ESR 43 mm/hr means : is it normal, good, bad or dangerous?

Published Date : 2023-12-03T13:31:03.637Z

Updated Date : 2023-12-03T13:31:03.637+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 43 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 43

Normal Range and Grading for Adult Women : ESR 43

Normal Range and Grading for Children : ESR 43

What does an ESR of 43 mm/hr mean?

An ESR level of 43 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 43 mm/hr good?

An ESR of 43 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 43 mm/hr bad?

An ESR of 43 is bad in all populations and should be further investigated.

Is an ESR of 43 mm/hr dangerous?

An ESR of 43 is elevated but not necessarily dangerous

Is an ESR of 43 mm/hr normal?

An ESR of 43 is not normal and is classified as elevated.

What are the causes of an ESR of 43 mm/hr?

An ESR of 43 can have various causing including the following

Hepatitis

Inflammation of the liver, often caused by viral infections.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Myeloma

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

Obesity

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

Autoimmune Disorders

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

Vasculitis

Inflammation of blood vessels.

Aging

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

Certain Medications

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

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

HIV/AIDS

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

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Lymphoma

A type of cancer that originates in the lymphatic system.

What are the causes for a falsely elevated ESR value of 43?

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

Stress

Physiological stress triggers the release of stress hormones and inflammatory mediators, potentially leading to a temporary increase in ESR. Chronic stress can have negative effects on overall health, emphasizing the importance of stress management for well-being.

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.

Postpartum Period

In the postpartum period following childbirth, the body goes through a process of recovery and adaptation. Hormonal changes, including a decrease in pregnancy-related hormones, can contribute to temporary fluctuations in ESR levels.

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.

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.

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.

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.

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.

Dietary Factors

Nutritional status can influence ESR levels. Dietary factors such as certain vitamins, minerals, and antioxidants play a role in modulating the inflammatory response. A well-balanced and nutrient-rich diet is essential for maintaining overall health, including appropriate ESR levels.

Surgery

Postoperative recovery involves a complex interplay of physiological responses, including inflammation. Surgery can lead to a temporary increase in ESR as part of the body's natural healing process. Monitoring ESR levels post-surgery is a routine part of medical care.

Blood Donation

Recent blood donation can lead to a temporary decrease in the number of red blood cells, affecting blood viscosity. This change may contribute to a transient increase in ESR. Understanding the timing of blood donation is essential for accurate interpretation of ESR results.

Mild Infections

Low-grade or chronic infections may result in a subtle increase in ESR. The immune system responds to even minor infections by releasing inflammatory markers, influencing ESR levels. Monitoring for signs of infection and addressing underlying causes is crucial.

What does an ESR of 43 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 43 can be classified as below.
If you are in the first three months of pregnancy an ESR of 43 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 43 is normal
If you are in the third trimester or months 7-9 of pregnancy an ESR of 43 is normal

What are the symptoms of an ESR of 43 ?

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 43

Night Sweats

Excessive sweating during sleep.

Mouth Ulcers

Sores in the mouth that may be painful.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Vision Changes

Blurred vision or other visual disturbances.

Depression

Persistent feelings of sadness or hopelessness.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Abdominal Pain

Discomfort or pain in the abdominal region.

Muscle Aches

Generalized or localized pain in muscles.

Fatigue

Persistent tiredness and lack of energy.

Loss of Appetite

Decreased desire to eat.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Nausea and Vomiting

Feeling of sickness and vomiting.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Photosensitivity

Increased sensitivity to sunlight.

Shortness of Breath

Difficulty breathing or breathlessness.

Neurological Symptoms

Tingling, numbness, or weakness.

Recurrent Infections

Frequent or persistent infections.

Skin Rashes

Unexplained skin eruptions or changes.

Cognitive Impairment

Memory problems or difficulty concentrating.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Dizziness

Feeling lightheaded or unsteady.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Cough

Persistent or chronic coughing.

Hair Loss

Unexplained loss of hair.

Headaches

Recurrent or persistent headaches.

Which foods can reduce an ESR of 43 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 43 mm/hr ?

For an ESR of 43, 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 43

What is my ESR:CRP ratio for an ESR of 43 mm/hr ?

ESR	CRP	Ratio	Means
43	1.0	43.0	More likely to be autoimmune disease flareup of SLE
43	1.5	28.666666666666668	More likely to be autoimmune disease flareup of SLE
43	2.0	21.5	More likely to be autoimmune disease flareup of SLE
43	2.5	17.2	More likely to be autoimmune disease flareup of SLE
43	3.0	14.333333333333334	Inconclusive
43	3.5	12.285714285714286	Inconclusive
43	4.0	10.75	Inconclusive
43	4.5	9.555555555555555	Inconclusive
43	5.0	8.6	Inconclusive
43	5.5	7.818181818181818	Inconclusive
43	6.0	7.166666666666667	Inconclusive
43	6.5	6.615384615384615	Inconclusive
43	7.0	6.142857142857143	Inconclusive
43	7.5	5.733333333333333	Inconclusive
43	8.0	5.375	Inconclusive
43	8.5	5.0588235294117645	Inconclusive
43	9.0	4.777777777777778	Inconclusive
43	9.5	4.526315789473684	Inconclusive
43	10.0	4.3	Inconclusive
43	10.5	4.095238095238095	Inconclusive
43	11.0	3.909090909090909	Inconclusive
43	11.5	3.739130434782609	Inconclusive
43	12.0	3.5833333333333335	Inconclusive
43	12.5	3.44	Inconclusive
43	13.0	3.3076923076923075	Inconclusive
43	13.5	3.185185185185185	Inconclusive
43	14.0	3.0714285714285716	Inconclusive
43	14.5	2.9655172413793105	Inconclusive
43	15.0	2.8666666666666667	Inconclusive
43	15.5	2.774193548387097	Inconclusive
43	16.0	2.6875	Inconclusive
43	16.5	2.606060606060606	Inconclusive
43	17.0	2.5294117647058822	Inconclusive
43	17.5	2.4571428571428573	Inconclusive
43	18.0	2.388888888888889	Inconclusive
43	18.5	2.324324324324324	Inconclusive
43	19.0	2.263157894736842	Inconclusive
43	19.5	2.2051282051282053	Inconclusive
43	20.0	2.15	Inconclusive
43	20.5	2.097560975609756	Inconclusive
43	21.0	2.0476190476190474	Inconclusive
43	21.5	2.0	More likely to be infection
43	22.0	1.9545454545454546	More likely to be infection
43	22.5	1.9111111111111112	More likely to be infection
43	23.0	1.8695652173913044	More likely to be infection
43	23.5	1.8297872340425532	More likely to be infection
43	24.0	1.7916666666666667	More likely to be infection
43	24.5	1.7551020408163265	More likely to be infection
43	25.0	1.72	More likely to be infection
43	25.5	1.6862745098039216	More likely to be infection
43	26.0	1.6538461538461537	More likely to be infection
43	26.5	1.6226415094339623	More likely to be infection
43	27.0	1.5925925925925926	More likely to be infection
43	27.5	1.5636363636363637	More likely to be infection
43	28.0	1.5357142857142858	More likely to be infection
43	28.5	1.5087719298245614	More likely to be infection
43	29.0	1.4827586206896552	More likely to be infection
43	29.5	1.4576271186440677	More likely to be infection