ESR 56 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 56 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 56 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?

ESR, or Erythrocyte Sedimentation Rate, is measured by taking a small blood sample from the patient, typically drawn from a vein in the arm after cleaning the area with an antiseptic solution. The collected blood is then mixed with an anticoagulant to prevent clotting and placed in a tall, thin tube. This tube is left undisturbed in an upright position for a specific period, usually one hour, allowing the red blood cells to settle. The distance they travel in the tube is then measured, and the rate at which they settle is recorded. The Westergren method, one common approach to ESR measurement, specifically involves collecting blood in a specialized Westergren tube. To prepare for the test, patients are generally advised to inform their healthcare provider about any medications they are taking, as certain drugs can affect the results. Fasting is not required for ESR, but staying well-hydrated before the test is recommended to ensure a smoother blood draw and accurate results. ESR is a valuable diagnostic tool, aiding healthcare professionals in assessing inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 56 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 56

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

Normal Range and Grading for Adult Women : ESR 56

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	You are here
>80	Very High

Normal Range and Grading for Children : ESR 56

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

What does an ESR of 56 mm/hr mean?

An ESR level of 56 is considered to be significantly elevated. A cause must be found for the elevated ESR, while ruling out normal or physiological causes. An ESR between 50 and 80, is definitely not normal and must be further investigated together with additional tests, that are listed in a subsequent section.

Is an ESR of 56 mm/hr good?

An ESR of 56 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 56 mm/hr bad?

An ESR of 56 is bad in all populations and should be further investigated.

Is an ESR of 56 mm/hr dangerous?

An ESR of 56 is elevated but not necessarily dangerous

Is an ESR of 56 mm/hr normal?

An ESR of 56 is not normal and is classified as elevated.

What are the causes of an ESR of 56 mm/hr?

An ESR of 56 can have various causing including the following

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Certain Cancers

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

Pregnancy

ESR levels can be higher during pregnancy.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Heart Disease

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

Autoimmune Disorders

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Rheumatoid Arthritis

A chronic inflammatory disorder affecting the joints.

Anemia

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

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

What are the causes for a falsely elevated ESR value of 56?

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

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.

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.

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.

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.

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.

Recent Vaccination

Vaccination stimulates the immune system, triggering an inflammatory response. This immune activity can lead to a temporary increase in ESR levels as part of the body's natural defense mechanism. The elevation is usually transient and not indicative of a pathological condition.

Iron Deficiency

Mild iron deficiency can affect the composition of blood, potentially leading to changes in ESR levels. Adequate iron levels are essential for overall health, and addressing iron deficiency is important for maintaining optimal blood parameters.

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.

Sleep Patterns

Disruptions in sleep patterns, including irregular sleep duration and quality, can influence the body's inflammatory response. Sleep deprivation or poor sleep hygiene may contribute to elevated ESR levels. Prioritizing good sleep habits is essential for overall health.

Sleep Deprivation

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

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.

What does an ESR of 56 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 56 can be classified as below.
If you are in the first three months of pregnancy an ESR of 56 is normal
If you are in the second trimester or months 3-6 of pregnancy an ESR of 56 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 56 is normal

What are the symptoms of an ESR of 56 ?

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 56

Fever

Elevated body temperature beyond normal range.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Abdominal Pain

Discomfort or pain in the abdominal region.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Skin Rashes

Unexplained skin eruptions or changes.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Photosensitivity

Increased sensitivity to sunlight.

Depression

Persistent feelings of sadness or hopelessness.

Nausea and Vomiting

Feeling of sickness and vomiting.

Vision Changes

Blurred vision or other visual disturbances.

Cough

Persistent or chronic coughing.

Recurrent Infections

Frequent or persistent infections.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Mouth Ulcers

Sores in the mouth that may be painful.

Cognitive Impairment

Memory problems or difficulty concentrating.

Chest Pain

Pain or discomfort in the chest area.

Hair Loss

Unexplained loss of hair.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Night Sweats

Excessive sweating during sleep.

Dizziness

Feeling lightheaded or unsteady.

Fatigue

Persistent tiredness and lack of energy.

Frequent Urination

Increased need to urinate.

Headaches

Recurrent or persistent headaches.

Shortness of Breath

Difficulty breathing or breathlessness.

Which foods can reduce an ESR of 56 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 56 mm/hr ?

For an ESR of 56, 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 56

What is my ESR:CRP ratio for an ESR of 56 mm/hr ?

ESR	CRP	Ratio	Means
56	1.0	56.0	More likely to be autoimmune disease flareup of SLE
56	1.5	37.333333333333336	More likely to be autoimmune disease flareup of SLE
56	2.0	28.0	More likely to be autoimmune disease flareup of SLE
56	2.5	22.4	More likely to be autoimmune disease flareup of SLE
56	3.0	18.666666666666668	More likely to be autoimmune disease flareup of SLE
56	3.5	16.0	More likely to be autoimmune disease flareup of SLE
56	4.0	14.0	Inconclusive
56	4.5	12.444444444444445	Inconclusive
56	5.0	11.2	Inconclusive
56	5.5	10.181818181818182	Inconclusive
56	6.0	9.333333333333334	Inconclusive
56	6.5	8.615384615384615	Inconclusive
56	7.0	8.0	Inconclusive
56	7.5	7.466666666666667	Inconclusive
56	8.0	7.0	Inconclusive
56	8.5	6.588235294117647	Inconclusive
56	9.0	6.222222222222222	Inconclusive
56	9.5	5.894736842105263	Inconclusive
56	10.0	5.6	Inconclusive
56	10.5	5.333333333333333	Inconclusive
56	11.0	5.090909090909091	Inconclusive
56	11.5	4.869565217391305	Inconclusive
56	12.0	4.666666666666667	Inconclusive
56	12.5	4.48	Inconclusive
56	13.0	4.3076923076923075	Inconclusive
56	13.5	4.148148148148148	Inconclusive
56	14.0	4.0	Inconclusive
56	14.5	3.8620689655172415	Inconclusive
56	15.0	3.7333333333333334	Inconclusive
56	15.5	3.6129032258064515	Inconclusive
56	16.0	3.5	Inconclusive
56	16.5	3.393939393939394	Inconclusive
56	17.0	3.2941176470588234	Inconclusive
56	17.5	3.2	Inconclusive
56	18.0	3.111111111111111	Inconclusive
56	18.5	3.027027027027027	Inconclusive
56	19.0	2.9473684210526314	Inconclusive
56	19.5	2.871794871794872	Inconclusive
56	20.0	2.8	Inconclusive
56	20.5	2.731707317073171	Inconclusive
56	21.0	2.6666666666666665	Inconclusive
56	21.5	2.604651162790698	Inconclusive
56	22.0	2.5454545454545454	Inconclusive
56	22.5	2.488888888888889	Inconclusive
56	23.0	2.4347826086956523	Inconclusive
56	23.5	2.382978723404255	Inconclusive
56	24.0	2.3333333333333335	Inconclusive
56	24.5	2.2857142857142856	Inconclusive
56	25.0	2.24	Inconclusive
56	25.5	2.196078431372549	Inconclusive
56	26.0	2.1538461538461537	Inconclusive
56	26.5	2.1132075471698113	Inconclusive
56	27.0	2.074074074074074	Inconclusive
56	27.5	2.036363636363636	Inconclusive
56	28.0	2.0	More likely to be infection
56	28.5	1.9649122807017543	More likely to be infection
56	29.0	1.9310344827586208	More likely to be infection
56	29.5	1.8983050847457628	More likely to be infection

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