View Full Version : The reliability of the ESR

12-21-2009, 11:11 AM
Anyone out there wondering about this one too?

I had a normal sed rate while in excruciating pain for over a week. So far I've read some things on the net that do point out there are situations that make them unreliable, but so much of it is hard to read. Goes right over my head!

12-21-2009, 01:25 PM
The ESR rate is only one of many markers to determine inflammation. Determination of inflammation is only one of many indicators of auto-immune disorders. Therefore, the rate (or reliability of the rate) alone will not determine if a particular disease is present or not. ESR is said to be nonspecific because increases do not tell the doctor exactly where the inflammation is in your body or what is causing it, and also because the rate can be affected by other conditions besides inflammation. For this reason, ESR is typically used in conjunction with other tests.

Again, since ESR is a nonspecific marker of inflammation and is affected by other factors, the results MUST be used along with the doctor's other clinical findings, with your health history, and with results from other appropriate laboratory tests. If the ESR and other clinical findings match a specific disorder, the doctor may be able to confirm or rule out a suspected diagnosis.

Doctor's do not base their decisions solely on the ESR results. You can have a normal result and still have a problem. Moderately elevated ESR occurs with inflammation, but it also occurs with anemia, infection, pregnancy, and old age.

A very high ESR usually has an obvious cause, such as a marked increase in globulins that can be due to a severe infection. So, your doctor will use other follow-up tests, such as cultures, depending on the your symptoms. Persons with multiple myeloma or Waldenstrom's macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammation. As noted before, polymyalgia rheumatica and temporal arteritis may also have very high ESRs and some auto-immune disorders (such as Lupus) can sometimes have very high ESRs. Usually, doctors will run ESR and C-reactive protein (CRP) tests because they are both markers of inflammation.

A rising ESR can mean an increase in inflammation or a poor response to a particular drug therapy; a decreasing ESR can mean a good response.

I hope that this has been helpful to you.

Peace and Blessings

12-23-2009, 08:33 AM
Thank you Saysusie. You should write a book! You're so informative and put things so eloquently. It would be a best seller!!!

I learn so much from my WHL family.

I'm curious how reliable it is as far as showing there is inflammation in the body. The way I felt at the time the blood was drawn, I felt sure it would be high...but it was normal. I'm reading some things that state if the blood isn't tested within a certain amount of time it can lessen the reliability of the test and other things that go beyond my ability to understand. I wonder how possible is it to have a lot of inflammation in the body but for some reason or another the sed rate is not showing it.

Maybe a lot of my pain is FMS related. Fibromyalgia never shows up on any labwork, correct? I'm going to ask if a CRP was also done.