ESR 76 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 76 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 76 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 76 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 76

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

Normal Range and Grading for Adult Women : ESR 76

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 76

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

What does an ESR of 76 mm/hr mean?

An ESR level of 76 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 76 mm/hr good?

An ESR of 76 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 76 mm/hr bad?

An ESR of 76 is bad in all populations and should be further investigated.

Is an ESR of 76 mm/hr dangerous?

An ESR of 76 is elevated but not necessarily dangerous

Is an ESR of 76 mm/hr normal?

An ESR of 76 is not normal and is classified as elevated.

What are the causes of an ESR of 76 mm/hr?

An ESR of 76 can have various causing including the following

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Heart Disease

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

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Aging

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

Chronic Obstructive Pulmonary Disease (COPD)

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

Hepatitis

Inflammation of the liver, often caused by viral infections.

Tissue injury

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

Behçet's Disease

A rare inflammatory disorder causing blood vessel inflammation.

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

Certain Cancers

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

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Inflammation

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

What are the causes for a falsely elevated ESR value of 76?

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

What does an ESR of 76 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 76 can be classified as below.
If you are in the first three months of pregnancy an ESR of 76 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 76 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 76 is elevated

What are the symptoms of an ESR of 76 ?

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 76

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Frequent Urination

Increased need to urinate.

Headaches

Recurrent or persistent headaches.

Loss of Appetite

Decreased desire to eat.

Skin Rashes

Unexplained skin eruptions or changes.

Dizziness

Feeling lightheaded or unsteady.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Depression

Persistent feelings of sadness or hopelessness.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Nausea and Vomiting

Feeling of sickness and vomiting.

Vision Changes

Blurred vision or other visual disturbances.

Mouth Ulcers

Sores in the mouth that may be painful.

Photosensitivity

Increased sensitivity to sunlight.

Cognitive Impairment

Memory problems or difficulty concentrating.

Abdominal Pain

Discomfort or pain in the abdominal region.

Cough

Persistent or chronic coughing.

Fatigue

Persistent tiredness and lack of energy.

Shortness of Breath

Difficulty breathing or breathlessness.

Chest Pain

Pain or discomfort in the chest area.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Hair Loss

Unexplained loss of hair.

Neurological Symptoms

Tingling, numbness, or weakness.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Night Sweats

Excessive sweating during sleep.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Which foods can reduce an ESR of 76 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 76 mm/hr ?

For an ESR of 76, 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 76

What is my ESR:CRP ratio for an ESR of 76 mm/hr ?

ESR	CRP	Ratio	Means
76	1.0	76.0	More likely to be autoimmune disease flareup of SLE
76	1.5	50.666666666666664	More likely to be autoimmune disease flareup of SLE
76	2.0	38.0	More likely to be autoimmune disease flareup of SLE
76	2.5	30.4	More likely to be autoimmune disease flareup of SLE
76	3.0	25.333333333333332	More likely to be autoimmune disease flareup of SLE
76	3.5	21.714285714285715	More likely to be autoimmune disease flareup of SLE
76	4.0	19.0	More likely to be autoimmune disease flareup of SLE
76	4.5	16.88888888888889	More likely to be autoimmune disease flareup of SLE
76	5.0	15.2	More likely to be autoimmune disease flareup of SLE
76	5.5	13.818181818181818	Inconclusive
76	6.0	12.666666666666666	Inconclusive
76	6.5	11.692307692307692	Inconclusive
76	7.0	10.857142857142858	Inconclusive
76	7.5	10.133333333333333	Inconclusive
76	8.0	9.5	Inconclusive
76	8.5	8.941176470588236	Inconclusive
76	9.0	8.444444444444445	Inconclusive
76	9.5	8.0	Inconclusive
76	10.0	7.6	Inconclusive
76	10.5	7.238095238095238	Inconclusive
76	11.0	6.909090909090909	Inconclusive
76	11.5	6.608695652173913	Inconclusive
76	12.0	6.333333333333333	Inconclusive
76	12.5	6.08	Inconclusive
76	13.0	5.846153846153846	Inconclusive
76	13.5	5.62962962962963	Inconclusive
76	14.0	5.428571428571429	Inconclusive
76	14.5	5.241379310344827	Inconclusive
76	15.0	5.066666666666666	Inconclusive
76	15.5	4.903225806451613	Inconclusive
76	16.0	4.75	Inconclusive
76	16.5	4.606060606060606	Inconclusive
76	17.0	4.470588235294118	Inconclusive
76	17.5	4.3428571428571425	Inconclusive
76	18.0	4.222222222222222	Inconclusive
76	18.5	4.108108108108108	Inconclusive
76	19.0	4.0	Inconclusive
76	19.5	3.8974358974358974	Inconclusive
76	20.0	3.8	Inconclusive
76	20.5	3.707317073170732	Inconclusive
76	21.0	3.619047619047619	Inconclusive
76	21.5	3.5348837209302326	Inconclusive
76	22.0	3.4545454545454546	Inconclusive
76	22.5	3.3777777777777778	Inconclusive
76	23.0	3.3043478260869565	Inconclusive
76	23.5	3.234042553191489	Inconclusive
76	24.0	3.1666666666666665	Inconclusive
76	24.5	3.1020408163265305	Inconclusive
76	25.0	3.04	Inconclusive
76	25.5	2.980392156862745	Inconclusive
76	26.0	2.923076923076923	Inconclusive
76	26.5	2.8679245283018866	Inconclusive
76	27.0	2.814814814814815	Inconclusive
76	27.5	2.7636363636363637	Inconclusive
76	28.0	2.7142857142857144	Inconclusive
76	28.5	2.6666666666666665	Inconclusive
76	29.0	2.6206896551724137	Inconclusive
76	29.5	2.5762711864406778	Inconclusive

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