When a person comes to the clinic complaining of any disease, he is first offered a general blood test. It includes checking such important indicators of the patient’s blood as the amount of hemoglobin, leukocytes, and erythrocyte sedimentation rate (ESR).

The complex result allows us to determine the patient’s health status. The last indicator is especially important. It can be used to determine the presence or absence of inflammatory processes in the body. Based on changes in ESR levels, doctors draw conclusions about the course of the disease and the effectiveness of the therapy used.

The importance of ESR level for the female body

In a general blood test, there is a very important parameter - the erythrocyte sedimentation rate; in women the norm is different and depends on age categories.

What does this mean - ESR? This indicator indicates the erythrocyte sedimentation rate, the rate at which blood breaks down into fractions. When performing a study, gravitational forces influence the blood in a test tube, and it gradually stratifies: a lower ball of greater thickness and dark color appears, and the upper one is of a light shade with some transparency. Red blood cells settle and stick together. The speed of this process is shown by a blood test for ESR..

When conducting this study, it is necessary to take into account that:

• women have an ESR level slightly higher than men, this is due to the peculiarities of the functioning of the body;
• the highest indicator can be observed in the morning;
• if there is an acute inflammatory process, then the ESR increases on average one day after the onset of the disease, and before this there is an increase in the number of leukocytes;
• ESR reaches its maximum value during recovery;
• if the reading is too high over a long period, conclusions can be drawn about inflammation or a malignant tumor.

It is noteworthy that this analysis does not always show the real state of the patient’s health. Sometimes, even in the presence of an inflammatory process, ESR may be within normal limits.

What level of ESR is considered normal?

Many factors influence a woman's ESR level. The general norm for erythrocyte sedimentation rate in women is 2-15 mm/h, and the average is 10 mm/h. The value depends on many factors. One of them is the presence of diseases that affect the level of ESR. Age also affects this indicator in women. Each age group has its own norm.

To understand how the ESR normal limits change in women, there is a table by age:

From the beginning of puberty until the age of 18, the ESR norm for women is 3-18 mm/h. It can fluctuate slightly depending on the menstrual period, vaccinations to prevent diseases, the presence or absence of injuries, and inflammatory processes.

The age group of 18-30 years is in the physiological dawn, in which the birth of children most often occurs. Women at this time have an ESR level of 2 to 15 mm/h. The result of the analysis, as in the previous case, depends on the menstrual cycle, as well as on the use of hormonal contraceptives and adherence to various diets.

When pregnancy occurs, the value of this indicator increases sharply and a value of up to 45 mm/h is considered normal. This occurs due to hormonal changes and other factors.

The amount of hemoglobin can also affect the period after childbirth. Its decrease due to blood loss during childbirth can provoke an increase in the number of leukocytes and ESR.

The norm for women at 30-40 years old increases. Deviation may be a consequence of poor nutrition, cardiovascular diseases, pneumonia and other pathological conditions.

Upon reaching 40-50 years of age, women begin menopause. The norm during this period expands: the lower limit decreases, the upper limit rises. And the result can be from 0 to 26 mm/h. It is affected by hormonal changes in a woman’s body under the influence of menopause. At this age, the development of pathologies of the endocrine system, osteoporosis, varicose veins, and dental diseases is not uncommon.

The ESR normal limits for women over 50 years of age do not differ significantly from those for the previous age period.

After reaching 60 years of age, the optimal boundaries change. The permissible value of the indicator can be in the range from 2 to 55 mm/h. In most cases, the older a person is, the more diseases he has.

This factor is reflected in the conditional norm. Conditions such as diabetes, fractures, high blood pressure, and taking medications affect the test result in older people.

If a woman has an ESR of 30, what does this mean? When such an analysis result occurs in a pregnant woman or an older lady, there is no cause for great concern. But if the owner of this indicator is young, then the result for her is increased. The same applies to ESR 40 and ESR 35.

An ESR of 20 is a normal level for middle-aged women, and if a girl has it, then she needs to be wary and pay close attention to her health. The same can also be said about ESR 25 and ESR 22. For age groups under 40 years old, these indicators are overestimated. Further examination and clarification of the reason for this result is necessary.

Methods for determining ESR

There are several ways to get results from a blood test for ESR:

1. Panchenkov's method. This diagnostic method is implemented using a glass pipette, also called a Panchenkov capillary. This test involves blood taken from a finger.
2. . A hematology analyzer is used to obtain the result. In this case, blood is taken from a vein. In a special test tube it is combined with an anticoagulant and placed in the device in a vertical position. The analyzer performs calculations.

Scientists compared these 2 methods and came to the conclusion that the result of the second is more reliable and allows one to obtain the results of a venous blood analysis in a shorter period of time.

The use of the Panchenkov method prevailed in the post-Soviet space, and the Westergren method is considered international. But in most cases, both methods show identical results.

If you have doubts about the reliability of the study, you can check it again in a paid clinic. Another method determines the level of C-reactive protein (CRP), while eliminating the human factor of distorting the result. The disadvantage of this method is its high cost, although the data obtained with its help can be trusted. In European countries, the analysis of ESR has already been replaced by the determination of PSA.

In what cases is analysis prescribed?

Doctors usually prescribe a test when a person’s health deteriorates, when he comes to see a doctor and complains of feeling unwell. A general blood test, the result of which is the ESR indicator, is often prescribed for various inflammatory processes, as well as to check the effectiveness of therapy.

Doctors refer the patient to this study to make a correct diagnosis for any illness or suspicion of it. The result of a blood test for ESR is needed even for every person to undergo a routine health check.

Most often, a referral is issued by a general practitioner, but a hematologist or oncologist can send for examination if such a need arises. This analysis is carried out free of charge in the laboratory of the medical institution where the patient is observed. But if a person wishes, he has the right to undergo research for money in the laboratory that he chooses.

There is a list of diseases for which a blood test for ESR is mandatory:

1. Possible development of rheumatic disease. This could be lupus, gout or rheumatoid arthritis. All of them provoke joint deformation, stiffness, and painful sensations during the functioning of the musculoskeletal system. Affects diseases and joints, connective tissues. The result in the presence of any of these diseases will be an increase in ESR.
2. Myocardial infarction. In the case of this pathology, blood flow in the heart arteries is disrupted. Although there is an opinion that this is a sudden illness, the prerequisites are formed even before its onset. People who are attentive to their health are quite capable of noticing the appearance of the corresponding symptoms even a month before the onset of the disease itself, so it is possible to prevent this disease. It must be remembered that if even mild pain occurs, you should consult a doctor.
3. Onset of pregnancy. In this case, the health of the woman and her unborn baby is checked. During pregnancy, there is a need for repeated blood donations. Doctors carefully check your blood for all indicators. As already mentioned, due to hormonal changes, a noticeable increase in the upper limit of normal is allowed.
4. When a neoplasm occurs, to control its development. This study will not only test the effectiveness of therapy, but also diagnose the presence of a tumor at the initial stage. An elevated erythrocyte sedimentation rate may indicate the presence of inflammation. It has a variety of causes, from the common cold to cancer. But a more in-depth examination is needed.
5. Suspicion of a bacterial infection. In this case, a blood test will show an ESR level higher than normal, but it may also indicate a disease of viral origin. Therefore, you cannot focus only on ESR; additional tests should be performed.

When referring a doctor for this study, it is necessary to fulfill all the requirements for proper preparation, since the ESR blood test is one of the most important in diagnosing diseases.

How to take the test correctly

To test a patient's blood, it is usually drawn from a vein. The analysis shows not only ESR, but also a number of other indicators. All of them are collectively assessed by the medical staff, and the comprehensive result is taken into account.

For it to be true, you need to prepare:

• It is better to donate blood on an empty stomach. If, in addition to the erythrocyte sedimentation rate, you need to find out your sugar level, then 12 hours before donating blood you should not eat, do not brush your teeth, you can only drink a little plain water.
• Do not drink alcohol the day before blood sampling. The same goes for smoking. If you have a strong desire to smoke, you must stop doing so at least in the morning. These factors are eliminated because they easily influence the research results.
• Of course, you need to stop taking medications. This primarily concerns hormonal contraceptives and multivitamins. If you cannot take a break from using any medication, then you need to let your doctor know about this, and he will make adjustments to the results obtained taking into account the use of this medication.
• In the morning, it is advisable to come early for blood collection in order to calm down a little and catch your breath. On this day it is better to be balanced and not give the body heavy physical activity.
• Since the ESR test depends on the menstrual phases, before donating blood you should consult with your doctor about the best time to take the test.
• The day before blood sampling, it is necessary to limit fatty and spicy foods in your diet.

The procedure for taking the test is quick and painless. If you still feel unwell or feel dizzy, you should tell the nurse.

If a woman's ESR level is elevated, what does this mean?

It is described above what the normal erythrocyte sedimentation rate for women should be according to age and condition (for example, during pregnancy). So when is ESR considered elevated? If the age indicator deviates from the norm upward by more than 5 units.

In this case, it is possible to detect the presence of diseases such as pneumonia, tuberculosis, poisoning, myocardial infarction and others. But this analysis is not enough to make a diagnosis based on it. It happens that even a hearty breakfast can cause an increase in this indicator. Therefore, there is no need to panic when an ESR is detected above normal.

With a normal erythrocyte sedimentation rate and elevated lymphocytes, the development of a viral disease is possible. Taking into account the inertia of this level, if you have doubts about the result, you just need to re-pass the examination.

State of health of a woman with a low ESR level

Having explained what the norm of ESR in the blood of women and an increased value mean, we will explain what reasons can lead to a low level of this indicator. This result can occur due to:

• blood flow insufficiency;
• epilepsy;
• liver disease (hepatitis);
• taking certain medications, in particular potassium chloride, salicylates, mercury-based medications;
• erythrocytosis, erythremia;
• neurotic illness;
• diseases that provoke changes in the shape of red cells, in particular anisocytosis;
• strict vegetarianism;
• hyperalbuminemia, hypofibrinogenemia, hypoglobulinemia.

As you can see, a low erythrocyte sedimentation rate should be no less alarming than an increased one. If there are deviations from the normal indicator in any direction, it is necessary to look for the cause of this health condition and treat the disease.

What is the easiest way to bring the ESR indicator back to normal?

In itself, an increased or decreased erythrocyte sedimentation rate is not a disease, but it shows the state of the human body. Therefore, to the question of how to lower ESR in the blood of women, we can answer that this value will return to normal only after the causes that caused it are eliminated.

Understanding this, sometimes the patient just needs to be patient and diligently treated.

Reasons why the ESR indicator will return to normal after a long time:

• the broken bone heals slowly and the wound takes a long time to heal;
• long-term therapeutic course of treatment for a specific disease;
• bearing a child.

Since an increase in erythrocyte sedimentation rate during pregnancy can be associated with anemia, it is necessary to try to prevent it. If it has already occurred, you need to undergo a course of treatment with safe drugs prescribed by the doctor.

In most cases, ESR can be lowered to an acceptable level only by eliminating inflammation or curing the disease. An even higher result may be due to a laboratory error.

If, when taking an erythrocyte sedimentation rate test, a value was found to be higher or lower than normal, it is necessary to undergo the examination again and make sure that there is no accidental distortion of the result. It’s also worth reviewing your diet and saying goodbye to bad habits.

• WBC (white blood cells - white blood cells) - absolute content of leukocytes.
• RBC (red blood cells - red blood cells) - absolute content of red blood cells.
• HGB (Hb, hemoglobin) - hemoglobin concentration in whole blood.
• HCT (hematocrit) - hematocrit - the ratio of the volume of formed elements to blood plasma.
• PLT (platelets - blood platelets) - absolute platelet content.

Red blood cell indices (MCV, MCH, MCHC):

• MCV is the average volume of a red blood cell in cubic micrometers (µm) or femtoliters (fl).
• MCH is the average hemoglobin content in an individual red blood cell.
• MCHC is the average hemoglobin concentration in a red blood cell.

Platelet indices (MPV, PDW, PCT):

• MPV (mean platelet volume) - average platelet volume.
• PDW is the relative width of platelet distribution by volume.
• PCT (platelet crit) - thrombocrit.

• LYM% (LY%) (lymphocyte) - relative (%) content of lymphocytes.
• LYM# (LY#) (lymphocyte) - absolute content of lymphocytes.
• MXD% is the relative (%) content of a mixture of monocytes, basophils and eosinophils.
• MXD# is the absolute content of a mixture of monocytes, basophils and eosinophils.
• NEUT% (NE%) (neutrophils) - relative (%) content of neutrophils.
• NEUT# (NE#) (neutrophils) - absolute content of neutrophils.
• MON% (MO%) (monocyte) - relative (%) content of monocytes.
• MON# (MO#) (monocyte) - absolute content of monocytes.
• EO% - relative (%) content of eosinophils.
• EO# is the absolute content of eosinophils.
• BA% - relative (%) content of basophils.
• BA# is the absolute content of basophils.
• IMM% - relative (%) content of immature granulocytes.
• IMM# is the absolute content of immature granulocytes.
• ATL% - relative (%) content of atypical lymphocytes.
• ATL# - absolute content of atypical lymphocytes.
• GR% - relative (%) content of granulocytes.
• GR# is the absolute content of granulocytes.

• RBC/HCT - average volume of red blood cells.
• HGB/RBC - average hemoglobin content in a red blood cell.
• HGB/HCT is the average hemoglobin concentration in a red blood cell.
• RDW - Red cell Distribution Width - coefficient of variation of the average volume of red blood cells.
• RDW-SD - relative width of distribution of erythrocytes by volume, standard deviation.
• RDW-CV - relative width of distribution of erythrocytes by volume, coefficient of variation.
• P-LCR - large platelet ratio.
• ESR - erythrocyte sedimentation rate.

Clinical blood test

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What does ESR mean in a blood test, and how is it indicated in tests?

A doctor can explain what ESR means in a blood test if abnormalities appear. The study is mandatory during a routine medical examination or any complaints from the patient. The blood result will help make a diagnosis; decoding is a matter for a specialist. ESR in a blood test is an important indicator indicating the presence of inflammation and pathology.

Indicator designation

A blood test is a method by which you can find out the level of ESR in the blood.

Here are the characteristics of the cells directly involved in determining the ESR:

• Red blood cells are red blood cells that contain hemoglobin, which provides the body with heme iron.
• The functions of erythrocytes are that, circulating through the peripheral blood, they carry oxygen to the tissues, and take back free molecules - metabolic products.

• The norm of these cells differs in men, women and children. This value is highest in men (4.4-5.0 × 1012 per 1 liter); in women the figure is slightly lower due to monthly blood loss. In children, the meaning is constantly changing due to the intensive growth of body structures.

The number of red blood cells is higher than other cells circulating in the blood, therefore their sedimentation rate is more indicative in diagnostic terms. Due to their quantity, sedimentation occurs faster. ESR is determined at every preventive examination, that is, at least once a year, and also when you feel unwell.

Determining the erythrocyte sedimentation rate allows you to determine the presence of a hidden inflammatory process or infection. The essence of calculating the parameter is that the cells settle under their own weight, and after a unit of time it is possible to register how many divisions this occurred. Increasing the weight of cells leads to an acceleration of their decline.

There are certain conditions that affect the result:

• temperature at which the sample is stored;
• selection of capillary length;
• correct fixation in the tripod;
• compliance with the recommended anticoagulant ratio;
• anticoagulant component used.

As a rule, normal ESR values ​​differ among people of different sexes: for the strong half of humanity, a value of up to 10 mm/hour is considered normal, for women - up to 15. In a newborn child, an ESR value of up to 2 mm/hour is considered a healthy indicator. Already at one month this limit moves to 5 mm/h, and by 6 months it is 2-6.

In this case, the blood test should be considered in conjunction with other health parameters: for some children at 6 months and 10 mm/h is the norm. You can find out the level of ESR using a general blood test.

The purpose of determining ESR

The interpretation of the blood test, and especially the ESR, should be done by a doctor, since the indicators can be ambiguous, and a competent specialist can understand further tactics in relation to the patient.

Decoding the ESR allows the doctor to understand the following:

• Is there an inflammatory or infectious process in the body?
• Is the previously prescribed treatment effective?
• Is it possible to suspect the presence of an oncological process if there are no specific complaints?

• Are there any residual effects after the infection?

The topic of what ESR means in a blood test exists inseparably from other indicators. Particular attention should be paid to leukocytes: with leukocytopenia, there is a need for a detailed blood test with the calculation of the leukocyte formula; analysis with a predominance of immature young forms of leukocytes raises suspicion of leukemia. In this case, the cells lose the possibility of final differentiation and maturation.

The simplest purpose of determining ESR is to quickly separate patients from healthy ones. As you know, if a disease is suspected, the doctor sends you for examination.

With a wide range of diagnostics, the group of suspected pathologies is so wide that it will require the use of many studies, including expensive ones (ultrasound, radiography, MRI, CT, analysis of tumor markers). If a general blood test seems suspicious to the doctor, then based on complaints and other criteria, he makes a presumptive diagnosis and prescribes methods that can help determine the nature of the disease.

The erythrocyte sedimentation rate is influenced by many factors. During the inflammatory process, biologically active substances are released that can recharge the red blood cell membrane and cause them to stick together. Another reason is the emergence of coarsely dispersed proteins, which cause red blood cells to stick together.

Here is a list of some conditions in which the rate of red blood cells increases:

• infectious processes;
• purulent-inflammatory diseases;
• oncology;
• glomerulonephritis, pyelonephritis;
• hepatitis, cirrhosis;
• anemia;
• tissue necrosis, in which tissue disintegrates and proteins leak into the bloodstream;
• infarction of the brain, myocardium, intestines;
• tuberculosis;
• systemic connective tissue diseases;
• metabolic disorders;
• oncological blood lesions (leukemia, lymphogranulomatosis).

You can indirectly assume the presence of an increased or decreased ESR by the amount of hemoglobin: with a high level, the reaction will be lower, with anemia the level increases. That is, the lower the level of pigment, and, consequently, the red blood cells, the faster they settle. With a large number of cells, the blood becomes viscous, which reduces the rate at which the elements fall.

In a number of conditions that are not a disease, the body’s reaction is also observed:

1. During pregnancy, after childbirth and during menstruation.
2. In the morning hours the level is higher.
3. When a woman takes oral contraceptives (pills).
4. If at the time of the study a person has an exacerbation of a chronic process, even a runny nose, or a rash of acne.
5. After eating spicy or fatty foods.
6. During or after stress.
7. In case of an allergic reaction.
8. After taking certain groups of medications.

A blood test with an elevated reading is more common, but a lower result can also occur. One of the reasons for this phenomenon is referred to as a viral infection.

boleznikrovi.com

ESR in the blood: interpretation and designation of the analysis

One of the indicators of a general blood test is ESR - erythrocyte sedimentation rate. Previously, another term ROE was adopted - erythrocyte sedimentation reaction, but since no reaction actually occurs, this name was abandoned.

ESR indicators in the blood cannot be considered separately from other clinical tests, since deciphering the normal ESR level does not indicate the absence of a disease, and vice versa, low or increased indicators do not always indicate a dysfunction of the body.

Analysis for ESR level

An ESR blood test in the laboratory is carried out using simple manipulations. When doing a general analysis, a laboratory technician places blood in a test tube, adding an anticoagulant, which prevents the blood from clotting. The material remains in the flask for an hour, while red blood cells, due to their mass, settle to the bottom, and plasma occupies the upper part of the liquid. After an hour, you can determine the ESR level - it corresponds to the height that the plasma occupies. The boundary between red cells and clear plasma on the test tube scale will indicate the rate of red blood cells per hour (in millimeters).

Men and women have different ESR standards, but there are many conditions under which a level above or below average also means normal.

ESR norm indicators

It is generally accepted that the erythrocyte sedimentation rate in newborns is 0-2 mm/h, under the age of six months 12-17 mm/h, in men 2-10 mm/h, in women 3-15 mm/h. Women are subject to frequent changes in blood composition and the level of its components. So, for example, for women from 20 to 30 years old, the optimal indicators will be 3-15 mm/hour, in adulthood (30-60 years old) - 8-25 mm/hour, for those over 60 - 12-53 mm/hour h. As for pregnant women, they have an average level of 25 to 45 mm/h.

Nutrition and lifestyle also affect ESR, which increases slightly as a result of a heavy breakfast, menstruation, during the postpartum period, during fasting or a strict diet, as well as in the case of allergic diseases. In the latter option, a general analysis is done several times while taking anti-allergenic drugs - if the indicators begin to approach the norm, this means the medicine was chosen correctly.

A very low sedimentation rate is observed when following a vegetarian diet and when taking certain blood thinning drugs (aspirin, calcium chloride).

ESR level categories

In modern medicine, deviations from the norm are usually classified by degree. The first degree includes indicators that differ by several units from the established ones. The interpretation of the tests determines that the cells in the blood are at a relatively acceptable level.

The second degree includes patients whose erythrocyte sedimentation rate exceeds 15-30 units. This already indicates inflammatory processes in the body as a reaction of the body to colds or infections, which can actually be cured within a period of about 30 days. During this period, you should monitor the dynamics of ESR and take a general blood test, since the first changes will be noticeable only after 24-72 hours, a significant increase will appear on the 12-14th day of the disease, and the peak can be reached during the recovery period. Such amplitudes are explained by the fact that the human body requires time to produce the required amount of antibodies.

If, over a period of 30 days, the general analysis shows higher deviations - by 30-60 units, it’s time to seriously think about your health. This primarily indicates the presence of serious inflammatory processes or intoxication of the body due to tissue breakdown or a progressive malignant tumor.

Fourth degree - an increase in ESR by 60 units cannot pass without leaving a trace. Usually the patient knows about his disease, purulent-septic reactions occur in his body.

What factors influence the erythrocyte sedimentation rate?

The main indicator affecting ESR is the protein composition of the blood. The more proteins in the blood (globulins and fibrinogen), the lower the stability of red blood cells. The immune system begins to actively produce immunoglobulin to fight infection and viruses, and the rate of red blood cells increases. As for leukocytes, their speed and quantity are directly proportional to the indicators of red blood cells. So at the beginning of the attack on the body there are more of them, on days 10-14 the number decreases, and only on days 21-30 do leukocytes and erythrocytes increase their level in the same dynamics.

Methods for determining ESR

In modern medicine, it is customary to determine ESR in two ways: the Panchenkov method and deciphering the Westergren analysis. The norm for both types of research is the same, but they differ in the type of test tubes and the scale used for measurements. The Westergren method is more sensitive to an increase in ESR.

There are a number of diseases that are accompanied by changes in the erythrocyte sedimentation rate: heart attacks, disruption of the immune system, malignant diseases, anemia, leukemia. A decrease in speed may indicate hyperproteinemia, erythrocytosis, hepatitis and others.

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Decoding ESR in a blood test

Our blood consists of a liquid part and a dry residue. The liquid part of the blood is plasma, and the dry remainder is mainly represented by red blood cells. In addition to red blood cells, there are also leukocytes and platelets. But their number is so small that it can not be taken into account. Erythrocytes, or red blood cells, are biconcave discs.

In order for red blood cells to perform their main function of transporting oxygen and carbon dioxide, they must be in the blood plasma in a free suspended state, and in no case stick together. This is achieved by a number of complex physiological mechanisms. However, in vitro (in a test tube) red blood cells settle, because their density, or specific gravity, exceeds the density of blood plasma. True, the rate of their subsidence varies.

Not the last factor influencing the speed indicator is the phenomenon of aggregation (sticking together) of red blood cells. Red blood cell aggregation is a consequence of various pathological conditions. Conglomerates of red blood cells glued together have a large mass with a relatively small surface area, which creates conditions for their faster sedimentation in a liquid medium.

Factors of influence

ESR in the blood depends on a number of factors, including:

1. Charge of the erythrocyte membrane. Normally, the surface of the red blood cell membrane has a negative charge. Likely charged red blood cells repel each other and do not stick together. Due to various pathological conditions (poisoning, infection, diseases of internal organs), the erythrocyte membrane can be damaged with a change in its charge.
2. Red blood cell count. The fewer red blood cells, the faster they settle, and vice versa. Consequently, with anemia (anemia), the ESR will be increased.
3. Protein composition of blood. The main proteins of blood plasma are represented by low-molecular-weight albumins and large-molecular-weight globulins. For various inflammatory reactions, incl. and infectious nature, the amount of globulins increases. “Inflammatory proteins” appear - fibrinogen, C-reactive protein. This is accompanied by a change in the membrane charge of erythrocytes. A decrease in albumin levels in liver diseases leads to the same result.
4. Acid-base status of blood (ABS). The higher the acidity (acidosis) of the blood plasma, the higher the ESR, and, conversely, when the ESR shifts to the alkaline side (alkalosis), the ESR increases.

Thus, ESR shows that certain pathological changes occur in various organs and biological environments.

Normal values

The unit of measurement for ESR is mm/h – millimeter per hour. When determining the ESR norm, the following are taken into account:

2. Floor. In men, the ESR norm is 2-10 mm/h, and in women it is slightly higher, and is equal to 3-15 mm/h.
4. Age. For persons of both sexes over 50-60 years of age, an upper limit of up to 15-20 mm/h is allowed. ESR changes especially quickly in children of different ages. In newborns, ESR is 0-2 mm/h, in children from 6 months to one year - 12-17 mm/h, and in the blood of a child older than one year - 12-18 mm/h.

Although in different sources, normal ESR values ​​may vary slightly. Apparently, this is due to improvements in the technology for measuring this indicator.

In some reference materials you can find another indicator - ROE. This is an erythrocyte sedimentation reaction.

The presence of this indicator in some cases can cause confusion in the interpretation of test results. However, it should be noted that ESR and ROE are the same thing. It’s just that ROE is an outdated term, which was replaced by ESR back in Soviet times.

Method of determination

The classic method for determining ESR is the Panchenkov method. To prevent clotting, capillary blood taken from the finger of the subject is mixed with a preservative in a ratio of 3:1 - 3 parts blood and 1 part preservative. 5% sodium citrate acts as a preservative. The citrated blood is then placed into specially graduated glass capillaries. The results of the analysis are assessed after 1 hour by the height of the light column corresponding to blood plasma devoid of settled red blood cells.

Now the Panchenkov method has been replaced by a more progressive method Westergren. At its core, it is practically no different from the Panchenkov method. True, here, instead of glass capillaries, special graduated test tubes are used. The concentration of the preservative and its ratio with blood are also different - 3.8% and 4:1. But the fundamental difference is different. When determining ESR using the Westergren method, instead of blood from a finger, blood is taken from a vein. The bottom line is that many external influences (cold, physical activity) lead to a spasm of the capillaries, a change in the characteristics of the blood flowing in them, and a distortion of the results obtained. From this it follows that the analysis of venous blood is more objective than arterial blood.

Reasons for high ESR

In clinical practice, an increase in ESR is most often observed. The main reasons for this standing:

• inflammatory processes of the upper respiratory tract of an infectious nature - sinusitis, pharyngitis, rhinitis, sore throat;
• liver diseases – hepatitis, cirrhosis;
• malignant oncological diseases - cancer, sarcoma;
• allergic reactions;
• anemia;
• various conditions leading to alkalosis;
• pregnancy;
• increased blood cholesterol levels;
• large intake of fatty foods - in this regard, a general blood test should be taken on an empty stomach.

ESR may increase when blood is collected in a hot climate, at temperatures above 270C. And this should also be taken into account when assessing the results.

Reasons for low ESR

A decrease in ESR may be due to reasons such as:

• polycythemia – a disease that leads to an increase in the content of red blood cells;
• diseases of the cardiovascular system leading to the formation of congestive heart failure;
• some genetic blood diseases - sickle cell anemia, hereditary microspherocytosis;
• blood plasma acidosis;
• taking certain medications, including non-steroidal anti-inflammatory drugs;
• increased levels of bile acids in the blood plasma with liver damage, inflammatory diseases of the gallbladder, pancreas;
• Low ESR is also observed when blood is taken for analysis at an ambient temperature below 220C.

Peculiarities of increase in some conditions

Depending on the pathology, there are 3 degrees of increase in ESR:

It is believed that the degree of increase in this indicator depends on the severity of the inflammatory process. In this regard, ESR in pneumonia will be higher than in bronchitis. Although this statement is not always true. The level of ESR depends on the phase of the disease. As a rule, it increases 1-2 days after the first symptom of the disease develops - weakness, cough or high temperature.

The maximum ESR value is reached approximately at the 2nd week of the disease. Along with ESR, the number of leukocytes increases. Then, as the patient's condition improves during treatment, the ESR decreases and returns to normal. During pregnancy, an increase in ESR occurs from about the 4th week, reaches a maximum towards the end of pregnancy (40-50 mm/h and above), and after successful delivery it quickly normalizes. IN oncology, due to massive protein breakdown, the composition of the blood plasma changes, and this is accompanied by a sharp increase in ESR to 80-90 mm/h.

Clinical significance

It should be noted that it is impossible to judge the severity and phase of the disease on the basis of ESR alone. This is a non-specific indicator, and deciphering the analysis in addition to ESR should take into account the content of other formed elements. Most often, a high ESR in a general blood test serves as a reason for more detailed laboratory diagnosis.

www.infmedserv.ru

ESR or erythrocyte sedimentation rate is a nonspecific indicator. It indicates inflammatory processes occurring in the body. What is the normal ESR rate for men? And what are the most common reasons for deviation from it?

Let's take a closer look.

Units of ESR measurement

Erythrocyte sedimentation rate test to confirm symptoms of unclear or broad etiology. For example, an unexplained increase in body temperature. This diagnostic method is also suitable for determining certain types of arthritis and other diseases with ambiguous symptoms.

The specific gravity of erythrocytes is greater than the specific gravity of blood plasma, so red blood cells slowly settle to the bottom of the test tube during analysis. The sedimentation rate depends on the degree of erythrocyte aggregation. It, in turn, is determined by the protein composition and electrical properties of the plasma.

Red blood cells are negatively charged and repel each other. An increase in the degree of their aggregation (sticking together, grouping) is observed with an increase in the plasma content of acute phase proteins (fibrinogen or immunoglobulins). They are absorbed on the surface of red blood cells and are a kind of marker of the inflammatory process. When grouped, red blood cells occupy less space in the plasma and settle to the bottom of the tube faster.

The distance in millimeters at which cells settle in one hour in a standard test tube is the unit of measurement for ESR: mm/hour. May be referred to as ESR or ESR on blood test forms. Medical personnel and laboratory technicians of the old school can also use the term ROE.

Reasons for increased ESR in the male body

The erythrocyte sedimentation rate may change for several reasons. However, the most common is the presence of an inflammatory focus in the man’s body. Meaning nothing in itself, this indicator can warn about the development of the disease even before the first acute symptoms. Therefore, if detected in the blood, you should undergo a thorough examination of the body.

Where should you start checking your health first?

This test is nonspecific and cannot serve as the only basis for making an unambiguous diagnosis. Yet it is useful in identifying a large group of possible disease states.

infection or inflammation of unknown etiology

tuberculosis

intoxication of the body

some types of arthritis and rheumatism

autoimmune diseases

tissue death, necrotic processes

skin infections

infections of the heart and heart valves

endocrine diseases and metabolic disorders

shock states and periods after operations

diseases of the kidneys, biliary tract and liver

suspicion of neoplasms

There are cases when the ESR rate in men is reduced. Low values ​​are possible when the body is affected by factors such as:

• increased blood viscosity;
• decreased fibrinogen levels;
• polycythemia;
• Fasting or vegetarianism;
• Overhydration;
• low protein levels in the blood (kidney or liver disease);
• heart failure.

Norm of ESR in men and degree of deviation

The normal erythrocyte sedimentation rate in men is from 2 to 10 mm/hour. With age, the ESR indicator in men may change, remaining within the age norm. It is known that 5% of absolutely healthy men have, as a variant of the norm, increased erythrocyte sedimentation rate.

Table1. Norm ESR in men by age

For convenience, deviations from normal ESR parameters are usually classified by degree:

1st degree – a slight deviation from the norm, characterizing changes in blood parameters that are within acceptable limits.

2nd degree – the indicator differs from the norm by 15-30 units. This signals microcirculatory disorders in the man’s body. For example, about the presence of an infection that slightly changes the normal functioning of the body.

Grade 3 – deviation from normal ESR values ​​by 30-60 units, which indicates the presence of a serious inflammatory or necrotic process in the male body.

4th degree - if the ESR norm in men is exceeded by 60 units, which is an indicator of a catastrophically serious condition of the body.

Is it possible that there is an error in the analysis?

Yes, not without this...

Measuring the erythrocyte sedimentation rate using the Westergren method or Panchenkov test is part of a general blood test.

In Russia, the Panchenkov method is still more widespread. A glass graduated capillary 1 mm wide and 10 cm high is filled with blood from a finger. It is mixed in certain proportions with an anticoagulant to slow down clotting. The sample is placed in a rack with a calibrated scale for 60 minutes. The remaining plasma column above the settled red blood cells is then measured in mm. This is the ESR indicator.

It is important to note that the ESR rate in men within the framework of this method is measured manually by a laboratory assistant. It inevitably follows from this that the measurement results are influenced by the “human factor.” It is clear that under conditions of high load, laboratory assistants perform tests on several samples at the same time. And of course, no one can sit with bated breath over one particular test tube for exactly an hour. There may also be inaccuracies in recording distances measured in millimeters.

Venous blood is used to perform the Westergren test.

Both methods produce similar results only within the normal range in younger people. In areas above typical values ​​for each age, the Westergren test shows higher ESR levels. Both methods have a satisfactory degree of accuracy, but the possibility of automated Westergren analysis makes it more preferable in modern diagnostics.

Erythrocyte sedimentation rate is a biological parameter that determines the ratio of proteins and blood elements. ESR is an important parameter of a general blood test, since sedimentation rates change in some diseases and specific conditions of the body.

When infectious and inflammatory reactions occur in the body, a large number of protein compounds are released into the blood (proteins of the acute phase of inflammation). During laboratory testing, red blood cells stick together under the influence of proteins and then settle to the bottom of the test tube.

The essence of the study is to measure the sedimentation rate: the more proteins there are in the plasma (markers of inflammatory processes in the body), the faster the red blood cells form fractions and settle.

Methods for determining ESR

There are several methods for determining the erythrocyte sedimentation rate: according to Panchenkov, according to Westergren, according to Wintrobe, microESR. These laboratory research methods differ in the method of blood sampling, the technique of conducting laboratory research and the dimensional scale of the results.

Panchenkov method

This method is used in public hospital laboratories and is included in a general blood test, for which biological material is taken from a finger.

During the study, a Panchenkov apparatus is used, which consists of a tripod into which special capillaries (thin tubes) with size marks are inserted.

After drawing blood from a finger, a reagent (sodium citrate solution) is added to the laboratory capillary to prevent coagulation (formation of a dense clot). Next, the biological material is placed in a capillary with a measuring scale of 100 divisions.

After an hour, the laboratory assistant determines how many millimeters the fractions of clumped red blood cells drop in 1 hour.

Westergen method

The Westergen determination method is used for a more accurate diagnosis of inflammatory processes and is an international laboratory research method.

The collection of biological material for the method of determining ESR according to Westergen is carried out from a vein on an empty stomach. The biological material is added to a test tube with a reagent (sodium citrate) that prevents clotting.

There are 200 divisions on the test tube using the Westergen method, which allows for a more accurate determination of ESR. The units of measurement for this indicator are similar in both versions of the study - millimeters per hour (mm/h).

There are factors that affect the accuracy of the analysis results, namely:

• temperature in the laboratory where the research is being carried out (at a temperature of more than 25 degrees Celsius, the ESR value increases, and if it is less than 18 degrees, a low erythrocyte sedimentation rate is detected);
• storage time (if biological material is stored for more than 4 hours before laboratory analysis);
• reagent used;
• degree of dilution and quality of mixing of biological material with the reagent;
• correct installation of the capillary in the tripod;
• using a plastic capillary instead of a glass one.

Taking into account possible errors, if ESR values ​​are too high or low for no apparent reason, it is necessary to re-take the test to confirm the pathology.

Norm of ESR in the blood of women by age (table)

The ESR parameter is relatively stable in healthy men, but in women the sedimentation rate may differ, depending on many factors:

• age (after 50 the ESR level increases);
• physique (in women who are overweight and have high cholesterol levels, ESR increases);
• hormonal background;
• pregnancy;
• taking hormonal contraceptives.

Also, physiological reasons for changes in the ESR parameter include diet: eating protein foods increases the ESR rate regardless of gender and age.

Woman's age, years	Norms according to the Panchenkov method, mm/h	Norms according to the Westiergen method, mm/h
Up to 17	4-11	2-10
17-30	2-15	2-20
30-50	2-20	2-25
Over 50	2-25	2-30

Determining ESR is an important diagnostic test that shows the presence of an inflammatory process in the body, but does not reveal the nature and location of the source of infection.

When is it appointed?

A general (biochemical) blood test with ESR measurement is prescribed in several cases:

• during a preventive examination, as a method of determining the degree of health of the body;
• for the diagnosis of diseases accompanied by inflammatory processes (infections, tumors, etc.), erythermia, acidosis, etc.

The determination of ESR is fundamental for identifying pathological processes in the body during the diagnosis of infectious diseases of the respiratory tract, namely:

• sinusitis, sinusitis;
• angina;
• inflammation of the pharynx, larynx and trachea;
• bronchitis;
• pneumonia;
• ARVI;
• flu.

After drug treatment of these diseases, a control clinical blood test for ESR is performed, which returns to normal within 7-10 days after recovery.

How to prepare for analysis

Preparing for blood collection for analysis is not difficult. It is necessary to follow some recommendations that contribute to the most realistic analysis results:

• biological material is collected on an empty stomach, 10-12 hours after the last meal;
• on the eve of the procedure, you need to refrain from eating large amounts of protein foods and not drinking alcoholic beverages at all;
• the day before the analysis, intense physical activity and stressful situations are excluded.

The procedure for removing material for analysis of erythrocyte sedimentation rate cannot be carried out after certain medical studies that can lead to a temporary disruption of the normal composition of the blood, namely:

• X-ray;
• probing of internal organs;
• physiotherapeutic procedures;
• treatment with heparin, dextran, corticotropin, fluorides, oxalates, cortisone;
• taking vitamin A;
• introduction of hepatitis B vaccine.

If it is necessary to analyze ESR, stop taking certain types of medications 3-5 days before the procedure (glucocorticosteroids, hormonal drugs, etc.).

Reasons for increasing ESR

The development of an acute or chronic inflammatory reaction in the body is accompanied by an increased content of coarse proteins in the blood (globulins, fibrinogens, paraproteins), which contribute to the rapid adhesion of red blood cells and an increase in ESR values. Manifests itself in the following diseases:

• diseases of the upper respiratory tract (ARVI, influenza, bronchitis, pneumonia, sinusitis);
• infections of the genitourinary system (cystitis, urethritis, pyelonephritis);
• rheumatism;
• rheumatic and bacterial endocarditis;
• infectious polyarthritis;
• cholecystitis;
• tuberculosis;
• pneumonia;
• abscess, gangrene of the lungs;
• pancreatitis;
• pleurisy, etc.

Also, the erythrocyte sedimentation rate can be increased in other pathologies, during which the amount of albumin in the blood decreases, namely:

• diseases of the gastrointestinal tract with impaired absorption of nutrients;
• parenchymal hepatitis;
• neoplasms in the liver;
• thyrotoxicosis;
• nephrotic syndrome.

An increase in ESR depends on indicators such as the level of cholesterol, lecithin, bile acids and pigments, which may deviate from the norm in the following diseases:

• poisoning;
• injuries;
• prolonged bleeding;
• heart attack, heart failure;
• pulmonary infarction;
• nephritis, renal failure;
• some types of anemia.

An increase in the erythrocyte sedimentation rate in women when taking hormonal drugs with estrogen, during pregnancy, during menstruation, as well as during fasting and a strict diet is not dangerous.

The main symptoms of elevated ESR, which may appear along with signs of the underlying disease, are as follows:

• migraines, prolonged headaches, dizziness;
• fatigue;
• nausea;
• abdominal pain, sometimes intestinal upset;
• rapid heartbeat;
• pale skin.

Reasons for low ESR levels

In some cases, the ESR level is determined to be too low. There are three main reasons that influence the decrease in erythrocyte sedimentation rate:

• blood thickening - increasing plasma viscosity due to increased red blood cell content;
• hyperbilirubinemia - increased bilirubin levels;
• acidosis is a violation of the alkaline-acid balance in the body.

As a rule, these pathologies occur with the following diseases:

• pathologies of the heart and circulatory system with congestion;
• simultaneous malfunctions of the liver and biliary tract;
• lack of nutrients;
• long-term vegetarian diet;
• starvation;
• vegetarian diet;
• excessive fluid intake;
• use of corticosteroid drugs,
• frequent use of aspirin.

The main manifestations of a reduced erythrocyte sedimentation rate depend on pathological processes in the body and can be as follows:

• shortness of breath, dry cough;
• weakness, dizziness;
• increased breathing;
• nausea and vomiting;
• weight loss;
• formation of hematomas with minor injuries;
• frequent nosebleeds.

During pregnancy

During pregnancy, ESR testing is carried out four times:

• at the beginning of pregnancy until the 12th week;
• at 20-21 weeks;
• at 28-30 weeks of pregnancy;
• before childbirth.

Due to hormonal changes that occur throughout pregnancy, a woman's erythrocyte sedimentation rate changes significantly during the 9 months of pregnancy, as well as for some time after childbirth.

1st trimester. The norm of ESR in the blood in the first months of pregnancy is very wide: depending on the body type and individual characteristics, this indicator can be either low (13 mm/h) or excessively high (up to 45 mm/h).

2nd trimester. At this time, the woman’s condition stabilizes somewhat and the erythrocyte sedimentation rate is approximately 20-30 mm/h.

3rd trimester. The last stages of pregnancy are characterized by a significant increase in the permissible norm of ESR - from 30 to 45 mm/h. Such a sharp increase indicates rapid fetal development and does not require treatment.

After childbirth, a woman's erythrocyte sedimentation rate remains elevated because a woman may lose a lot of blood during labor. For 2-3 months after birth, ESR can reach 30 mm/h. When hormonal processes return to normal, a woman’s ESR level decreases to 0-15 mm/h.

During menopause

The climacteric period of a woman's life is characterized by strong hormonal changes, which significantly affects the chemical composition of the blood. During menopause, the ESR rate in the blood, as a rule, increases significantly and can reach up to 50 millimeters per hour.

In women over 50 years of age, the ESR level can be quite high (up to 30 mm/hour), which is normal if other blood parameters do not exceed the permissible norm.

However, after the onset of menopause, an ESR in the blood of women greater than 50 mm/hour can signal the following diseases:

• diseases of the thyroid gland (hyperthyroidism, hypothyroidism), occurring in 50-60% of women after 50 years of age;
• chronic infections;
• tumor growth;
• active rheumatological processes;
• kidney disease;
• allergic reactions;
• fractures.

A reduced level of ESR in women during menopause and in the postmenstrual period always indicates pathological processes in the body. A reduced erythrocyte sedimentation rate (below 15-12 mm/hour) can be caused by the following diseases:

• diseases of the gastrointestinal tract (duodenitis, gastritis, stomach ulcer);
• leukocytosis - an increase in the number of leukocytes that occurs during many inflammatory and oncological processes (meningitis, peritonitis, pyelonephritis, malignant tumors);
• erythrocytosis, manifested in polycythemia vera, diseases of the respiratory system (pulmonary pleurisy, lung tumors), etc.;
• hepatitis;
• blood clotting disorder.

It should be remembered that the ESR level drops below normal after taking aspirin.

For cancer

Suspicion of oncological processes in the body arises if the ESR value is higher than normal, despite long-term treatment with anti-inflammatory drugs (up to 70 mm/s). At the same time, the hemoglobin level decreases from 120-130 units to 70-80 units, and the level of leukocytes also increases.

A prolonged increase in the red blood cell sedimentation rate may indicate the formation of malignant tumors:

• intestinal tumors;
• cancerous tumors of the breast, cervix and ovaries in women;
• oncological processes in the bone marrow;
• brain tumors.

An increase in the ESR level also occurs with the development of benign tumors, namely:

• myeloma;
• polyps;
• papillomas;
• fibroids;
• lymphangiomas, etc.

Laboratory analysis of the ESR norm in women is not a direct indicator of the presence of cancer processes in the body, therefore, after determining the erythrocyte sedimentation rate of more than 70-80 mm/hour, an additional examination is carried out to confirm the diagnosis (ultrasound, magnetic resonance imaging, etc. ).

How to reduce ESR using folk remedies

In order to reduce the ESR level to normal, you can use effective folk remedies: beets, honey, garlic, lemons, herbal infusion, etc. The action of folk recipes is aimed at cleansing the blood, relieving inflammatory processes in the body and strengthening the immune system.

Beetroot decoction. Red beets have many beneficial properties that can improve your health, namely:

• Due to B vitamins, metabolism can be normalized;
• with the help of vitamin C and beta-carotene, the functioning of the immune system improves;
• contains quartz, which strengthens the vascular system and helps cleanse the body;
• removes toxins;
• normalizes plasma levels.

To prepare the decoction you will need 3 small beets, which must be thoroughly washed and cooked unpeeled. There is no need to trim the beet tails.

Cook the beets over low heat for 3 hours, making sure that the water does not boil away. The broth is cooled and stored in the refrigerator.

You need to take 50 grams of the decoction on an empty stomach in the morning, without getting out of bed. After taking the medicine, you should lie down for another 10-15 minutes. Treatment lasts 7 days, followed by a week break, and the course of treatment is repeated.

Infusion of medicinal herbs. To reduce the erythrocyte sedimentation rate, effective herbs such as chamomile, linden flowers, coltsfoot, which have anti-inflammatory, disinfectant, and cleansing properties, are used.

Take dried crushed leaves (0.5 teaspoon) of each plant, pour a glass of boiling water and leave for 30 minutes. The infusion is filtered and drunk 2 times a day after meals. The course of treatment is 20 days.