ESR 94 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 94 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 94 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 94 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 94

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

Normal Range and Grading for Adult Women : ESR 94

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 94

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

What does an ESR of 94 mm/hr mean?

An ESR level of 94 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 94 mm/hr good?

Is an ESR of 94 mm/hr bad?

Is an ESR of 94 mm/hr dangerous?

Is an ESR of 94 mm/hr normal?

What are the causes of an ESR of 94 mm/hr?

An ESR of 94 can have various causing including the following

Infection

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

Thyroid Disorders

Both hyperthyroidism and hypothyroidism can influence ESR levels.

Pregnancy

ESR levels can be higher during pregnancy.

Chronic Kidney Disease

Impaired kidney function can lead to higher ESR levels.

Chronic Obstructive Pulmonary Disease (COPD)

Inflammatory changes in the lungs can lead to an increased ESR.

Certain Cancers

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

Heart Disease

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

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

Autoimmune Disorders

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

Myeloma

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

Dehydration

Though less common, dehydration can affect blood viscosity and ESR.

What are the causes for a falsely elevated ESR value of 94?

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

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.

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.

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.

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.

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.

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.

Hormonal Contraceptives

The use of hormonal contraceptives can impact hormonal levels in the body, potentially affecting the inflammatory response. This can lead to variations in ESR levels in some individuals. It's important for healthcare providers to consider these factors when interpreting ESR results in individuals using hormonal contraceptives.

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.

Blood Donation

Recent blood donation can lead to a temporary decrease in the number of red blood cells, affecting blood viscosity. This change may contribute to a transient increase in ESR. Understanding the timing of blood donation is essential for accurate interpretation of ESR results.

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.

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 94 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 94 can be classified as below.
If you are in the first three months of pregnancy an ESR of 94 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 94 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 94 is elevated

What are the symptoms of an ESR of 94 ?

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 94

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Unexplained Weight Loss

Losing weight without intentional changes in diet or exercise.

Nausea and Vomiting

Feeling of sickness and vomiting.

Fever

Elevated body temperature beyond normal range.

Frequent Urination

Increased need to urinate.

Chest Pain

Pain or discomfort in the chest area.

Cognitive Impairment

Memory problems or difficulty concentrating.

Hair Loss

Unexplained loss of hair.

Muscle Aches

Generalized or localized pain in muscles.

Loss of Appetite

Decreased desire to eat.

Recurrent Infections

Frequent or persistent infections.

Depression

Persistent feelings of sadness or hopelessness.

Photosensitivity

Increased sensitivity to sunlight.

Vision Changes

Blurred vision or other visual disturbances.

Neurological Symptoms

Tingling, numbness, or weakness.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Dizziness

Feeling lightheaded or unsteady.

Mouth Ulcers

Sores in the mouth that may be painful.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Difficulty Sleeping

Insomnia or disrupted sleep patterns.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Shortness of Breath

Difficulty breathing or breathlessness.

Night Sweats

Excessive sweating during sleep.

Fatigue

Persistent tiredness and lack of energy.

Which foods can reduce an ESR of 94 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.

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.

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.

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.

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.

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 94 mm/hr ?

For an ESR of 94, 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 94

What is my ESR:CRP ratio for an ESR of 94 mm/hr ?

ESR	CRP	Ratio	Means
94	1.0	94.0	More likely to be autoimmune disease flareup of SLE
94	1.5	62.666666666666664	More likely to be autoimmune disease flareup of SLE
94	2.0	47.0	More likely to be autoimmune disease flareup of SLE
94	2.5	37.6	More likely to be autoimmune disease flareup of SLE
94	3.0	31.333333333333332	More likely to be autoimmune disease flareup of SLE
94	3.5	26.857142857142858	More likely to be autoimmune disease flareup of SLE
94	4.0	23.5	More likely to be autoimmune disease flareup of SLE
94	4.5	20.88888888888889	More likely to be autoimmune disease flareup of SLE
94	5.0	18.8	More likely to be autoimmune disease flareup of SLE
94	5.5	17.09090909090909	More likely to be autoimmune disease flareup of SLE
94	6.0	15.666666666666666	More likely to be autoimmune disease flareup of SLE
94	6.5	14.461538461538462	Inconclusive
94	7.0	13.428571428571429	Inconclusive
94	7.5	12.533333333333333	Inconclusive
94	8.0	11.75	Inconclusive
94	8.5	11.058823529411764	Inconclusive
94	9.0	10.444444444444445	Inconclusive
94	9.5	9.894736842105264	Inconclusive
94	10.0	9.4	Inconclusive
94	10.5	8.952380952380953	Inconclusive
94	11.0	8.545454545454545	Inconclusive
94	11.5	8.173913043478262	Inconclusive
94	12.0	7.833333333333333	Inconclusive
94	12.5	7.52	Inconclusive
94	13.0	7.230769230769231	Inconclusive
94	13.5	6.962962962962963	Inconclusive
94	14.0	6.714285714285714	Inconclusive
94	14.5	6.482758620689655	Inconclusive
94	15.0	6.266666666666667	Inconclusive
94	15.5	6.064516129032258	Inconclusive
94	16.0	5.875	Inconclusive
94	16.5	5.696969696969697	Inconclusive
94	17.0	5.529411764705882	Inconclusive
94	17.5	5.371428571428571	Inconclusive
94	18.0	5.222222222222222	Inconclusive
94	18.5	5.081081081081081	Inconclusive
94	19.0	4.947368421052632	Inconclusive
94	19.5	4.82051282051282	Inconclusive
94	20.0	4.7	Inconclusive
94	20.5	4.585365853658536	Inconclusive
94	21.0	4.476190476190476	Inconclusive
94	21.5	4.372093023255814	Inconclusive
94	22.0	4.2727272727272725	Inconclusive
94	22.5	4.177777777777778	Inconclusive
94	23.0	4.086956521739131	Inconclusive
94	23.5	4.0	Inconclusive
94	24.0	3.9166666666666665	Inconclusive
94	24.5	3.836734693877551	Inconclusive
94	25.0	3.76	Inconclusive
94	25.5	3.6862745098039214	Inconclusive
94	26.0	3.6153846153846154	Inconclusive
94	26.5	3.547169811320755	Inconclusive
94	27.0	3.4814814814814814	Inconclusive
94	27.5	3.418181818181818	Inconclusive
94	28.0	3.357142857142857	Inconclusive
94	28.5	3.2982456140350878	Inconclusive
94	29.0	3.2413793103448274	Inconclusive
94	29.5	3.1864406779661016	Inconclusive

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