What does a high heel mean? What can a high forehead tell about a person?

An increase or decrease in the number of cells in the blood (red blood cells, leukocytes, platelets, etc.) is an indicator of certain diseases or inflammatory processes. Diseases are especially often detected if the level of measured components is elevated.

In this article we will look at why the ESR is increased in a blood test, and what this means in each specific case in women or men.

ESR - what is it?

ESR is the sedimentation rate of erythrocytes, red blood cells, which, under the influence of anticoagulants, settle at the bottom of a medical test tube or capillary over time.

The settling time is estimated from the height of the plasma layer obtained as a result of the analysis, estimated in millimeters per 1 hour. ESR is highly sensitive, although it is a nonspecific indicator.

What does it mean? A change in the erythrocyte sedimentation rate may indicate the development of a certain pathology of a different nature, even before the onset of obvious symptoms of the disease.

Using this analysis you can diagnose:

1. The body's reaction to the prescribed treatment. For example, with tuberculosis, lupus erythematosus, inflammation of connective tissue (rheumatoid arthritis) or Hodgkin's lymphoma (lymphogranulomatosis).
2. Accurately differentiate the diagnosis: heart attack, acute appendicitis, signs of ectopic pregnancy or osteoarthritis.
3. Identify hidden forms of the disease in the human body.

If the analysis is normal, then additional examination and tests are still prescribed, since a normal ESR level does not exclude serious illness or the presence of malignant neoplasms.

Normal indicators

The norm for men is 1-10 mm/h, for women on average - 3-15 mm/h. After 50 years, this figure can increase. During pregnancy, the rate can sometimes reach 25 mm/h. These numbers are explained by the fact that a pregnant woman is anemic and her blood is thinning. In children, depending on age - 0-2 mm/h (in newborns), mm/h (up to 6 months).

An increase as well as a decrease in the red cell sedimentation rate for people of different ages and gender depends on many factors. During the course of life, the human body is exposed to various infectious and viral diseases, which is why an increase in the number of leukocytes, antibodies, and red blood cells is noticed.

Why ESR in the blood is higher than normal: reasons

So, why does a blood test show an elevated ESR, and what does it mean? Most common cause high ESR is the development of inflammatory processes in organs and tissues, which is why many perceive this reaction as specific.

In general, the following groups of diseases can be distinguished in which the sedimentation rate of red blood cells increases:

1. Infections. High ESR indicator accompanies almost everything bacterial infections respiratory tract and genitourinary system, as well as other localizations. This usually occurs due to leukocytosis, which affects aggregation characteristics. If leukocytes are normal, then other diseases must be excluded. If symptoms of infection are present, it is likely to be viral or fungal in nature.
2. Diseases in which not only an inflammatory process is observed, but also disintegration (necrosis) of tissues, blood cells and the entry of protein breakdown products into the bloodstream: purulent and septic diseases; malignant neoplasms; myocardial, lung, brain, intestinal infarctions, pulmonary tuberculosis, etc.
3. ESR increases very strongly and remains at a high level for a long time in diseases of an autoimmune nature. These include various vasculitis, thrombocytopenic purpura, lupus erythematosus, rheumatic and rheumatoid arthritis, scleroderma. Such a reaction of the indicator is due to the fact that all these diseases change the properties of the blood plasma so much that it becomes oversaturated with immune complexes, making the blood defective.
4. Kidney diseases. Of course, with an inflammatory process that affects the renal parenchyma, the ESR value will be higher than normal. However, quite often an increase in the described indicator occurs due to a decrease in the level of protein in the blood, which in high concentration goes into the urine due to damage to the renal vessels.
5. Metabolic and endocrine pathologies - thyrotoxicosis, hypothyroidism, diabetes mellitus.
6. Malignant degeneration bone marrow, in which red blood cells enter the blood without being ready to perform their functions.
7. Hemoblastoses (leukemia, lymphogranulomatosis, etc.) and paraproteinemic hemoblastoses (myeloma, Waldenström's disease).

These causes are most common when the erythrocyte sedimentation rate is high. In addition, when taking the test, all test rules must be followed. If a person has even a minor cold, the indicator will be increased.

Women due to hormonal and physiological changes During the menstrual cycle, pregnancy, childbirth, breastfeeding and menopause, they are more often subject to qualitative and quantitative changes in the content of dry residues in the blood. These reasons can cause increased ESR in the blood of women (domm/h).

As you can see, there are a lot of reasons when ESR is higher than normal, and it is problematic to understand what this means from just one analysis. Therefore, the assessment of this indicator can only be entrusted to a truly knowledgeable specialist. You should not do things on your own that cannot be determined correctly with certainty.

Physiological reasons for increased ESR

Many people know that an increase in this indicator, as a rule, indicates some kind of inflammatory reaction. But it is not Golden Rule. If an increased ESR is detected in the blood, the causes may be completely safe and do not require any treatment:

• eat a large meal before taking the test;
• fasting, strict diet;
• menstruation, pregnancy and postpartum period among women;
• allergic reactions in which fluctuations in the initially increased erythrocyte sedimentation rate
• allow us to judge the correct anti-allergy therapy - if the drug works, the indicator will gradually decrease.

Undoubtedly, just by the deviation of one indicator from the norm it is very difficult to determine what it means. It will help you figure this out experienced doctor and additional examination.

Increase above 100 mm/h

The indicator exceeds the level of 100 m/h in acute infectious processes:

A significant increase in the norm does not occur overnight; ESR increases for 2–3 days before reaching a level of 100 mm/h.

False increase in ESR

In some situations, changes in indicators do not indicate a pathological process, but some chronic conditions. The level of ESR can increase with obesity and acute inflammatory process. Also, false changes in ESR indicators are observed:

1. With elevated blood cholesterol levels.
2. Due to the use of oral contraceptives.
3. Subsequently, vaccination against hepatitis B.
4. At long-term use vitamins that contain large amounts of vitamin A.

Medical research shows that ESR can often increase in women for no reason. Doctors explain such changes by hormonal imbalances.

Increased ESR in a child: causes

Increased soya in the blood of a child is most often caused by: inflammatory in nature. You can also identify the following factors leading to an increase in erythrocyte sedimentation rate in children:

• metabolic disease;
• getting injured;
• acute poisoning;
• autoimmune diseases;
• stressful state;
• allergic reactions;
• the presence of helminths or sluggish infectious diseases.

In a child, an increase in the erythrocyte sedimentation rate can be observed in the case of teething, an unbalanced diet, or a lack of vitamins. If children complain of feeling unwell, then you should consult a doctor and conduct a comprehensive examination, the doctor will determine why the ESR test is elevated, after which the only correct treatment will be prescribed.

What to do

Prescribing treatment for an increase in the erythrocyte sedimentation rate in the blood is inappropriate, since this indicator is not a disease.

Therefore, in order to make sure that there are no pathologies in the human body (or, on the contrary, they do exist), it is necessary to schedule comprehensive examination, which will answer this question.

Normal ESR in the blood of men, women and children: table

4 comments

Namesake, so why was the indicator still increased? Have you thought about it and found out the reason? Or, like mine, all tests are normal except for ESR in the last 2 years?

And my ESR has been constantly elevated for several years now, all readings are normal. ESR is elevated

I, too, have had an ESR level above normal for more than a year and stay at 24, all other indicators are normal, although sometimes the urine test is not very good, what should I do, I’m 66 years old, maybe it’s really a hormonal imbalance, I haven’t had my period for 20 years, why earlier Wasn't there an increase? Well, I wasn’t left without prescription of an expensive medicine, the therapist immediately prescribed me for cystitis

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Increased ESR in the blood: what does it mean?

The abbreviation “ESR” stands for “erythrocyte sedimentation rate.” This is a nonspecific laboratory indicator that is determined by examining the patient’s blood.

ESR is one of the initial diagnostic methods. Correct interpretation allows you to determine the algorithm for further actions of the doctor.

History and essence of the method

In 1918, it was found that women's ESR changes during pregnancy. Later it turned out that changes in the indicator are observed in inflammatory diseases. One of the methods for determining the indicator, which is still widely used in clinical practice, was developed by Westergren back in 1928.

The density of red blood cells is higher than the density of plasma, and if the blood does not coagulate, the red blood cells gradually sink to the bottom of the laboratory tube under their own weight.

Please note: to prevent blood clotting, an anticoagulant substance, sodium citrate (5% or 3.8% solution), is added to the container before the test.

The leading factor affecting the sedimentation rate is the aggregation of erythrocytes (i.e., their sticking together). The formed indivisible particles known as “coin columns” have a smaller area to volume ratio, so they overcome the resistance of the liquid (plasma) more easily and settle faster. The larger the size and number of aggregates, the higher the ESR.

Affects aggregation protein composition plasma and surface potential of erythrocytes. With the development of pathology of infectious-inflammatory genesis, the electrochemical composition of the blood changes. The main reason for the increase in aggregation is the presence in the blood of the so-called. “acute phase proteins” - immunoglobulins, fibrinogen, ceruloplasmin and C-reactive protein. Agglutination is normally hampered by the negative charge of red blood cells, but it tends to change with the addition of antibodies and acute-phase fibrinogen.

Note: altered electrical charge and increased tendency to aggregation are characteristic of atypical forms red blood cells

Minor decreases in albumin content have virtually no effect on the sedimentation rate, but a significant decrease in concentration causes a decrease in serum viscosity and an increase in the rate.

Research using the Panchenkov method

To evaluate ESR using this method, a special laboratory vessel is used - the so-called. Panchenkov capillary. First, sodium citrate is filled into it up to the “P” mark, and the anticoagulant is transferred to the glass. Then the test blood is drawn twice successively to the “K” mark and combined with citrate. Citrate blood is again drawn into the capillary, which is fixed in a vertical position. ESR is determined after 60 minutes. or after 24 hours; the indicator is expressed in millimeters. This method, which doctors in our country most often rely on, provides high accuracy in single studies. Its main disadvantage is that it takes a relatively long time to carry out the analysis.

Study using the Westergren method

The European method is slightly more sensitive to an increase in ESR. To carry out the analysis, Westergren tubes with a diameter of 2.5 mm and a graduation of 200 mm are used. The material for research is deoxygenated blood, mixed with sodium citrate (3.8%) in a ratio of 4:1. A reagent such as ethylenediaminetetraacetic acid (EDTA) may be added to the blood. The indicator is expressed in mm/hour.

Important: studies according to Panchenkov and Westergren may give different figures, and the higher the ESR, the greater the possible difference. Therefore, the transcript of the analysis must indicate by what method the analysis was done. If you received the results from a laboratory that determines ESR by international standards– be sure to clarify whether the results were brought to the standards of Panchenkov’s indicators.

Interpretation of results: normal ESR values ​​in adults and children

Normal ESR values ​​vary depending on gender, age, and some individual characteristics of the subject.

Normal limits for adults:

Important: with age, the indicator increases, significantly exceeding the normal limits. In older people, the rate of mm/hour can be determined, and this is not always a sign of infection, inflammation or other pathology. For women over 60 years of age, figures in the range of 2-30 mm/hour are considered normal, and for men of the same age, mm/hour.

Normal limits for children of different ages (in mm/hour):

• newborns – up to 2;
• from 2 to 12 months – 2-7;
• from 2 to 5 years – 5-11;
• from 5 to 12 years – 4-17;
• boys over 12 years old 2-15;
• girls over 12 years old – 2-12.

The most common deviations are in the direction of increasing numbers. The inaccuracy of the analysis may be due to violation of the rules of conduct. Blood for ESR must be donated on an empty stomach in the morning. If the subject was hungry the day before or, conversely, had too much dinner, the results are distorted. In such situations, it is recommended to retake the test after 1-2 days. The ESR result is influenced by the storage conditions of biological material before the study.

What does an increase in ESR indicate?

ESR analysis is famous for its simplicity and low cost, but interpretation of the results often presents certain difficulties. Figures within the normal range do not always indicate the absence of an active pathological process.

It has been established that in a number of patients with diagnosed malignant diseases this figure is less than 20 mm/hour. As for cancer patients, a significant increase in the red cell sedimentation rate is more typical for individuals with solitary tumors than for patients with malignant blood diseases.

In some cases, no disease is detected in subjects with an ESR of 100 mm/hour or higher.

The main reasons for the increase in ESR:

• acute and chronic bacterial infections ( infectious diseases respiratory and urinary systems, as well as tuberculosis);
• viral infections (including hepatitis);
• fungal infections (systemic candidiasis);
• malignant diseases (tumor neoplasms, leukemia, lymphoma and myeloma);
• rheumatological diseases;
• kidney diseases.

An increase in ESR is also typical for some other diseases and conditions, including:

Important: an increase in erythrocyte sedimentation rate over 100 mm/hour is most often detected during an active infectious process (including sepsis), malignant tumors, oncohematological diseases, systemic connective tissue lesions and kidney diseases.

An increased ESR does not necessarily indicate the presence of pathology. Within mm/hour, it increases in pregnant women, during menstruation, and also when taking certain pharmacological drugs– in particular salicylates (Acetylsalicylic acid, Aspirin), complexes containing vitamin A and oral contraceptives. Increased speed Erythrocyte sedimentation may be due to recent administration of hepatitis vaccine.

Note: An increase in numbers is often observed in obesity in the absence of acute processes, as well as against the background of high blood cholesterol.

In the first hours and days of the disease, the indicator may remain normal, since it takes a certain time (from 24 to 48 hours) for serum proteins to undergo changes. At the onset of the infectious process, leukocytosis appears much earlier, i.e., an increase in the number of leukocytes. It also takes time to normalize the indicator. After complete cure elevated ESR may persist for several weeks or even months. In this case, the indicator simply reflects the period of convalescence (recovery).

An increase in ESR is the basis for additional research. In particular, to diagnose inflammation you need biochemical analysis blood to assess C-reactive proteins, which are markers of inflammation.

Betsik Yulia, medical columnist

The information is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor. There are contraindications, a doctor's consultation is required. The site may contain content prohibited for viewing by persons under 18 years of age.

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Normal ESR values

The rate of erythrocyte sedimentation rate in the blood directly depends on the gender and age of the person whose blood is being tested. Thus, the highest ESR rate is usually observed in infants: It ranges from 12 to 17 millimeters per hour. Normal indicator ESR for women is 3-15 mm/hour, for men mm/hour, for newborns mm/hour. In older people, the ESR rate is usually higher: it can be up to 38 mm/hour and up to 53 mm/hour in women. Therefore, if your results obtained as a result of the analysis differ significantly from these figures, you should consult a doctor to figure out what is the cause of the elevated ESR level.

Increased ESR levels

You can independently draw preliminary conclusions about what problems an elevated ESR level in your blood may indicate. Thus, a deviation of the result from the norm by several units is most often due to the specific characteristics of your body and may not be a sign of the presence of any serious dysfunction. However, in order to make sure that the result is normal for you, it is recommended to consult a physician for advice.

Increased ESR

A blood test for ESR - erythrocyte sedimentation rate - is required during the initial diagnosis.

This study only helps to determine the further course of medical actions. After all, whatever the results of the analysis, they are not reliable sign pathologies. A deviation of ESR from the norm only indirectly indicates that an inflammatory process may be occurring in the body or an infection may be developing.

The importance of ESR testing

The results of the analysis are very individual. Their upward deviation is due to many reasons. Specific disease, at which ESR increases, no.

This indicator is considered general, nonspecific, since it does not answer the question of whether a person is healthy or sick.

But studying the results of the study:

• promotes accelerated and timely implementation of additional tests;
• in combination with data from other tests, it allows you to objectively assess the condition of the body;
• makes it possible to make forecasts for the short term;
• in dynamics indicates the course of the disease and how correctly the therapeutic methods have been chosen. Approaching the ESR to normal confirms that the medications and procedures prescribed by the doctor are successful and the patient is recovering.

Standard ESR values ​​depend on a person’s age and gender.

The average for men is in the range from 8 to 12 units (millimeters per hour), for women - from 3 to 20.

With age, ESR increases and in advanced years reaches 50 units.

Elevated ESR: degrees of growth

For correct diagnosis, it matters how much the ESR value exceeds the norm. Depending on this, four degrees of deviation can be distinguished:

• The first, which is characterized by a slight increase in ESR. Other blood counts remain normal.
• Second, the results of the analysis recorded an excess of ESR by 15–29 units. This signals that there is an infectious process in the body, which so far has little effect on its general condition. This situation is typical for colds. If they are treated, the ESR will return to normal in a couple of weeks.
• Third – the increase in ESR is more than 30 units. This increase in the indicator is considered significant and serious. As a rule, the size of the ESR indicates the development of dangerous inflammatory or necrotic processes. It may take several months to treat the disease.
• Fourth – ESR increases by 60 units or more. This situation reflects an extremely difficult and life-threatening condition of the body. Immediate and thorough treatment is required.

Causes of elevated ESR

An increase in ESR may be the result of the development of one or even several diseases at the same time. They can be classified as follows:

• Infections are viral, bacterial and fungal. They can be relatively mild, such as acute respiratory viral infections or acute respiratory infections. But a serious illness often develops, in which the ESR exceeds the norm several times and reaches 100 mm/hour. For example:
  • viral hepatitis;
  • flu;
  • pyelonephritis;
  • pneumonia;
  • bronchitis.
• Neoplasms, both benign and malignant. ESR increases significantly, but the level of leukocytes may remain normal.

  An increase in the indicator is more typical in the presence of single peripheral formations. Less commonly, it occurs when tumors of lymphoid and hematopoietic tissue are present.

• Rheumatological diseases:
  • true rheumatism;
  • arthritis and arthrosis;
  • ankylosing spondylitis (ankylosing spondylitis);
  • all systemic vasculitis;
  • transformation of connective tissue of a diffuse nature: Sjogren's disease, Sharp's syndrome, systemic scleroderma and lupus erythematosus, polymyositis.
• Kidney disease and urinary tract dysfunction:
  • hydronephrosis;
  • urolithiasis disease;
  • nephroptosis (prolapse of the kidney);
  • pyelonephritis (more common in women);
  • glomerulonephritis.
• Blood diseases:
  • hemoglobinopathy, namely thalassemia and sickle cell anemia;
  • anisocytosis.
• Severe conditions that are accompanied by an increase in blood viscosity:
  • intestinal obstruction;
  • diarrhea and vomiting;
  • food poisoning.

In almost 20% of cases, the cause of excess growth of ESR is poisoning of the body and rheumatological diseases. These pathologies lead to the fact that the blood becomes thicker and more viscous, and red cells begin to settle at a faster rate.

The greatest increase in ESR occurs when infectious processes are present and developing in the body. The value of the indicator does not increase immediately, but only a day or two after the onset of the disease. When the body recovers, the ESR decreases slowly. It will take a month and a half before the indicator returns to normal limits.

An increase in ESR also occurs after surgery. It can also accompany post-shock states.

False increase in ESR

Exceeding the ESR norm is possible even without the presence of ailments in the body. There are a number of natural reasons:

• taking medications containing hormones;
• allergic reactions;
• overuse vitamin complexes, especially vitamin A;
• errors in diet;
• individual characteristics of the body. Statistics show that almost 5% of the planet's population has an accelerated red blood cell sedimentation reaction;
• bearing a child. In pregnant women, ESR can increase by three and more than times, which is not considered a pathology;
• insufficient absorption of iron by the body, its deficiency;
• age from 4 to 12 years. During this period, especially in boys, an increase in ESR is possible, associated with the development and formation of the body. There are no infections or inflammations.

An increase in ESR above normal in some cases is accompanied by certain chronic conditions. These include:

• increased blood cholesterol levels;
• recent hepatitis vaccination;

High levels of obesity also cause red blood cells to sediment faster than they should.

Features of increasing ESR in men and women

A slight increase in ESR was observed in approximately eight percent of men. And it is not considered a deviation from the norm. The explanation lies in the individual characteristics of a particular person’s body. The value of the indicator is influenced by lifestyle and the presence bad habits, like smoking and addiction to alcohol.

IN female body Increased ESR can be explained by relatively safe reasons:

• the beginning of critical days;
• reception hormonal drugs, in particular contraceptives;
• dietary habits: following a diet containing few calories, or overeating, consuming fatty foods shortly before a blood test;
• pregnancy.

Increased ESR during pregnancy

During pregnancy, processes in the female body occur in a special way. The protein composition of the blood also changes somewhat, which is reflected in the ESR.

The indicator can jump up to 45 units, and this will not indicate the manifestation of diseases.

ESR begins to gradually increase already in the tenth week of pregnancy. Highest value, as a rule, is fixed in the third trimester.

Almost a month after birth, the ESR is also elevated. The cause is anemia, which developed during pregnancy. It provokes significant blood thinning and increases the rate of red cell sedimentation.

The size of the ESR is influenced by the woman’s build. In thinner expectant mothers, the indicator increases to a greater extent than in plump women.

A month or a month and a half after the baby is born, the ESR quickly returns to normal.

But even such objective processes should not be ignored. Only a doctor can determine how normal the pregnancy is and whether everything is okay with the expectant mother.

Features of increased ESR in children

The reasons for increased ESR in children are not much different from those that are typical for adults. Most often, this symptom manifests itself as a result of:

• infectious diseases, including chronic illnesses;
• intoxication;
• allergic reactions;
• helminthiasis;
• metabolic disorders;
• injuries to limbs and other parts of the body.

Infectious and inflammatory processes in children manifest themselves not only by an increase in ESR. Other indicators, which are determined using a general blood test, also change. The baby's general condition worsens.

A slight increase in ESR can be explained by such non-hazardous factors as:

• violation of the diet by a nursing mother: the diet contains an excess of food with a significant fat content;
• taking oral medications;
• The baby is teething;
• There is a lack of vitamins in the body.

For parents whose children have a reading higher than the established norm, panic is contraindicated. It is necessary to carefully examine the child and establish the causes. Successful treatment the main ailment will help normalize the ESR in a month or a month and a half.

Treatment of elevated ESR

An increased level of ESR in itself is not a pathology, but only indicates the development of a disease in the body. Therefore, bringing the indicator back to normal is possible only after treatment of the underlying disease.

In some cases there is no need to lower it. For example, the ESR will not return to normal until:

• whether the wound will heal or the broken bone will not heal;
• the course of taking a certain drug will come to an end;
• a child will be born in the womb.

If ESR is elevated during pregnancy, you need to think about how to prevent anemia or reduce its consequences.

Women in an “interesting” position need to take a responsible approach to their diet and follow all the recommendations prescribed by the gynecologist. The doctor can make an appointment safe drugs containing iron, special food additives.

In many cases, it is possible to lower the ESR to normal limits only by eliminating the inflammatory process. To determine its cause, a general blood test is not enough; a more in-depth study of the condition of the patient’s body is necessary. A general practitioner can prescribe it. He is the one who knows all the examination protocols and treatment tactics.

Medicines should be taken only on the recommendation of a doctor. Self-selected medications will most likely not help desired result, but will only have a negative impact on internal organs and lead to unnecessary spending.

When an elevated ESR is accompanied by a slight temperature, you can try to help the body with herbs and natural products.

There are many useful recipes in the traditional medicine collection. It is recommended to cook the most ordinary beets in one of them. Properly prepared, it can lower the ESR in ten days.

You need to select three small beets, wash them thoroughly and do not remove the tails. Then the vegetables are cooked for about three hours. The resulting broth is filtered and stored in a cool place. It is enough to drink 50 grams of beetroot liquid per day. Take the decoction in the morning on an empty stomach.

Juice squeezed from beets is also a good blood cleanser. You need to drink half a glass of it before bed. Ten days of this intake will help improve blood circulation.

A product that contains lemon juice and garlic is effective. One hundred grams of the latter needs to be crushed. Then mix the resulting pulp with the juice of six to seven lemons. Place the drink in the refrigerator and take a teaspoon in the evening, diluting it with a glass of boiled water.

Freshly squeezed citrus juices are also beneficial. It is advisable to add a teaspoon of honey to them.

It happens that the examination did not reveal serious pathologies, and the ESR does not decrease. In this case, it is necessary to periodically carry out preventive examinations. If negative symptoms appear, you should not leave things to chance, but seek advice. Preventive measures always give positive results and help maintain health for many years.

Excellent article, clear, understandable, precise. Thank you

ESR (ROE, erythrocyte sedimentation rate): norm and deviations, why it increases and decreases

Previously, it was called ROE, although some still habitually use this abbreviation, now they call it ESR, but in most cases they apply the neuter gender to it (increased or accelerated ESR). With the permission of the readers, the author will use the modern abbreviation (ESR) and the feminine gender (speed).

ESR (erythrocyte sedimentation rate), together with other routine laboratory tests, is considered one of the main diagnostic indicators in the first stages of the search. ESR is a nonspecific indicator that increases absolutely in many pathological conditions of different origins. People who had to go to the emergency room with a suspicion of some kind of inflammatory disease (appendicitis, pancreatitis, adnexitis) probably remember that the first thing they do is take a “two” (ESR and leukocytes), which after an hour allows us to clarify a little picture. True, new laboratory equipment can perform analysis in less time.

The ESR rate depends on gender and age

The normal ESR level in the blood (where else could it be?) primarily depends on gender and age, but is not particularly diverse:

• In children under one month old (newborns) healthy babies) ESR can be 1 or 2 mm/hour, other values ​​are rare. Most likely, this is due to high hematocrit, low protein concentration, in particular its globulin fraction, hypercholesterolemia, and acidosis. The erythrocyte sedimentation rate in infants under six months of age begins to differ sharply in mm/hour.
• In older children, the ESR levels out somewhat and is 1-8 mm/h, corresponding approximately normal ESR adult male.
• In men, ESR should not exceed 1-10 mm/hour.
• The norm for women is 2-15 mm/hour, its wider range of values ​​is due to the influence of androgenic hormones. In addition, in different periods life, ESR in females tends to change, for example, during pregnancy, from the beginning of the 2nd trimester (4th month), it begins to grow steadily and reaches a maximum by childbirth (up to 55 mm/h, which is considered absolutely normal occurrence). The erythrocyte sedimentation rate returns to its previous values ​​after childbirth in about three weeks. Probably, the increased ESR in this case is explained by an increase in plasma volume during pregnancy, an increase in the content of globulins, cholesterol, and a decrease in the level of Ca 2++ (calcium).

Accelerated ESR is not always a consequence pathological changes, among the reasons for the increase in erythrocyte sedimentation rate, other factors that are not related to pathology can be noted:

1. Starvation diets and limited fluid intake will likely lead to the breakdown of tissue proteins, and, consequently, an increase in fibrinogen, globulin fractions and, accordingly, ESR in the blood. However, it should be noted that eating will also speed up ESR physiologically (up to 25 mm/hour), so it is better to go for analysis on an empty stomach, so as not to worry in vain and not donate blood again.
2. Some medications (high molecular weight dextrans, contraceptives) can accelerate the erythrocyte sedimentation rate.
3. Intense physical activity that increases everything metabolic processes in the body will most likely increase the ESR.

This is approximately what the change in ESR looks like depending on age and gender:

The erythrocyte sedimentation rate accelerates, first of all, due to an increase in the level of fibrinogen and globulins, that is, the main reason for the increase is considered to be a protein shift in the body, which, however, may indicate the development of inflammatory processes, destructive changes in connective tissue, the formation of necrosis, the emergence of malignant neoplasm, immune disorders. A long-term unreasonable increase in ESR to 40 mm/hour or more acquires not only diagnostic, but also differential diagnostic significance, since in combination with other hematological indicators it helps to find the real reason high ESR.

How is ESR determined?

If you take blood with an anticoagulant and let it stand, then after a certain period of time you will notice that the red blood cells have sank down, and a yellowish transparent liquid (plasma) remains on top. How far red blood cells travel in one hour is the erythrocyte sedimentation rate (ESR). This indicator is widely used in laboratory diagnostics, which depends on the radius of the red blood cell, its density and plasma viscosity. The calculation formula is a wildly twisted plot that is unlikely to interest the reader, especially since in reality everything is much simpler and, perhaps, the patient himself will be able to reproduce the procedure.

The laboratory technician takes blood from a finger into a special glass tube called a capillary, places it on a glass slide, and then draws it back into the capillary and places it in a Panchenkov stand to record the result an hour later. The column of plasma following the settled red blood cells will be their sedimentation rate, it is measured in millimeters per hour (mm/hour). This old method is called ESR according to Panchenkov and is still used by most laboratories in the post-Soviet space.

The definition of this indicator according to Westergren is more widespread on the planet, the original version of which differed very little from our traditional analysis. Modern automated modifications for determining ESR according to Westergren are considered more accurate and allow you to get results within half an hour.

Elevated ESR requires examination

The main factor accelerating ESR is rightfully considered to be a change physical and chemical properties and blood composition: a shift in the protein A/G (albumin-globulin) coefficient towards a decrease, an increase in the pH value, active saturation of red blood cells (erythrocytes) with hemoglobin. Plasma proteins that carry out the process of erythrocyte sedimentation are called agglomerins.

An increase in the level of the globulin fraction, fibrinogen, cholesterol, and an increase in the aggregation abilities of red blood cells occurs in many pathological conditions, which are considered the causes of high ESR in a general blood test:

1. Acute and chronic inflammatory processes of infectious origin (pneumonia, rheumatism, syphilis, tuberculosis, sepsis). Using this laboratory test, one can judge the stage of the disease, the subsidence of the process, and the effectiveness of therapy. Synthesis of “acute phase” proteins in acute period and enhanced production of immunoglobulins in the midst of “war operations” significantly increase the aggregation abilities of erythrocytes and the formation of coin columns by them. It should be noted that bacterial infections give higher numbers compared to viral lesions.
2. Collagenosis (rheumatoid polyarthritis).
3. Heart damage (myocardial infarction - damage to the heart muscle, inflammation, synthesis of “acute phase” proteins, including fibrinogen, increased aggregation of red blood cells, formation of coin columns - increased ESR).
4. Diseases of the liver (hepatitis), pancreas (destructive pancreatitis), intestines (Crohn's disease, ulcerative colitis), kidneys (nephrotic syndrome).
5. Endocrine pathology (diabetes mellitus, thyrotoxicosis).
6. Hematological diseases (anemia, lymphogranulomatosis, myeloma).
7. Injury to organs and tissues ( surgical operations, wounds and bone fractures) - any damage increases the ability of red blood cells to aggregate.
8. Lead or arsenic poisoning.
9. Conditions accompanied by severe intoxication.
10. Malignant neoplasms. Of course, the test can hardly claim to be the main diagnostic sign in oncology, however, its increase will one way or another create many questions that will have to be answered.
11. Monoclonal gammopathies (Waldenström's macroglobulinemia, immunoproliferative processes).
12. High cholesterol levels (hypercholesterolemia).
13. Exposure to certain medications (morphine, dextran, vitamin D, methyldopa).

However, at different periods of the same process or under different pathological conditions, ESR does not change the same:

• Very sharp increase ESR domm/hour is typical for myeloma, lymphosarcoma and other tumors.
• Tuberculosis on initial stages The erythrocyte sedimentation rate does not change, but if it is not stopped or a complication occurs, the rate will quickly creep up.
• In the acute period of infection, ESR will begin to increase only from 2-3 days, but may not decrease for quite a long time, for example, with lobar pneumonia– the crisis has passed, the disease is receding, but the ESR is holding.
• It is unlikely that this laboratory test will be able to help on the first day of acute appendicitis, since it will be within normal limits.
• Active rheumatism can last for a long time with an increase in ESR, but without frightening numbers, but its decrease should alert you to the development of heart failure (blood thickening, acidosis).
• Usually, when the infectious process subsides, the total number of leukocytes returns to normal first (eosinophils and lymphocytes remain to complete the reaction), ESR is somewhat delayed and decreases later.

Meanwhile, long-term persistence of high ESR values ​​(20-40, or even 75 mm/hour and above) in infectious and inflammatory diseases of any kind will most likely suggest complications, and in the absence of obvious infections, the presence of some then hidden and possibly very serious diseases. And, although not in all cancer patients the disease begins with an increase in ESR, its high level (70 mm/hour and above) in the absence inflammatory process most often occurs in oncology, because the tumor will sooner or later cause significant damage to tissues, damage to which will ultimately begin to increase the erythrocyte sedimentation rate.

What could a decrease in ESR mean?

The reader will probably agree that we attach little importance to ESR if the numbers are within the normal range, but reducing the indicator, taking into account age and gender, to 1-2 mm/hour will still raise a number of questions for particularly curious patients. For example, a general blood test of a woman of reproductive age, when examined repeatedly, “spoils” the level of erythrocyte sedimentation rate, which does not fit into the physiological parameters. Why is this happening? As in the case of an increase, a decrease in ESR also has its own reasons, due to a decrease or lack of the ability of red blood cells to aggregate and form coin columns.

at decrease in ESR one (or more) components of correct erythrocyte sedimentation are not in order

Factors leading to such deviations include:

1. Increased blood viscosity, which, with an increase in the number of red blood cells (erythremia), can generally stop the sedimentation process;
2. Changes in the shape of red blood cells, which, in principle, due to their irregular shape, cannot fit into coin columns (sickling, spherocytosis, etc.);
3. Changes in physical and chemical blood parameters with a shift in pH downward.

Such changes in the blood are characteristic of the following conditions of the body:

• High levels of bilirubin (hyperbilirubinemia);
• Obstructive jaundice and, as a consequence, the release of large amounts of bile acids;
• Erythremia and reactive erythrocytosis;
• Sickle cell anemia;
• Chronic circulatory failure;
• Decreased fibrinogen levels (hypofibrinogenemia).

However, clinicians do not consider a decrease in erythrocyte sedimentation rate to be an important diagnostic indicator, so the data is presented specifically for particularly inquisitive people. It is clear that in men this decrease is not noticeable at all.

It is definitely not possible to determine whether your ESR has increased without a finger prick, but it is quite possible to assume an accelerated result. Increased heart rate (tachycardia), increased body temperature (fever), and other symptoms indicating the approach of an infectious-inflammatory disease may be indirect signs changes in many hematological parameters, including erythrocyte sedimentation rate.

Video: clinical blood test, ESR, Dr. Komarovsky

My ESR is 45 mm/h, other tests are normal, leukocytes are slightly elevated (9.5), temperature has been above 38 for 19 days, cough with foamy sputum, and occasionally pus. I did an ultrasound - an exacerbation of chronic bronchitis, but why doesn’t the temperature drop?! And also severe pain in the legs, burning in the feet and pain in the knees. How to treat if antibiotics do not help?

Hello! Before starting treatment, you need to determine the diagnosis. You may have an acute inflammatory process in the lungs, to exclude which it is necessary to take a survey X-ray; if necessary, the doctor may refer you to a CT scan. You should definitely go to a therapist and talk about problems with your legs, which may indicate some kind of systemic inflammatory process, possibly an infection, etc. It is impossible to make a diagnosis based on the Internet and some indicators of your general blood test, so go to see doctor for a more in-depth examination.

Tell me what to do? My mother (she is 60 years old) has an ESR of 60 mm/h for many years, very many years, she “walks” from 40 to 70.

She simply underwent a lot of examinations: FGS, ultrasound of everything possible, etc., etc. At first, simply because of this analysis, she was not allowed to go to the sanatorium, while every two years she goes through all the rounds of examinations. Now they refused the operation because of ESR, they said: “Solve the issue and then come.” At first the therapist let me through, but the surgeon refused. And she was again prescribed a whole examination with FGS and various ultrasounds, walking in a circle. What should we do if all searches are in vain every time? How to get rid of or how to explain (more precisely, prove) that this happens in a 60-year-old lady with anemia and rheumatism due to arthritis.

Hello! Having started reading your question, it seemed that the reason had not been found, but then you write about rheumatism and arthritis, which may well be the cause of the acceleration of ESR. It’s not entirely clear, in this case, why go through all the examinations in a circle every time, but it is clear that surgery is being refused due to an inflammatory process in the body. If rheumatism is confirmed and the diagnosis is established, then the therapist understands the reason for the increase in ESR, so there is no point in proving anything. Your mother should try contacting a rheumatologist, who can tell you whether surgery, a stay in a sanatorium, etc. is possible, acting as an expert in this case.