Sed Rate

April 17, 1999

Funny, but I just asked my Rheumy yesterday about the sed rate. I asked

him how important it is and why do so many people talk about it as being

very important. He told me that the sed rate is an indicator that can go

up simply because someone has an infection so he doesn't depend it. He

said he is more concerned about listening to what the patient has to

say about how they are doing and what the patient's joints feel like

when he examines them. I never did find out what my sed rate was since I

was happy with his answer.

Confident,

Pat B

April 19, 1999

Dear Pat,

You doctor was correct about the Sed rate being a nonspecific indicator of

inflammation in the body. When I had a wound infection this past summer for

instance my sed rate was sky high for both reasons-the infection and a huge

arthritis flare. Once the infection went away, I was left with the sed rate

being affected by only the arthritis. I and my doctor still argue that it is

an indicator that can corroborate your symptomology and can also be helpful

in deciding if a Med is working or needs to be increased etc...

October 31, 1999

Actually I believe that the sed rate shows how quickly the componants of

blood separate. It is a very nonspecific test . The higher the sed rate does

not correlate to how much inflammation there is, but that something is not

right in the immune response. You would see a high sed rate with an ordinary

virus. Unfortunately there is no specific test to tell how active the disease

is and thats why the doctor's objective findings i.e. limitation in motion

is so important.

October 31, 1999

Also the sed rate could be normal but the arthritis still could be active.

My webpages:

http://fadedjeans.com/jraworld

http://www.bmi.net/acnelson

Reach me by ICQ. ICQ# 34033888

Re: [ ] sed rate

Actually I believe that the sed rate shows how quickly the componants of

blood separate. It is a very nonspecific test . The higher the sed rate does

not correlate to how much inflammation there is, but that something is not

right in the immune response. You would see a high sed rate with an ordinary

virus. Unfortunately there is no specific test to tell how active the disease

is and thats why the doctor's objective findings i.e. limitation in motion

is so important.

------------------------------------------------------------------------

Visit my homepage for a list of sites with info on childhood arthritis:

http://www.geocities.com/Heartland/Village/8414/

------------------------------------------------------------------------------

Click Here

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November 15, 1999

It's a mystery to me, Jayne. My sed rate never went over 20. Last visit it

was 10. Go figure. - Patty

<< How can one keep having a normal sed rate and have arthritis???????

Doesn't that measure inflammation???????? Jayne >>

November 15, 1999

<< How can one keep having a normal sed rate and have arthritis???????

Doesn't that measure inflammation???????? Jayne >>

I have never had an abnormal sed rate, really any swelling or redness. But I

have definite pain and arthritic symptoms. My ANA goes all over the place

though.

November 16, 1999

Jayne

I believe that is a sign that your med is working and taking the inflammation

down, so not to cause any damage to the joints. Info correct if I understood

my Dr. right. Ask the next time you go to get a clear answer.

June 19, 2000

In a message dated 6/19/00 12:34:23 AM Central Daylight Time,

egroups writes:

<< I recall reading somewhere...I believe it was in 's, _Osler's

Web_, that Dr. Byron Hyde said that there are only 4 other conditions

(besides CFIDS) that are characterized by a low sed rate. One was

hypergammaglobulinemia; I don't recall the others.

I think mine was 2 last time it was measured. >>

Mine was zero. Guess I should have it checked again.

Mike

August 23, 2000

Matt,

Strictly speaking, we use millimeters per hour, but since it's a

one-hour test, many people simply quote it as millimeters.

Rich

> Ken, or anyone

>

> I was just wondering if you know what the units are for the sed

rate

> there in the US. Here in Europe, I assume they are mm from Dennis'

> post. Due to metric/english differences, units are often different

> between here and US. (here a cholesterol count of six is high!! due

> to different units). Since the numbers are similar, it looks like

> they are using mm in the US as well for this, but it would be nice

to

> know for sure, since I feel sure I will need to intrepret my own

test

> when I get it done.

>

> Matt

August 25, 2000

Thanks very much Rich, Ken and Jerry for the good info on Sed rate

units

Matt

August 26, 2000

Could the group explain the Sed Rate Blood test? Also what do the numbers

mean (i.e. normal versus what?)

Thanks,

Sandi A. (Ashli's mom)

August 26, 2000

hi

i always go and make sure i get a copy of the lab results

the sed rate normal range is

0-20

melissas was 3 last time and the first was 6

in normal range

its called the westergren sed rate

i believe this is the inflamation test in the blood

i have a site for lab tests and the meaning i will post tomorrow

Robbin

August 27, 2000

Up to 20 is normal in most children. They sed rate watches how quickle or

slowly cellfall to determine inflamation in pepole. they can also do a c

reactive protien.

August 27, 2000

mommytme@... wrote:

>

> Could the group explain the Sed Rate Blood test? Also what do the numbers

> mean (i.e. normal versus what?)

>

> Thanks,

> Sandi A. (Ashli's mom)

--------------------------------------------------------------------------------

Definition of SED rate from 2 sources:

http://members.tripod.com/stilligans/guideto.htm :

Erythrocyte sedimentation rate (ESR), also called " sed rate, " determines

if

you have inflammation. The sed rate can measure the amount of

inflammation

present. The test measures how fast red blood cells cling together,

fall,

and settle toward the bottom of a glass tube in an hour's time, like

sediment. The higher the sed rate, the greater the amount of

inflammation.

As inflammation responds to medication, the sed rate usually goes down.

Male: 0-15mm/hr Female: 0-20 mm/hr Child: 0-10mm/h

http://my.webmd.com/content/dmk/dmk_article_40005

Erythrocyte Sedimentation Rate Test. A blood tests showing an elevated

so-called erythrocyte sedimentation rate (ESR or sed rate) may indicate

rheumatoid arthritis. The test measures how fast red blood cells

(erythrocytes) fall to the bottom of a fine glass tube that is filled

with

the patient's blood. The higher the sed rate the greater the

inflammation.

The sed rate can be high in many other conditions, however, ranging from

infection to inflammation to tumors. It is used, then, not for diagnosis

but

to help determine how serious the condition is.

-------------------------------------------------------------------------------

Alternative names: erythrocyte sedimentation rate; sed rate;

sedimentation rate

Definition: A nonspecific screening test for various inflammatory

diseases. The test measures the distance (in millimeters) that red blood

cells settle in unclotted blood toward the bottom of a specially marked

test tube in 1 hour.

How the test is performed: Adult or child: Blood is drawn from a vein

(venipuncture), usually from the inside of the elbow or the back of the

hand. The puncture site is cleaned with antiseptic, and a tourniquet (an

elastic band) or blood pressure cuff is placed around the upper arm to

apply pressure and restrict blood flow

through the vein. This causes veins below the tourniquet to distend

(fill with blood). A needle is inserted into the vein, and the blood is

collected in an air-tight vial or a syringe. During the procedure, the

tourniquet is removed to restore circulation. Once the blood has been

collected, the needle is removed, and the puncture site is covered to

stop any bleeding.

Infant or young child: The area is cleansed with antiseptic and

punctured with a sharp needle or a lancet. The blood may be collected in

a pipette (small glass tube), on a slide, onto a test strip, or into a

small container. Cotton or a bandage may be applied to the puncture site

if there is any continued bleeding.

How to prepare for the test: There are no food or fluid restrictions.

Infants and children: The physical and psychological preparation you can

provide for this or any test or procedure depends on your child's age,

interests, previous experience, and level of trust.

How the test will feel: When the needle is inserted to draw blood, some

people feel moderate pain, while others feel only a prick or stinging

sensation. Afterward, there may be some throbbing.

What the risks are: excessive bleeding fainting or feeling lightheaded

hematoma (blood accumulating under the skin) infection (a slight risk

any time the skin is broken) multiple punctures to locate veins

Why the test is performed: The test is most commonly performed for

suspected rheumatologic disorders. The erythrocyte sedimentation rate

(ESR) can be used to monitor inflammatory or malignant disease,

rheumatic fever, and acute myocardial infarction. Although it is a

screening test (not considered diagnostic for any particular disorder),

it is useful in detecting and monitoring tuberculosis, tissue necrosis

(tissue death),

connective tissue disease, or an otherwise unsuspected disease in which

symptoms are vague or physical findings are minimal.

Normal values: (Westergren method*)

Adults: Men under 50 years old: less than 15 mm/hr.

> Men over 50 years old: less than 20 mm/hr.

> Women under 50 years old: less than 20 mm/hr.

> Women over 50 years old: less than 30 mm/hr.

Pediatric: Newborn: 0 to 2 mm/hr.

> Neonatal to puberty: 3 to 13 mm/hr.

Note: mm/hr. = millimeters per hour Other methods will have differing

values.

What abnormal results mean:

Elevated values occur with: kidney disease ~ pregnancy ~ rheumatic fever

~ rheumatoid arthritis ~ severe anemia ~ syphilis ~ systemic lupus

erythematosus ~ thyroid disease ~ tuberculosis

Markedly elevated values occur with: giant cell (temporal, cranial)

arteritis multiple myeloma macroglobulinemia - primary

hyperfibrinogenemia (elevated fibrinogen levels in the blood)

necrotizing vasculitis polymyalgia rheumatica

Additional conditions that may affect test results:

>

> allergic vasculitis

> atrial myxoma; left

> atrial myxoma; right

> autoimmune hepatitis

> endometritis

> eosinophilic fasciitis

> erysipelas

> juvenile rheumatoid arthritis

> Legionnaire's disease

> osteomyelitis

> pelvic inflammatory disease (PID)

> pericarditis; post-MI

> retroperitoneal fibrosis

> skin lesion of blastomycosis

> subacute thyroiditis

> systemic sclerosis (scleroderma)

Cost: The estimated cost is $11.

Special considerations: Veins and arteries vary in size from one patient

to another and from one side of the body to the other. Obtaining a blood

sample from some people may be more difficult than from others.

October 14, 2000

> Anybody have an elevated SED rate? Went to my rheumy today and she

said

> mine was 40. Normal for a woman over 50 is 30. And I'm over 50.

Most people with PA or any other inflammatory disease may have an

elevated Sed rate at one time or another. It is a non-specific

measure of inflammation. (it actually measures the time it takes for

red blood cells to " settle " out of whole blood) Some docs consider it

an outdated test and it seems silly (to me anyway) to do a test for

inflammation on a person with obvious evidence like swollen joints.

I hope that answers your question. I am a Medical Technologist and

used to run those tests a long time ago...I apologize for

editorializing.

NJT

October 16, 2000

miztiff@... wrote:

> Most people with PA or any other inflammatory disease may have an

> elevated Sed rate at one time or another. It is a non-specific

> measure of inflammation. (it actually measures the time it takes for

> red blood cells to " settle " out of whole blood) Some docs consider it

> an outdated test and it seems silly (to me anyway) to do a test for

> inflammation on a person with obvious evidence like swollen joints.

But there are times when there's not much " obvious swelling " and it can

also be used as an indicator of pain according to some sufferers. So,

although it is non-specific, it *does* validate some symptoms and

encourage the physician to search further, IMHO.

Patty B in the Pineywoods of East Texas

November 18, 2000

All,

FYI-

Some info on SED rate below. The rate is definitely a measurement of inflammation. I have psoriatic arthritis; my SED rate use to be in the 30's, now is 8; I still have inflammation and pain. So when the rate drops into the normal range (1-15) there can still be pain. From what I read a couple of years ago, it is a measurement of reactive proteins in the blood.

Jeff

"The erythrocyte sedimentation rate (ESR) was first developed as a pregnancy test in the early 1900's. As such it was not a very reliable test but was then shown to have value as a non-specific marker of illness. Two methods have been used - Westergren or Wintrobe with the former method being the more commonly used method today.

Method

The test is performed by diluting whole blood in citrate at a dilution of 4:1. This whole blood may be anticoagulated with EDTA prior to dilution. The mixture is then aspirated into a vertical tube, which has a uniform internal diameter, to a height of 200mm. The distance that the red cells sediment down through the plasma in 1 hour is taken to be the ESR.

Sedimentation of red cells in this system is affected by forces both for and against sedimentation. The forces resisting sedimentation are the negative charge on the red cell surface (causing red cells to repel each other (zeta potential)), the upflow of plasma displaced by falling red cells, and the rigidity of red cells. The forces accelerating sedimentation are anaemia, and plasma proteins. Plasma proteins bind to red cell membranes thereby reducing the zeta potential thus allowing rouleaux formation to occur. There are a number of artifactual causes of an elevated ESR. These include vibration of the ESR tube, the tube being non-vertical, and the age of the sample (increasing age decreases the ESR).

The degree to which proteins reduce the zeta potential can be rated on a scale of 1-10: fibrinogen 10, beta-globulin 5, alpha globulin 2, gamma globulin 2, albumin 1.

Interpretation

The ESR is a non-specific test and so can be difficult to interpret. Recent trials of the ESR have demonstrated no value in screening asymptomatic individuals, because not only is the number of abnormals low but also in most cases the abnormal test returns to normal over several months without any significant diagnosis being made.

There is also little evidence of value in screening symptomatic patients because a complete history and physical examination is a much better tool for detecting abnormalities. Older text books suggest that an extensive search should be made for the cause of an elevated ESR but provide little evidence of the benefits of such a search. Recent cost-benefit analysis has suggested that tests in addition to a complete history and physical examination are not cost effective.

However, there are several groups of patients where the ESR is important, viz. patients suspected of having temporal arteritis or polymyalgia rheumatica. In these cases treatment is often initiated after an elevated ESR result is known and prior to a definitive biopsy. In these patients the diagnosis is difficult to sustain, but not excluded, if the ESR is normal.

The ESR can also be useful in monitoring certain groups of patients viz. rheumatoid arthritis, temporal arteritis, polymyalgia rheumatica, and Hodgkin's Disease (H.D.), where disease activity is mirrored by changes in the ESR.

There is debate as to whether this test is useful in distinguishing between organic and psychosomatic disease.

There is no evidence of any diagnostic value to the ESR when attempting to evaluate acutely ill patients already known to have acute or chronic infections, or cancer (except H.D.). Even in screening patients with possible myeloma the ESR has been replaced by measurement of total protein and globulin fraction."

References

1. Sox H.C., Liang M.H. The Erythrocyte Sedimentation Rate. Ann. Int. Med. 1986: 104: 515-523.2. Fincher R-M., Page M.I. Clinical Significance of Extreme Elevation of the Erythrocyte Sedimentation Rate. Arch. Int. Med. 1986: 146: 1581-1583.3. Dacie J.V., S.M. Practical Haematology. Ed. Churchill Livingstone. 5th Ed 1977.4. Lee G.R., et al. Wintrobe's Clinical Haematology. Ed. Lea & Feriger. 9th Ed. 1993. Re: Reg SED RateHi Suranjan : SED rate is a measure of the amount of inflammation present inyour body. A normal level for men is 0 to 20 or so as I remember and women abit lower. your level is not real high but as it is going upwards, it is anindication that inflammation is getting worse. CRP is another test andsupposedly, more accurate than SED rate. Prednisone will bring SED rate downin a hurry -- it did for me and mine was a lot higher than 32 - it was overdouble that at one point. Some are even higher -- especially during flaresand a large amount of swelling / pain. Hope this helps. My best toyou......Dean.I thoughTo unsubscribe, email: rheumatic-unsubscribeegroups

December 28, 2000

Hi, Jackie,

>Does anyone know what a sed rate of 30 means? My doctor didn't deign to

>discuss results with me, and the nurse implied it could just " be the CFS "

>or a low grade infection or inflammation.

A high sed rate almost always indicates an active infection or inflammatory

process.

OTOH, 30 is not all that far out of normal range (5-20 for females).

So it could be that the CFS is going into an actively autoimmune phase (e.g.

ANA may go up).

Sed rates are done with anti-coagulated blood because otherwise the blood

sample would just clot (a useful test, but a different one).

The process being looked at by the sed rate is cross-linking of RBCs by Igs.

The Igs (can be either IgG or IgM) are generally to some infecting organism

that adheres to RBCs, but can also be autoimmune.

Jerry

_________________________________________________________________

Get your FREE download of MSN Explorer at http://explorer.msn.com

December 28, 2000

Jerry what do you mean by an " actively autoimmune phase " ? My sed rates have

run between 35-21 since getting sick 16 months ago, were down during the

summer and now up again to 32. My ANA was constantly 1:40 for the first year

but has now disappeared, meaning negative. However I still have the lowgrade

fever and feel exhausted, although better than last year (exhaustion, not

the 37.2 fever).

Judy B.

Re: sed rate

> Hi, Jackie,

>

> >Does anyone know what a sed rate of 30 means? My doctor didn't deign to

> >discuss results with me, and the nurse implied it could just " be the CFS "

> >or a low grade infection or inflammation.

>

> A high sed rate almost always indicates an active infection or

inflammatory

> process.

> OTOH, 30 is not all that far out of normal range (5-20 for females).

> So it could be that the CFS is going into an actively autoimmune phase

(e.g.

> ANA may go up).

>

> Sed rates are done with anti-coagulated blood because otherwise the blood

> sample would just clot (a useful test, but a different one).

> The process being looked at by the sed rate is cross-linking of RBCs by

Igs.

> The Igs (can be either IgG or IgM) are generally to some infecting

organism

> that adheres to RBCs, but can also be autoimmune.

>

> Jerry

> _________________________________________________________________

> Get your FREE download of MSN Explorer at http://explorer.msn.com

>

> This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

May 21, 2001

I have been on doxy now for 8 months and lovenox for 2 months. Honestly I see

just a little improvement, verylittle. I notice though that on my latest

bloodwork my sed rate was 3. It has always been at 1. is this significant?

Also my bilirubin has been very elevated for years and on the latest workup

it was just within normal. I am hoping that this may mean that my body is

coming back into balance and I may soon feel some good effects. Anyone think

that this is likely?

a

_________________________________________________________________

" Do me a favor, doc, tell me something good. " - Blair -

~~ The Exorcist ~~

July 1, 2001

Hi everyone,

I just got back a bunch of blood tests because of my itching problem (not

liver, not kidney, what's left?!) on my arms and legs, anyhow, that's

another issue. but one of my results was very interesting - for the first

time in almost two years, since having CFS, my sed rate was back to normal -

12! When I first got sick it was 35, then up and down for the next year

between 23 to 35, and now - normal...what does it mean, if anything? Am I

getting better? The only blood signs I ever had were the sed rate, a

slightly high gamma globulin (which by now is probably back to normal), and

a slightly high ANA 1:40 which also was normal about six months ago. But I

still have the lowgrade fever all the time, the exhaustion, the dry

eyes/lips and the neurological symptoms. So....(and dont tell me sjogrens, I

was tested and am negative so far)

Judy B.

July 2, 2001

Judy, your sed rate readings mean to me that you have something

causing your 'CFS' which is quite different from those of us who

have sed rates that run between 0-2. Did you know that many on

this list are low sed raters? To the best of my knowledge a high

sed rate means an ongoing infection, polymyalgia rheumatica or

cancer (which you certainly don't have, etc. A low sed rate means

hypercoag if you believe Berg (Hemex) or nothing at all if you

believe my doc and most other MDs who practice traditional western

medicine. Anyway, I think your most recent reading is good news,

and whatever you have been doing to bring it down, keep on doing it.

Mike

> Hi everyone,

> I just got back a bunch of blood tests because of my itching

problem (not

> liver, not kidney, what's left?!) on my arms and legs, anyhow,

that's

> another issue. but one of my results was very interesting - for the

first

> time in almost two years, since having CFS, my sed rate was back to

normal -

> 12! When I first got sick it was 35, then up and down for the next

year

> between 23 to 35, and now - normal...what does it mean, if

anything?

July 2, 2001

In a message dated 7/1/01 10:13:26 PM Eastern Daylight Time, kmcamp22@...

writes:

> To the best of my knowledge a high

> sed rate means an ongoing infection, polymyalgia rheumatica or

> cancer (which you certainly don't have, etc. A low sed rate means

> hypercoag if you believe Berg (Hemex) or nothing at all if you

> believe my doc and most other MDs who practice traditional western

> medicine.

>

> So, a low sed rate meanng hypercoag..... wouldn't that be indicative of a

> long standing infection possibly? Hypercoag would either be caused by an

>

a

_________________________________________________________________

" Do me a favor, doc, tell me something good. " - Blair -

~~ The Exorcist ~~

July 2, 2001

Dear Mike,

thanks for the good word, however I'm not really doing anything...just

eating right and resting. I did think that I have an ongoing infection, was

tested for Cancers (thank heavens' nothing so far) and for RA and other

rheumatic and autoimmune diseases. I'm really happy that the sed rate has

gone down, however I have this funny feeling that I should be doing more -

maybe antibiotics, or something else - because I still have the fever. I

have this strange and definitely unbased feeling (meaning that it doesnt

have a rational basis just a gut feeling) that I have a window of

opportunity now to do something to finally get rid of this creature eating

me up inside...but what?! My doctor won't give me antibiotics or antivirals,

says there is no definite cause so he wont give a definite treatment and

anyhow, to take them without cause is dangerous...and I'm afraid that the

window of opportunity will close and I will be at that plateau stage of many

CFS'ers who can't do much but can do more than before and still feel sick

and fluey much if not all of the time..

what should I do?

Thanks,

Judy

Re: sed rate

> Judy, your sed rate readings mean to me that you have something

> causing your 'CFS' which is quite different from those of us who

> have sed rates that run between 0-2. Did you know that many on

> this list are low sed raters? To the best of my knowledge a high

> sed rate means an ongoing infection, polymyalgia rheumatica or

> cancer (which you certainly don't have, etc. A low sed rate means

> hypercoag if you believe Berg (Hemex) or nothing at all if you

> believe my doc and most other MDs who practice traditional western

> medicine. Anyway, I think your most recent reading is good news,

> and whatever you have been doing to bring it down, keep on doing it.

>

> Mike

>

> > Hi everyone,

> > I just got back a bunch of blood tests because of my itching

> problem (not

> > liver, not kidney, what's left?!) on my arms and legs, anyhow,

> that's

> > another issue. but one of my results was very interesting - for the

> first

> > time in almost two years, since having CFS, my sed rate was back to

> normal -

> > 12! When I first got sick it was 35, then up and down for the next

> year

> > between 23 to 35, and now - normal...what does it mean, if

> anything?

>

> This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

July 6, 2001

This may be of interest. When I realized I was probably hypercoagulative

I checked all my past test results and sed rate was always less than 3.

Was tested by Hemex and had coagulation, genetic factors, etc. However, I

just got ahold of some test results that I didn't have copies of before.

They are from 7-8 years ago when I first got sick. At that time I had CMV

pretty bad, and that was my diagnosis. Was that the beginning of the

CFIDS, or did the CFIDS as a result of having that (like the theory that

getting a vaccine while you have a virus can cause CFIDS) ??? Who knows.

But anyway, at that time I had a sed rate measured and it was 35.

So at my first sign of sickness, sed rate was 35. Might have had a sinus

infection in addition to CMV, I had a lot of them back then. But since

then all sed rates have been below 3. I don't know what it means but it

is interesting.

Cindi

kmcamp22@...

07/01/01 07:01 PM

Please respond to

cc:

Subject: Re: sed rate