ESR 89 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 89 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 89 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 89 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 89

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

Normal Range and Grading for Adult Women : ESR 89

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 89

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

What does an ESR of 89 mm/hr mean?

An ESR level of 89 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 89 mm/hr good?

Is an ESR of 89 mm/hr bad?

Is an ESR of 89 mm/hr dangerous?

Is an ESR of 89 mm/hr normal?

What are the causes of an ESR of 89 mm/hr?

An ESR of 89 can have various causing including the following

Inflammation

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

Certain Cancers

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

Heart Disease

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

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Anemia

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

Vasculitis

Inflammation of blood vessels.

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Hepatitis

Inflammation of the liver, often caused by viral infections.

What are the causes for a falsely elevated ESR value of 89?

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

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.

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.

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.

Sleep Deprivation

Lack of sleep can be associated with changes in inflammatory markers, including ESR. Sleep deprivation disrupts the body's natural regulatory processes, affecting the immune system and potentially leading to an elevation in ESR. Prioritizing sufficient and quality sleep is crucial for overall health.

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.

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.

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.

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.

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.

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.

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.

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.

What does an ESR of 89 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 89 can be classified as below.
If you are in the first three months of pregnancy an ESR of 89 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 89 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 89 is elevated

What are the symptoms of an ESR of 89 ?

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 89

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Muscle Aches

Generalized or localized pain in muscles.

Dizziness

Feeling lightheaded or unsteady.

Headaches

Recurrent or persistent headaches.

Cognitive Impairment

Memory problems or difficulty concentrating.

Nausea and Vomiting

Feeling of sickness and vomiting.

Vision Changes

Blurred vision or other visual disturbances.

Loss of Appetite

Decreased desire to eat.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Frequent Urination

Increased need to urinate.

Recurrent Infections

Frequent or persistent infections.

Skin Rashes

Unexplained skin eruptions or changes.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Mouth Ulcers

Sores in the mouth that may be painful.

Cough

Persistent or chronic coughing.

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.

Depression

Persistent feelings of sadness or hopelessness.

Neurological Symptoms

Tingling, numbness, or weakness.

Fever

Elevated body temperature beyond normal range.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Photosensitivity

Increased sensitivity to sunlight.

Night Sweats

Excessive sweating during sleep.

Which foods can reduce an ESR of 89 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.

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.

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.

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.

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 89 mm/hr ?

For an ESR of 89, 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 89

What is my ESR:CRP ratio for an ESR of 89 mm/hr ?

ESR	CRP	Ratio	Means
89	1.0	89.0	More likely to be autoimmune disease flareup of SLE
89	1.5	59.333333333333336	More likely to be autoimmune disease flareup of SLE
89	2.0	44.5	More likely to be autoimmune disease flareup of SLE
89	2.5	35.6	More likely to be autoimmune disease flareup of SLE
89	3.0	29.666666666666668	More likely to be autoimmune disease flareup of SLE
89	3.5	25.428571428571427	More likely to be autoimmune disease flareup of SLE
89	4.0	22.25	More likely to be autoimmune disease flareup of SLE
89	4.5	19.77777777777778	More likely to be autoimmune disease flareup of SLE
89	5.0	17.8	More likely to be autoimmune disease flareup of SLE
89	5.5	16.181818181818183	More likely to be autoimmune disease flareup of SLE
89	6.0	14.833333333333334	Inconclusive
89	6.5	13.692307692307692	Inconclusive
89	7.0	12.714285714285714	Inconclusive
89	7.5	11.866666666666667	Inconclusive
89	8.0	11.125	Inconclusive
89	8.5	10.470588235294118	Inconclusive
89	9.0	9.88888888888889	Inconclusive
89	9.5	9.368421052631579	Inconclusive
89	10.0	8.9	Inconclusive
89	10.5	8.476190476190476	Inconclusive
89	11.0	8.090909090909092	Inconclusive
89	11.5	7.739130434782608	Inconclusive
89	12.0	7.416666666666667	Inconclusive
89	12.5	7.12	Inconclusive
89	13.0	6.846153846153846	Inconclusive
89	13.5	6.592592592592593	Inconclusive
89	14.0	6.357142857142857	Inconclusive
89	14.5	6.137931034482759	Inconclusive
89	15.0	5.933333333333334	Inconclusive
89	15.5	5.741935483870968	Inconclusive
89	16.0	5.5625	Inconclusive
89	16.5	5.393939393939394	Inconclusive
89	17.0	5.235294117647059	Inconclusive
89	17.5	5.085714285714285	Inconclusive
89	18.0	4.944444444444445	Inconclusive
89	18.5	4.8108108108108105	Inconclusive
89	19.0	4.684210526315789	Inconclusive
89	19.5	4.564102564102564	Inconclusive
89	20.0	4.45	Inconclusive
89	20.5	4.341463414634147	Inconclusive
89	21.0	4.238095238095238	Inconclusive
89	21.5	4.1395348837209305	Inconclusive
89	22.0	4.045454545454546	Inconclusive
89	22.5	3.9555555555555557	Inconclusive
89	23.0	3.869565217391304	Inconclusive
89	23.5	3.7872340425531914	Inconclusive
89	24.0	3.7083333333333335	Inconclusive
89	24.5	3.63265306122449	Inconclusive
89	25.0	3.56	Inconclusive
89	25.5	3.4901960784313726	Inconclusive
89	26.0	3.423076923076923	Inconclusive
89	26.5	3.358490566037736	Inconclusive
89	27.0	3.2962962962962963	Inconclusive
89	27.5	3.2363636363636363	Inconclusive
89	28.0	3.1785714285714284	Inconclusive
89	28.5	3.1228070175438596	Inconclusive
89	29.0	3.0689655172413794	Inconclusive
89	29.5	3.016949152542373	Inconclusive

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