ESR 98 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 98 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 98 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 98 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 98

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

Normal Range and Grading for Adult Women : ESR 98

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 98

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

What does an ESR of 98 mm/hr mean?

An ESR level of 98 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 98 mm/hr good?

Is an ESR of 98 mm/hr bad?

Is an ESR of 98 mm/hr dangerous?

Is an ESR of 98 mm/hr normal?

What are the causes of an ESR of 98 mm/hr?

An ESR of 98 can have various causing including the following

Hepatitis

Inflammation of the liver, often caused by viral infections.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Myeloma

A type of cancer that affects plasma cells in the bone marrow.

Anemia

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

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Infection

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

Inflammatory Bowel Disease

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

Inflammation

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

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Certain Medications

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

Lymphoma

A type of cancer that originates in the lymphatic system.

Pregnancy

ESR levels can be higher during pregnancy.

What are the causes for a falsely elevated ESR value of 98?

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

Aging

ESR tends to increase with age, and a mild elevation may be a normal part of the aging process. The gradual wear and tear on the body's tissues can contribute to a low-level inflammatory state, leading to a slightly higher ESR in elderly individuals.

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.

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.

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.

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.

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.

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.

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.

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.

Pregnancy

During pregnancy, the body undergoes significant hormonal and physiological changes. The increased blood volume, hormonal fluctuations, and immune system adaptations can contribute to higher ESR levels. This elevation is often considered normal in pregnant individuals.

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.

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.

What does an ESR of 98 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 98 can be classified as below.
If you are in the first three months of pregnancy an ESR of 98 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 98 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 98 is elevated

What are the symptoms of an ESR of 98 ?

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 98

Vision Changes

Blurred vision or other visual disturbances.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Photosensitivity

Increased sensitivity to sunlight.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Headaches

Recurrent or persistent headaches.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Abdominal Pain

Discomfort or pain in the abdominal region.

Neurological Symptoms

Tingling, numbness, or weakness.

Fatigue

Persistent tiredness and lack of energy.

Muscle Aches

Generalized or localized pain in muscles.

Nausea and Vomiting

Feeling of sickness and vomiting.

Recurrent Infections

Frequent or persistent infections.

Depression

Persistent feelings of sadness or hopelessness.

Skin Rashes

Unexplained skin eruptions or changes.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Dizziness

Feeling lightheaded or unsteady.

Cognitive Impairment

Memory problems or difficulty concentrating.

Hair Loss

Unexplained loss of hair.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Night Sweats

Excessive sweating during sleep.

Fever

Elevated body temperature beyond normal range.

Loss of Appetite

Decreased desire to eat.

Mouth Ulcers

Sores in the mouth that may be painful.

Chest Pain

Pain or discomfort in the chest area.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Which foods can reduce an ESR of 98 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.

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.

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.

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.

What other tests should be done with an ESR of 98 mm/hr ?

For an ESR of 98, 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 98

What is my ESR:CRP ratio for an ESR of 98 mm/hr ?

ESR	CRP	Ratio	Means
98	1.0	98.0	More likely to be autoimmune disease flareup of SLE
98	1.5	65.33333333333333	More likely to be autoimmune disease flareup of SLE
98	2.0	49.0	More likely to be autoimmune disease flareup of SLE
98	2.5	39.2	More likely to be autoimmune disease flareup of SLE
98	3.0	32.666666666666664	More likely to be autoimmune disease flareup of SLE
98	3.5	28.0	More likely to be autoimmune disease flareup of SLE
98	4.0	24.5	More likely to be autoimmune disease flareup of SLE
98	4.5	21.77777777777778	More likely to be autoimmune disease flareup of SLE
98	5.0	19.6	More likely to be autoimmune disease flareup of SLE
98	5.5	17.818181818181817	More likely to be autoimmune disease flareup of SLE
98	6.0	16.333333333333332	More likely to be autoimmune disease flareup of SLE
98	6.5	15.076923076923077	More likely to be autoimmune disease flareup of SLE
98	7.0	14.0	Inconclusive
98	7.5	13.066666666666666	Inconclusive
98	8.0	12.25	Inconclusive
98	8.5	11.529411764705882	Inconclusive
98	9.0	10.88888888888889	Inconclusive
98	9.5	10.31578947368421	Inconclusive
98	10.0	9.8	Inconclusive
98	10.5	9.333333333333334	Inconclusive
98	11.0	8.909090909090908	Inconclusive
98	11.5	8.521739130434783	Inconclusive
98	12.0	8.166666666666666	Inconclusive
98	12.5	7.84	Inconclusive
98	13.0	7.538461538461538	Inconclusive
98	13.5	7.2592592592592595	Inconclusive
98	14.0	7.0	Inconclusive
98	14.5	6.758620689655173	Inconclusive
98	15.0	6.533333333333333	Inconclusive
98	15.5	6.32258064516129	Inconclusive
98	16.0	6.125	Inconclusive
98	16.5	5.9393939393939394	Inconclusive
98	17.0	5.764705882352941	Inconclusive
98	17.5	5.6	Inconclusive
98	18.0	5.444444444444445	Inconclusive
98	18.5	5.297297297297297	Inconclusive
98	19.0	5.157894736842105	Inconclusive
98	19.5	5.0256410256410255	Inconclusive
98	20.0	4.9	Inconclusive
98	20.5	4.780487804878049	Inconclusive
98	21.0	4.666666666666667	Inconclusive
98	21.5	4.558139534883721	Inconclusive
98	22.0	4.454545454545454	Inconclusive
98	22.5	4.355555555555555	Inconclusive
98	23.0	4.260869565217392	Inconclusive
98	23.5	4.170212765957447	Inconclusive
98	24.0	4.083333333333333	Inconclusive
98	24.5	4.0	Inconclusive
98	25.0	3.92	Inconclusive
98	25.5	3.843137254901961	Inconclusive
98	26.0	3.769230769230769	Inconclusive
98	26.5	3.69811320754717	Inconclusive
98	27.0	3.6296296296296298	Inconclusive
98	27.5	3.5636363636363635	Inconclusive
98	28.0	3.5	Inconclusive
98	28.5	3.43859649122807	Inconclusive
98	29.0	3.3793103448275863	Inconclusive
98	29.5	3.3220338983050848	Inconclusive

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