ESR 81 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 81 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 81 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 81 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 81

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

Normal Range and Grading for Adult Women : ESR 81

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
>80	Very High

Normal Range and Grading for Children : ESR 81

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

What does an ESR of 81 mm/hr mean?

An ESR level of 81 is considered to be dangerously or alarmingly elevated. You should get immediate medical attention, and a doctor must evaluate all your health parameters to arrive at a cause for this ESR level.Other tests will inevitably be prescribed and a detailed medical history will also need to be taken.

Is an ESR of 81 mm/hr good?

Is an ESR of 81 mm/hr bad?

Is an ESR of 81 mm/hr dangerous?

Is an ESR of 81 mm/hr normal?

What are the causes of an ESR of 81 mm/hr?

An ESR of 81 can have various causing including the following

Lymphoma

A type of cancer that originates in the lymphatic system.

Dehydration

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

Infection

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

Heart Disease

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

Vasculitis

Inflammation of blood vessels.

Autoimmune Disorders

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

Tissue injury

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

Liver Disease

Certain liver conditions can be associated with higher ESR.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Chronic Obstructive Pulmonary Disease (COPD)

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

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

What are the causes for a falsely elevated ESR value of 81?

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

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.

Recent Vaccination

Vaccination stimulates the immune system, triggering an inflammatory response. This immune activity can lead to a temporary increase in ESR levels as part of the body's natural defense mechanism. The elevation is usually transient and not indicative of a pathological condition.

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.

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.

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.

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.

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.

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.

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.

Race/Ethnicity

ESR levels can exhibit variations among different racial and ethnic groups. Genetic and environmental factors specific to certain populations may contribute to these differences. However, individual health and lifestyle choices remain crucial factors influencing ESR levels.

Menstrual Cycle

Throughout the menstrual cycle, hormonal fluctuations, especially variations in estrogen levels, can influence the inflammatory response in the body, leading to periodic changes in ESR. This is particularly noticeable during the menstrual period.

What does an ESR of 81 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 81 can be classified as below.
If you are in the first three months of pregnancy an ESR of 81 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 81 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 81 is elevated

What are the symptoms of an ESR of 81 ?

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 81

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Cough

Persistent or chronic coughing.

Vision Changes

Blurred vision or other visual disturbances.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Nausea and Vomiting

Feeling of sickness and vomiting.

Shortness of Breath

Difficulty breathing or breathlessness.

Loss of Appetite

Decreased desire to eat.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Mouth Ulcers

Sores in the mouth that may be painful.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Recurrent Infections

Frequent or persistent infections.

Depression

Persistent feelings of sadness or hopelessness.

Photosensitivity

Increased sensitivity to sunlight.

Hair Loss

Unexplained loss of hair.

Fatigue

Persistent tiredness and lack of energy.

Chest Pain

Pain or discomfort in the chest area.

Fever

Elevated body temperature beyond normal range.

Headaches

Recurrent or persistent headaches.

Muscle Aches

Generalized or localized pain in muscles.

Abdominal Pain

Discomfort or pain in the abdominal region.

Night Sweats

Excessive sweating during sleep.

Skin Rashes

Unexplained skin eruptions or changes.

Which foods can reduce an ESR of 81 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.

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.

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.

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.

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.

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.

What other tests should be done with an ESR of 81 mm/hr ?

For an ESR of 81, 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 81

What is my ESR:CRP ratio for an ESR of 81 mm/hr ?

ESR	CRP	Ratio	Means
81	1.0	81.0	More likely to be autoimmune disease flareup of SLE
81	1.5	54.0	More likely to be autoimmune disease flareup of SLE
81	2.0	40.5	More likely to be autoimmune disease flareup of SLE
81	2.5	32.4	More likely to be autoimmune disease flareup of SLE
81	3.0	27.0	More likely to be autoimmune disease flareup of SLE
81	3.5	23.142857142857142	More likely to be autoimmune disease flareup of SLE
81	4.0	20.25	More likely to be autoimmune disease flareup of SLE
81	4.5	18.0	More likely to be autoimmune disease flareup of SLE
81	5.0	16.2	More likely to be autoimmune disease flareup of SLE
81	5.5	14.727272727272727	Inconclusive
81	6.0	13.5	Inconclusive
81	6.5	12.461538461538462	Inconclusive
81	7.0	11.571428571428571	Inconclusive
81	7.5	10.8	Inconclusive
81	8.0	10.125	Inconclusive
81	8.5	9.529411764705882	Inconclusive
81	9.0	9.0	Inconclusive
81	9.5	8.526315789473685	Inconclusive
81	10.0	8.1	Inconclusive
81	10.5	7.714285714285714	Inconclusive
81	11.0	7.363636363636363	Inconclusive
81	11.5	7.043478260869565	Inconclusive
81	12.0	6.75	Inconclusive
81	12.5	6.48	Inconclusive
81	13.0	6.230769230769231	Inconclusive
81	13.5	6.0	Inconclusive
81	14.0	5.785714285714286	Inconclusive
81	14.5	5.586206896551724	Inconclusive
81	15.0	5.4	Inconclusive
81	15.5	5.225806451612903	Inconclusive
81	16.0	5.0625	Inconclusive
81	16.5	4.909090909090909	Inconclusive
81	17.0	4.764705882352941	Inconclusive
81	17.5	4.628571428571429	Inconclusive
81	18.0	4.5	Inconclusive
81	18.5	4.378378378378378	Inconclusive
81	19.0	4.2631578947368425	Inconclusive
81	19.5	4.153846153846154	Inconclusive
81	20.0	4.05	Inconclusive
81	20.5	3.951219512195122	Inconclusive
81	21.0	3.857142857142857	Inconclusive
81	21.5	3.7674418604651163	Inconclusive
81	22.0	3.6818181818181817	Inconclusive
81	22.5	3.6	Inconclusive
81	23.0	3.5217391304347827	Inconclusive
81	23.5	3.4468085106382977	Inconclusive
81	24.0	3.375	Inconclusive
81	24.5	3.306122448979592	Inconclusive
81	25.0	3.24	Inconclusive
81	25.5	3.176470588235294	Inconclusive
81	26.0	3.1153846153846154	Inconclusive
81	26.5	3.056603773584906	Inconclusive
81	27.0	3.0	Inconclusive
81	27.5	2.9454545454545453	Inconclusive
81	28.0	2.892857142857143	Inconclusive
81	28.5	2.8421052631578947	Inconclusive
81	29.0	2.793103448275862	Inconclusive
81	29.5	2.7457627118644066	Inconclusive

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