ESR 49 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?

ESR, or Erythrocyte Sedimentation Rate, is measured by collecting a small blood sample from the patient's arm, usually from a vein. Before the blood draw, the area is cleaned with an antiseptic solution to ensure a sterile collection. Once obtained, the blood is mixed with an anticoagulant to prevent clotting. The prepared blood sample is then placed in a tall, thin tube, which is positioned upright to allow red blood cells to settle over a specific period, often one hour. The distance the red blood cells travel in the tube during this time is carefully measured, and the settling rate is recorded. The Westergren method, a widely recognized technique for ESR measurement, involves the use of a specialized Westergren tube for blood collection. In preparation for the test, patients are usually advised to communicate any medications they are taking to their healthcare provider, as certain drugs can influence the results. Fasting is not mandatory for ESR, but maintaining hydration is recommended to facilitate an efficient blood draw and ensure accurate results. ESR is an essential diagnostic tool, providing healthcare professionals with valuable information to assess and monitor inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 49 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 49

Normal Range and Grading for Adult Women : ESR 49

Normal Range and Grading for Children : ESR 49

What does an ESR of 49 mm/hr mean?

An ESR level of 49 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 49 mm/hr good?

An ESR of 49 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 49 mm/hr bad?

An ESR of 49 is bad in all populations and should be further investigated.

Is an ESR of 49 mm/hr dangerous?

An ESR of 49 is elevated but not necessarily dangerous

Is an ESR of 49 mm/hr normal?

An ESR of 49 is not normal and is classified as elevated.

What are the causes of an ESR of 49 mm/hr?

An ESR of 49 can have various causing including the following

Inflammatory Bowel Disease

Conditions like Crohn's disease and ulcerative colitis can cause elevated ESR.

Pregnancy

ESR levels can be higher during pregnancy.

Tissue injury

Any injury or trauma to tissues can result in an elevated ESR.

Myeloma

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

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Inflammation

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

Autoimmune Disorders

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

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Temporal Arteritis

An inflammatory condition affecting the blood vessels.

Liver Disease

Certain liver conditions can be associated with higher ESR.

What are the causes for a falsely elevated ESR value of 49?

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

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.

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.

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.

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.

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.

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.

Recent Vaccination

Vaccination stimulates the immune system, triggering an inflammatory response. This immune activity can lead to a temporary increase in ESR levels as part of the body's natural defense mechanism. The elevation is usually transient and not indicative of a pathological condition.

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.

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.

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.

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.

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.

What does an ESR of 49 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 49 can be classified as below.
If you are in the first three months of pregnancy an ESR of 49 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 49 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 49 is normal

What are the symptoms of an ESR of 49 ?

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 49

Photosensitivity

Increased sensitivity to sunlight.

Fatigue

Persistent tiredness and lack of energy.

Fever

Elevated body temperature beyond normal range.

Dizziness

Feeling lightheaded or unsteady.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Recurrent Infections

Frequent or persistent infections.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Loss of Appetite

Decreased desire to eat.

Night Sweats

Excessive sweating during sleep.

Cognitive Impairment

Memory problems or difficulty concentrating.

Headaches

Recurrent or persistent headaches.

Skin Rashes

Unexplained skin eruptions or changes.

Depression

Persistent feelings of sadness or hopelessness.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Nausea and Vomiting

Feeling of sickness and vomiting.

Abdominal Pain

Discomfort or pain in the abdominal region.

Hair Loss

Unexplained loss of hair.

Muscle Aches

Generalized or localized pain in muscles.

Neurological Symptoms

Tingling, numbness, or weakness.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Mouth Ulcers

Sores in the mouth that may be painful.

Shortness of Breath

Difficulty breathing or breathlessness.

Which foods can reduce an ESR of 49 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.

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.

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.

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.

Legumes

Legumes, such as lentils and chickpeas, are high in phytochemicals. These compounds have anti-inflammatory effects, making legumes an essential part of the Mediterranean diet for promoting a healthier lifestyle.

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 49 mm/hr ?

For an ESR of 49, 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 49

What is my ESR:CRP ratio for an ESR of 49 mm/hr ?

ESR	CRP	Ratio	Means
49	1.0	49.0	More likely to be autoimmune disease flareup of SLE
49	1.5	32.666666666666664	More likely to be autoimmune disease flareup of SLE
49	2.0	24.5	More likely to be autoimmune disease flareup of SLE
49	2.5	19.6	More likely to be autoimmune disease flareup of SLE
49	3.0	16.333333333333332	More likely to be autoimmune disease flareup of SLE
49	3.5	14.0	Inconclusive
49	4.0	12.25	Inconclusive
49	4.5	10.88888888888889	Inconclusive
49	5.0	9.8	Inconclusive
49	5.5	8.909090909090908	Inconclusive
49	6.0	8.166666666666666	Inconclusive
49	6.5	7.538461538461538	Inconclusive
49	7.0	7.0	Inconclusive
49	7.5	6.533333333333333	Inconclusive
49	8.0	6.125	Inconclusive
49	8.5	5.764705882352941	Inconclusive
49	9.0	5.444444444444445	Inconclusive
49	9.5	5.157894736842105	Inconclusive
49	10.0	4.9	Inconclusive
49	10.5	4.666666666666667	Inconclusive
49	11.0	4.454545454545454	Inconclusive
49	11.5	4.260869565217392	Inconclusive
49	12.0	4.083333333333333	Inconclusive
49	12.5	3.92	Inconclusive
49	13.0	3.769230769230769	Inconclusive
49	13.5	3.6296296296296298	Inconclusive
49	14.0	3.5	Inconclusive
49	14.5	3.3793103448275863	Inconclusive
49	15.0	3.2666666666666666	Inconclusive
49	15.5	3.161290322580645	Inconclusive
49	16.0	3.0625	Inconclusive
49	16.5	2.9696969696969697	Inconclusive
49	17.0	2.8823529411764706	Inconclusive
49	17.5	2.8	Inconclusive
49	18.0	2.7222222222222223	Inconclusive
49	18.5	2.6486486486486487	Inconclusive
49	19.0	2.5789473684210527	Inconclusive
49	19.5	2.5128205128205128	Inconclusive
49	20.0	2.45	Inconclusive
49	20.5	2.3902439024390243	Inconclusive
49	21.0	2.3333333333333335	Inconclusive
49	21.5	2.2790697674418605	Inconclusive
49	22.0	2.227272727272727	Inconclusive
49	22.5	2.1777777777777776	Inconclusive
49	23.0	2.130434782608696	Inconclusive
49	23.5	2.0851063829787235	Inconclusive
49	24.0	2.0416666666666665	Inconclusive
49	24.5	2.0	More likely to be infection
49	25.0	1.96	More likely to be infection
49	25.5	1.9215686274509804	More likely to be infection
49	26.0	1.8846153846153846	More likely to be infection
49	26.5	1.849056603773585	More likely to be infection
49	27.0	1.8148148148148149	More likely to be infection
49	27.5	1.7818181818181817	More likely to be infection
49	28.0	1.75	More likely to be infection
49	28.5	1.719298245614035	More likely to be infection
49	29.0	1.6896551724137931	More likely to be infection
49	29.5	1.6610169491525424	More likely to be infection