ESR 65 means : Is ESR 65 dangerous - causes, symptoms

Published Date : 2023-12-05T13:31:03.637Z

Updated Date : 2024-05-15T19:05:01.290+05:30

What is ESR?

ESR, stands for Erythrocyte Sedimentation Rate. It is the rate or speed at which red blood cells (erythrocytes) settle down to the bottom of a standardized tube. ESR measures how fast the cells go down by gravity. This speed depends on many factors like what kind of other proteins are present in the blood and in what amounts.

ESR is measured by the ESR test, a commonly performed test in many laboratories.

The test is important because it is a measure of inflammation or infection - the value of ESR is usually high in conditions like cancers, tuberculosis, infections, fevers and also in anemia and advanced age.

It is a common test in many blood test panels, and is usually done to rule out infection or inflammation as a cause of your symptoms

The test usually takes upto an hour to perform, but as far as the patient is concerned, all it needs is a single blood sample.

How is ESR measured?

ESR is measured in the laboratory. This is not a test that can be done at home. To measure ESR the laboratory will first collect a sample of blood. If you have ever had a blood test before, this will be familiar to you.

The blood is collected by inserting a small needle in your vein, and collecting about 3-4ml of blood in a tube

The blood is then filled into a glass tube, that is standardized height and width. This blood is then allowed to settle over an hour inside the tube

Over time a clear portion emerges at the upper end of the tube, and the red cells settle at the bottom

The length of the clear portion is measured and it is then entered into your report as the ESR in mm per hour

What is the normal range of ESR and how is an ESR of 65 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 65 mm/hr

Normal Range and Grading for Adult Women : ESR 65 mm/hr

Normal Range and Grading for Children : ESR 65 mm/hr

What does an ESR of 65 mean?

An ESR level of 65 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 ESR 65 good?

An ESR of 65 is not a good value. In adults, or children this value is above normal and needs investigating.

Is ESR 65 bad?

An ESR of 65 is bad in all populations and should be further investigated.

Is ESR 65 dangerous?

An ESR of 65 is elevated but not necessarily dangerous Note that an ESR is basically a measure of the thickness of your blood and itself is not a thing or an entity. It on its own will not harm you, rather the underlying cause is what needs to be investigated.

Is ESR 65 normal?

An ESR of 65 is not normal and is classified as elevated.

What are the causes of an ESR of 65 mm/hr?

An ESR of 65 can have various causing including the following :

• Temporal Arteritis : This is a disease of the blood vessels in the body, especially the ones in the head. In this disease there is inflammation inside the blood vessels in the head and this causes headaches. Patients are usually men above the age of 55. The ESR is high and is one of the best tests to diagnose this disease. If you are male, above the age of 55 and have throbbing headaches, consider this disease.
• Polymyalgia Rheumatica : This is an autoimmune disease in which there is pain in the muscles and joints. This disease shows an increased value for ESR
• Chronic Obstructive Pulmonary Disease (COPD) : Smokers and people exposed to pollution and coal dust, may develop diseases of the lungs, in which they have a long standing cough. This can lead to increase in ESR due to the inflammation in the lungs.
• Chronic Kidney Disease : If your kidney is not working properly, it can cause various changes in your body including anemia and a raised ESR
• Vasculitis : Vasculitis is another autoimmune disease. In this disease there is inflammation inside the blood vessels. Sometimes this affects small vessels, sometimes large ones and sometimes medium sized vessels. Blood vessels in the lungs, kidneys or even the brain can be affected. This usually leads to an increased ESR.
• Autoimmune Disorders : Autoimmune conditions are those in which the body's immune system begins to act against specific tissues or organs in the body itself. Conditions like rheumatoid arthritis and systemic lupus erythematosus can cause inflammation and elevate ESR. As far as the body is concerned the condition is similar to attack by an external infection, as the body does not recognize that these are its own tissues. The inflammatory process follows and the ESR gets elevated as a result.
• Anemia : Anemia is a condition in which the blood becomes thinner and less red. This happens due to fewer or smaller red cells. ESR is known to increase in people who are anemic. This is because the red cells, fewer and smaller in number, settle down faster. Infact, the ESR can increase to such an extent, that a correction factor is often applied to anemic patients before their ESR value is reported.
• Rheumatoid Arthritis : Arthritis is one of the most common causes of elevated ESR. ESR is almost always increased in patients of arthritis. The disease is seen in people with certain genes, and it often leads to painful joints, in the fingers or the back. The disease invariably needs treatment with medications.
• Behçet's Disease : A rare inflammatory disorder causing blood vessel inflammation.
• Certain Medications : Various medicines can impact your body's constitutional balance. These include medicines for inflammation, which can themselves alter the ESR. If you are on different types of medicines make sure to inform your doctor or laboratory before getting the ESR done.
• Hepatitis : Hepatitis caused by the three hepatitis viruses, A, B, and C can all lead to increased ESR levels. When these viruses infect the liver, they cause inflammation and pain, as well as fever and sometimes yellow colored eyes - also called jaundice. ESR is elevated due to the fact that these diseases take a long time to heal, and are called chronic infections.
• Liver Disease : Certain liver conditions can be associated with higher ESR. Infections by viruses like Hepatits B and C can cause inflammation in the liver, and also increase the ESR level.

What are the causes for a falsely elevated ESR value of 65?

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

• Obesity : Obesity is when your weight is too much for your height. People who are obese often suffer from metabolic syndrome, a condition with poor tolerance for sugar and fats. ESR is found to be increased in obese patients.
• Aging : If you are above 55 years of age, your ESR is expected to be higher than normal. ESR increases progressively with increased age. The rise in ESR is attributed to age related wear and tear in the body, as well as age related anemias.
• Smoking : Heavy smokers are found to have a higher ESR level, when all other factors are adjusted for. This is probably due to the low grade of inflammation produced by the chemicals found in smoke.
• Menstrual Cycle : In females, ESR may show various fluctuations from normal during the menstrual cycle. During menses, there is a small rise in the ESR, due to the small amount of inflammation that accompanies the shedding of the uterine lining. This is expected as there is bleeding during the menstrual phase of the menstrual cycle.
• Pregnancy : Pregnancy produces a physiological or natural increase in ESR. If you are pregnant, make sure that your doctor/lab uses the normal ranges of pregnancy for ESR. ESR can change by a lot during pregnancy especially in the later few months.
• Stress : An stress on the body like heavy exercise, emotional stress, a sudden illness and similar factors can produce an increase in the level of ESR.
• Menopause : ESR increases in women after meonopause, or the normal cessation of menstruation. Part of this is due to a drop in the levels of female hormones. Age is another factor, as advancing age is associated with higher ESR.
• Sleep Deprivation : Staying awake for long hours, and not getting enough sleep are associated with an increase in inflammation in the body. This is also reflected in the levels of ESR, which are higher in people who suffer from sleep deprivation.
• Race/Ethnicity : ESR levels have been found to be higher in blacks, as compared to whites. This difference is independent of all other factors like age, gender etc. Make sure to check with your doctor for more information.
• Postpartum Period : During the first week after delivery, the body is still under stress. The mother's ESR and other markers of inflammation like fibrinogen are known to remain elevated. The cause is the process of childbirth, which puts the mother's body under strain.
• Surgery : Any surgery that is done on the body, will trigger an inflammatory response. Major surgeries are associated with
• Strenuous Exercise : Sudden, intense physical activity, of any kind, can lead to an inflammatory response from the body. Inflammation can be in the muscles, joints or tendons and this can lead to a rise in ESR. Patients are advised to avoid intense activity before providing their sample for the ESR test as it can cause significant deviations from the mean.

What does an ESR of 65 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 65 can be classified as below.
If you are in the first three months of pregnancy an ESR of 65 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 65 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 65 is normal

What are the symptoms of an ESR of 65 ?

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 65 :

• Abnormal Blood Counts : Changes in white blood cell count or other blood parameters.
• Abdominal Pain : Pain in the stomach is a very non-specific complaint. If it is due to an infection or appendicites, it may be accompanied by a high ESR level.
• Dry Eyes and Mouth : These symptoms may be seen in some autoimmune diseases which will also lead to a rise in the ESR. The most common diseases causing this are the Sjogrens Syndrome.
• Loss of Appetite : Decreased desire to eat is one of the most common symptoms of chronic infections. This is common in cancers, tuberculosis and some infections. This may be accompanied by a rise in ESR.
• Unexplained Weight Loss : Loss of weight, without any change in your daily intake of calories or exercise is a cause of concern and is seen in many of the causes of ESR. Weight loss associated with rise in ESR is one of the cardinal signs of Tuberculosis. Tests for a sudden loss of weight may help you to learn more about your condition.
• Shortness of Breath : Shortness of breath or difficulty in breathing may be due to a chest infection, allergies, pneumonia or even tuberculosis. If accompanied by a high ESR level it may be a cause of concern.
• Skin Rashes : Autoimmune diseases may show skin rashes, such as SLE. This may be one of the rarer symptoms with a high ESR level
• Hair Loss : Hair loss may be seen in severe deficiencies and these may also cause a rise in ESR due to inflammation in the body.
• Night Sweats : Night sweats are a common symptom in Tuberculosis, as well as some tropical diseases. Night sweats, together with weight loss and an increased ESR are all suggestive of a chronic inflammatory process. Night sweats refer to waking up in bed, drenched in sweat, despite there being adequate cooling in the room. Tests for night sweats may shed more light on this symptom.
• Fever : Fever is often accompanied by a rise in ESR. Fever is caused by proteins released by the liver in response to inflammation. The same proteins cause a rise in ESR. Fever is a rise in temperature above normal, and is one of the most common symptoms associated with ESR and may be seen in conditions like dengue. Read more about tests for dengue here.
• Irregular Menstrual Cycles : Changes in menstrual patterns for women.
• Cough : Chronic cough, or coughing persistently with other symptoms may be a common symptom that is linked with a rise in ESR.
• Depression : Persistent feelings of sadness or hopelessness.
• Nausea and Vomiting : Feeling of sickness and vomiting.
• Digestive Issues : Changes in your bowel habits, constipation and diarrhea ,if present, alternatingly are all signs of irritable bowel syndrome, which itself is often associated with an elevated ESR.
• Joint Pain : Joint pain is often seen in Arthritis and different autoimmune disease that may be causing the rise in your ESR levels. Joint pain may be in the small joints of your hands or the bigger joints like shoulders or knees. Joint pains may also be seen in some infections like dengue, which can also cause a rise in ESR. Read about tests for joint pains to know more.
• Vision Changes : Blurred vision or other visual disturbances may be seen in some autoimmune diseases of the blood vessles in the head. These diseases produce headaches and a high ESR level
• Frequent Urination : Increased need to urinate.
• Dizziness : Feeling lightheaded or unsteady.
• Difficulty Sleeping : Insomnia or disrupted sleep patterns.
• Swollen Lymph Nodes : A very common sign seen in chronic diseases like Tuberculosis, some blood cancers are swollen lymph nodes. These are swellings in the neck region. ESR is often increased when the lymph nodes are swollen. Read about tests for swollen lymph nodes to know more.
• Photosensitivity : Increased sensitivity to sunlight.
• Fatigue : Feeling tired all the time is a feature of several of the causes of ESR. ESR itself does not cause any symptoms. Fatigue is commonly seen in anemia, cancers, infections and autoimmune diseases, all of which are the causes of a raised ESR.
• Muscle Aches : Pain in the muscles may be a sign of an inflammatory process. Muscle pain is very hard to pinpoint, but it may be the beginning of a fever or infection. ESR is sometimes increased in injuries to multiple muscles like after an accident or fall.

Which foods can reduce an ESR of 65 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.

• Legumes : Legumes, such as lentils and chickpeas, contain peptides, polyphenols and saponins, all of which are very potent anti-inflammatory agents. Specifically acting against chronic inflammation which is a key factor that causes an elevated ESR, legumes can help reduce ESR.
• Vegetables : Vegetables are rich in fiber and minerals and vitamins. All are essential components of helping to combat oxidation and infections. This helps to bring down the ESR.
• Probiotics : Probiotic foods help to reduce inflammation, and specifically Reactive Oxygen Species, that are the cause of many of the components of inflammation. Reactive Oxygen species cause damage to tissues and inflammation. Probiotics improve the gut health and help reduce inflammation contributing to reduce ESR.
• Fatty Fish : Fish like salmon and mackarel are rich in Long Chain and omega fatty acids. These are natural anti-inflammatory agents and have been shown to reduce inflammatory markers both before and after food intake. A diet that mixes in balanced amounts of these foods, help to reduce inflammation and consequently ESR.
• Nuts : Walnuts, contain the highest content of plant-based polyunsaturated fatty acids (PUFAs), including ALA. Other nuts are also rich in anti inflammatory chemicals that help to reduce inflammation. This brings down the ESR levels.
• Fruits : Various fruits, including citrus fruits and berries, are packed with vitamins, minerals, and antioxidants. Fruits also contain fiber and help reduce inflammation by combating oxidation. This, combined with various vitamins help to combat inflammation and tissue damage and will consequently bring down the ESR.

What other tests should be done with an ESR of 65 ?

For an ESR of 65, 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

Living with an ESR of 65

An elevated ESR level is not something you should take lightly or live with. If the cause is an infection or inflammation, this should be investigated or treated. If the cause is a chronic disease or a cancer, you should get medical advice. Consulting a medical practitioner is essential if your ESR remains at 65 for a prolonged period of time.

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 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 65

What is my ESR:CRP ratio for an ESR of 65 ?

ESR	CRP	Ratio	Means
65	1.0	65.0	More likely to be autoimmune disease flareup of SLE
65	1.5	43.3	More likely to be autoimmune disease flareup of SLE
65	2.0	32.5	More likely to be autoimmune disease flareup of SLE
65	2.5	26.0	More likely to be autoimmune disease flareup of SLE
65	3.0	21.7	More likely to be autoimmune disease flareup of SLE
65	3.5	18.6	More likely to be autoimmune disease flareup of SLE
65	4.0	16.3	More likely to be autoimmune disease flareup of SLE

References

1. Dapper DV, Didia BC. Haemorheological changes during the menstrual cycle. East Afr Med J. 2002 Apr;79(4):181-3. doi: 10.4314/eamj.v79i4.8874. PMID: 12625671.
2. https://applications.emro.who.int/imemrf/Sci_Med_J_1991_3_1_171.pdf
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571720/