ESR 84 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 84 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 84 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?

ESR, or Erythrocyte Sedimentation Rate, is measured by collecting a small blood sample from the patient's arm, usually from a vein. Before the blood draw, the area is cleaned with an antiseptic solution to ensure a sterile collection. Once obtained, the blood is mixed with an anticoagulant to prevent clotting. The prepared blood sample is then placed in a tall, thin tube, which is positioned upright to allow red blood cells to settle over a specific period, often one hour. The distance the red blood cells travel in the tube during this time is carefully measured, and the settling rate is recorded. The Westergren method, a widely recognized technique for ESR measurement, involves the use of a specialized Westergren tube for blood collection. In preparation for the test, patients are usually 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 84 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 84

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

Normal Range and Grading for Adult Women : ESR 84

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 84

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

What does an ESR of 84 mm/hr mean?

An ESR level of 84 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 84 mm/hr good?

Is an ESR of 84 mm/hr bad?

Is an ESR of 84 mm/hr dangerous?

Is an ESR of 84 mm/hr normal?

What are the causes of an ESR of 84 mm/hr?

An ESR of 84 can have various causing including the following

Certain Cancers

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

Pregnancy

ESR levels can be higher during pregnancy.

Aging

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

Autoimmune Disorders

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

Liver Disease

Certain liver conditions can be associated with higher ESR.

Vasculitis

Inflammation of blood vessels.

Inflammatory Bowel Disease

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

Chronic Obstructive Pulmonary Disease (COPD)

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

Anemia

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

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Lymphoma

A type of cancer that originates in the lymphatic system.

What are the causes for a falsely elevated ESR value of 84?

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.

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.

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.

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.

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.

Sun Exposure

Exposure to sunlight influences vitamin D levels in the body, which in turn can affect the immune system and inflammatory response. Changes in ESR levels related to sun exposure highlight the interconnectedness of environmental factors and inflammation.

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.

Temperature Changes

Extreme temperatures, whether due to fever or exposure to cold, can affect the viscosity of blood. These temperature-related changes can influence ESR levels. Monitoring body temperature and addressing the underlying cause is important for accurate interpretation of ESR results.

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.

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.

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.

What does an ESR of 84 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 84 can be classified as below.
If you are in the first three months of pregnancy an ESR of 84 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 84 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 84 is elevated

What are the symptoms of an ESR of 84 ?

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 84

Abdominal Pain

Discomfort or pain in the abdominal region.

Neurological Symptoms

Tingling, numbness, or weakness.

Headaches

Recurrent or persistent headaches.

Night Sweats

Excessive sweating during sleep.

Chest Pain

Pain or discomfort in the chest area.

Dizziness

Feeling lightheaded or unsteady.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Hair Loss

Unexplained loss of hair.

Recurrent Infections

Frequent or persistent infections.

Cough

Persistent or chronic coughing.

Vision Changes

Blurred vision or other visual disturbances.

Mouth Ulcers

Sores in the mouth that may be painful.

Muscle Aches

Generalized or localized pain in muscles.

Frequent Urination

Increased need to urinate.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Fatigue

Persistent tiredness and lack of energy.

Fever

Elevated body temperature beyond normal range.

Photosensitivity

Increased sensitivity to sunlight.

Nausea and Vomiting

Feeling of sickness and vomiting.

Shortness of Breath

Difficulty breathing or breathlessness.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Loss of Appetite

Decreased desire to eat.

Skin Rashes

Unexplained skin eruptions or changes.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Cognitive Impairment

Memory problems or difficulty concentrating.

Which foods can reduce an ESR of 84 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.

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.

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.

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.

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 84 mm/hr ?

For an ESR of 84, 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 84

What is my ESR:CRP ratio for an ESR of 84 mm/hr ?

ESR	CRP	Ratio	Means
84	1.0	84.0	More likely to be autoimmune disease flareup of SLE
84	1.5	56.0	More likely to be autoimmune disease flareup of SLE
84	2.0	42.0	More likely to be autoimmune disease flareup of SLE
84	2.5	33.6	More likely to be autoimmune disease flareup of SLE
84	3.0	28.0	More likely to be autoimmune disease flareup of SLE
84	3.5	24.0	More likely to be autoimmune disease flareup of SLE
84	4.0	21.0	More likely to be autoimmune disease flareup of SLE
84	4.5	18.666666666666668	More likely to be autoimmune disease flareup of SLE
84	5.0	16.8	More likely to be autoimmune disease flareup of SLE
84	5.5	15.272727272727273	More likely to be autoimmune disease flareup of SLE
84	6.0	14.0	Inconclusive
84	6.5	12.923076923076923	Inconclusive
84	7.0	12.0	Inconclusive
84	7.5	11.2	Inconclusive
84	8.0	10.5	Inconclusive
84	8.5	9.882352941176471	Inconclusive
84	9.0	9.333333333333334	Inconclusive
84	9.5	8.842105263157896	Inconclusive
84	10.0	8.4	Inconclusive
84	10.5	8.0	Inconclusive
84	11.0	7.636363636363637	Inconclusive
84	11.5	7.304347826086956	Inconclusive
84	12.0	7.0	Inconclusive
84	12.5	6.72	Inconclusive
84	13.0	6.461538461538462	Inconclusive
84	13.5	6.222222222222222	Inconclusive
84	14.0	6.0	Inconclusive
84	14.5	5.793103448275862	Inconclusive
84	15.0	5.6	Inconclusive
84	15.5	5.419354838709677	Inconclusive
84	16.0	5.25	Inconclusive
84	16.5	5.090909090909091	Inconclusive
84	17.0	4.9411764705882355	Inconclusive
84	17.5	4.8	Inconclusive
84	18.0	4.666666666666667	Inconclusive
84	18.5	4.54054054054054	Inconclusive
84	19.0	4.421052631578948	Inconclusive
84	19.5	4.3076923076923075	Inconclusive
84	20.0	4.2	Inconclusive
84	20.5	4.097560975609756	Inconclusive
84	21.0	4.0	Inconclusive
84	21.5	3.9069767441860463	Inconclusive
84	22.0	3.8181818181818183	Inconclusive
84	22.5	3.7333333333333334	Inconclusive
84	23.0	3.652173913043478	Inconclusive
84	23.5	3.574468085106383	Inconclusive
84	24.0	3.5	Inconclusive
84	24.5	3.4285714285714284	Inconclusive
84	25.0	3.36	Inconclusive
84	25.5	3.2941176470588234	Inconclusive
84	26.0	3.230769230769231	Inconclusive
84	26.5	3.169811320754717	Inconclusive
84	27.0	3.111111111111111	Inconclusive
84	27.5	3.0545454545454547	Inconclusive
84	28.0	3.0	Inconclusive
84	28.5	2.9473684210526314	Inconclusive
84	29.0	2.896551724137931	Inconclusive
84	29.5	2.847457627118644	Inconclusive

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