGB / HCT - the average concentration of hemoglobin in the erythrocyte.
• RDW - Red cell Distribution Width - coefficient of variation of the average volume of erythrocytes.
• RDW-SD - relative distribution width of erythrocytes by volume, standard deviation.
• RDW-CV - relative width of distribution of erythrocytes by volume, coefficient of variation.
• P-LCR - large platelet ratio.
• ESR - erythrocyte sedimentation rate.

Clinical blood test

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What does ESR mean in a blood test, and how is it indicated in analyzes

About what the ESR means in the blood test, the doctor can explain when abnormalities appear. The study is mandatory during a routine medical examination or any complaints from the patient. The result of the blood will help to make a diagnosis, decoding is the business of a specialist. ESR in a blood test is an important indicator indicating the presence of inflammation, pathology.

Indicator designation

A blood test is a method by which you can find out the level of ESR in the blood.

Here are the characteristics of the cells directly involved in the determination of ESR:

• Red blood cells are red blood cells that contain hemoglobin, which provides the body with heme iron levels.
• The functions of erythrocytes are that they, circulating through the peripheral blood, carry oxygen to the tissues, and free molecules take back the products of metabolism.

• The rate of these cells differs in men, women and children. This value is highest in men (4.4-5.0 × 1012 per 1 liter), in women the figure is slightly lower due to monthly blood loss. In children, the value is constantly changing due to the fact that there is an intensive growth of body structures.

The number of erythrocytes is higher than other cells circulating in the blood, therefore, their sedimentation rate is more indicative in terms of diagnostics. Due to their number and settling occurs faster. Determination of ESR occurs at each routine examination, that is, at least once a year, as well as when you feel unwell.

Determination of the erythrocyte sedimentation rate allows you to determine the presence of a latent inflammatory process or infection. The essence of the parameter calculation is that cells settle under their own weight, and after a unit of time it is possible to register how many divisions this happened. An increase in the weight of cells leads to an acceleration of their fall.

There are certain conditions that affect the result:

• the temperature at which the sample is stored;
• choice of capillary length;
• correct fixation in a tripod;
• compliance with the recommended ratio of anticoagulant;
• used anticoagulant component.

As a rule, normal ESR values ​​differ in people of different sexes: in a strong half of humanity, a value of up to 10 mm / h is considered the norm, in women - up to 15. In a newborn child, an ESR value of up to 2 mm / h is considered a healthy indicator. Already in a month, this border moves to 5 mm / h, and by 6 months it is 2-6.

At the same time, a blood test should be considered in conjunction with other health parameters: for some children at 6 months and 10 mm / h is the norm. You can find out the level of ESR using a complete blood count.

The purpose of determining the ESR

The interpretation of the blood test, and especially the ESR, should be done by a doctor, since the indicators can be ambiguous, and a competent specialist can understand further tactics in relation to the patient.

Deciphering the ESR allows the doctor to understand the following:

• Is there an inflammatory or infectious process in the body?
• Is the previous treatment effective?
• Is it possible to suspect the presence of an oncological process if there are no specific complaints?

• Are there any residual effects after the infection?

The topic of what ESR means in a blood test exists inseparably with other indicators. Particular attention should be paid to leukocytes: with leukocytopenia, there is a need for a detailed blood test with the calculation of the leukocyte formula; analysis with a predominance of immature young forms of leukocytes raises the suspicion of leukemia. In this case, cells lose the possibility of final differentiation and maturation.

The simplest goal of determining ESR is the rapid separation of patients from healthy ones. As you know, if a disease is suspected, the doctor sends for examination.

With a large range of diagnostics, the group of suspected pathologies is so wide that it will require the use of many studies, including expensive ones (ultrasound, radiography, MRI, CT, analysis for tumor markers). If the general blood test seems suspicious to the doctor, then he makes a presumptive diagnosis based on complaints and other criteria and prescribes those methods that can help in determining the nature of the disease.

Many factors influence the erythrocyte sedimentation rate. During the inflammatory process, biologically active substances are released, which are able to recharge the erythrocyte membrane and cause them to stick together. Another reason is the emergence of large-dispersed proteins, which provoke red blood cells to stick together.

Here is a list of some conditions in which the level of red blood cell velocity increases:

• infectious processes;
• purulent-inflammatory diseases;
• oncology;
• glomerulonephritis, pyelonephritis;
• hepatitis, cirrhosis;
• anemia;
• tissue necrosis, in which they disintegrate and release proteins into the bloodstream;
• infarction of the brain, myocardium, intestines;
• tuberculosis;
• systemic connective tissue diseases;
• metabolic disorders;
• oncological lesions of the blood (leukemia, lymphogranulomatosis).

It is possible to indirectly assume the presence of an increased or decreased ESR by the amount of hemoglobin: with a high indicator, the reaction will be lower, with anemia, the level will increase. That is, the lower the level of pigment, and, consequently, erythrocytes, the faster they settle. With a large number of cells, the blood becomes viscous, which reduces the rate of fall of elements.

In a number of conditions that are not a disease, the reaction of the body is also observed:

1. During pregnancy, after childbirth and during menstruation.
2. In the morning hours the level is higher.
3. When a woman takes oral contraceptives (pills).
4. If at the time of the study a person has an exacerbation of a chronic process, even a runny nose, or with a rash of acne.
5. After eating spicy or fatty foods.
6. During or after stress.
7. With an allergic reaction.
8. After taking certain groups of drugs.

A blood test with an increased indicator is more common, but there is also a lower result. One of the reasons for this phenomenon is referred to as a viral infection.

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ESR in the blood: decoding and designation of the analysis

One of the indicators of a general blood test is ESR - the erythrocyte sedimentation rate. Previously, another term for ROE was adopted - the erythrocyte sedimentation reaction, but since no reaction actually occurs, this name was abandoned.

Indicators of ESR in the blood cannot be considered separately from other clinical tests, since deciphering the level of ESR in the norm does not yet indicate the absence of a disease, and vice versa, underestimated or increased indicators do not always indicate a violation of the functioning of the body.

ESR analysis

An ESR blood test in the laboratory is carried out with simple manipulations. When doing a general analysis, the laboratory assistant puts the blood into a test tube, adding an anticoagulant that prevents the blood from clotting. The material is in the flask for an hour, while the erythrocytes due to their mass settle to the bottom, and the plasma occupies the upper part of the liquid. An hour later, you can determine the level of ESR - it corresponds to the height that the plasma occupies. The border between red bodies and clear plasma on the scale of the test tube will be the rate of erythrocytes per hour (in millimeters).

In men and women, the compliance with the ESR norm is different, but there are many conditions under which a level above or below the average also means the norm.

ESR norm indicators

It is generally accepted that the rate of erythrocyte sedimentation in newborns is 0-2 mm / h, under the age of six months 12-17 mm / h, in men 2-10 mm / h, in women 3-15 mm / h. Women are subject to frequent changes in the composition of the blood and the level of its components. So, for example, for women from 20 to 30 years old, the optimal indicators will be 3-15 mm / h, in adulthood (30 - 60 years old) - 8-25 mm / h, for those who are over 60 - 12-53 mm / h h. As for pregnant women, they have an average level of 25 to 45 mm / h.

Diet, lifestyle also affects the ESR, which slightly increases as a result of a hearty breakfast, menstruation, in the postpartum period, fasting or a strict diet, as well as in the case of allergic diseases. In the latter version, a general analysis is done several times when taking anti-allergic drugs - if the indicators begin to approach the norm, this means the medicine is chosen correctly.

A very low sedimentation rate is observed when following a vegetarian diet and when taking certain blood-thinning drugs (aspirin, calcium chloride).

ESR level categories

In modern medicine, deviations from the norm are usually classified by degrees. The first degree includes indicators that differ by several units from the established ones. The decoding of the analyzes determines that the bodies in the blood are at a relatively acceptable level.

The second degree includes patients whose erythrocyte sedimentation rate exceeds 15-30 units. This already indicates inflammatory processes in the body as a reaction of the body to colds or infections that can be cured over a period of about 30 days. During this period, the dynamics of ESR should be monitored and a general blood test should be taken, since the first changes will be noticeable only after 24-72 hours, a significant increase will appear on the 12-14th day of the disease, and the peak can be reached already during the recovery period. Such amplitudes are explained by the fact that the human body takes time to produce the required amount of antibodies.

If in the dynamics within 30 days the general analysis shows higher deviations - by 30-60 units, it's time to seriously think about health. This primarily indicates the presence of serious inflammatory processes or intoxication of the body due to tissue breakdown or a progressive malignant tumor.

The fourth degree - an increase in ESR by 60 units cannot pass without a trace. Usually the patient knows about his disease, purulent-septic reactions take place in his body.

What factors affect the erythrocyte sedimentation rate?

The main indicator that affects the ESR is the protein composition of the blood. The more proteins in the blood (globulins and fibrinogen), the lower the resistance of red blood cells. The immune system begins to actively produce immunoglobulin to fight infection and viruses, and the rate of red blood cells increases. As for leukocytes, their speed and number are directly proportional to the indicators of erythrocytes. So at the beginning of the attack on the body, there are more of them, on the 10th-14th day the number decreases, and only on the 21st-30th day, leukocytes and erythrocytes increase their level in the same dynamics.

Methods for determining ESR

In modern medicine, it is customary to determine the ESR in two ways: the Panchenkov method and the decoding of the analysis according to Westergren. The norm for both types of research is the same, but they differ in the type of test tubes and the scale during measurements. More sensitive to an increase in ESR is the Westergren method.

A number of diseases can be distinguished that are accompanied by a level of change in the erythrocyte sedimentation rate: heart attacks, impaired functioning of the immune system, malignant diseases, anemia, leukemia. A decrease in speed may indicate hyperproteinemia, erythrocytosis, hepatitis, and others.

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Deciphering ESR in a blood test

Our blood consists of a liquid part and a dry residue. The liquid part of the blood is plasma, and the dry residue is mainly represented by erythrocytes. In addition to erythrocytes, there are also leukocytes and platelets. But their number is so small that it can not be taken into account. Erythrocytes, or red blood cells, are biconcave discs.

In order for erythrocytes to perform their main function of transporting oxygen and carbon dioxide, they must be in the blood plasma in a free suspended state, and in no case should they stick together. This is achieved by a number of complex physiological mechanisms. However, in vitro (in vitro) erythrocytes settle because their density, or specific gravity, exceeds the density of blood plasma. True, the speed of their settling is different.

Not the last factor affecting the rate is the phenomenon of erythrocyte aggregation (gluing). RBC aggregation is a consequence of various pathological conditions. Conglomerates of erythrocytes glued together have a large mass with a relatively small surface area, which creates conditions for their faster settling in a liquid medium.

Influencing factors

ESR in the blood depends on a number of factors, including:

1. The charge of the erythrocyte membrane. Normally, the surface of the erythrocyte membrane has a negative charge. Similarly charged erythrocytes repel each other and do not stick together. Due to various pathological conditions (poisoning, infection, diseases of internal organs), the erythrocyte membrane can be damaged with a change in its charge.
2. The number of erythrocytes. The fewer red blood cells, the faster they settle, and vice versa. Therefore, with anemia (anemia), the ESR will be increased.
3. The protein composition of the blood. The main proteins of blood plasma are represented by low molecular weight albumins and large molecular weight globulins. With various inflammatory reactions, incl. and infectious nature, the amount of globulins increases. “Inflammatory proteins” appear - fibrinogen, C-reactive protein. This is accompanied by a change in the membrane charge of erythrocytes. A decrease in albumin levels in liver disease leads to the same result.
4. Acid-base state of the blood (ACS). The higher the acidity (acidosis) of the blood plasma, the higher the ESR, and, conversely, when the CBS is shifted to the alkaline side (alkalosis), the ESR increases.

Thus, ESR shows that certain pathological changes occur in various organs and biological environments.

Normal values

The unit of measurement of ESR is mm/h - millimeter per hour. When determining the ESR norm, the following are taken into account:

2. Floor. In men, the ESR rate is 2-10 mm / h, and in women it is slightly higher, and is equal to 3-15 mm / h.
4. Age. In persons of both sexes older than 50-60 years, the upper limit of values ​​\u200b\u200bis up to 15-20 mm / h is allowed. ESR changes especially rapidly in children of different ages. In newborns, ESR is 0-2 mm / h, in children from 6 months to a year - 12-17 mm / h, and in the blood of a child older than a year - 12-18 mm / h.

Although in various sources, the normal values ​​​​of ESR may vary slightly. Apparently, this is due to the improvement of the technology for measuring this indicator.

In some reference materials, you can find another indicator - ROE. This is the erythrocyte sedimentation reaction.

The presence of this indicator in some cases can confuse the interpretation of the test results. However, it should be noted that ESR and ROE are one and the same. It's just that ROE is an outdated term, which was replaced by ESR back in Soviet times.

Method of determination

The classic method for determining ESR is the Panchenkov method. Capillary blood taken from the finger of the subject, in order to avoid clotting, is mixed with a preservative in a ratio of 3: 1 - 3 parts of blood and 1 part of a preservative. 5% sodium citrate acts as a preservative. The citrated blood is then placed into specially graduated glass capillaries. The results of the analysis are evaluated after 1 hour by the height of the light bar corresponding to blood plasma devoid of settled erythrocytes.

Now the Panchenkov method has been replaced by a more progressive method Westergren. At its core, it practically does not differ from the Panchenkov method. True, here, instead of glass capillaries, special graduated test tubes are used. The concentration of the preservative and its ratio with blood is also different - 3.8% and 4:1. But the fundamental difference is different. When determining ESR according to the Westergren method, instead of blood from a finger, blood is taken from a vein. The bottom line is that many external influences (cold, physical activity) lead to capillary spasm, to a change in the characteristics of the blood flowing in them, and to a distortion of the results obtained. It follows from this that the analysis of venous blood is more objective than that of arterial blood.

Causes of high ESR

In clinical practice, an increase in ESR is most often observed. The main reasons for this standing:

• inflammatory processes of the upper respiratory tract of an infectious nature - sinusitis, pharyngitis, rhinitis, tonsillitis;
• liver diseases - hepatitis, cirrhosis;
• malignant oncological diseases - cancer, sarcoma;
• allergic reactions;
• anemia;
• various conditions leading to alkalosis;
• pregnancy;
• increased blood cholesterol levels;
• abundant intake of fatty foods - in this regard, a complete blood count should be taken on an empty stomach.

ESR may increase during blood sampling in hot climates, at temperatures above 270C. And this should also be taken into account when evaluating the results.

Causes of low ESR

A decrease in ESR may be due to such reasons as:

• polycythemia - a disease that leads to an increase in the content of red blood cells in the blood;
• diseases of the cardiovascular system, leading to the formation of congestive heart failure;
• some genetic blood diseases - sickle cell anemia, hereditary microspherocytosis;
• plasma acidosis;
• taking certain medications, including non-steroidal anti-inflammatory drugs;
• an increase in the level of bile acids in the blood plasma with liver damage, inflammatory diseases of the gallbladder, pancreas;
• Low ESR is also observed when blood is taken for analysis with an ambient temperature below 220C.

Features of the increase in certain conditions

Depending on the pathology, 3 degrees of increased ESR are distinguished:

It is believed that the degree of increase in this indicator depends on the severity of the inflammatory process. In this regard, the ESR in pneumonia will be higher than in bronchitis. Although this statement is not always true. The level of ESR depends on the phase of the course of the disease. As a rule, it rises 1-2 days after the first symptom of the disease has developed - weakness, cough or fever.

The maximum value of ESR is reached approximately at the 2nd week of the disease. Together with ESR, the number of leukocytes increases. Then, as the patient's condition improves during treatment, the ESR decreases and returns to normal. During pregnancy, an increase in ESR occurs approximately from the 4th week, reaches a maximum by the end of pregnancy (40-50 mm / h and above), and after successful delivery it quickly normalizes. In oncology, due to the massive breakdown of the protein, the composition of the blood plasma changes, and this is accompanied by a sharp increase in ESR to 80-90 mm / h.

Clinical Significance

It should be noted that it is impossible to judge the severity and phase of the course of the disease on the basis of ESR alone. This is a non-specific indicator, and the decoding of the analysis, in addition to the ESR, should take into account the content of other uniform elements. Most often, a high ESR in the general blood test is the reason for a more detailed laboratory diagnosis.

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When a person comes to the clinic complaining of any disease, he is first of all offered to do a general blood test. It includes checking such important indicators of the patient's blood as the amount of hemoglobin, leukocytes, erythrocyte sedimentation rate (ESR).

A comprehensive result allows you to determine the state of health of the patient. The last indicator is especially important. It can be used to determine the presence or absence of inflammatory processes in the body. According to changes in the level of ESR, doctors draw conclusions about the course of the disease and the effectiveness of the therapy used.

The importance of the level of ESR for the female body

In the general blood test, there is a very important parameter - the erythrocyte sedimentation rate, in women the norm is different and depends on age categories.

What does it mean - SOE? This indicator indicates the rate of erythrocyte sedimentation, the rate of disintegration of blood into fractions. When performing a study, gravitational forces affect the blood in a test tube, and it gradually stratifies: a lower ball of greater density and dark color appears, and an upper ball of a light shade with some transparency. The erythrocytes are deposited, which stick together. The speed of this process is shown by a blood test for ESR.

When conducting this study, it is necessary to take into account that:

• women have an ESR level slightly higher than that of men, this is due to the peculiarities of the functioning of the body;
• the highest rate can be observed in the morning;
• if there is an acute inflammatory process, then the ESR increases on average a day from the onset of the development of the disease, and before that there is an increase in the number of leukocytes;
• ESR reaches its maximum value during recovery;
• with an overestimated indicator for a long period, conclusions can be drawn about inflammation or a malignant tumor.

It is noteworthy that this analysis does not always show the real state of health of the patient. Sometimes, and in the presence of an inflammatory process, ESR may be within the normal range.

What level of ESR is considered normal?

Many factors affect a woman's ESR level. The general rate of erythrocyte sedimentation rate in women is 2-15 mm/h, and the average is 10 mm/h. The value depends on many factors. One of them is the presence of diseases that affect the level of ESR. Age also affects this indicator in women. Each age group has its own norm.

To understand how the limits of the ESR norm change in women, there is a table by age:

From the onset of puberty to the age of 18, the ESR rate for women is 3-18 mm / h. It can fluctuate a little depending on the menstrual period, vaccinations for the prevention of diseases, the presence or absence of injuries, and inflammatory processes.

The age group of 18-30 years old is in a physiological dawn, in which the birth of children most often occurs. Women at this time have an ESR level of 2 to 15 mm / h. The result of the analysis, as in the previous case, depends on the menstrual cycle, as well as on the use of hormonal contraceptives, adherence to various diets.

When pregnancy occurs, the value of this indicator increases sharply and is considered a normal value up to 45 mm / h. This happens due to hormonal changes and other factors.

Also, the amount of hemoglobin can affect and in the period after childbirth. Its decrease due to blood loss during childbirth can provoke an increase in the number of leukocytes and the ESR index.

The norm for women in 30-40 years increases. Deviation may be the result of poor nutrition, cardiovascular diseases, pneumonia and other pathological conditions.

When women reach the age of 40-50, menopause begins. The norm in this period expands: the lower limit decreases, the upper one rises. And the result can be from 0 to 26mm/h. It is affected by hormonal changes in the body of a woman under the influence of menopause. At this age, the development of pathologies of the endocrine system, osteoporosis, varicose veins, and dental diseases is not uncommon.

The limits of the ESR norm in women after 50 years of age do not have significant differences from those for the previous age period.

After the age of 60, the optimal boundaries change. The permissible value of the indicator can be in the range from 2 to 55 mm / h. In most cases, the older the person, the more diseases he has.

This factor is reflected in the conditional norm. Conditions such as diabetes mellitus, fractures, high blood pressure, and medications affect the result of the analysis in older people.

If a woman has an ESR of 30 - what does it mean? When such an analysis result is in a pregnant woman or an older lady, there is no cause for great concern. But if the owner of this indicator is young, then the result for her is increased. The same applies to ESR 40 and ESR 35.

ESR 20 is a normal level for middle-aged women, and if a girl has it, then she needs to be alert and take care of her health. The same can also be said about ESR 25 and ESR 22. For age groups up to 40 years, these figures are overestimated. Further investigation is needed to determine the cause of this result.

Methods for determining ESR

There are several ways to get a result from a blood test for ESR:

1. Panchenkov's method. This diagnostic method is implemented using a glass pipette, also called Panchenkov's capillary. This study involves blood taken from a finger.
2. . To obtain the result, a hematological analyzer is used. In this case, blood is taken from a vein. In a special test tube, it is combined with an anticoagulant and placed in the device in a vertical position. The analyzer makes calculations.

Scientists compared these 2 methods and came to the conclusion that the result of the second one is more reliable and allows you to get the results of a venous blood test in a shorter period of time.

The use of the Panchenkov method prevailed in the post-Soviet space, and the Westergren method is considered international. But in most cases, both methods show identical results.

If there are doubts about the reliability of the study, then you can check it again in a paid clinic. Another method determines the level of C-reactive protein (CRP), while eliminating the human factor of distorting the result. The disadvantage of this method is its high cost, although the data obtained with its help can be trusted. In European countries, the ESR analysis has already been replaced by the determination of the PSA.

When is an analysis ordered?

Usually, doctors prescribe a study when a person’s health deteriorates, when he comes to see a doctor and complains of feeling unwell. A general blood test, the result of which is the ESR, is often prescribed for various inflammatory processes, as well as to check the effectiveness of therapy.

Doctors refer the patient to this study to make the correct diagnosis for any illness or suspicion of it. The result of a blood test for ESR is needed even to undergo a routine health check for each person.

Most often, the referral is issued by the therapist, but a hematologist or oncologist can send for examination if such a need arises. This analysis is carried out free of charge in the laboratory of the medical institution in which the patient is observed. But if desired, a person has the right to undergo research for money in the laboratory that he chooses.

There is a list of diseases in which a blood test for ESR is mandatory:

1. Possible development of rheumatic disease. It could be lupus, gout, or rheumatoid arthritis. All of them provoke deformation of the joints, stiffness, pain during the work of the musculoskeletal system. Affect diseases and joints, connective tissues. The result in the presence of any of these diseases will be an increase in ESR.
2. Myocardial infarction. In the case of this pathology, the blood flow in the cardiac arteries is disturbed. Although there is an opinion that this is a sudden illness, the prerequisites are formed even before its onset. People who are attentive to their health are quite capable of noticing the appearance of the corresponding symptoms a month before the onset of the disease itself, so it is possible to prevent this disease. It must be remembered that if even mild pain occurs, you should consult a doctor.
3. The onset of pregnancy. In this case, the health of the woman and her unborn baby is checked. During pregnancy, there is a need for repeated blood donations. Doctors carefully check the blood for all indicators. As already mentioned, due to hormonal changes, a noticeable increase in the upper limit of the norm is allowed.
4. When a neoplasm occurs, to control its development. This study will allow not only to check the effectiveness of therapy, but also to diagnose the presence of a tumor at an early stage. An elevated erythrocyte sedimentation rate may indicate the presence of inflammation. It has a variety of causes, from the common cold to cancer. But a deeper examination is needed.
5. Suspicion of a bacterial infection. In this case, a blood test will show an ESR level above normal, but it may also indicate a disease of viral origin. Therefore, it is impossible to focus only on ESR, additional tests should be carried out.

When referring a doctor to this study, it is necessary to fulfill all the requirements for proper preparation, since the ESR blood test is one of the main ones in the diagnosis of diseases.

How to take an analysis

To examine the patient's blood, it is usually taken from a vein. The analysis shows not only ESR, but also a number of other indicators. All of them in the aggregate are evaluated by the medical staff, and the complex result is taken into account.

For it to be true, you need to prepare:

• It is best to donate blood on an empty stomach. If, in addition to the erythrocyte sedimentation rate, you need to find out the level of sugar, then 12 hours before donating blood, you should not eat, do not brush your teeth, you can only drink a little plain water.
• Do not drink alcohol the day before blood sampling. The same goes for smoking. With an acute desire to smoke, you must stop doing it at least in the morning. These factors are eliminated because they easily affect the results of studies.
• Of course, you need to stop taking medications. First of all, this applies to hormonal contraceptives, multivitamins. If you can not take a break in the use of any remedy, then you need to let your doctor know about it, and he will make an adjustment in the result obtained, taking into account the intake of this medication.
• In the morning, it is advisable to come in advance to collect blood in order to calm down a little and catch your breath. On this day, it is better to be balanced and not give the body heavy physical exertion.
• Since the ESR test depends on the menstrual phases, before donating blood, you should consult with your doctor about the time at which it is best to take the test.
• The day before blood sampling, it is necessary to limit fatty and spicy foods in the diet.

Manipulation with the delivery of the analysis is quick and without much pain. If you still feel unwell or dizzy, you should tell the nurse about this.

If the level of ESR in a woman is elevated, what does this mean?

It is described above what the rate of erythrocyte sedimentation rate for women should be according to age and condition (for example, during pregnancy). So when is ESR considered elevated? If the age indicator deviated from the norm upwards by more than 5 units.

At the same time, the presence of diseases such as pneumonia, tuberculosis, poisoning, myocardial infarction and others can be detected. But this analysis is not enough to make a diagnosis based on it. It happens that even a hearty breakfast can cause an increase in this indicator. Therefore, there is no need to panic if an ESR is found above the norm.

With a normal erythrocyte sedimentation rate and elevated lymphocytes, the development of a viral disease is possible. Given the inertia of this level, if there is any doubt about the result, you just need to re-examine.

The state of health of a woman with a low level of ESR

Having told what the norm of ESR in the blood in women and an increased value means, we will explain what reasons can lead to a low level of this indicator. This result can occur due to:

• insufficiency of blood flow;
• epilepsy;
• liver disease (hepatitis);
• taking certain medications, in particular, potassium chloride, salicylates, mercury-based medicines;
• erythrocytosis, erythremia;
• neurotic illness;
• diseases that provoke a change in the shape of red cells, in particular anisocytosis;
• strict vegetarianism;
• hyperalbuminemia, hypofibrinogenemia, hypoglobulinemia.

As you can see, a low value of the erythrocyte sedimentation rate should be no less alarming than an increased one. With deviations from the normal indicator in any direction, it is necessary to look for the cause of this state of health and treat the disease.

The easiest way to bring the ESR back to normal

By itself, an increased or decreased erythrocyte sedimentation rate is not a disease, but it shows the state of the human body. Therefore, the question of how to lower the ESR in the blood of women can be answered that this value will return to normal only after the elimination of the causes that caused it.

Realizing this, sometimes the patient just needs to be patient and diligently treated..

The reasons why the ESR indicator will return to normal after a long time:

• there is a slow fusion of a broken bone, the wound heals for a long time;
• a long therapeutic course of treatment for a specific disease;
• bearing a child.

Since an increase in the erythrocyte sedimentation rate during pregnancy may be associated with anemia, it is necessary to try to prevent it. If it has already arisen, you need to undergo a course of treatment with safe drugs prescribed by a doctor.

In most cases, ESR can be reduced to acceptable levels only by eliminating inflammation or curing the disease. Another high result may be due to a laboratory error.

If, during the test for the erythrocyte sedimentation rate, an indicator was found higher or lower than normal, it is necessary to re-examine and make sure that there is no accidental distortion of the result. It is also worth reviewing your diet and saying goodbye to bad habits.

Blood washes all organs and systems, therefore, first of all, it reflects the anomalies that occur in the body. A general blood test consists in counting the number of certain leukocytes, reticulocytes, platelets), an increase or decrease in the number of which indicates certain pathologies.

About what is ESR in a blood test, I would like to know many people who go to the doctor about various diseases. directly depends on the composition of protein molecules in plasma.

How is the analysis carried out?

Under laboratory conditions, blood with the addition of drugs that prevent clotting is placed in a narrow and tall test tube. Within an hour, red blood cells begin to sink under their own weight to the bottom, leaving blood plasma on top - a yellowish liquid. Measuring its level allows you to determine in mm / h.

Why is this indicator needed?

Every doctor who treats inflammatory diseases knows what ESR is in a blood test and what factors affect it. red blood cells can rise and fall, which will indicate the reaction of the body. Red blood cells move down faster when other large molecules appear - immunoglobulins or fibrinogen. These proteins are produced during the first two days of infection. Just then, the ESR indicator begins to grow, reaching a peak value by the 12-14th day of illness. If at this level there was an increase in the number of leukocytes, it means that the body is actively fighting microbes.

Increasing or decreasing the settling rate

You can find out what ESR is in a blood test, why the indicator may increase, at the appointment of your doctor. The norm for women is from 2 to 15 mm / hour, and for men - from 1 to 10 mm / hour. It follows that the weaker sex is more prone to inflammation. Most often, the reason for the acceleration of ESR is precisely such processes as:

1. Purulent inflammatory (tonsillitis, damage to bones, uterine appendages).
2. Infectious diseases.
3. Malignant tumors.
4. Autoimmune diseases (rheumatoid arthritis, psoriasis, multiple sclerosis).
5. Thrombosis.
6. Cirrhosis of the liver.
7. Anemia and blood cancer.
8. Diseases of the endocrine system (diabetes mellitus, goiter).

When should I go to the doctor and be examined?

It happens that the result of a blood test remains undeciphered. Then you need to contact your doctor with a question about what is ROE in a blood test (an outdated name for ESR).

A level of up to 30 mm per hour is a manifestation of sinusitis, otitis media, inflammation of the female genital organs, prostatitis, pyelonephritis. Most likely, the disease is in a chronic stage, but requires medical supervision.

A level above 40 mm per hour is a reason for a large-scale examination, since the value indicates serious infections, metabolic disorders, and immunity, foci of purulent lesions.

It has been known for a long time, although earlier this indicator was called ROE. However, the older generation did not even pay attention to the replacement of the first letter, since few people thought about the essence of this indicator. They knew that an increased ESR (formerly ROE) is bad and something needs to be done to lower it. What and how didn't matter.

In fact, it is believed that the ESR indicator can indirectly indicate the presence of an inflammatory process in the body, that is, the presence of some kind of disease. The method for determining the indicator is about a hundred years old. It attracts with simplicity and clarity. Well, modern equipment makes it possible to increase its reliability.

ESR stands for "erythrocyte sedimentation rate". Erythrocytes in the blood perform some of the most important functions ( more details in the article here ) and most of them in the blood plasma. The study of their behavior led in 1918 to the discovery of certain patterns, which made it possible to formulate a new diagnostic method.

The essence of the study was that a certain amount of blood was placed in a test tube, which was unable to clot, and erythrocyte sedimentation was observed as cells denser than the density of plasma. Settling occurred under the influence of gravity. The number of red blood cells settled to the bottom of the test tube (in millimeters) was measured for a certain time (in the end, an hour was chosen as the control time), which was determined as the settling rate per hour.

Red blood cells can stick together (aggregation), which leads to an increase in the rate of falling to the bottom of the tube. But the main accelerators of sedimentation are the so-called acute phase proteins, which are markers of inflammatory processes. First of all, it is fibrinogen and immunoglobulins.

The body reacts to any inflammatory or pathological process by releasing the “soldiers” of immunity into the blood, which are fibrinogen and immunoglobulins. There are more, but these are the most recognizable. An increase in the concentration of acute phase proteins leads to increased erythrocyte aggregation (weights them), which leads to an increase in the sedimentation rate.

For the first time, a change in the erythrocyte sedimentation rate was noticed in pregnant women. Further studies have shown that ESR changes with various diseases. All these observations made it possible to formulate a method for diagnosing diseases.

Attention. A blood test for ESR is only a preliminary diagnosis for many diseases, allowing a preliminary understanding of the presence of an inflammatory process or pathology. When abnormal, an in-depth investigation based on symptoms is required.

For example, if oncology is suspected, a specialist consultation is required, the taking of biological material and its special examination.

Definition of ESR

In addition to medical equipment, the study uses the anticoagulant sodium citrate in solution, which prevents blood clotting during the time necessary to measure the volume of precipitated erythrocytes.

Panchenkov's method

The main instrument in this method is the Panchenkov capillary (also called the Panchenkov pipette). This is a glass tube, made strictly according to certain dimensions and graduated according to established standards.

For the quality of work with blood samples, the upper and lower ends of the original straight tube are ground at certain angles (20 degrees for a length of up to 7 mm from the base of the tube). A scale with divisions of 1.0 mm is applied to the outer surface of the tube. An important parameter is the inner diameter of the tube is strictly 1.2 mm.

Let us supplement the information with the fact that the ESR-meter PR-3, which is called the “Panchenkov apparatus” by physicians, is equipped with capillaries.

How does it all work? First, a sodium citrate solution is drawn into the pipette (note that a 5% solution is used in this method). The collected solution is blown onto a watch glass (not literally watch glass, but so-called because of its concave shape). In fact, this glass is used to mix the citrate solution with the blood sample.

Then, blood is drawn into the same pipette from the test tube with the sample and blown into the citrate solution on the glass. Blow out twice to get a solution of blood to citrate in a ratio of 4 to 1. Mix thoroughly and draw again into the pipette, but already to the level of the “K” mark (blood).

The pipette prepared in this way is installed in a special tripod of the Panchenkov apparatus, the start time is noted, and exactly one hour later the measurement is made in millimeters of the precipitated precipitate (erythrocytes). Although, if necessary, the study time can be extended up to 24 hours.

Westergren method

Recall that this is an international method, and for this reason, the characteristics of the instruments and the calibration of their scale of results differ from those used in the Panchenkov method. Although the results presented in normal (identical) values ​​are the same. The main difference of this method in relation to the results is more accurate values ​​at elevated ESR values.

In terms of technical support of this method, there are the following differences:

• instead of a capillary, a special Westergren test tube is used,
• venous blood is used for analysis,
• either sodium citrate (but a 3.8% solution instead of a 5% solution) or EDTA (ethylenediaminetetraacetic acid) is used as a coagulant.

Westergren's tubes are graduated differently from Panchenkov's capillaries and the result of the sedimentation rate analysis is read in mm per hour. All other actions are performed as in the previous method.

ESR norm

The standard forms for filling out the results of a blood test indicate the norms of the sedimentation rate, which statistically
set for different ages and gender. Each patient can compare the result obtained with the norm and draw a preliminary conclusion for himself (before going to the doctor).

Norm values ​​for childhood:

• for newborns 1mm/h;
• up to six months 2-4 mm / h;
• 6-12 months 4-9 mm/h;
• from one to ten years 4-12 mm/h;
• until adulthood 2-12 mm / h.

The norm of ESR in women is in the range from 2 to 16 mm / h. During pregnancy, the indicator can exceed the norm several times.

The norm of ESR in men is up to 12 mm / h.

In older people, the characteristic is even higher, in older women the norm is up to 30 mm / h, and in men up to 20 mm / h.

For reference. Elevated ESR does not always correspond to the presence of pathological changes in the body.

The following factors can provoke an increase in the settling rate:

• starvation diets,
• food intake (this point should be taken into account when preparing for blood donation),
• restrictions on fluid intake,
• taking certain medications
• intense physical activity.

These factors should be kept in mind if you are dealing with increased erythrocyte sedimentation rate.

Increased ESR

As a rule, an increased rate of erythrocyte sedimentation reaction is the most common case among patients. In women, an excess of the norm can be associated with pregnancy, after childbirth, or even with the menstrual cycle.

The most likely case with a strong excess of the result is the presence of an inflammatory process, and it does not matter whether it is pneumonia or just SARS. ESR also increases in chronic diseases such as allergies or sinusitis, diabetes.

If the sedimentation rate is increased by 60 or more units, it is worth taking urgent measures, it is quite possible that there is a tumor in the body.

Attention! The presence of oncology must be confirmed by a number of specialized studies.. Therefore, do not immediately tie any disease to an increased ESR. Check, check and check again.

In severe operations, severe burns or significant loss of blood in the body, the sedimentation rate often also increases. The rehabilitation process in such cases can be delayed for several months, depending on the injuries and characteristics of the patient's body, and all this time the ESR result will be increased. With HIV infections, this figure is usually increased several times.

Do not be afraid if you are completely healthy, and the ESR value in the blood test is still exceeded. Such a result may be associated with stress at work, with an unhealthy lifestyle (smoking and drinking), excessive physical activity, while taking certain medications (in women, the number may be increased due to oral contraceptives or vitamins, with "fast » diets). According to statistics, in people who are overweight, this figure is higher than normal, this is due to the high content of cholesterol in the body.

The erythrocyte sedimentation rate can be used to determine how long the disease has been occurring. In the first few days after the onset of the disease, the level of sedimentation rate increases, and in the period from seven to fourteen days, the indicator takes on maximum numbers and gradually declines with proper treatment.

Reasons for the increase

1. An increased rate may indicate the presence of inflammatory processes of infectious origin (for example, rheumatism, tuberculosis, pneumonia, syphilis, sepsis). According to the dynamics of the change in the value of the indicator, one can speak about the stage of the disease, the state of the process, and control the effectiveness of therapy. Note that bacterial infections show higher numbers in the results compared to viral invasion.
2. The development of collagenosis (rheumatoid arthritis).
3. Possible damage to the heart (myocardial infarction - damage to the heart muscle, inflammation).
4. Possible liver damage (hepatitis), pancreatic disease (destructive pancreatitis), bowel disease (Crohn's disease, ulcerative colitis), kidney disease (nephrotic syndrome).
5. Endocrine pathology (thyrotoxicosis, diabetes mellitus).
6. Possible blood diseases (multiple myeloma, anemia, lymphogranulomatosis).
7. Possible injuries of internal organs and tissues (wounds and fractures, surgical operations) - any damage leads to the ability of red blood cells to aggregate.
8. Possible lead or arsenic poisoning.
9. Conditions in which intoxication of the body is traced.
10. Possible development of oncology, especially in the absence of obvious signs of the inflammatory process. However, the erythrocyte sedimentation rate test can only claim to be a preliminary diagnosis.
11. Possible excess of cholesterol levels (hypercholesterolemia).
12. The implicit reasons for the increase in speed include the use of certain drugs (for example, methyldopa, dextran, morphine, vitamin D).

It should be noted that for different reasons for an increase in ESR, and at different stages of the same disease, the sedimentation rate may not change in the same way:

• a sharp increase in the sedimentation rate (up to 60-80 mm/hour) is typical for oncological diseases (for example, with myeloma, lymphosarcoma).
• in the initial stages of tuberculosis, the sedimentation rate does not noticeably change, however, with the progression of the disease or its complication, the rate will increase rapidly.
• the acute period of infection will make itself felt by an increase in ESR only from 2-3 days, but often does not decrease for a long time. As an example, croupous pneumonia - the crisis has already passed, and the level of the rate of subsidence is still holding.
• one should not expect an increase in acute appendicitis, especially on the first day.
• rheumatism as a chronic disease can proceed for a long time with an elevated ESR, but with a slight increase. But a decrease in the sedimentation rate should alert, since heart failure may develop due to blood clotting or acidosis.

Ways to reduce ESR

Attention. A high value of the erythrocyte sedimentation rate in itself is not a disease, but only indicates its presence.

Thus, to reduce the value of the sedimentation rate, the disease should be treated, for example, with antibiotics or anti-inflammatory drugs. To prescribe medications, it is better to consult a doctor who will give recommendations.

Pregnancy is one of the reasons for the increase in ESR and the level of the indicator will return to normal after childbirth. That is, you don't have to do anything.

Inflammation can be tried to remove and folk remedies. Decoctions, tinctures, herbal teas will help in many cases. You can use coltsfoot, chamomile, raspberry, lime blossom.

Traditionally, onion, garlic, lemon, beets, honey are used.

All citrus fruits are suitable for treatment: oranges, grapefruits, lemons. Raspberry tea and linden decoction are very useful.

You should also think about getting rid of bad habits and switch to proper nutrition. It will not be superfluous to check the functioning of the liver and drink a course of drugs aimed at removing harmful substances from the body.

Reasons for low ESR

A low settling rate is also a deviation from the norm. A reduced value may be due to DIC or the presence of a hepatitis virus in the body.

Doctors tend to believe that people who have deliberately given up meat and animal products have an ESR value below the natural range. Another reason may be a pathology in a person or genetic diseases such as anemia.

The decrease in value may be affected by certain medications.

Recall that according to the ESR indicator, the diagnosis is not made, therefore, the cause of the deviation from the norm is established by conducting additional special studies. In some people, the value is constantly exceeded, this may be due to the characteristics of the organism. In any case, you should give up bad habits, follow the rules of a healthy diet - these are simple recommendations that will keep you healthy.