ESR 61 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 61 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 61 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 collecting a small blood sample from the patient's arm, usually from a vein. Before the blood draw, the area is cleaned with an antiseptic solution to ensure a sterile collection. Once obtained, the blood is mixed with an anticoagulant to prevent clotting. The prepared blood sample is then placed in a tall, thin tube, which is positioned upright to allow red blood cells to settle over a specific period, often one hour. The distance the red blood cells travel in the tube during this time is carefully measured, and the settling rate is recorded. The Westergren method, a widely recognized technique for ESR measurement, involves the use of a specialized Westergren tube for blood collection. In preparation for the test, patients are usually advised to communicate any medications they are taking to their healthcare provider, as certain drugs can influence the results. Fasting is not mandatory for ESR, but maintaining hydration is recommended to facilitate an efficient blood draw and ensure accurate results. ESR is an essential diagnostic tool, providing healthcare professionals with valuable information to assess and monitor inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 61 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 61

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

Normal Range and Grading for Adult Women : ESR 61

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 61

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

What does an ESR of 61 mm/hr mean?

An ESR level of 61 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 61 mm/hr good?

An ESR of 61 is not a good value. In adults, or children this value is above normal and needs investigating.

Is an ESR of 61 mm/hr bad?

An ESR of 61 is bad in all populations and should be further investigated.

Is an ESR of 61 mm/hr dangerous?

An ESR of 61 is elevated but not necessarily dangerous

Is an ESR of 61 mm/hr normal?

An ESR of 61 is not normal and is classified as elevated.

What are the causes of an ESR of 61 mm/hr?

An ESR of 61 can have various causing including the following

Bronchiectasis

A chronic lung condition characterized by damaged airways.

Autoimmune Disorders

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

Lymphoma

A type of cancer that originates in the lymphatic system.

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Vasculitis

Inflammation of blood vessels.

Heart Disease

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

Obesity

Higher body mass index (BMI) has been associated with increased ESR.

HIV/AIDS

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

Infection

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

Temporal Arteritis

An inflammatory condition affecting the blood vessels.

Certain Medications

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

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

What are the causes for a falsely elevated ESR value of 61?

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

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.

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.

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.

Temperature Changes

Extreme temperatures, whether due to fever or exposure to cold, can affect the viscosity of blood. These temperature-related changes can influence ESR levels. Monitoring body temperature and addressing the underlying cause is important for accurate interpretation of ESR results.

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.

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.

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.

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.

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.

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.

Dietary Factors

Nutritional status can influence ESR levels. Dietary factors such as certain vitamins, minerals, and antioxidants play a role in modulating the inflammatory response. A well-balanced and nutrient-rich diet is essential for maintaining overall health, including appropriate ESR levels.

What does an ESR of 61 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 61 can be classified as below.
If you are in the first three months of pregnancy an ESR of 61 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 61 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 61 is normal

What are the symptoms of an ESR of 61 ?

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 61

Headaches

Recurrent or persistent headaches.

Depression

Persistent feelings of sadness or hopelessness.

Loss of Appetite

Decreased desire to eat.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Muscle Aches

Generalized or localized pain in muscles.

Neurological Symptoms

Tingling, numbness, or weakness.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Shortness of Breath

Difficulty breathing or breathlessness.

Recurrent Infections

Frequent or persistent infections.

Cognitive Impairment

Memory problems or difficulty concentrating.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Nausea and Vomiting

Feeling of sickness and vomiting.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Frequent Urination

Increased need to urinate.

Hair Loss

Unexplained loss of hair.

Fatigue

Persistent tiredness and lack of energy.

Skin Rashes

Unexplained skin eruptions or changes.

Fever

Elevated body temperature beyond normal range.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Photosensitivity

Increased sensitivity to sunlight.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Night Sweats

Excessive sweating during sleep.

Vision Changes

Blurred vision or other visual disturbances.

Chest Pain

Pain or discomfort in the chest area.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Which foods can reduce an ESR of 61 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.

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.

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.

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.

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.

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.

What other tests should be done with an ESR of 61 mm/hr ?

For an ESR of 61, 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 61

What is my ESR:CRP ratio for an ESR of 61 mm/hr ?

ESR	CRP	Ratio	Means
61	1.0	61.0	More likely to be autoimmune disease flareup of SLE
61	1.5	40.666666666666664	More likely to be autoimmune disease flareup of SLE
61	2.0	30.5	More likely to be autoimmune disease flareup of SLE
61	2.5	24.4	More likely to be autoimmune disease flareup of SLE
61	3.0	20.333333333333332	More likely to be autoimmune disease flareup of SLE
61	3.5	17.428571428571427	More likely to be autoimmune disease flareup of SLE
61	4.0	15.25	More likely to be autoimmune disease flareup of SLE
61	4.5	13.555555555555555	Inconclusive
61	5.0	12.2	Inconclusive
61	5.5	11.090909090909092	Inconclusive
61	6.0	10.166666666666666	Inconclusive
61	6.5	9.384615384615385	Inconclusive
61	7.0	8.714285714285714	Inconclusive
61	7.5	8.133333333333333	Inconclusive
61	8.0	7.625	Inconclusive
61	8.5	7.176470588235294	Inconclusive
61	9.0	6.777777777777778	Inconclusive
61	9.5	6.421052631578948	Inconclusive
61	10.0	6.1	Inconclusive
61	10.5	5.809523809523809	Inconclusive
61	11.0	5.545454545454546	Inconclusive
61	11.5	5.304347826086956	Inconclusive
61	12.0	5.083333333333333	Inconclusive
61	12.5	4.88	Inconclusive
61	13.0	4.6923076923076925	Inconclusive
61	13.5	4.518518518518518	Inconclusive
61	14.0	4.357142857142857	Inconclusive
61	14.5	4.206896551724138	Inconclusive
61	15.0	4.066666666666666	Inconclusive
61	15.5	3.935483870967742	Inconclusive
61	16.0	3.8125	Inconclusive
61	16.5	3.696969696969697	Inconclusive
61	17.0	3.588235294117647	Inconclusive
61	17.5	3.4857142857142858	Inconclusive
61	18.0	3.388888888888889	Inconclusive
61	18.5	3.2972972972972974	Inconclusive
61	19.0	3.210526315789474	Inconclusive
61	19.5	3.128205128205128	Inconclusive
61	20.0	3.05	Inconclusive
61	20.5	2.975609756097561	Inconclusive
61	21.0	2.9047619047619047	Inconclusive
61	21.5	2.8372093023255816	Inconclusive
61	22.0	2.772727272727273	Inconclusive
61	22.5	2.7111111111111112	Inconclusive
61	23.0	2.652173913043478	Inconclusive
61	23.5	2.595744680851064	Inconclusive
61	24.0	2.5416666666666665	Inconclusive
61	24.5	2.489795918367347	Inconclusive
61	25.0	2.44	Inconclusive
61	25.5	2.392156862745098	Inconclusive
61	26.0	2.3461538461538463	Inconclusive
61	26.5	2.30188679245283	Inconclusive
61	27.0	2.259259259259259	Inconclusive
61	27.5	2.2181818181818183	Inconclusive
61	28.0	2.1785714285714284	Inconclusive
61	28.5	2.1403508771929824	Inconclusive
61	29.0	2.103448275862069	Inconclusive
61	29.5	2.0677966101694913	Inconclusive

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