ESR 69 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 69 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 69 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?

To measure Erythrocyte Sedimentation Rate (ESR), a healthcare professional collects a small blood sample from the patient's arm, typically from a vein. Before the blood draw, the area is cleaned with an antiseptic solution to minimize the risk of infection. The collected blood is then mixed with an anticoagulant to prevent clotting. Subsequently, the blood is placed in a tall, thin tube and positioned upright to allow the red blood cells to settle over a specified period, often 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 common approach to ESR measurement, involves utilizing a specialized Westergren tube for blood collection. In preparation for the test, patients are typically 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 69 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 69

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

Normal Range and Grading for Adult Women : ESR 69

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 69

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

What does an ESR of 69 mm/hr mean?

An ESR level of 69 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 69 mm/hr good?

An ESR of 69 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 69 mm/hr bad?

An ESR of 69 is bad in all populations and should be further investigated.

Is an ESR of 69 mm/hr dangerous?

An ESR of 69 is elevated but not necessarily dangerous

Is an ESR of 69 mm/hr normal?

An ESR of 69 is not normal and is classified as elevated.

What are the causes of an ESR of 69 mm/hr?

An ESR of 69 can have various causing including the following

Lymphoma

A type of cancer that originates in the lymphatic system.

Vasculitis

Inflammation of blood vessels.

Myeloma

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

Dehydration

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

HIV/AIDS

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

Anemia

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

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Certain Medications

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

Inflammation

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

Infection

Both acute and chronic infections can lead to an increased ESR.

Autoimmune Disorders

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

What are the causes for a falsely elevated ESR value of 69?

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

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.

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.

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.

Aging

ESR tends to increase with age, and a mild elevation may be a normal part of the aging process. The gradual wear and tear on the body's tissues can contribute to a low-level inflammatory state, leading to a slightly higher ESR in elderly individuals.

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.

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 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.

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.

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.

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.

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.

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.

What does an ESR of 69 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 69 can be classified as below.
If you are in the first three months of pregnancy an ESR of 69 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 69 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 69 is normal

What are the symptoms of an ESR of 69 ?

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 69

Cognitive Impairment

Memory problems or difficulty concentrating.

Nausea and Vomiting

Feeling of sickness and vomiting.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Depression

Persistent feelings of sadness or hopelessness.

Abdominal Pain

Discomfort or pain in the abdominal region.

Night Sweats

Excessive sweating during sleep.

Chest Pain

Pain or discomfort in the chest area.

Mouth Ulcers

Sores in the mouth that may be painful.

Loss of Appetite

Decreased desire to eat.

Fever

Elevated body temperature beyond normal range.

Skin Rashes

Unexplained skin eruptions or changes.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Headaches

Recurrent or persistent headaches.

Fatigue

Persistent tiredness and lack of energy.

Hair Loss

Unexplained loss of hair.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Frequent Urination

Increased need to urinate.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Cough

Persistent or chronic coughing.

Recurrent Infections

Frequent or persistent infections.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Neurological Symptoms

Tingling, numbness, or weakness.

Vision Changes

Blurred vision or other visual disturbances.

Muscle Aches

Generalized or localized pain in muscles.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Which foods can reduce an ESR of 69 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.

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.

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.

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.

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.

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 69 mm/hr ?

For an ESR of 69, 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 69

What is my ESR:CRP ratio for an ESR of 69 mm/hr ?

ESR	CRP	Ratio	Means
69	1.0	69.0	More likely to be autoimmune disease flareup of SLE
69	1.5	46.0	More likely to be autoimmune disease flareup of SLE
69	2.0	34.5	More likely to be autoimmune disease flareup of SLE
69	2.5	27.6	More likely to be autoimmune disease flareup of SLE
69	3.0	23.0	More likely to be autoimmune disease flareup of SLE
69	3.5	19.714285714285715	More likely to be autoimmune disease flareup of SLE
69	4.0	17.25	More likely to be autoimmune disease flareup of SLE
69	4.5	15.333333333333334	More likely to be autoimmune disease flareup of SLE
69	5.0	13.8	Inconclusive
69	5.5	12.545454545454545	Inconclusive
69	6.0	11.5	Inconclusive
69	6.5	10.615384615384615	Inconclusive
69	7.0	9.857142857142858	Inconclusive
69	7.5	9.2	Inconclusive
69	8.0	8.625	Inconclusive
69	8.5	8.117647058823529	Inconclusive
69	9.0	7.666666666666667	Inconclusive
69	9.5	7.2631578947368425	Inconclusive
69	10.0	6.9	Inconclusive
69	10.5	6.571428571428571	Inconclusive
69	11.0	6.2727272727272725	Inconclusive
69	11.5	6.0	Inconclusive
69	12.0	5.75	Inconclusive
69	12.5	5.52	Inconclusive
69	13.0	5.3076923076923075	Inconclusive
69	13.5	5.111111111111111	Inconclusive
69	14.0	4.928571428571429	Inconclusive
69	14.5	4.758620689655173	Inconclusive
69	15.0	4.6	Inconclusive
69	15.5	4.451612903225806	Inconclusive
69	16.0	4.3125	Inconclusive
69	16.5	4.181818181818182	Inconclusive
69	17.0	4.0588235294117645	Inconclusive
69	17.5	3.942857142857143	Inconclusive
69	18.0	3.8333333333333335	Inconclusive
69	18.5	3.72972972972973	Inconclusive
69	19.0	3.6315789473684212	Inconclusive
69	19.5	3.5384615384615383	Inconclusive
69	20.0	3.45	Inconclusive
69	20.5	3.3658536585365852	Inconclusive
69	21.0	3.2857142857142856	Inconclusive
69	21.5	3.2093023255813953	Inconclusive
69	22.0	3.1363636363636362	Inconclusive
69	22.5	3.066666666666667	Inconclusive
69	23.0	3.0	Inconclusive
69	23.5	2.9361702127659575	Inconclusive
69	24.0	2.875	Inconclusive
69	24.5	2.816326530612245	Inconclusive
69	25.0	2.76	Inconclusive
69	25.5	2.7058823529411766	Inconclusive
69	26.0	2.6538461538461537	Inconclusive
69	26.5	2.6037735849056602	Inconclusive
69	27.0	2.5555555555555554	Inconclusive
69	27.5	2.5090909090909093	Inconclusive
69	28.0	2.4642857142857144	Inconclusive
69	28.5	2.4210526315789473	Inconclusive
69	29.0	2.3793103448275863	Inconclusive
69	29.5	2.3389830508474576	Inconclusive

---