ESR 39 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 39 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 39

Normal Range and Grading for Adult Women : ESR 39

Normal Range and Grading for Children : ESR 39

What does an ESR of 39 mm/hr mean?

An ESR level of 39 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 39 mm/hr good?

An ESR of 39 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 39 mm/hr bad?

An ESR of 39 is bad in all populations and should be further investigated.

Is an ESR of 39 mm/hr dangerous?

An ESR of 39 is elevated but not necessarily dangerous

Is an ESR of 39 mm/hr normal?

An ESR of 39 is not normal and is classified as elevated.

What are the causes of an ESR of 39 mm/hr?

An ESR of 39 can have various causing including the following

Pregnancy

ESR levels can be higher during pregnancy.

Bronchiectasis

A chronic lung condition characterized by damaged airways.

Behçet's Disease

A rare inflammatory disorder causing blood vessel inflammation.

Myeloma

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Inflammation

Any inflammatory condition in the body can cause an elevation in ESR.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Anemia

Certain types of anemia, such as sickle cell anemia, can be associated with an elevated ESR.

Obesity

Higher body mass index (BMI) has been associated with increased ESR.

Certain Cancers

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

Certain Medications

Some medications, such as corticosteroids, can influence ESR levels.

Hepatitis

Inflammation of the liver, often caused by viral infections.

What are the causes for a falsely elevated ESR value of 39?

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

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.

Strenuous Exercise

Intense physical activity, especially when not part of the routine, can cause muscle and tissue damage, triggering an inflammatory response. This acute inflammation can lead to a temporary increase in ESR. Regular exercise, however, generally has a positive impact on overall health.

Hormonal Fluctuations

Beyond the menstrual cycle, fluctuations in hormonal levels can occur due to various factors, including stress, medication changes, or natural hormonal variations. These hormonal shifts may influence the inflammatory response and contribute to variations in ESR levels.

Sleep Deprivation

Lack of sleep can be associated with changes in inflammatory markers, including ESR. Sleep deprivation disrupts the body's natural regulatory processes, affecting the immune system and potentially leading to an elevation in ESR. Prioritizing sufficient and quality sleep is crucial for overall health.

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.

Obesity

Obesity is linked to chronic low-grade inflammation, and individuals with higher body mass indexes (BMIs) may experience elevated ESR levels. Adipose tissue releases inflammatory molecules, influencing the overall inflammatory status in the body. Maintaining a healthy weight is crucial for overall well-being.

Sun Exposure

Exposure to sunlight influences vitamin D levels in the body, which in turn can affect the immune system and inflammatory response. Changes in ESR levels related to sun exposure highlight the interconnectedness of environmental factors and inflammation.

Menstrual Cycle

Throughout the menstrual cycle, hormonal fluctuations, especially variations in estrogen levels, can influence the inflammatory response in the body, leading to periodic changes in ESR. This is particularly noticeable during the menstrual period.

Emotional Factors

Emotional stress and psychological factors can influence the body's inflammatory response, potentially leading to a temporary increase in ESR. The mind-body connection underscores the importance of mental health for overall well-being.

Ovulation

The process of ovulation in the menstrual cycle involves hormonal changes that can affect ESR levels. Fluctuations in estrogen and progesterone during ovulation contribute to variations in the inflammatory response, leading to changes in ESR.

Circadian Rhythms

ESR levels can vary throughout the day due to natural circadian rhythms. The body's internal clock influences various physiological processes, including inflammation. Understanding these fluctuations helps in interpreting ESR results accurately.

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.

What does an ESR of 39 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 39 can be classified as below.
If you are in the first three months of pregnancy an ESR of 39 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 39 is normal
If you are in the third trimester or months 7-9 of pregnancy an ESR of 39 is normal

What are the symptoms of an ESR of 39 ?

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 39

Fever

Elevated body temperature beyond normal range.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Fatigue

Persistent tiredness and lack of energy.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Neurological Symptoms

Tingling, numbness, or weakness.

Mouth Ulcers

Sores in the mouth that may be painful.

Abdominal Pain

Discomfort or pain in the abdominal region.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Loss of Appetite

Decreased desire to eat.

Depression

Persistent feelings of sadness or hopelessness.

Recurrent Infections

Frequent or persistent infections.

Photosensitivity

Increased sensitivity to sunlight.

Skin Rashes

Unexplained skin eruptions or changes.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Headaches

Recurrent or persistent headaches.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Muscle Aches

Generalized or localized pain in muscles.

Frequent Urination

Increased need to urinate.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Cough

Persistent or chronic coughing.

Vision Changes

Blurred vision or other visual disturbances.

Dizziness

Feeling lightheaded or unsteady.

Night Sweats

Excessive sweating during sleep.

Hair Loss

Unexplained loss of hair.

Nausea and Vomiting

Feeling of sickness and vomiting.

Which foods can reduce an ESR of 39 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 39 mm/hr ?

For an ESR of 39, 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 39

What is my ESR:CRP ratio for an ESR of 39 mm/hr ?

ESR	CRP	Ratio	Means
39	1.0	39.0	More likely to be autoimmune disease flareup of SLE
39	1.5	26.0	More likely to be autoimmune disease flareup of SLE
39	2.0	19.5	More likely to be autoimmune disease flareup of SLE
39	2.5	15.6	More likely to be autoimmune disease flareup of SLE
39	3.0	13.0	Inconclusive
39	3.5	11.142857142857142	Inconclusive
39	4.0	9.75	Inconclusive
39	4.5	8.666666666666666	Inconclusive
39	5.0	7.8	Inconclusive
39	5.5	7.090909090909091	Inconclusive
39	6.0	6.5	Inconclusive
39	6.5	6.0	Inconclusive
39	7.0	5.571428571428571	Inconclusive
39	7.5	5.2	Inconclusive
39	8.0	4.875	Inconclusive
39	8.5	4.588235294117647	Inconclusive
39	9.0	4.333333333333333	Inconclusive
39	9.5	4.105263157894737	Inconclusive
39	10.0	3.9	Inconclusive
39	10.5	3.7142857142857144	Inconclusive
39	11.0	3.5454545454545454	Inconclusive
39	11.5	3.391304347826087	Inconclusive
39	12.0	3.25	Inconclusive
39	12.5	3.12	Inconclusive
39	13.0	3.0	Inconclusive
39	13.5	2.888888888888889	Inconclusive
39	14.0	2.7857142857142856	Inconclusive
39	14.5	2.689655172413793	Inconclusive
39	15.0	2.6	Inconclusive
39	15.5	2.5161290322580645	Inconclusive
39	16.0	2.4375	Inconclusive
39	16.5	2.3636363636363638	Inconclusive
39	17.0	2.2941176470588234	Inconclusive
39	17.5	2.2285714285714286	Inconclusive
39	18.0	2.1666666666666665	Inconclusive
39	18.5	2.108108108108108	Inconclusive
39	19.0	2.0526315789473686	Inconclusive
39	19.5	2.0	More likely to be infection
39	20.0	1.95	More likely to be infection
39	20.5	1.9024390243902438	More likely to be infection
39	21.0	1.8571428571428572	More likely to be infection
39	21.5	1.813953488372093	More likely to be infection
39	22.0	1.7727272727272727	More likely to be infection
39	22.5	1.7333333333333334	More likely to be infection
39	23.0	1.6956521739130435	More likely to be infection
39	23.5	1.6595744680851063	More likely to be infection
39	24.0	1.625	More likely to be infection
39	24.5	1.5918367346938775	More likely to be infection
39	25.0	1.56	More likely to be infection
39	25.5	1.5294117647058822	More likely to be infection
39	26.0	1.5	More likely to be infection
39	26.5	1.471698113207547	More likely to be infection
39	27.0	1.4444444444444444	More likely to be infection
39	27.5	1.4181818181818182	More likely to be infection
39	28.0	1.3928571428571428	More likely to be infection
39	28.5	1.368421052631579	More likely to be infection
39	29.0	1.3448275862068966	More likely to be infection
39	29.5	1.3220338983050848	More likely to be infection