ESR 32 means : Is ESR 32 dangerous - causes, symptoms

Published Date : 2023-12-02T13:31:03.637Z

Updated Date : 2024-05-15T19:05:00.525+05:30

What is ESR?

ESR, stands for Erythrocyte Sedimentation Rate. It is the rate or speed at which red blood cells (erythrocytes) settle down to the bottom of a standardized tube. ESR measures how fast the cells go down by gravity. This speed depends on many factors like what kind of other proteins are present in the blood and in what amounts.

ESR is measured by the ESR test, a commonly performed test in many laboratories.

The test is important because it is a measure of inflammation or infection - the value of ESR is usually high in conditions like cancers, tuberculosis, infections, fevers and also in anemia and advanced age.

It is a common test in many blood test panels, and is usually done to rule out infection or inflammation as a cause of your symptoms

The test usually takes upto an hour to perform, but as far as the patient is concerned, all it needs is a single blood sample.

How is ESR measured?

ESR is measured in a laboratory by trained personnel. To measure ESR the laboratory will need a sample of your blood, as this is a test done on your blood

The blood sample is collected by a needle or syringe, and about 3-4ml of blood is aspirated into a vacuum tube

The blood is then transferred into a glass tube, that is of a certain material, size and height. The ESR is a measure of how fast your blood settles to the bottom of this tube

Over time a clear portion emerges at the upper end of the tube, and the red cells settle at the bottom

The length of the clear portion is measured and it is then entered into your report as the ESR in mm per hour

What is the normal range of ESR and how is an ESR of 32 graded?

Different sources mention slightly different normal ranges for ESR. The normal range also varies slightly based on the method of measurement. When measured by the Westergren method, the normal range for ESR is mentioned below for adult males, adult females and children.

Normal Range and Grading for Adult Males : ESR 32 mm/hr

Normal Range and Grading for Adult Women : ESR 32 mm/hr

Normal Range and Grading for Children : ESR 32 mm/hr

What does an ESR of 32 mean?

An ESR level of 32 is considered to be above normal or elevated. Whilst, this may not be an immediate cause for worry, you should get a detailed physical and medical examination from a qualified medical practitioner. There are numerous reasons why the ESR may be above normal that are themselves normal, which are termed physiological causes, these are listed in a subsequent section.

Is ESR 32 good?

An ESR of 32 is not a good value. In adults, or children this value is above normal and needs investigating.

Is ESR 32 bad?

An ESR of 32 is bad in all populations and should be further investigated.

Is ESR 32 dangerous?

An ESR of 32 is elevated but not necessarily dangerous Note that an ESR is basically a measure of the thickness of your blood and itself is not a thing or an entity. It on its own will not harm you, rather the underlying cause is what needs to be investigated.

Is ESR 32 normal?

An ESR of 32 is not normal and is classified as elevated.

What are the causes of an ESR of 32 mm/hr?

An ESR of 32 can have various causing including the following :

• Aging : ESR is known to increase with age, and also is known to be higher in females. The value of ESR changes considerably after the age of 55-60 and is much higher in elderly patients or those who are very old.
• Certain Medications : Various medicines can impact your body's constitutional balance. These include medicines for inflammation, which can themselves alter the ESR. If you are on different types of medicines make sure to inform your doctor or laboratory before getting the ESR done.
• HIV/AIDS : The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a viral infection that is passed by sexual contact or through shared needles, or blood transfusiosn. Patients of this disease cannot fight off infections. ESR levels are often increased, in this condition, and more so in its later stages.
• Giant Cell Arteritis : In simple english, this is an inflammation of the blood vessel lining. It leads to symptoms in various organs and systems in the body. ESR is elevated due to the inflammation
• Bronchiectasis : A chronic lung condition characterized by damaged airways.
• Inflammatory Bowel Disease : Autoimmune diseases of the intestine, are called inflammatory bowel diseases. In these diseases there are small erosions in the intestine or gut. These lead to constipation and diarrhea both. If you have Inflammatory Bowel disease you may have an increased ESR.
• Tissue injury : Trauma, or acute injuries, like those in a road accident or burns, may also cause the ESR to rise as a part of the generalized inflammatory process.
• Lymphoma : This is a type of blood cancer, that leads to increased numbers of white cells. Most cancers lead to increased ESR levels, and lymphomas are often associated with an elevated ESR.
• Myeloma : A type of blood cancer, that affects the bones and many other organs in the body. Myelomas originate from plasma cells - cells that normally fight off infections. They cause a very big increase in ESR.
• Polymyalgia Rheumatica : This is an autoimmune disease in which there is pain in the muscles and joints. This disease shows an increased value for ESR
• Certain Cancers : Cancers are one of the most common reasons for an elevation in the ESR. Cancers usually cause a marked and sharp increase in the ESR, and are one of the first things to be suspected in people who dont have any of the other causes of ESR increase.
• Liver Disease : Certain liver conditions can be associated with higher ESR. Infections by viruses like Hepatits B and C can cause inflammation in the liver, and also increase the ESR level.

What are the causes for a falsely elevated ESR value of 32?

There are certain normal or physiological conditions in which the ESR May be falsely elevated or elevated without any abnormality.

• Recent Vaccination : Vaccination usually causes an initial period of fever and ill health for a couple of days. During this time the body's immune system reacts to the vaccine and starts making antibodies to the vaccine agent. In this period, the ESR will be raised as a consequence of the inflammation
• Menstrual Cycle : In females, ESR may show various fluctuations from normal during the menstrual cycle. During menses, there is a small rise in the ESR, due to the small amount of inflammation that accompanies the shedding of the uterine lining. This is expected as there is bleeding during the menstrual phase of the menstrual cycle.
• Smoking : Heavy smokers are found to have a higher ESR level, when all other factors are adjusted for. This is probably due to the low grade of inflammation produced by the chemicals found in smoke.
• Postpartum Period : During the first week after delivery, the body is still under stress. The mother's ESR and other markers of inflammation like fibrinogen are known to remain elevated. The cause is the process of childbirth, which puts the mother's body under strain.
• Obesity : Obesity is when your weight is too much for your height. People who are obese often suffer from metabolic syndrome, a condition with poor tolerance for sugar and fats. ESR is found to be increased in obese patients.
• Surgery : Any surgery that is done on the body, will trigger an inflammatory response. Major surgeries are associated with
• Menopause : ESR increases in women after meonopause, or the normal cessation of menstruation. Part of this is due to a drop in the levels of female hormones. Age is another factor, as advancing age is associated with higher ESR.
• Strenuous Exercise : Sudden, intense physical activity, of any kind, can lead to an inflammatory response from the body. Inflammation can be in the muscles, joints or tendons and this can lead to a rise in ESR. Patients are advised to avoid intense activity before providing their sample for the ESR test as it can cause significant deviations from the mean.
• Stress : An stress on the body like heavy exercise, emotional stress, a sudden illness and similar factors can produce an increase in the level of ESR.
• Race/Ethnicity : ESR levels have been found to be higher in blacks, as compared to whites. This difference is independent of all other factors like age, gender etc. Make sure to check with your doctor for more information.
• Dehydration : Dehydration leads to increased thickness of blood, this is because water is lost, so the blood becomes hyperviscous and thick. Dehydration can lead to increased ESR, as anything that makes the blood thicker, usually causes the ESR to increase.
• Aging : If you are above 55 years of age, your ESR is expected to be higher than normal. ESR increases progressively with increased age. The rise in ESR is attributed to age related wear and tear in the body, as well as age related anemias.

What does an ESR of 32 in pregnancy mean?

The normal range of ESR during pregnancy is different in the different months or trimesters of pregnancy. This is because pregnancy causes a small rise in the ESR, which is considered normal. The following table lists the normal ranges.

Trimester	Lower Limit	Upper Limit
1st	4	57
2nd	7	47
3rd	13	70

Based on these criteria, your ESR of 32 can be classified as below.
If you are in the first three months of pregnancy an ESR of 32 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 32 is normal
If you are in the third trimester or months 7-9 of pregnancy an ESR of 32 is normal

What are the symptoms of an ESR of 32 ?

ESR itself does not cause any direct symptoms. The symptoms of ESR are due the underlying disease process. The following is a list of symptoms that may be associated with an ESR of 32 :

• Dry Eyes and Mouth : These symptoms may be seen in some autoimmune diseases which will also lead to a rise in the ESR. The most common diseases causing this are the Sjogrens Syndrome.
• Recurrent Infections : This means repeatedly getting infections, and it can be a sign of a deficient immune system. These disorders may produce a rise in ESR as a part of the inflammatory proceses.
• Headaches : Severe headaches, especially in male patients above 50, may be a sign of an autoimmune disease of the blood vessels. If headaches are the only symptom, combined with an elevated ESR, then you should get yourself to a rheumatologist at soonest. Learn more about tests for headaches here.
• Difficulty Sleeping : Insomnia or disrupted sleep patterns.
• Irregular Menstrual Cycles : Changes in menstrual patterns for women.
• Cough : Chronic cough, or coughing persistently with other symptoms may be a common symptom that is linked with a rise in ESR.
• Dizziness : Feeling lightheaded or unsteady.
• Muscle Aches : Pain in the muscles may be a sign of an inflammatory process. Muscle pain is very hard to pinpoint, but it may be the beginning of a fever or infection. ESR is sometimes increased in injuries to multiple muscles like after an accident or fall.
• Skin Rashes : Autoimmune diseases may show skin rashes, such as SLE. This may be one of the rarer symptoms with a high ESR level
• Vision Changes : Blurred vision or other visual disturbances may be seen in some autoimmune diseases of the blood vessles in the head. These diseases produce headaches and a high ESR level
• Loss of Appetite : Decreased desire to eat is one of the most common symptoms of chronic infections. This is common in cancers, tuberculosis and some infections. This may be accompanied by a rise in ESR.
• Shortness of Breath : Shortness of breath or difficulty in breathing may be due to a chest infection, allergies, pneumonia or even tuberculosis. If accompanied by a high ESR level it may be a cause of concern.
• Fatigue : Feeling tired all the time is a feature of several of the causes of ESR. ESR itself does not cause any symptoms. Fatigue is commonly seen in anemia, cancers, infections and autoimmune diseases, all of which are the causes of a raised ESR.
• Abnormal Blood Counts : Changes in white blood cell count or other blood parameters.
• Photosensitivity : Increased sensitivity to sunlight.
• Night Sweats : Night sweats are a common symptom in Tuberculosis, as well as some tropical diseases. Night sweats, together with weight loss and an increased ESR are all suggestive of a chronic inflammatory process. Night sweats refer to waking up in bed, drenched in sweat, despite there being adequate cooling in the room. Tests for night sweats may shed more light on this symptom.
• Digestive Issues : Changes in your bowel habits, constipation and diarrhea ,if present, alternatingly are all signs of irritable bowel syndrome, which itself is often associated with an elevated ESR.
• Swollen Lymph Nodes : A very common sign seen in chronic diseases like Tuberculosis, some blood cancers are swollen lymph nodes. These are swellings in the neck region. ESR is often increased when the lymph nodes are swollen. Read about tests for swollen lymph nodes to know more.
• Nausea and Vomiting : Feeling of sickness and vomiting.
• Abdominal Pain : Pain in the stomach is a very non-specific complaint. If it is due to an infection or appendicites, it may be accompanied by a high ESR level.
• Neurological Symptoms : Tingling, numbness, or weakness.
• Joint Pain : Joint pain is often seen in Arthritis and different autoimmune disease that may be causing the rise in your ESR levels. Joint pain may be in the small joints of your hands or the bigger joints like shoulders or knees. Joint pains may also be seen in some infections like dengue, which can also cause a rise in ESR. Read about tests for joint pains to know more.
• Frequent Urination : Increased need to urinate.
• Unexplained Weight Loss : Loss of weight, without any change in your daily intake of calories or exercise is a cause of concern and is seen in many of the causes of ESR. Weight loss associated with rise in ESR is one of the cardinal signs of Tuberculosis. Tests for a sudden loss of weight may help you to learn more about your condition.

Which foods can reduce an ESR of 32 mm/hr?

Based on a study by Hulander et al, eating foods that lower inflammation can lead to a lowered value of ESR. The following foods can be consumed to try to reduce inflammation.

• Fatty Fish : Fish like salmon and mackarel are rich in Long Chain and omega fatty acids. These are natural anti-inflammatory agents and have been shown to reduce inflammatory markers both before and after food intake. A diet that mixes in balanced amounts of these foods, help to reduce inflammation and consequently ESR.
• Nuts : Walnuts, contain the highest content of plant-based polyunsaturated fatty acids (PUFAs), including ALA. Other nuts are also rich in anti inflammatory chemicals that help to reduce inflammation. This brings down the ESR levels.
• Vegetables : Vegetables are rich in fiber and minerals and vitamins. All are essential components of helping to combat oxidation and infections. This helps to bring down the ESR.
• Probiotics : Probiotic foods help to reduce inflammation, and specifically Reactive Oxygen Species, that are the cause of many of the components of inflammation. Reactive Oxygen species cause damage to tissues and inflammation. Probiotics improve the gut health and help reduce inflammation contributing to reduce ESR.
• Fruits : Various fruits, including citrus fruits and berries, are packed with vitamins, minerals, and antioxidants. Fruits also contain fiber and help reduce inflammation by combating oxidation. This, combined with various vitamins help to combat inflammation and tissue damage and will consequently bring down the ESR.
• Whole Grains : Whole grains are a great food to reduce inflammation in the body. They are packed with nutrients, anti oxidants, phytochemicals and dietary fiber, all of which are necessary to reduce chemicals responsible for information like CRP, interleukins and others. All these properties make them great foods to reduce inflammation and consequently reduce ESR, as long as its cause is inflammation. Consuming whole grains will not help if the cause of an elevated ESR is cancer, or a chronic infection which will have to be treated first.

What other tests should be done with an ESR of 32 ?

For an ESR of 32, other tests can be done to further ascertain the immune status of the body, as well as rule out infections or malignancies if any.
The following table lists other tests that can be done.

Lab Tests Related to ESR

Living with an ESR of 32

An elevated ESR level is not something you should take lightly or live with. If the cause is an infection or inflammation, this should be investigated or treated. If the cause is a chronic disease or a cancer, you should get medical advice. Consulting a medical practitioner is essential if your ESR remains at 32 for a prolonged period of time.

What is the ESR to CRP ratio and why does it matter?

The ESR to CRP ratio is the ratio of the Erythryocyte Sedimentation Rate in to the C-Reactive Protein Value. The ratio has value in patients with Systemic Lupus Erythematosus. If the value is below 2 it indicates that the patient has an infection in addition to the SLE. If the value is above 15 it is more likely to be a flare up of SLE. You can find the ratio calculated for various values of CRP given your ESR value of 32

What is my ESR:CRP ratio for an ESR of 32 ?

ESR	CRP	Ratio	Means
32	1.0	32.0	More likely to be autoimmune disease flareup of SLE
32	1.5	21.3	More likely to be autoimmune disease flareup of SLE
32	2.0	16.0	More likely to be autoimmune disease flareup of SLE
32	16.0	2.0	More likely to be infection
32	16.5	1.9	More likely to be infection
32	17.0	1.9	More likely to be infection
32	17.5	1.8	More likely to be infection
32	18.0	1.8	More likely to be infection
32	18.5	1.7	More likely to be infection
32	19.0	1.7	More likely to be infection
32	19.5	1.6	More likely to be infection
32	20.0	1.6	More likely to be infection
32	20.5	1.6	More likely to be infection
32	21.0	1.5	More likely to be infection
32	21.5	1.5	More likely to be infection
32	22.0	1.5	More likely to be infection
32	22.5	1.4	More likely to be infection
32	23.0	1.4	More likely to be infection
32	23.5	1.4	More likely to be infection
32	24.0	1.3	More likely to be infection
32	24.5	1.3	More likely to be infection
32	25.0	1.3	More likely to be infection
32	25.5	1.3	More likely to be infection
32	26.0	1.2	More likely to be infection
32	26.5	1.2	More likely to be infection
32	27.0	1.2	More likely to be infection
32	27.5	1.2	More likely to be infection
32	28.0	1.1	More likely to be infection
32	28.5	1.1	More likely to be infection
32	29.0	1.1	More likely to be infection
32	29.5	1.1	More likely to be infection

References

1. Dapper DV, Didia BC. Haemorheological changes during the menstrual cycle. East Afr Med J. 2002 Apr;79(4):181-3. doi: 10.4314/eamj.v79i4.8874. PMID: 12625671.
2. https://applications.emro.who.int/imemrf/Sci_Med_J_1991_3_1_171.pdf
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571720/