ESR 88 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 88 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 88 in pregnancy. We conclude with the ESR to CRP ratio that can help distinguish an infection from SLE.

What is ESR?

How is ESR measured?

The measurement of Erythrocyte Sedimentation Rate (ESR) involves the collection of a small blood sample from the patient's arm, typically drawn from a vein. Before the blood draw, the area is meticulously cleaned with an antiseptic solution to maintain sterility. Following the collection, the blood is mixed with an anticoagulant to prevent clotting. Subsequently, the prepared blood sample is placed in a tall, thin tube, which is then positioned upright. This allows red blood cells to settle over a specified period, usually one hour. The distance the red blood cells travel in the tube during this time is measured, and the settling rate is recorded. The Westergren method, a commonly employed technique for ESR measurement, uses a specialized Westergren tube for blood collection. To prepare for the test, patients are generally advised to inform their healthcare provider about any medications they are taking, as certain drugs can impact the results. While fasting is not obligatory for ESR, maintaining adequate hydration is recommended to ensure a smooth blood draw and accurate results. ESR is a vital diagnostic tool, offering healthcare professionals valuable insights into inflammatory conditions within the body.

What is the normal range of ESR and how is an ESR of 88 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 88

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

Normal Range and Grading for Adult Women : ESR 88

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 88

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

What does an ESR of 88 mm/hr mean?

An ESR level of 88 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 88 mm/hr good?

Is an ESR of 88 mm/hr bad?

Is an ESR of 88 mm/hr dangerous?

Is an ESR of 88 mm/hr normal?

What are the causes of an ESR of 88 mm/hr?

An ESR of 88 can have various causing including the following

Certain Medications

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

Inflammatory Bowel Disease

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

Sickle Cell Anemia

A genetic blood disorder affecting red blood cells.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Inflammation

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

Pregnancy

ESR levels can be higher during pregnancy.

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Myeloma

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Liver Disease

Certain liver conditions can be associated with higher ESR.

Aging

ESR tends to increase with age, and mild elevation may be normal in elderly individuals.

Vasculitis

Inflammation of blood vessels.

What are the causes for a falsely elevated ESR value of 88?

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

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.

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.

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.

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.

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.

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.

Circadian Rhythms

ESR levels can vary throughout the day due to natural circadian rhythms. The body's internal clock influences various physiological processes, including inflammation. Understanding these fluctuations helps in interpreting ESR results accurately.

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.

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.

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.

What does an ESR of 88 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 88 can be classified as below.
If you are in the first three months of pregnancy an ESR of 88 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 88 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 88 is elevated

What are the symptoms of an ESR of 88 ?

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 88

Night Sweats

Excessive sweating during sleep.

Shortness of Breath

Difficulty breathing or breathlessness.

Hair Loss

Unexplained loss of hair.

Cognitive Impairment

Memory problems or difficulty concentrating.

Mouth Ulcers

Sores in the mouth that may be painful.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Photosensitivity

Increased sensitivity to sunlight.

Nausea and Vomiting

Feeling of sickness and vomiting.

Vision Changes

Blurred vision or other visual disturbances.

Depression

Persistent feelings of sadness or hopelessness.

Skin Rashes

Unexplained skin eruptions or changes.

Fever

Elevated body temperature beyond normal range.

Fatigue

Persistent tiredness and lack of energy.

Recurrent Infections

Frequent or persistent infections.

Headaches

Recurrent or persistent headaches.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Frequent Urination

Increased need to urinate.

Neurological Symptoms

Tingling, numbness, or weakness.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Chest Pain

Pain or discomfort in the chest area.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Muscle Aches

Generalized or localized pain in muscles.

Which foods can reduce an ESR of 88 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.

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.

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.

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.

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.

What other tests should be done with an ESR of 88 mm/hr ?

For an ESR of 88, 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 88

What is my ESR:CRP ratio for an ESR of 88 mm/hr ?

ESR	CRP	Ratio	Means
88	1.0	88.0	More likely to be autoimmune disease flareup of SLE
88	1.5	58.666666666666664	More likely to be autoimmune disease flareup of SLE
88	2.0	44.0	More likely to be autoimmune disease flareup of SLE
88	2.5	35.2	More likely to be autoimmune disease flareup of SLE
88	3.0	29.333333333333332	More likely to be autoimmune disease flareup of SLE
88	3.5	25.142857142857142	More likely to be autoimmune disease flareup of SLE
88	4.0	22.0	More likely to be autoimmune disease flareup of SLE
88	4.5	19.555555555555557	More likely to be autoimmune disease flareup of SLE
88	5.0	17.6	More likely to be autoimmune disease flareup of SLE
88	5.5	16.0	More likely to be autoimmune disease flareup of SLE
88	6.0	14.666666666666666	Inconclusive
88	6.5	13.538461538461538	Inconclusive
88	7.0	12.571428571428571	Inconclusive
88	7.5	11.733333333333333	Inconclusive
88	8.0	11.0	Inconclusive
88	8.5	10.352941176470589	Inconclusive
88	9.0	9.777777777777779	Inconclusive
88	9.5	9.263157894736842	Inconclusive
88	10.0	8.8	Inconclusive
88	10.5	8.380952380952381	Inconclusive
88	11.0	8.0	Inconclusive
88	11.5	7.6521739130434785	Inconclusive
88	12.0	7.333333333333333	Inconclusive
88	12.5	7.04	Inconclusive
88	13.0	6.769230769230769	Inconclusive
88	13.5	6.518518518518518	Inconclusive
88	14.0	6.285714285714286	Inconclusive
88	14.5	6.068965517241379	Inconclusive
88	15.0	5.866666666666666	Inconclusive
88	15.5	5.67741935483871	Inconclusive
88	16.0	5.5	Inconclusive
88	16.5	5.333333333333333	Inconclusive
88	17.0	5.176470588235294	Inconclusive
88	17.5	5.0285714285714285	Inconclusive
88	18.0	4.888888888888889	Inconclusive
88	18.5	4.756756756756757	Inconclusive
88	19.0	4.631578947368421	Inconclusive
88	19.5	4.512820512820513	Inconclusive
88	20.0	4.4	Inconclusive
88	20.5	4.2926829268292686	Inconclusive
88	21.0	4.190476190476191	Inconclusive
88	21.5	4.093023255813954	Inconclusive
88	22.0	4.0	Inconclusive
88	22.5	3.911111111111111	Inconclusive
88	23.0	3.8260869565217392	Inconclusive
88	23.5	3.74468085106383	Inconclusive
88	24.0	3.6666666666666665	Inconclusive
88	24.5	3.5918367346938775	Inconclusive
88	25.0	3.52	Inconclusive
88	25.5	3.450980392156863	Inconclusive
88	26.0	3.3846153846153846	Inconclusive
88	26.5	3.3207547169811322	Inconclusive
88	27.0	3.259259259259259	Inconclusive
88	27.5	3.2	Inconclusive
88	28.0	3.142857142857143	Inconclusive
88	28.5	3.087719298245614	Inconclusive
88	29.0	3.0344827586206895	Inconclusive
88	29.5	2.983050847457627	Inconclusive

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