ESR 57 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 57 means, together with its causes, false elevations and whether it is good, bad or normal. We also delve into reasons for false elevation of ESR, and explain the significance of an ESR of 57 in pregnancy. We conclude with the ESR to CRP ratio that can help distinguish an infection from SLE.

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 57 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 57

Range	Classification	Comments
0 to 20	Normal
20-80	Elevated	You are here
>80	Very High

Normal Range and Grading for Adult Women : ESR 57

Range	Classification	Comments
0 to 20	Normal
20 to 30	Normal above 50 years of age, slightly elevated below 50 years of age
30-80	Elevated	You are here
>80	Very High

Normal Range and Grading for Children : ESR 57

Range	Classification	Comments
0 to 10	Normal
10-80	Elevated	You are here
>80	Very High

What does an ESR of 57 mm/hr mean?

An ESR level of 57 is considered to be significantly elevated. A cause must be found for the elevated ESR, while ruling out normal or physiological causes. An ESR between 50 and 80, is definitely not normal and must be further investigated together with additional tests, that are listed in a subsequent section.

Is an ESR of 57 mm/hr good?

An ESR of 57 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 57 mm/hr bad?

An ESR of 57 is bad in all populations and should be further investigated.

Is an ESR of 57 mm/hr dangerous?

An ESR of 57 is elevated but not necessarily dangerous

Is an ESR of 57 mm/hr normal?

An ESR of 57 is not normal and is classified as elevated.

What are the causes of an ESR of 57 mm/hr?

An ESR of 57 can have various causing including the following

Bronchiectasis

A chronic lung condition characterized by damaged airways.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Certain Cancers

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

Temporal Arteritis

An inflammatory condition affecting the blood vessels.

Certain Medications

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

Heart Disease

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

Chronic Obstructive Pulmonary Disease (COPD)

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

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Dehydration

Though less common, dehydration can affect blood viscosity and ESR.

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.

Lymphoma

A type of cancer that originates in the lymphatic system.

What are the causes for a falsely elevated ESR value of 57?

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

What does an ESR of 57 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 57 can be classified as below.
If you are in the first three months of pregnancy an ESR of 57 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 57 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 57 is normal

What are the symptoms of an ESR of 57 ?

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 57

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Mouth Ulcers

Sores in the mouth that may be painful.

Chest Pain

Pain or discomfort in the chest area.

Neurological Symptoms

Tingling, numbness, or weakness.

Skin Rashes

Unexplained skin eruptions or changes.

Fever

Elevated body temperature beyond normal range.

Cognitive Impairment

Memory problems or difficulty concentrating.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Hair Loss

Unexplained loss of hair.

Dizziness

Feeling lightheaded or unsteady.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Night Sweats

Excessive sweating during sleep.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Muscle Aches

Generalized or localized pain in muscles.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Loss of Appetite

Decreased desire to eat.

Photosensitivity

Increased sensitivity to sunlight.

Nausea and Vomiting

Feeling of sickness and vomiting.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Vision Changes

Blurred vision or other visual disturbances.

Cough

Persistent or chronic coughing.

Frequent Urination

Increased need to urinate.

Headaches

Recurrent or persistent headaches.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Recurrent Infections

Frequent or persistent infections.

Which foods can reduce an ESR of 57 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.

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.

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 57 mm/hr ?

For an ESR of 57, 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

Test	Description
High Sensitivity CRP	High Sensitivity C-Reactive Protein (CRP) test measures inflammation in the body.
LDH	Lactate Dehydrogenase (LDH) test assesses tissue damage and disease and inflammation in the body
Ferritin	Ferritin test measures the levels of iron storage in the body, as well as the level of inflammation in the body.

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 57

What is my ESR:CRP ratio for an ESR of 57 mm/hr ?

ESR	CRP	Ratio	Means
57	1.0	57.0	More likely to be autoimmune disease flareup of SLE
57	1.5	38.0	More likely to be autoimmune disease flareup of SLE
57	2.0	28.5	More likely to be autoimmune disease flareup of SLE
57	2.5	22.8	More likely to be autoimmune disease flareup of SLE
57	3.0	19.0	More likely to be autoimmune disease flareup of SLE
57	3.5	16.285714285714285	More likely to be autoimmune disease flareup of SLE
57	4.0	14.25	Inconclusive
57	4.5	12.666666666666666	Inconclusive
57	5.0	11.4	Inconclusive
57	5.5	10.363636363636363	Inconclusive
57	6.0	9.5	Inconclusive
57	6.5	8.76923076923077	Inconclusive
57	7.0	8.142857142857142	Inconclusive
57	7.5	7.6	Inconclusive
57	8.0	7.125	Inconclusive
57	8.5	6.705882352941177	Inconclusive
57	9.0	6.333333333333333	Inconclusive
57	9.5	6.0	Inconclusive
57	10.0	5.7	Inconclusive
57	10.5	5.428571428571429	Inconclusive
57	11.0	5.181818181818182	Inconclusive
57	11.5	4.956521739130435	Inconclusive
57	12.0	4.75	Inconclusive
57	12.5	4.56	Inconclusive
57	13.0	4.384615384615385	Inconclusive
57	13.5	4.222222222222222	Inconclusive
57	14.0	4.071428571428571	Inconclusive
57	14.5	3.9310344827586206	Inconclusive
57	15.0	3.8	Inconclusive
57	15.5	3.6774193548387095	Inconclusive
57	16.0	3.5625	Inconclusive
57	16.5	3.4545454545454546	Inconclusive
57	17.0	3.3529411764705883	Inconclusive
57	17.5	3.257142857142857	Inconclusive
57	18.0	3.1666666666666665	Inconclusive
57	18.5	3.081081081081081	Inconclusive
57	19.0	3.0	Inconclusive
57	19.5	2.923076923076923	Inconclusive
57	20.0	2.85	Inconclusive
57	20.5	2.7804878048780486	Inconclusive
57	21.0	2.7142857142857144	Inconclusive
57	21.5	2.6511627906976742	Inconclusive
57	22.0	2.590909090909091	Inconclusive
57	22.5	2.533333333333333	Inconclusive
57	23.0	2.4782608695652173	Inconclusive
57	23.5	2.425531914893617	Inconclusive
57	24.0	2.375	Inconclusive
57	24.5	2.326530612244898	Inconclusive
57	25.0	2.28	Inconclusive
57	25.5	2.235294117647059	Inconclusive
57	26.0	2.1923076923076925	Inconclusive
57	26.5	2.150943396226415	Inconclusive
57	27.0	2.111111111111111	Inconclusive
57	27.5	2.0727272727272728	Inconclusive
57	28.0	2.0357142857142856	Inconclusive
57	28.5	2.0	More likely to be infection
57	29.0	1.9655172413793103	More likely to be infection
57	29.5	1.9322033898305084	More likely to be infection

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