This Is The Optimal Erythrocyte Sedimentation Rate

Are you looking at your blood tests and reviewing your erythrocyte sedimentation rate (ESR), wondering what the optimal ESR is?
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In this video, we're going to look at the optimal erythrocyte sedimentation rate (ESR). As we discussed in a previous video, the ESR is the rate at which red blood cells fall or settle into a hematocrit tube. This rate can tell us about certain immune activity and also inflammation.

Specifically, the standard reference range for ESR is age- and gender-specific. For instance, at LabCorp, for a male aged 0 to 50 years, the range is 0 to 15 millimeters per hour. As you get older, above 50 years, the range goes up to 0 to 30 millimeters per hour. For females aged 0 to 50 years, the range starts closer to 0 to 30 millimeters per hour. And above 50 years, the LabCorp reference range is 0 to 40 millimeters per hour.

Just as a comparison, I also looked at the NIH reference values for ESR. If you're less than 50 years old, the range there for males is 0 to 15 millimeters per hour. And above 50 years old for males, the range is less than 15 millimeters per hour. For females less than 50 years old, the range is 20 millimeters per hour. And as you get above 50 years old for females, the range is less than 30 millimeters per hour. As you can see, there is a bit of a difference between those two reference ranges, but the general idea is yes, it will go up as you get older, and for males and females, there will be a bit of a difference, with the range being slightly higher for females.

These are the stated or standard reference ranges that you'll see for this test. Of course, we know that the ESR level will go up when you have more inflammation going on in your body, and that this is a good test to use to track the amount of inflammation going on in your body and track the immune activity going on in your body. We also know that many common health issues increase with aging, and that inflammation is a key driver or variable in most, but not all, chronic disease processes.

So the question then is, is there something inherent in the aging process, independent of inflammation, that's causing us to want to have a higher reference range for someone who's older? And if not, would we then want to change the reference range or reference interval that we're going to shoot for as we get older?

Studies looking at this question or looking to answer this question find that when they correct for things like elevated fibrinogen, elevated glucose, and elevated triglycerides, there's really not a lot of difference in the ESR as you get older. So if you have normal triglycerides, normal glucose, and normal fibrinogen, you actually have the same sedimentation rate that you would if you're 20 years old versus 70 years old.

When things like blood sugar and triglycerides are elevated, they do create micro-inflammation in the blood vessels. With this kind of micro-inflammation, you're not going to get diagnosed with an autoimmune disease, and many times it's just going to be overlooked entirely because it's not going to increase the numbers, the sedimentation rate, or other inflammatory markers by a whole lot. However, if you're interested in optimal health, then you want your ESR to be in the optimal range and possibly in a lower range than what your age-defined reference range would suggest.