ESR 74 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 74 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 74 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 selected 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 inform their healthcare provider about any medications they are taking, as certain drugs can affect the results. While fasting is not obligatory for ESR, maintaining hydration is recommended to facilitate a smoother blood draw and ensure accurate results. ESR serves as a valuable diagnostic tool, aiding healthcare professionals in evaluating inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 74 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 74

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

Normal Range and Grading for Adult Women : ESR 74

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 74

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

What does an ESR of 74 mm/hr mean?

An ESR level of 74 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 74 mm/hr good?

An ESR of 74 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 74 mm/hr bad?

An ESR of 74 is bad in all populations and should be further investigated.

Is an ESR of 74 mm/hr dangerous?

An ESR of 74 is elevated but not necessarily dangerous

Is an ESR of 74 mm/hr normal?

An ESR of 74 is not normal and is classified as elevated.

What are the causes of an ESR of 74 mm/hr?

An ESR of 74 can have various causing including the following

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.

Tissue injury

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

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.

Lymphoma

A type of cancer that originates in the lymphatic system.

Dehydration

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Bronchiectasis

A chronic lung condition characterized by damaged airways.

Aging

ESR tends to increase with age, and mild elevation may be normal in elderly individuals.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

What are the causes for a falsely elevated ESR value of 74?

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

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.

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.

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.

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.

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.

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.

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.

Stress

Physiological stress triggers the release of stress hormones and inflammatory mediators, potentially leading to a temporary increase in ESR. Chronic stress can have negative effects on overall health, emphasizing the importance of stress management for well-being.

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.

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.

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.

Iron Deficiency

Mild iron deficiency can affect the composition of blood, potentially leading to changes in ESR levels. Adequate iron levels are essential for overall health, and addressing iron deficiency is important for maintaining optimal blood parameters.

What does an ESR of 74 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 74 can be classified as below.
If you are in the first three months of pregnancy an ESR of 74 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 74 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 74 is elevated

What are the symptoms of an ESR of 74 ?

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 74

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Dizziness

Feeling lightheaded or unsteady.

Vision Changes

Blurred vision or other visual disturbances.

Shortness of Breath

Difficulty breathing or breathlessness.

Depression

Persistent feelings of sadness or hopelessness.

Night Sweats

Excessive sweating during sleep.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Photosensitivity

Increased sensitivity to sunlight.

Fatigue

Persistent tiredness and lack of energy.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Muscle Aches

Generalized or localized pain in muscles.

Recurrent Infections

Frequent or persistent infections.

Mouth Ulcers

Sores in the mouth that may be painful.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Abdominal Pain

Discomfort or pain in the abdominal region.

Hair Loss

Unexplained loss of hair.

Chest Pain

Pain or discomfort in the chest area.

Frequent Urination

Increased need to urinate.

Cognitive Impairment

Memory problems or difficulty concentrating.

Neurological Symptoms

Tingling, numbness, or weakness.

Headaches

Recurrent or persistent headaches.

Skin Rashes

Unexplained skin eruptions or changes.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Which foods can reduce an ESR of 74 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.

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.

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.

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 74 mm/hr ?

For an ESR of 74, 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 74

What is my ESR:CRP ratio for an ESR of 74 mm/hr ?

ESR	CRP	Ratio	Means
74	1.0	74.0	More likely to be autoimmune disease flareup of SLE
74	1.5	49.333333333333336	More likely to be autoimmune disease flareup of SLE
74	2.0	37.0	More likely to be autoimmune disease flareup of SLE
74	2.5	29.6	More likely to be autoimmune disease flareup of SLE
74	3.0	24.666666666666668	More likely to be autoimmune disease flareup of SLE
74	3.5	21.142857142857142	More likely to be autoimmune disease flareup of SLE
74	4.0	18.5	More likely to be autoimmune disease flareup of SLE
74	4.5	16.444444444444443	More likely to be autoimmune disease flareup of SLE
74	5.0	14.8	Inconclusive
74	5.5	13.454545454545455	Inconclusive
74	6.0	12.333333333333334	Inconclusive
74	6.5	11.384615384615385	Inconclusive
74	7.0	10.571428571428571	Inconclusive
74	7.5	9.866666666666667	Inconclusive
74	8.0	9.25	Inconclusive
74	8.5	8.705882352941176	Inconclusive
74	9.0	8.222222222222221	Inconclusive
74	9.5	7.7894736842105265	Inconclusive
74	10.0	7.4	Inconclusive
74	10.5	7.0476190476190474	Inconclusive
74	11.0	6.7272727272727275	Inconclusive
74	11.5	6.434782608695652	Inconclusive
74	12.0	6.166666666666667	Inconclusive
74	12.5	5.92	Inconclusive
74	13.0	5.6923076923076925	Inconclusive
74	13.5	5.481481481481482	Inconclusive
74	14.0	5.285714285714286	Inconclusive
74	14.5	5.103448275862069	Inconclusive
74	15.0	4.933333333333334	Inconclusive
74	15.5	4.774193548387097	Inconclusive
74	16.0	4.625	Inconclusive
74	16.5	4.484848484848484	Inconclusive
74	17.0	4.352941176470588	Inconclusive
74	17.5	4.228571428571429	Inconclusive
74	18.0	4.111111111111111	Inconclusive
74	18.5	4.0	Inconclusive
74	19.0	3.8947368421052633	Inconclusive
74	19.5	3.7948717948717947	Inconclusive
74	20.0	3.7	Inconclusive
74	20.5	3.6097560975609757	Inconclusive
74	21.0	3.5238095238095237	Inconclusive
74	21.5	3.441860465116279	Inconclusive
74	22.0	3.3636363636363638	Inconclusive
74	22.5	3.2888888888888888	Inconclusive
74	23.0	3.217391304347826	Inconclusive
74	23.5	3.148936170212766	Inconclusive
74	24.0	3.0833333333333335	Inconclusive
74	24.5	3.020408163265306	Inconclusive
74	25.0	2.96	Inconclusive
74	25.5	2.9019607843137254	Inconclusive
74	26.0	2.8461538461538463	Inconclusive
74	26.5	2.792452830188679	Inconclusive
74	27.0	2.740740740740741	Inconclusive
74	27.5	2.690909090909091	Inconclusive
74	28.0	2.642857142857143	Inconclusive
74	28.5	2.5964912280701755	Inconclusive
74	29.0	2.5517241379310347	Inconclusive
74	29.5	2.5084745762711864	Inconclusive

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