ESR 96 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 96 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 96 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 96 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 96

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

Normal Range and Grading for Adult Women : ESR 96

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 96

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

What does an ESR of 96 mm/hr mean?

An ESR level of 96 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 96 mm/hr good?

Is an ESR of 96 mm/hr bad?

Is an ESR of 96 mm/hr dangerous?

Is an ESR of 96 mm/hr normal?

What are the causes of an ESR of 96 mm/hr?

An ESR of 96 can have various causing including the following

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.

Liver Disease

Certain liver conditions can be associated with higher ESR.

Pregnancy

ESR levels can be higher during pregnancy.

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Chronic Obstructive Pulmonary Disease (COPD)

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

Certain Cancers

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

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

HIV/AIDS

The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) can lead to immune system dysfunction and inflammation.

Lymphoma

A type of cancer that originates in the lymphatic system.

Hepatitis

Inflammation of the liver, often caused by viral infections.

Anemia

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

What are the causes for a falsely elevated ESR value of 96?

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 96 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 96 can be classified as below.
If you are in the first three months of pregnancy an ESR of 96 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 96 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 96 is elevated

What are the symptoms of an ESR of 96 ?

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 96

Skin Rashes

Unexplained skin eruptions or changes.

Photosensitivity

Increased sensitivity to sunlight.

Fatigue

Persistent tiredness and lack of energy.

Depression

Persistent feelings of sadness or hopelessness.

Nausea and Vomiting

Feeling of sickness and vomiting.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Night Sweats

Excessive sweating during sleep.

Mouth Ulcers

Sores in the mouth that may be painful.

Loss of Appetite

Decreased desire to eat.

Muscle Aches

Generalized or localized pain in muscles.

Abdominal Pain

Discomfort or pain in the abdominal region.

Neurological Symptoms

Tingling, numbness, or weakness.

Cough

Persistent or chronic coughing.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Frequent Urination

Increased need to urinate.

Chest Pain

Pain or discomfort in the chest area.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Fever

Elevated body temperature beyond normal range.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Dizziness

Feeling lightheaded or unsteady.

Shortness of Breath

Difficulty breathing or breathlessness.

Vision Changes

Blurred vision or other visual disturbances.

Recurrent Infections

Frequent or persistent infections.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Headaches

Recurrent or persistent headaches.

Which foods can reduce an ESR of 96 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.

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.

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.

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 96 mm/hr ?

For an ESR of 96, 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 96

What is my ESR:CRP ratio for an ESR of 96 mm/hr ?

ESR	CRP	Ratio	Means
96	1.0	96.0	More likely to be autoimmune disease flareup of SLE
96	1.5	64.0	More likely to be autoimmune disease flareup of SLE
96	2.0	48.0	More likely to be autoimmune disease flareup of SLE
96	2.5	38.4	More likely to be autoimmune disease flareup of SLE
96	3.0	32.0	More likely to be autoimmune disease flareup of SLE
96	3.5	27.428571428571427	More likely to be autoimmune disease flareup of SLE
96	4.0	24.0	More likely to be autoimmune disease flareup of SLE
96	4.5	21.333333333333332	More likely to be autoimmune disease flareup of SLE
96	5.0	19.2	More likely to be autoimmune disease flareup of SLE
96	5.5	17.454545454545453	More likely to be autoimmune disease flareup of SLE
96	6.0	16.0	More likely to be autoimmune disease flareup of SLE
96	6.5	14.76923076923077	Inconclusive
96	7.0	13.714285714285714	Inconclusive
96	7.5	12.8	Inconclusive
96	8.0	12.0	Inconclusive
96	8.5	11.294117647058824	Inconclusive
96	9.0	10.666666666666666	Inconclusive
96	9.5	10.105263157894736	Inconclusive
96	10.0	9.6	Inconclusive
96	10.5	9.142857142857142	Inconclusive
96	11.0	8.727272727272727	Inconclusive
96	11.5	8.347826086956522	Inconclusive
96	12.0	8.0	Inconclusive
96	12.5	7.68	Inconclusive
96	13.0	7.384615384615385	Inconclusive
96	13.5	7.111111111111111	Inconclusive
96	14.0	6.857142857142857	Inconclusive
96	14.5	6.620689655172414	Inconclusive
96	15.0	6.4	Inconclusive
96	15.5	6.193548387096774	Inconclusive
96	16.0	6.0	Inconclusive
96	16.5	5.818181818181818	Inconclusive
96	17.0	5.647058823529412	Inconclusive
96	17.5	5.485714285714286	Inconclusive
96	18.0	5.333333333333333	Inconclusive
96	18.5	5.1891891891891895	Inconclusive
96	19.0	5.052631578947368	Inconclusive
96	19.5	4.923076923076923	Inconclusive
96	20.0	4.8	Inconclusive
96	20.5	4.682926829268292	Inconclusive
96	21.0	4.571428571428571	Inconclusive
96	21.5	4.465116279069767	Inconclusive
96	22.0	4.363636363636363	Inconclusive
96	22.5	4.266666666666667	Inconclusive
96	23.0	4.173913043478261	Inconclusive
96	23.5	4.085106382978723	Inconclusive
96	24.0	4.0	Inconclusive
96	24.5	3.9183673469387754	Inconclusive
96	25.0	3.84	Inconclusive
96	25.5	3.764705882352941	Inconclusive
96	26.0	3.6923076923076925	Inconclusive
96	26.5	3.6226415094339623	Inconclusive
96	27.0	3.5555555555555554	Inconclusive
96	27.5	3.4909090909090907	Inconclusive
96	28.0	3.4285714285714284	Inconclusive
96	28.5	3.3684210526315788	Inconclusive
96	29.0	3.310344827586207	Inconclusive
96	29.5	3.2542372881355934	Inconclusive

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