Soe in a clinical blood test decoding. ESR (erythrocyte sedimentation rate): concept, norm and deviations - why it rises and falls. What causes an increase in ESR

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.

The article is based on the findings of 63 scientific studies

The article citesresearch authors:

• Unità Reumatologica, 2nd Divisione di Medicina, Ospedale di Prato, Italy
• Harvard School of Public Health, Boston, Massachusetts, USA
• Abbotsford Regional Hospital and Cancer Center, Canada
• Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
• Department of Clinical Medicine, Aarhus University, Denmark
• and other authors.

Please note that the numbers in brackets (1 , 2 , 3 , etc.) are clickable links to peer-reviewed scientific studies. You can follow these links and read the original source of information for the article.

What is ESR (erythrocyte sedimentation rate)

Normally, red blood cells (erythrocytes) settle relatively slowly. Settling faster than normal values ​​may show inflammation. in the body. Inflammation is part of the immune system's response to problems in the body. It could be a reaction to an infection or injury. Inflammation can also be a sign of a chronic illness, an immune system disorder, or other health problems.

Erythrocyte sedimentation(ESR) was discovered in 1897 Polish physician Edmund Faustyn Biernacki (1866-1911). The practical use of ESR was not known at the time, so it was often ignored by physicians. But in 1918 it was found that the ESR changes in pregnant women, and in 1926 Westergren developed his own method for determining the ESR (erythrocyte sedimentation rate). [,]

The main factors affecting ESR - hematocrit(proportion of erythrocytes in the blood) and blood proteins such asfibrinogen. .

ESR in a blood test

Sedimentation rate of erythrocytes ( ESR) is a blood test that checks for inflammation. He measures distance in millimeters on which red blood cells move (settle) in one hour (mm/h). [ , ].

There are several ways to do this, such as the Westergren method, the Wintrobe method, or MicroESR and automated methods. [ , , ]

Westergren's method for calculating ESR

The Westergren method is considered gold standard in the measurement of ESR.

The doctor mixes the blood sample with sodium citrate (4:1 ratio). He then puts the mixture into a Westergren-Katz tube (diameter 2.5 mm) up to the 200 mm mark. Then he sets the tube vertically and leaves it in that position at room temperature (18-25 °C) for one hour. At the end of that hour, the doctor measures how far the red blood cells have moved (dropped down by gravity). This distance shows the ESR (erythrocyte sedimentation rate).

In a modified Westergren method, the doctor uses edetic acid instead of sodium citrate. [ , , ].

Other methods for calculating ESR

Wintrob Method e is less sensitive than the Westergren method and its maximum values ​​can be misleading. [ , ]

Micro ESR method Quite fast (approximately 20 minutes) and popular for determining ESR in infants, as this test requires very little blood. This study is also useful for diagnosing neonatal sepsis. [ , R, ]

Automated Methods are faster, easier to use, and could be better predictors for autoimmune diseases. However, their sensitivity to the technical procedures for obtaining and storing blood (blood mixing, tube size, etc.) may affect test results. [ , , , , , R , , ]

What can show the value of ESR

Inflammation

The ESR test checks if you have inflammation. During inflammation, some proteins appear in the blood, for example, fibrinogen. These proteins cause red blood cells to cling to each other and form clumps. This makes them heavier than a single erythrocyte, and therefore they settle faster, which increases the ESR value. [ , , ]

In this way, high ESR indicates inflammation. The higher the ESR, the higher the inflammation. [ , , ]

But, the ESR test is not very sensitive (so it cannot detect all types of inflammation), and it is not very specific, so it cannot diagnose specific diseases.

Presence of specific diseases

An ESR test can help diagnose certain conditions:

• Polymyalgia rheumatica (an inflammatory disease that causes muscle pain and stiffness) [ , , ]
• Giant cell arteritis (inflammation of the blood vessels) [ , , , , ]
• Bone infections [ , , ].
• Subacute thyroiditis (inflammation of the thyroid gland) [ , , ]
• Ulcerative colitis

The course of some diseases

Determination of ESR cannot diagnose diseases, but this test can track the progress of treatment for certain diseases :

• Heart diseases [ , , ]
• Crayfish [ , , ]
• [R, , , ]
• Systemic lupus erythematosus (SLE) [ , , r]
• Sickle cell anemia [ , , ]

See the threat to life

ESR level above 100 mm/h may suggest serious illnesses such as infections, heart disease or crayfish.[ , , , ]

An increase in the level of ESR with oncological suspicion can predict the development of a malignant tumor or the progression of the disease in the form appearance of metastases. [ , , , , ]

Relationship between ESR and C-reactive protein

During inflammation, our liver produces a substance called C-reactive protein (CRP). A blood test for CRP levels checks to see if you have inflammation or infection. A CRP level greater than 10 mg/dL almost certainly indicates the presence of an infection. [ , , ]

More information about the possibilities to reduce the values ​​​​of C-reactive protein can be found in.

In most blood tests, the CRP test is used in conjunction with the ESR. [ , , ].

Analysis for C-reactive protein (especially its ultra-sensitive test type) is more sensitive than ESR and produces fewer false negatives/positives than ESR.

C-reactive protein is best used to check and track progress acute

Revealing ESR best used to check and track progress chronic inflammation and infections. [ , , ]

The ratio of CRP and ESR in various diseases

High ESR and high CRP

• Systemic lupus erythematosus
• Bone and joint infection
• Ischemic stroke
• Macroglobulinemia waldenstrom
• multiple myeloma
• kidney failure
• Low albumin in the blood

Low ESR and high CRP

• Urinary tract, lung and bloodstream infections
• myocardial infarction
• Venous thromboembolic disease
• Rheumatoid arthritis
• Low albumin in the blood

How You Can Reduce Inflammation and CRP

A special anti-inflammatory diet and exercise together can significantly reduce CRP (highly sensitive) levels. After 3 weeks of following a special diet and exercise, scientists from the University of California recorded that the level of highly sensitive-CRP decreased by an average of 39% in men, 45% in women, and 41% in children.

• Headache
• Fever
• Joint or shoulder pain
• Rapid weight loss

Normal ESR values

At age under 50 years old normal values ​​of ESR: for men n - 0-15 mm/hour, for women– 0-20 mm/hour.

At age over 50 years old normal values ​​of ESR: for men– 0-20 mm/hour, for women– 0-30 mm/hour.

For kids normal ESR should be less 10 mm/hour.

Low ESR values ​​are normal and do not cause any symptoms.

What raises the level of ESR

Diseases

• Inflammation, infection, or cancer can increase ESR [ , , , , , ]
• / old age [ , , , , ]
• Anemia ( a decrease in hematocrit increases the values ​​of ESR) [ , , , ]
• macrocytosis(the appearance of large red blood cells in the blood) [ , ]
• Polycythemia(increased production of red blood cells) [ , , , , ]
• Enhanced levelfibrinogen[ , ]
• Pregnancy[ , ]
• [ , , ]
• kidney failure
• Chronic heart failure
• Obesity[ , ].
• Hyperlipidemia(high blood lipids)
• Heart diseases[ , , ]
• Autoimmune diseases(but not required)
• Rheumatic polymyalgia(inflammatory disease in which there is pain in the muscles of the shoulders and hips) [ , p , ]
• Subacute thyroiditis
• alcoholic liver disease, which can lead to a decrease in albumin production, and therefore an increase in ESR
• and ulcerative colitis[ , ]
• Giant cell arteritis(inflammation in large arteries) [ , ]
• multiple myeloma
• Macroglobulinemia of Waldenström(a tumor that produces a large amount of immunoglobulins) [ , ]
• and stroke
• Crayfish(risk of progression and death) [ , , ]

Substances and drugs

• Iodine(for thyroid problems)
• Eating large amounts of ginger(in the presence of subacute thyroiditis)
• Contraceptive drugs
• [ , , , ]
• Dextran(antithrombotic)

What lowers ESR

When the size of the red blood cells becomes smaller, they will settle more slowly in the test tube, hence a lower ESR will be diagnosed. With various blood diseases, the size, number and shape of red blood cells can change.

The list of physiological conditions when red blood cells can change and at the same time the ESR level will decrease:

• Red blood cell diseases: extreme leukocytosis, erythrocytosis, sickle cell anemia, spherocytosis, acanthocytosis, and anisocytosis. [ , , , , ]

• Protein anomalies: hypofibrinogenemia, hypogammaglobulinemia, and dysproteinemia with blood hyperviscosity. [ , , , , , ]

• The use of drugs: NSAIDs, statins, corticosteroids, painkillers, levamisole, prednisolone. [ , , , , ]

Increased ESR in some diseases

Rheumatic polymyalgia

Rheumatic polymyalgia is an inflammatory disease that mainly affects people over the age of 50. The disease causes pain and stiffness in the neck, shoulders, upper arms, and hips, or causes pain throughout the body. [R, , ]

ESR analysis is often used as a diagnostic tool in polymyalgia rheumatica by assessing levels of inflammation. [ , ]

In numerous studies involving a total of 872 people diagnosed with polymyalgia rheumatica, the majority of patients showed ESR values ​​above 30 mm/h. Only 6% to 22% of them showed ESR below 30 mm/h. [ , , , , , ]

A high ESR value (>30-40 mm/h) may indicate polymyalgia rheumatica. However, a normal erythrocyte sedimentation rate cannot rule out this disease, so additional tests are required when making a diagnosis. [ , , , ]

Temporal arteritis or giant cell arteritis- This disease manifests itself in the form of inflammation of the blood vessels. It affects people over 50 and is more common among women. Symptoms of the disease can include headaches, joint pain, fever, eye pain, blindness, and even a stroke. This condition is often associated with polymyalgia rheumatica. [ , , , , ]

One of the diagnostic criteria for temporal arteritis is the level ESR within or above 50 mm/h.[ , , , , ]

In numerous studies (a total of 388 people with temporal arteritis participated), most patients showed ESR values ​​above 40 mm/h. [ , , , , , ]

Elevated ESR (>40-50 mm/h) may indicate temporal arteritis, but lower ESR values ​​(< 40 мм/ч) также не могут исключить это заболевание. Other tests are required, such as C-reactive protein testing, which are more sensitive in diagnosing this disease. [ , ]

Diseases of the heart and cardiovascular system

A large number of studies involving 262,652 people demonstrated that people with elevated ESR had a higher chance of developing cardiac insufficiency, heart attack or compared to people with normal ESR levels. [ , , , , , , ]

Other studies with a total of 20,933 participants showed that people with high ESR had an increased risk death from heart disease or stroke. [ , , , , , ]

Another group of studies involving 484 patients with cardiovascular disease or stroke found an increase in ESR values ​​in most of these people. [ , , ]

Two studies (involving 983 patients undergoing heart surgery) found that patients with an ESR greater than 40 mm/h were in hospitals and intensive care units more often, and they had an increased risk of developing side effects during treatment. [R, ]

Cancer (malignant tumor)

The study involved 239,658 Swedish men. For those who showed meaning ESR above 15 mm/h was on 63% increased risk of colon cancer compared with those men whose ESR was below 10 mm/h.

In a study of 5,500 people, those who had weight loss, anemia and high ESR had a 50% chance of diagnosing a malignant tumor. Who had only weight loss and high ESR, but no anemia, the chance of a cancer diagnosis was in 33%.

Another study, involving 4,452 women, evaluated the possible diagnosis breast cancer. As a result of this work, it was concluded that those women who had a significantly higher ESR level (>35 mm/h) were more likely to have a malignant tumor compared to healthy women and those women who had a benign tumor.

Numerous studies involving more than 1,200,000 men with a diagnosis have identified an addiction that indicated low survival and high risk of metastasis with ESR above 50 mm/h. [ , , ]

Two other studies with over 1,477 patients diagnosed with kidney cancer an increased risk of death was determined at high values ​​of ESR. [ , ]

In 854 patients with the disease Hodgkin's disease those people with an ESR above 30 mm/h had an active disease and had a higher risk of death. [R, ]

In a study involving 139 patients with skin cancer ESR values ​​above 22 mm/h were associated with lower survival and higher risk metastasis.

In another scientific experiment, 97 patients with blood cancer elevated ESR values ​​gave only a 53% chance of survival in this disease.

In 220 patients with stomach cancer ( men with ESR above 10 mm/h, women with ESR above 20 mm/h) was lower survival, large metastases and the size of the tumor itself in the stomach is larger.

In a study of 410 patients with a particular type bladder cancer ( urothelial carcinoma), ESR values ​​greater than 22 mm/h for men and 27 mm/h for women were associated with disease progression and death.

Patients with skin disease (dermatomyositis) and an ESR level above 35 mm/h had a higher chance of developing a malignant tumor.

In 94 patients with glioma(tumor of the brain or spinal cord) ESR values above 15 mm/h showed a higher chance of death.

In a study involving 42 patients multiple myeloma elevated ESR has been associated with lower survival rates.

Patients (189 people) diagnosed with lung cancer and high ESR showed low chances of survival compared with patients with low ESR values.

Rheumatoid arthritis

In a 25-year follow-up of 1,892 patients with rheumatoid arthritis, 64% of patients had elevated ESR levels compared to healthy individuals.

Several studies involving 373 people and a 2-year study with 251 patients with rheumatoid arthritis found that high ESR values ​​were indicative of a worsening of the disease or a decrease in the effectiveness of its treatment. [ , , ]

However, in another study, 159 children with rheumatoid arthritis were followed for 1 year, and in this case, elevated ESR levels were not associated with disease progression.

infections

ESR values ​​greater than 70 mm/h in adults and less than 12 mm/h in children may correspond to bone infections. [ , , , ]

In a study involving 61 patients with untreated leg infections, ESR values ​​greater than 67 mm/h indicated the development of osteomyelitis. .

With an inflammatory disease - spondylodiscitis, more than 90% of patients showed ESR values ​​in the range of 43 - 87 mm / h.

In a study involving 259 children who have been diagnosed with leg pain, at values ​​of ESR not higher than 12 mm/hour and C-reactive protein (CRP) higher than 7 mg/l, they most likely had an orthopedic infection.

In patients after hip arthroplasty an increase in ESR may indicate a postoperative infection.

A decrease in ESR during the treatment of infections may indicate the effectiveness of this treatment and an improvement in the degree of the disease. [p, p]

Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease. It can affect the joints, nervous system, kidneys, skin, heart, and lungs. People with lupus have periods of improvement (remissions) and periods of worsening disease (flares). [ , R, ]

In patients with the active phase of systemic lupus erythematosus, ESR usually shows high values. Such an increase in ESR in patients with lupus may mean an outbreak of the disease. [ , ]

sickle cell anemia

In two studies involving 139 children with sickle cell anemia, normal ESR values ​​were below 8 mm/hour. And ESR values ​​above 20 mm/h indicated a crisis of the disease or an infection. [R, ]

If people with sickle cell anemia have a high ESR (>20 mm/h), this indicates an infection or a worsening disease.[ , , ]

Ulcerative colitis

The study followed 240,984 healthy men for 7 years. Those men who had a higher erythrocyte sedimentation rate (ESR) than normal ESR had higher risk of developing ulcerative colitis.

ESR above 15 mm/h may predict relapse in patients with ulcerative colitis.

Thyroiditis (subacute)

Subacute thyroiditis is an inflammation of the thyroid gland. The disease causes pain and swelling of the thyroid gland, fever and fatigue. In most patients with subacute thyroiditis ESR level is above 50 mm/h. [ , , , , , , ]

Ginger and iodine can cause an outbreak (exacerbation) of subacute thyroiditis, which will increase ESR. [ , ]

Causes of a high level of ESR

Increased fibrinogen

Nutrition (diet) high iniron, sugar, and caffeine may increase the amount of fibrinogen in the blood (study of 206 people).

Protein is known to be essential for maintaining healthy fibrinogen levels. In the case of protein deficiency (for example, in an animal study), a low level of fibrinogen is recorded compared to those who were fed with sufficient protein.

In a study with 16 people, getting protein shake or bringing the diet to a balanced state in terms of protein levels, there was a 2-fold increase in fibrinogen values ​​in relation to the values ​​before the start of the study.

High triglycerides

In a study of 101 patients, most of these people with high cholesterol levels and, was found elevated ESR values.

A low-fat, high-carbohydrate diet (the standard "Western" or urban diet) has been found to have elevated blood triglycerides in healthy adults. [ , r , r , r ]

A diet low in fat and high in carbohydrates and sugar increases the production of very low density lipoproteins (VLDL) and triglycerides. [

ESR - what is it? You will find an exhaustive answer to the question asked in the materials of the presented article. We will tell you about what is the norm of this indicator in human blood, why it is determined, in what diseases it is observed, and so on.

General information about the indicator and decoding

Surely every patient who donated blood for tests saw the abbreviation ESR in the results. The decoding of the presented combination of letters is as follows: erythrocyte sedimentation rate.

In medical practice, this term is called laboratory non-specific, which reflects the ratio of plasma.

History of the research method

ESR - what is it? How long has this indicator been taken into account in the study of the material of the patient? This phenomenon was known in ancient Greece, but it was not used in clinical practice until the twentieth century.

In 1918, it was found that the erythrocyte sedimentation rate differed significantly between pregnant women and ordinary people. Subsequently, scientists have revealed the fact that this indicator changes under the influence of certain diseases. Thus, in the period from 1926 to 1935, several research methods were developed, which are still actively used in medical practice to determine the ESR value.

The principle of the research method

ESR - what is it, and how is this indicator determined? To determine the value of the patient, it is necessary to donate blood for analysis. As a result of her research, laboratory staff determine the specific mass of red cells. If they exceed the specific gravity of the plasma, then the erythrocytes begin to slowly settle to the bottom of the tube. This is how the rate and degree of aggregation (the ability to stick together) of red blood cells is determined.

Chemical causes of an increase and decrease in the erythrocyte sedimentation rate

The ESR index directly depends on the degree of erythrocyte aggregation. However, it increases if the plasma concentration of acute phase proteins or markers of the inflammatory process increases. Conversely, the ESR value decreases if the amount of albumin increases.

ESR analysis: the norm of the indicator

As mentioned above, in order to determine the patient, it is necessary to donate blood for analysis. After the material enters the laboratory, it is subjected to a thorough examination. Specialists observe the process of erythrocyte sedimentation under the influence of gravity, depriving the blood of any possibility of clotting.

So, what should be the normal ESR? The rate of sedimentation of red blood cells in healthy women is 2-15 mm per hour. As for the representatives of the stronger sex, this value is somewhat lower for them and equals 1-10 mm per hour.

ESR: indicator level

In medical practice, deviations from the norm are usually distinguished by degrees:

Possible causes of deviations from the norm

Now you know the information about ESR - what it is. Most often, an increase in this indicator is associated with chronic or acute infection, heart attacks of internal organs, as well as immunopathological diseases.

Despite the fact that inflammatory reactions in the body are the most common causes of accelerated erythrocyte sedimentation, this deviation can also be due to other, not always pathological, phenomena.

A significant increase in ESR is observed with malignant neoplasms, a decrease in the total number of red blood cells, during pregnancy, and also during treatment with any drugs (for example, salicylates).

A moderate increase in ESR (by about 20-30 mm per hour) can occur with hypoproteinemia, anemia, pregnancy, and also in women during menstruation.

Diseases with increased or decreased ESR

Sharp and significant red cells (more than 60 mm per hour) are accompanied by conditions such as autoimmune diseases, septic process and malignant tumors characterized by tissue breakdown.

A reduced value of this indicator is possible with changes in the shape of erythrocytes, hyperproteinemia, leukocytosis, erythrocytosis, as well as hepatitis and DIC.

Why is it important to conduct a blood test for ESR?

Despite all the non-specificity of determining the ESR, this study is still the most popular and important laboratory test. Thanks to him, specialists can quickly establish the fact of the presence and intensity of the development of the inflammatory process.

Such a study of the patient's blood often reveals a malignant neoplasm, which allows you to start eliminating it in time and save the patient's life. That is why the determination of ESR is an extremely important research method, which is subjected to the blood of almost every person who seeks help from a medical institution.

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 complete blood count, which also results in an 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, taking into account the intake of this medicine.
• In the morning, it is advisable to come in advance to collect blood in order to calm down a bit 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.

Erythrocytes - red blood cells - are the most important component of the blood, since they carry out several basic functions of the circulatory system- nutritional, respiratory, protective, etc. Therefore, it is necessary to know all their properties. One of these properties is sedimentation rate of erythrocytes- ESR, which is determined by a laboratory method, and the data obtained carry information about the state of the human body.

ESR is determined when donating blood for OA. There are several methods for measuring its level in the blood of an adult, but their essence is almost the same. It consists in the fact that a blood sample is taken under certain temperature conditions, mixed with an anticoagulant to prevent blood clotting and placed in a special tube with graduation, which is left upright for an hour.

As a result, after the time has elapsed, the sample is divided into two fractions - erythrocytes will settle on the bottom of the tube, and a transparent plasma solution is formed on top, along the height of which the sedimentation rate is measured for a given period of time (millimeter / hour).

• The norm of ESR in the body of a healthy adult differs according to age and gender. In men it is:
• 2-12 mm/h (up to 20 years);
• 2-14 mm/h (from 20 to 55 years);
• 2-38 mm/h (from 55 years and above).

Among women:

• 2-18 mm/h (up to 20 years);
• 2-21 mm/h (from 22 to 55 years old);
• 2-53 mm / h (from 55 and above).

There is an error of the method (no more than 5%), which should be taken into account when determining the ESR.

What causes an increase in ESR

ESR mainly depends on the concentration in the blood albumin(protein) because decrease in its concentration leads to the fact that the speed of erythrocytes change, and hence the speed with which they will settle changes. And this happens precisely during adverse processes in the body, which makes it possible to use the method as an additional one when making a diagnosis.

To others physiological reasons for the increase in ESR include changes in blood pH - this is affected by an increase in blood acidity or its alkalization, which leads to the development of alkalosis (acid-base imbalance), a decrease in blood viscosity, changes in the external shape of red cells, a decrease in their level in the blood, an increase in such blood proteins such as fibrinogen, paraprotein, α-globulin. It is these processes that lead to an increase in ESR, which means that they indicate the presence of pathogenic processes in the body.

What does elevated ESR in adults indicate?

When changing the indicators of ESR, one should understand the initial reason for these changes. But not always the increased value of this indicator indicates the presence of a serious disease. So, temporary and acceptable reasons(false positive), in which you can get overestimated research data, consider:

• elderly age;
• menstruation;
• obesity;
• strict diet, starvation;
• pregnancy (sometimes it rises to 25 mm / h, as the composition of the blood at the protein level changes, and hemoglobin levels often decrease);
• postpartum period;
• daytime;
• the ingestion of chemicals into the body, which affects the composition and properties of the blood;
• the influence of hormonal drugs;
• allergic reaction of the body;
• vaccination against hepatitis B;
• taking vitamins of group A;
• nervous tension.

pathogenic causes. for which an increase in ESR is detected and which require treatment are:

• severe inflammatory processes in the body, infection;
• tissue destruction;
• the presence of malignant cells or blood cancer;
• ectopic pregnancy;
• tuberculosis disease;
• infections of the heart or valves;
• problems of the endocrine system;
• anemia;
• problems with the thyroid gland;
• kidney disease;
• gallbladder problems and cholelithiasis.

Do not forget about such a reason as a distorted result of the method - if the conditions for conducting the study are violated, not only an error occurs, but often false positive or false negative results are given.

Diseases associated with ESR above normal

A clinical blood test for ESR is the most accessible, due to which it is actively used and confirms, and sometimes establishes, the diagnosis of many diseases. Increased ESR by 40% cases determines diseases associated with infected processes in the body of an adult - tuberculosis, inflammation of the respiratory tract, viral hepatitis, urinary tract infections, the presence of fungal infections.

In 23% of cases, ESR increases in the presence of cancer cells in the body, both in the blood itself and in any other organ.

17% of people with an increased rate have rheumatism, systemic lupus erythematosus (a disease in which the human immune system recognizes tissue cells as foreign).

In another 8%, an increase in ESR is caused by inflammatory processes in other organs - the intestines, bile excretory organs, ENT organs, and injuries.

And only 3% of the sedimentation rate responds to kidney disease.

With all diseases, the immune system begins to actively fight pathogenic cells, which leads to an increase in the production of antibodies, and at the same time, the erythrocyte sedimentation rate also accelerates.

What to do to lower the ESR

Before starting treatment, you should make sure that the reason for the increased ESR is not a false positive (see above), because some of these reasons are quite safe (pregnancy, menstruation, etc.). Otherwise, it is necessary to find the source of the disease and prescribe treatment. But for correct and accurate treatment, one cannot rely only on the results of determining this indicator. On the contrary, the determination of ESR is additional in nature and is carried out along with a comprehensive examination at the initial stage of treatment, especially if there are signs of a specific disease.

Basically, ESR is examined and monitored at elevated temperature or to rule out cancer. In 2-5% of people, an increased ESR is not at all associated with the presence of any diseases or false-positive signs - it is associated with the individual characteristics of the body.

Do not forget that even with a full recovery, the level of this indicator may not drop for some time (up to a month, and sometimes up to 6 weeks), so you should not sound the alarm. And you need to donate blood in the early morning and on an empty stomach for more reliable results.

Since ESR in diseases is an indicator of pathogenic processes, it can only be brought back to normal by eliminating the main lesion.

Thus, in medicine, the determination of the erythrocyte sedimentation rate is one of the important analyzes definition of the disease and precise treatment at the initial stage of the disease. What is very important when detecting serious diseases, for example, a malignant tumor at an early stage of development, due to which the level of ESR increases sharply, which makes doctors pay attention to the problem. In many countries, this method has ceased to be used due to the mass of false positive reasons, but in Russia it is still widely used.