ESR 71 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 71 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 71 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 71 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 71

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

Normal Range and Grading for Adult Women : ESR 71

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 71

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

What does an ESR of 71 mm/hr mean?

An ESR level of 71 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 71 mm/hr good?

An ESR of 71 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 71 mm/hr bad?

An ESR of 71 is bad in all populations and should be further investigated.

Is an ESR of 71 mm/hr dangerous?

An ESR of 71 is elevated but not necessarily dangerous

Is an ESR of 71 mm/hr normal?

An ESR of 71 is not normal and is classified as elevated.

What are the causes of an ESR of 71 mm/hr?

An ESR of 71 can have various causing including the following

Bronchiectasis

A chronic lung condition characterized by damaged airways.

Myeloma

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

Behçet's Disease

A rare inflammatory disorder causing blood vessel inflammation.

Infection

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

Inflammatory Bowel Disease

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

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

Obesity

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

Liver Disease

Certain liver conditions can be associated with higher ESR.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Heart Disease

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

What are the causes for a falsely elevated ESR value of 71?

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

Altitude Changes

Changes in altitude can impact oxygen levels in the blood, influencing the inflammatory response. These altitude-related changes may contribute to variations in ESR levels. Adjusting to altitude and maintaining proper hydration are important considerations.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Ovulation

The process of ovulation in the menstrual cycle involves hormonal changes that can affect ESR levels. Fluctuations in estrogen and progesterone during ovulation contribute to variations in the inflammatory response, leading to changes in ESR.

What does an ESR of 71 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 71 can be classified as below.
If you are in the first three months of pregnancy an ESR of 71 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 71 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 71 is elevated

What are the symptoms of an ESR of 71 ?

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 71

Loss of Appetite

Decreased desire to eat.

Muscle Aches

Generalized or localized pain in muscles.

Cognitive Impairment

Memory problems or difficulty concentrating.

Depression

Persistent feelings of sadness or hopelessness.

Recurrent Infections

Frequent or persistent infections.

Vision Changes

Blurred vision or other visual disturbances.

Hair Loss

Unexplained loss of hair.

Chest Pain

Pain or discomfort in the chest area.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Night Sweats

Excessive sweating during sleep.

Mouth Ulcers

Sores in the mouth that may be painful.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Shortness of Breath

Difficulty breathing or breathlessness.

Abdominal Pain

Discomfort or pain in the abdominal region.

Skin Rashes

Unexplained skin eruptions or changes.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Nausea and Vomiting

Feeling of sickness and vomiting.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Dizziness

Feeling lightheaded or unsteady.

Fever

Elevated body temperature beyond normal range.

Frequent Urination

Increased need to urinate.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Photosensitivity

Increased sensitivity to sunlight.

Fatigue

Persistent tiredness and lack of energy.

Which foods can reduce an ESR of 71 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 71 mm/hr ?

For an ESR of 71, 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 71

What is my ESR:CRP ratio for an ESR of 71 mm/hr ?

ESR	CRP	Ratio	Means
71	1.0	71.0	More likely to be autoimmune disease flareup of SLE
71	1.5	47.333333333333336	More likely to be autoimmune disease flareup of SLE
71	2.0	35.5	More likely to be autoimmune disease flareup of SLE
71	2.5	28.4	More likely to be autoimmune disease flareup of SLE
71	3.0	23.666666666666668	More likely to be autoimmune disease flareup of SLE
71	3.5	20.285714285714285	More likely to be autoimmune disease flareup of SLE
71	4.0	17.75	More likely to be autoimmune disease flareup of SLE
71	4.5	15.777777777777779	More likely to be autoimmune disease flareup of SLE
71	5.0	14.2	Inconclusive
71	5.5	12.909090909090908	Inconclusive
71	6.0	11.833333333333334	Inconclusive
71	6.5	10.923076923076923	Inconclusive
71	7.0	10.142857142857142	Inconclusive
71	7.5	9.466666666666667	Inconclusive
71	8.0	8.875	Inconclusive
71	8.5	8.352941176470589	Inconclusive
71	9.0	7.888888888888889	Inconclusive
71	9.5	7.473684210526316	Inconclusive
71	10.0	7.1	Inconclusive
71	10.5	6.761904761904762	Inconclusive
71	11.0	6.454545454545454	Inconclusive
71	11.5	6.173913043478261	Inconclusive
71	12.0	5.916666666666667	Inconclusive
71	12.5	5.68	Inconclusive
71	13.0	5.461538461538462	Inconclusive
71	13.5	5.2592592592592595	Inconclusive
71	14.0	5.071428571428571	Inconclusive
71	14.5	4.896551724137931	Inconclusive
71	15.0	4.733333333333333	Inconclusive
71	15.5	4.580645161290323	Inconclusive
71	16.0	4.4375	Inconclusive
71	16.5	4.303030303030303	Inconclusive
71	17.0	4.176470588235294	Inconclusive
71	17.5	4.057142857142857	Inconclusive
71	18.0	3.9444444444444446	Inconclusive
71	18.5	3.8378378378378377	Inconclusive
71	19.0	3.736842105263158	Inconclusive
71	19.5	3.641025641025641	Inconclusive
71	20.0	3.55	Inconclusive
71	20.5	3.4634146341463414	Inconclusive
71	21.0	3.380952380952381	Inconclusive
71	21.5	3.302325581395349	Inconclusive
71	22.0	3.227272727272727	Inconclusive
71	22.5	3.1555555555555554	Inconclusive
71	23.0	3.0869565217391304	Inconclusive
71	23.5	3.021276595744681	Inconclusive
71	24.0	2.9583333333333335	Inconclusive
71	24.5	2.8979591836734695	Inconclusive
71	25.0	2.84	Inconclusive
71	25.5	2.784313725490196	Inconclusive
71	26.0	2.730769230769231	Inconclusive
71	26.5	2.6792452830188678	Inconclusive
71	27.0	2.6296296296296298	Inconclusive
71	27.5	2.581818181818182	Inconclusive
71	28.0	2.5357142857142856	Inconclusive
71	28.5	2.491228070175439	Inconclusive
71	29.0	2.4482758620689653	Inconclusive
71	29.5	2.406779661016949	Inconclusive

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