ESR 93 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 93 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 93 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 93 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 93

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

Normal Range and Grading for Adult Women : ESR 93

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 93

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

What does an ESR of 93 mm/hr mean?

An ESR level of 93 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 93 mm/hr good?

Is an ESR of 93 mm/hr bad?

Is an ESR of 93 mm/hr dangerous?

Is an ESR of 93 mm/hr normal?

What are the causes of an ESR of 93 mm/hr?

An ESR of 93 can have various causing including the following

Certain Cancers

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

Temporal Arteritis

An inflammatory condition affecting the blood vessels.

Hepatitis

Inflammation of the liver, often caused by viral infections.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Pregnancy

ESR levels can be higher during pregnancy.

Tissue injury

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

Inflammatory Bowel Disease

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

Lymphoma

A type of cancer that originates in the lymphatic system.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Autoimmune Disorders

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

Certain Medications

Some medications, such as corticosteroids, can influence ESR levels.

What are the causes for a falsely elevated ESR value of 93?

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

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.

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.

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.

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.

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.

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.

Mild Infections

Low-grade or chronic infections may result in a subtle increase in ESR. The immune system responds to even minor infections by releasing inflammatory markers, influencing ESR levels. Monitoring for signs of infection and addressing underlying causes is crucial.

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.

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.

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.

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.

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.

What does an ESR of 93 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 93 can be classified as below.
If you are in the first three months of pregnancy an ESR of 93 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 93 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 93 is elevated

What are the symptoms of an ESR of 93 ?

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 93

Headaches

Recurrent or persistent headaches.

Neurological Symptoms

Tingling, numbness, or weakness.

Nausea and Vomiting

Feeling of sickness and vomiting.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Hair Loss

Unexplained loss of hair.

Cough

Persistent or chronic coughing.

Shortness of Breath

Difficulty breathing or breathlessness.

Frequent Urination

Increased need to urinate.

Dizziness

Feeling lightheaded or unsteady.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Vision Changes

Blurred vision or other visual disturbances.

Skin Rashes

Unexplained skin eruptions or changes.

Chest Pain

Pain or discomfort in the chest area.

Fever

Elevated body temperature beyond normal range.

Cognitive Impairment

Memory problems or difficulty concentrating.

Night Sweats

Excessive sweating during sleep.

Photosensitivity

Increased sensitivity to sunlight.

Depression

Persistent feelings of sadness or hopelessness.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Loss of Appetite

Decreased desire to eat.

Fatigue

Persistent tiredness and lack of energy.

Recurrent Infections

Frequent or persistent infections.

Muscle Aches

Generalized or localized pain in muscles.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Which foods can reduce an ESR of 93 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.

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.

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.

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 93 mm/hr ?

For an ESR of 93, 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 93

What is my ESR:CRP ratio for an ESR of 93 mm/hr ?

ESR	CRP	Ratio	Means
93	1.0	93.0	More likely to be autoimmune disease flareup of SLE
93	1.5	62.0	More likely to be autoimmune disease flareup of SLE
93	2.0	46.5	More likely to be autoimmune disease flareup of SLE
93	2.5	37.2	More likely to be autoimmune disease flareup of SLE
93	3.0	31.0	More likely to be autoimmune disease flareup of SLE
93	3.5	26.571428571428573	More likely to be autoimmune disease flareup of SLE
93	4.0	23.25	More likely to be autoimmune disease flareup of SLE
93	4.5	20.666666666666668	More likely to be autoimmune disease flareup of SLE
93	5.0	18.6	More likely to be autoimmune disease flareup of SLE
93	5.5	16.90909090909091	More likely to be autoimmune disease flareup of SLE
93	6.0	15.5	More likely to be autoimmune disease flareup of SLE
93	6.5	14.307692307692308	Inconclusive
93	7.0	13.285714285714286	Inconclusive
93	7.5	12.4	Inconclusive
93	8.0	11.625	Inconclusive
93	8.5	10.941176470588236	Inconclusive
93	9.0	10.333333333333334	Inconclusive
93	9.5	9.789473684210526	Inconclusive
93	10.0	9.3	Inconclusive
93	10.5	8.857142857142858	Inconclusive
93	11.0	8.454545454545455	Inconclusive
93	11.5	8.08695652173913	Inconclusive
93	12.0	7.75	Inconclusive
93	12.5	7.44	Inconclusive
93	13.0	7.153846153846154	Inconclusive
93	13.5	6.888888888888889	Inconclusive
93	14.0	6.642857142857143	Inconclusive
93	14.5	6.413793103448276	Inconclusive
93	15.0	6.2	Inconclusive
93	15.5	6.0	Inconclusive
93	16.0	5.8125	Inconclusive
93	16.5	5.636363636363637	Inconclusive
93	17.0	5.470588235294118	Inconclusive
93	17.5	5.314285714285714	Inconclusive
93	18.0	5.166666666666667	Inconclusive
93	18.5	5.027027027027027	Inconclusive
93	19.0	4.894736842105263	Inconclusive
93	19.5	4.769230769230769	Inconclusive
93	20.0	4.65	Inconclusive
93	20.5	4.536585365853658	Inconclusive
93	21.0	4.428571428571429	Inconclusive
93	21.5	4.325581395348837	Inconclusive
93	22.0	4.2272727272727275	Inconclusive
93	22.5	4.133333333333334	Inconclusive
93	23.0	4.043478260869565	Inconclusive
93	23.5	3.9574468085106385	Inconclusive
93	24.0	3.875	Inconclusive
93	24.5	3.795918367346939	Inconclusive
93	25.0	3.72	Inconclusive
93	25.5	3.6470588235294117	Inconclusive
93	26.0	3.576923076923077	Inconclusive
93	26.5	3.509433962264151	Inconclusive
93	27.0	3.4444444444444446	Inconclusive
93	27.5	3.381818181818182	Inconclusive
93	28.0	3.3214285714285716	Inconclusive
93	28.5	3.263157894736842	Inconclusive
93	29.0	3.206896551724138	Inconclusive
93	29.5	3.152542372881356	Inconclusive

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