ESR 97 mm/hr means : is it normal, good, bad or dangerous?

In this article we discuss what an ESR of 97 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 97 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 97 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 97

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

Normal Range and Grading for Adult Women : ESR 97

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 97

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

What does an ESR of 97 mm/hr mean?

An ESR level of 97 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 97 mm/hr good?

Is an ESR of 97 mm/hr bad?

Is an ESR of 97 mm/hr dangerous?

Is an ESR of 97 mm/hr normal?

What are the causes of an ESR of 97 mm/hr?

An ESR of 97 can have various causing including the following

Giant Cell Arteritis

An inflammatory disease affecting large blood vessels.

Hepatitis

Inflammation of the liver, often caused by viral infections.

Chronic Obstructive Pulmonary Disease (COPD)

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

Dehydration

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

Liver Disease

Certain liver conditions can be associated with higher ESR.

Pregnancy

ESR levels can be higher during pregnancy.

Systemic Lupus Erythematosus

An autoimmune disease that can affect multiple organs.

Obesity

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

Polymyalgia Rheumatica

An inflammatory disorder that commonly affects older adults.

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.

Behçet's Disease

A rare inflammatory disorder causing blood vessel inflammation.

What are the causes for a falsely elevated ESR value of 97?

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

Hormonal Fluctuations

Beyond the menstrual cycle, fluctuations in hormonal levels can occur due to various factors, including stress, medication changes, or natural hormonal variations. These hormonal shifts may influence the inflammatory response and contribute to variations in ESR levels.

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.

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.

What does an ESR of 97 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 97 can be classified as below.
If you are in the first three months of pregnancy an ESR of 97 is elevated
If you are in the second trimester or months 3-6 of pregnancy an ESR of 97 is elevated
If you are in the third trimester or months 7-9 of pregnancy an ESR of 97 is elevated

What are the symptoms of an ESR of 97 ?

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 97

Photosensitivity

Increased sensitivity to sunlight.

Fever

Elevated body temperature beyond normal range.

Frequent Urination

Increased need to urinate.

Swollen Lymph Nodes

Enlarged and tender lymph nodes.

Muscle Aches

Generalized or localized pain in muscles.

Hair Loss

Unexplained loss of hair.

Digestive Issues

Irregular bowel movements, diarrhea, or constipation.

Cognitive Impairment

Memory problems or difficulty concentrating.

Dizziness

Feeling lightheaded or unsteady.

Fatigue

Persistent tiredness and lack of energy.

Nausea and Vomiting

Feeling of sickness and vomiting.

Joint Pain

Discomfort, swelling, or stiffness in the joints.

Recurrent Infections

Frequent or persistent infections.

Abdominal Pain

Discomfort or pain in the abdominal region.

Depression

Persistent feelings of sadness or hopelessness.

Mouth Ulcers

Sores in the mouth that may be painful.

Irregular Menstrual Cycles

Changes in menstrual patterns for women.

Cough

Persistent or chronic coughing.

Abnormal Blood Counts

Changes in white blood cell count or other blood parameters.

Shortness of Breath

Difficulty breathing or breathlessness.

Headaches

Recurrent or persistent headaches.

Loss of Appetite

Decreased desire to eat.

Chest Pain

Pain or discomfort in the chest area.

Vision Changes

Blurred vision or other visual disturbances.

Dry Eyes and Mouth

Symptoms of Sjögren's syndrome.

Neurological Symptoms

Tingling, numbness, or weakness.

Which foods can reduce an ESR of 97 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.

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.

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.

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.

What other tests should be done with an ESR of 97 mm/hr ?

For an ESR of 97, 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 97

What is my ESR:CRP ratio for an ESR of 97 mm/hr ?

ESR	CRP	Ratio	Means
97	1.0	97.0	More likely to be autoimmune disease flareup of SLE
97	1.5	64.66666666666667	More likely to be autoimmune disease flareup of SLE
97	2.0	48.5	More likely to be autoimmune disease flareup of SLE
97	2.5	38.8	More likely to be autoimmune disease flareup of SLE
97	3.0	32.333333333333336	More likely to be autoimmune disease flareup of SLE
97	3.5	27.714285714285715	More likely to be autoimmune disease flareup of SLE
97	4.0	24.25	More likely to be autoimmune disease flareup of SLE
97	4.5	21.555555555555557	More likely to be autoimmune disease flareup of SLE
97	5.0	19.4	More likely to be autoimmune disease flareup of SLE
97	5.5	17.636363636363637	More likely to be autoimmune disease flareup of SLE
97	6.0	16.166666666666668	More likely to be autoimmune disease flareup of SLE
97	6.5	14.923076923076923	Inconclusive
97	7.0	13.857142857142858	Inconclusive
97	7.5	12.933333333333334	Inconclusive
97	8.0	12.125	Inconclusive
97	8.5	11.411764705882353	Inconclusive
97	9.0	10.777777777777779	Inconclusive
97	9.5	10.210526315789474	Inconclusive
97	10.0	9.7	Inconclusive
97	10.5	9.238095238095237	Inconclusive
97	11.0	8.818181818181818	Inconclusive
97	11.5	8.434782608695652	Inconclusive
97	12.0	8.083333333333334	Inconclusive
97	12.5	7.76	Inconclusive
97	13.0	7.461538461538462	Inconclusive
97	13.5	7.185185185185185	Inconclusive
97	14.0	6.928571428571429	Inconclusive
97	14.5	6.689655172413793	Inconclusive
97	15.0	6.466666666666667	Inconclusive
97	15.5	6.258064516129032	Inconclusive
97	16.0	6.0625	Inconclusive
97	16.5	5.878787878787879	Inconclusive
97	17.0	5.705882352941177	Inconclusive
97	17.5	5.542857142857143	Inconclusive
97	18.0	5.388888888888889	Inconclusive
97	18.5	5.243243243243243	Inconclusive
97	19.0	5.105263157894737	Inconclusive
97	19.5	4.9743589743589745	Inconclusive
97	20.0	4.85	Inconclusive
97	20.5	4.7317073170731705	Inconclusive
97	21.0	4.619047619047619	Inconclusive
97	21.5	4.511627906976744	Inconclusive
97	22.0	4.409090909090909	Inconclusive
97	22.5	4.311111111111111	Inconclusive
97	23.0	4.217391304347826	Inconclusive
97	23.5	4.127659574468085	Inconclusive
97	24.0	4.041666666666667	Inconclusive
97	24.5	3.9591836734693877	Inconclusive
97	25.0	3.88	Inconclusive
97	25.5	3.803921568627451	Inconclusive
97	26.0	3.730769230769231	Inconclusive
97	26.5	3.660377358490566	Inconclusive
97	27.0	3.5925925925925926	Inconclusive
97	27.5	3.5272727272727273	Inconclusive
97	28.0	3.4642857142857144	Inconclusive
97	28.5	3.4035087719298245	Inconclusive
97	29.0	3.3448275862068964	Inconclusive
97	29.5	3.288135593220339	Inconclusive

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