ESR 33 mm/hr means : is it normal, good, bad or dangerous?

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

Updated Date : 2023-12-02T13:31:03.637+00:00

What is ESR?

How is ESR measured?

The measurement of Erythrocyte Sedimentation Rate (ESR) involves the collection of a small blood sample from the patient's arm, typically drawn from a vein. Before the blood draw, the area is meticulously cleaned with an antiseptic solution to maintain sterility. Following the collection, the blood is mixed with an anticoagulant to prevent clotting. Subsequently, the prepared blood sample is placed in a tall, thin tube, which is then positioned upright. This allows red blood cells to settle over a specified period, usually one hour. The distance the red blood cells travel in the tube during this time is measured, and the settling rate is recorded. The Westergren method, a commonly employed technique for ESR measurement, uses a specialized Westergren tube for blood collection. To prepare for the test, patients are generally advised to inform their healthcare provider about any medications they are taking, as certain drugs can impact the results. While fasting is not obligatory for ESR, maintaining adequate hydration is recommended to ensure a smooth blood draw and accurate results. ESR is a vital diagnostic tool, offering healthcare professionals valuable insights into inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 33 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 33

Normal Range and Grading for Adult Women : ESR 33

Normal Range and Grading for Children : ESR 33

What does an ESR of 33 mm/hr mean?

An ESR level of 33 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 an ESR of 33 mm/hr good?

An ESR of 33 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 33 mm/hr bad?

An ESR of 33 is bad in all populations and should be further investigated.

Is an ESR of 33 mm/hr dangerous?

An ESR of 33 is elevated but not necessarily dangerous

Is an ESR of 33 mm/hr normal?

An ESR of 33 is not normal and is classified as elevated.

What are the causes of an ESR of 33 mm/hr?

An ESR of 33 can have various causing including the following

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Myeloma

A type of cancer that affects plasma cells in the bone marrow.

Lymphoma

A type of cancer that originates in the lymphatic system.

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Vasculitis

Inflammation of blood vessels.

Infection

Both acute and chronic infections can lead to an increased ESR.

HIV/AIDS

The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) can lead to immune system dysfunction and inflammation.

Certain Cancers

Some cancers, especially those associated with inflammation, can cause an increase in ESR.

Chronic Obstructive Pulmonary Disease (COPD)

Inflammatory changes in the lungs can lead to an increased ESR.

Aging

ESR tends to increase with age, and mild elevation may be normal in elderly individuals.

Autoimmune Disorders

Conditions like rheumatoid arthritis and systemic lupus erythematosus can cause inflammation and elevate ESR.

Heart Disease

Inflammatory changes in the cardiovascular system may contribute to an elevated ESR.

What are the causes for a falsely elevated ESR value of 33?

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

Lack of Physical Activity

A sedentary lifestyle or lack of physical activity can impact overall health, including inflammatory markers like ESR. Regular exercise has anti-inflammatory effects and is crucial for maintaining a healthy balance in the body's immune response.

Menopause

The hormonal changes associated with menopause, including a decline in estrogen levels, can impact the inflammatory response in the body. These changes may contribute to alterations in ESR levels, reflecting the natural physiological transition of menopause.

Race/Ethnicity

ESR levels can exhibit variations among different racial and ethnic groups. Genetic and environmental factors specific to certain populations may contribute to these differences. However, individual health and lifestyle choices remain crucial factors influencing ESR levels.

Sleep Patterns

Disruptions in sleep patterns, including irregular sleep duration and quality, can influence the body's inflammatory response. Sleep deprivation or poor sleep hygiene may contribute to elevated ESR levels. Prioritizing good sleep habits is essential for overall health.

Genetic Factors

Genetic variations can contribute to individual differences in baseline ESR levels. While genetics play a role, lifestyle factors and overall health also significantly influence ESR. Understanding genetic predispositions can provide insights into an individual's inflammatory response.

Dehydration

Dehydration can result in reduced plasma volume, affecting blood viscosity. This change in blood composition may lead to an elevation in ESR. It's essential to maintain proper hydration levels for overall health and accurate blood test results.

Temperature Changes

Extreme temperatures, whether due to fever or exposure to cold, can affect the viscosity of blood. These temperature-related changes can influence ESR levels. Monitoring body temperature and addressing the underlying cause is important for accurate interpretation of ESR results.

Pregnancy

During pregnancy, the body undergoes significant hormonal and physiological changes. The increased blood volume, hormonal fluctuations, and immune system adaptations can contribute to higher ESR levels. This elevation is often considered normal in pregnant individuals.

Iron Deficiency

Mild iron deficiency can affect the composition of blood, potentially leading to changes in ESR levels. Adequate iron levels are essential for overall health, and addressing iron deficiency is important for maintaining optimal blood parameters.

Hormonal Contraceptives

The use of hormonal contraceptives can impact hormonal levels in the body, potentially affecting the inflammatory response. This can lead to variations in ESR levels in some individuals. It's important for healthcare providers to consider these factors when interpreting ESR results in individuals using hormonal contraceptives.

Smoking

Smoking has been associated with higher ESR levels in some individuals. The chemicals in tobacco smoke can induce inflammation and oxidative stress, contributing to an elevated ESR. Quitting smoking has numerous health benefits, including potential improvements in inflammatory markers.

Altitude Changes

Changes in altitude can impact oxygen levels in the blood, influencing the inflammatory response. These altitude-related changes may contribute to variations in ESR levels. Adjusting to altitude and maintaining proper hydration are important considerations.

What does an ESR of 33 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 33 can be classified as below.
If you are in the first three months of pregnancy an ESR of 33 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 33 is normal
If you are in the third trimester or months 7-9 of pregnancy an ESR of 33 is normal

What are the symptoms of an ESR of 33 ?

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 33

Abdominal Pain

Discomfort or pain in the abdominal region.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Neurological Symptoms

Tingling, numbness, or weakness.

Mouth Ulcers

Sores in the mouth that may be painful.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Vision Changes

Blurred vision or other visual disturbances.

Fatigue

Persistent tiredness and lack of energy.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Shortness of Breath

Difficulty breathing or breathlessness.

Chest Pain

Pain or discomfort in the chest area.

Night Sweats

Excessive sweating during sleep.

Muscle Aches

Generalized or localized pain in muscles.

Recurrent Infections

Frequent or persistent infections.

Hair Loss

Unexplained loss of hair.

Loss of Appetite

Decreased desire to eat.

Nausea and Vomiting

Feeling of sickness and vomiting.

Cough

Persistent or chronic coughing.

Photosensitivity

Increased sensitivity to sunlight.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Frequent Urination

Increased need to urinate.

Dizziness

Feeling lightheaded or unsteady.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Fever

Elevated body temperature beyond normal range.

Cognitive Impairment

Memory problems or difficulty concentrating.

Which foods can reduce an ESR of 33 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.

Fruits

Various fruits, including citrus fruits and berries, are packed with vitamins, minerals, and antioxidants. Their consumption is associated with reduced inflammation, aligning with the Mediterranean diet's focus on whole, nutrient-dense foods.

Whole Grains

Whole grains are a key component of the Mediterranean diet, providing essential nutrients and fiber. They contribute to reducing inflammation and promoting overall health.

Nuts

Nuts, like almonds and walnuts, are rich in healthy fats and antioxidants. They contribute to the anti-inflammatory effects of the Mediterranean diet, supporting heart health and overall well-being.

Fatty Fish

Fatty fish, such as salmon and mackerel, are rich in omega-3 fatty acids. These acids have anti-inflammatory properties, making fatty fish an excellent choice in the Mediterranean diet to combat inflammation.

Probiotics

Foods enriched with probiotics, like yogurt and fermented products, support a healthy gut microbiome. A balanced gut contributes to reduced inflammation and improved overall well-being, aligning with the principles of the Mediterranean diet.

Vegetables

A diverse array of vegetables is a cornerstone of the Mediterranean diet. They provide essential nutrients and phytochemicals that contribute to reducing inflammation and supporting overall health.

What other tests should be done with an ESR of 33 mm/hr ?

For an ESR of 33, 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

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 mm/hr 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 33

What is my ESR:CRP ratio for an ESR of 33 mm/hr ?

ESR	CRP	Ratio	Means
33	1.0	33.0	More likely to be autoimmune disease flareup of SLE
33	1.5	22.0	More likely to be autoimmune disease flareup of SLE
33	2.0	16.5	More likely to be autoimmune disease flareup of SLE
33	2.5	13.2	Inconclusive
33	3.0	11.0	Inconclusive
33	3.5	9.428571428571429	Inconclusive
33	4.0	8.25	Inconclusive
33	4.5	7.333333333333333	Inconclusive
33	5.0	6.6	Inconclusive
33	5.5	6.0	Inconclusive
33	6.0	5.5	Inconclusive
33	6.5	5.076923076923077	Inconclusive
33	7.0	4.714285714285714	Inconclusive
33	7.5	4.4	Inconclusive
33	8.0	4.125	Inconclusive
33	8.5	3.8823529411764706	Inconclusive
33	9.0	3.6666666666666665	Inconclusive
33	9.5	3.473684210526316	Inconclusive
33	10.0	3.3	Inconclusive
33	10.5	3.142857142857143	Inconclusive
33	11.0	3.0	Inconclusive
33	11.5	2.869565217391304	Inconclusive
33	12.0	2.75	Inconclusive
33	12.5	2.64	Inconclusive
33	13.0	2.5384615384615383	Inconclusive
33	13.5	2.4444444444444446	Inconclusive
33	14.0	2.357142857142857	Inconclusive
33	14.5	2.2758620689655173	Inconclusive
33	15.0	2.2	Inconclusive
33	15.5	2.129032258064516	Inconclusive
33	16.0	2.0625	Inconclusive
33	16.5	2.0	More likely to be infection
33	17.0	1.9411764705882353	More likely to be infection
33	17.5	1.8857142857142857	More likely to be infection
33	18.0	1.8333333333333333	More likely to be infection
33	18.5	1.7837837837837838	More likely to be infection
33	19.0	1.736842105263158	More likely to be infection
33	19.5	1.6923076923076923	More likely to be infection
33	20.0	1.65	More likely to be infection
33	20.5	1.6097560975609757	More likely to be infection
33	21.0	1.5714285714285714	More likely to be infection
33	21.5	1.5348837209302326	More likely to be infection
33	22.0	1.5	More likely to be infection
33	22.5	1.4666666666666666	More likely to be infection
33	23.0	1.434782608695652	More likely to be infection
33	23.5	1.4042553191489362	More likely to be infection
33	24.0	1.375	More likely to be infection
33	24.5	1.346938775510204	More likely to be infection
33	25.0	1.32	More likely to be infection
33	25.5	1.2941176470588236	More likely to be infection
33	26.0	1.2692307692307692	More likely to be infection
33	26.5	1.2452830188679245	More likely to be infection
33	27.0	1.2222222222222223	More likely to be infection
33	27.5	1.2	More likely to be infection
33	28.0	1.1785714285714286	More likely to be infection
33	28.5	1.1578947368421053	More likely to be infection
33	29.0	1.1379310344827587	More likely to be infection
33	29.5	1.11864406779661	More likely to be infection