How to Reduce the Erythrocyte Sedimentation Rate

Engage in Regular High-Intensity Exercise, If Possible. For high-intensity exercise, you will need to push yourself hard during the workout. The activity you choose should make you sweat, increase your heart rate, and leave you saying, “Wow, that was tough!” Exercise for at least 30 minutes, at least 3 times a week. This activity has been proven to significantly reduce inflammation.

• Examples of high-intensity activities include running or cycling at a fast pace, swimming, aerobics, or hill climbing.

Engage in Moderate-Intensity Exercises Instead of High-Intensity Ones. If you're new to exercise or your health doesn't allow for high-intensity activity, you can opt for lighter exercises for at least 30 minutes. Even small daily movements can help reduce inflammation. Try to exercise to a point where you feel like, “Okay, this is challenging, but not overwhelming.”

• Take brisk walks around the neighborhood or sign up for a water aerobics class.

Practice Meditation Yoga for 30 Minutes Daily. Meditation yoga is a type of yoga that places you in a semi-conscious state. It allows for complete relaxation of both body and mind. At least one study has shown that this practice significantly reduces elevated ESR levels. Here's how you can do meditation yoga:

• Lie flat on a mat or a comfortable surface.
• Follow the guidance of a yoga instructor (you can download an app or find recordings or videos if no local classes are available).
• Let your breath flow naturally in and out of your body.
• Remain still during the practice.
• Allow your mind to drift from one thought to the next, staying aware but not focused.
• Achieve a state of “sleep controlled by consciousness.”

Avoid Processed Foods and Sugary Products. These foods contain harmful cholesterol (LDL), which can lead to inflammation in the body. Inflammation can, in turn, elevate your ESR. Specifically, steer clear of fried foods like potato chips, white bread, pasta, soda, red meat, processed meats, margarine, or lard.

Consume Fruits, Vegetables, Nuts, and Healthy Oils. These are essential components of a healthy diet along with lean meats such as chicken and fish. Additionally, include anti-inflammatory fruits, vegetables, and oils in your meals a few times a week. Some examples include:

• Tomatoes
• Strawberries, blueberries, cherries, and/or oranges.
• Leafy greens like spinach, kale, and collard greens
• Almonds and/or walnuts
• Fatty fish (high in oils) like salmon, mackerel, tuna, and sardines
• Olive oil

Add Herbs Like Oregano, Cayenne Pepper, and Basil to Your Meals. These ingredients have natural anti-inflammatory properties, so try incorporating them into your meals whenever possible. Luckily, these herbs also add great flavor to your dishes. You can also use ginger, turmeric, and white willow bark to help reduce inflammation and lower ESR levels.

• Search online for recipes you enjoy that use herbs.
• With ginger and white willow bark, you can brew herbal tea using a teapot.
• Avoid using white willow bark if you're pregnant or breastfeeding.

Drink plenty of fluids every day. While dehydration may not necessarily make inflammation worse, staying well-hydrated is crucial to preventing muscle and bone damage. If you're increasing your physical activity to reduce inflammation, it's especially important to drink enough water to avoid injury. Aim to consume at least 1-2 liters of water daily. Drink water immediately if you experience any of the following symptoms:

• Extreme thirst
• Fatigue, dizziness, or confusion
• Less frequent urination
• Dark-colored urine

Consult your doctor to understand your test results. As with most tests, normal ranges can vary depending on the laboratory. When you receive your test results, make sure to discuss them with your doctor for a better understanding of your health condition. Generally, the normal ranges are as follows:

• Below 15 mm/hr (millimeters per hour) for men under 50 years old.
• Below 20 mm/hr for men over 50 years old.
• Below 20 mm/hr for women under 50 years old.
• Below 30 mm/hr for women over 50 years old.
• 0-2 mm/hr for newborns.
• 3-13 mm/hr for children from birth to adolescence.

Ask your doctor if your ESR rate is elevated or extremely high. Several conditions can cause ESR levels to exceed the normal range, including pregnancy, anemia, thyroid disorders, kidney disease, or cancers like lymphoma or multiple myeloma. Extremely high ESR levels may indicate conditions like lupus, rheumatoid arthritis, or severe infections in the body.

• Extremely high ESR levels may also be a sign of rare autoimmune disorders such as allergic vasculitis, giant cell arteritis, hyperfibrinogenemia, macroglobulinemia, necrotizing vasculitis, or polymyalgia rheumatica.
• An infection causing high ESR can affect bones, heart, skin, or the entire body. It could also indicate tuberculosis or rheumatic fever.

Your doctor will order additional tests to diagnose your condition. Elevated or high ESR levels can indicate various health issues, so it's highly likely your doctor will recommend further tests to assess your health. While waiting for your doctor to determine which tests are necessary, try to relax and stay calm. It's okay to voice your concerns to your doctor and seek support from family and friends to ease your worries.

• A single ESR test cannot provide a definitive diagnosis.

Repeated ESR tests are important. Elevated ESR levels are often associated with chronic pain and inflammation, so frequent monitoring might be necessary. Keeping track of your ESR levels during regular check-ups helps your doctor understand your pain and inflammation status. With an appropriate treatment plan, your condition is likely to improve!

Managing rheumatoid arthritis with medication and physical therapy. Unfortunately, rheumatoid arthritis cannot be completely cured. However, its symptoms can be controlled and alleviated. Your doctor may prescribe disease-modifying antirheumatic drugs (DMARDs), nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and corticosteroids. Physical or occupational therapy experts can teach you exercises to maintain joint mobility and flexibility, as well as provide alternative techniques for performing daily tasks (such as pouring water into a cup) in case of severe pain.

Preventing lupus flare-ups with NSAIDs and other medications. Since lupus varies from person to person, you need to have detailed discussions with your doctor to determine the most suitable treatment plan. NSAIDs can relieve pain and reduce fever, while corticosteroids can help control inflammation. Based on your symptoms, your doctor may also prescribe antimalarial drugs and immunosuppressants.

Treating bone and joint infections with antibiotics and/or surgery. Elevated ESR levels can signal several infections, but they often point specifically to bone and joint infections. These infections are particularly challenging to treat, so your doctor will conduct further tests to identify the type and cause of the infection. In severe cases, surgery may be necessary to remove infected tissue.

Consult a cancer specialist if you're diagnosed with cancer. Very high ESR levels (over 100 mm/hr) may indicate malignancy or the presence of cells that could invade surrounding tissues and spread cancer. Specifically, high ESR levels may signal multiple myeloma. If diagnosed with this condition through other blood tests, imaging, and urine analysis, an oncologist will collaborate with you to create a specialized treatment plan.

Consult a doctor if you believe you need an ESR test. The ESR test is most commonly used to determine if an infection is causing pain. If you're experiencing unexplained fever, joint pain, muscle aches, or visible swelling, the ESR test can help your doctor better understand the underlying cause and severity of the issue.

• The ESR test can also be useful for diagnosing unexplained symptoms such as loss of appetite, unexplained weight loss, headaches, or neck and shoulder pain.
• ESR tests are rarely done alone. Your doctor will usually also request a C-reactive protein (CRP) test, which is also used to check for inflammation in the body.

Discuss with your doctor the medications you're currently taking. Several prescription and over-the-counter medications can either increase or decrease the natural rate of erythrocyte sedimentation. If you're taking any of these, your doctor might ask you to stop a week before the blood test. Do not change medications without consulting your doctor.

• Dextran, methyldopa, birth control pills, penicillamine, procainamide, theophylline, and vitamin A can raise ESR levels.
• Aspirin, cortisone, and quinine can lower ESR levels.

Inform healthcare staff which arm you'd prefer for blood draw. Typically, blood is drawn from the inside of the elbow. Although you won’t experience pain or swelling after the blood test, you can ask if the blood can be taken from your non-dominant arm. The healthcare provider will also need to find the vein that is easiest to access.

• Choosing the right vein can make the blood draw process slightly quicker.
• If no suitable vein can be found in either arm, they may attempt another area.
• Also, let the person drawing your blood know about any previous experiences with blood draws. If you tend to faint or feel lightheaded during blood draws, they may ask you to lie down to prevent discomfort or fainting. If you often feel unwell when giving blood, consider having someone accompany you.

Relax during the blood draw. The healthcare provider will apply a tourniquet around your upper arm and clean the area with alcohol. Then, they will insert a needle into a vein and draw blood into a tube. Once the blood is collected, they will remove the needle and loosen the tourniquet. Finally, the nurse or doctor will apply a gauze pad to the puncture site.

• If you're feeling nervous, try not to look at your arm while the blood is being drawn.
• They may need to draw more than one vial of blood. Don't worry if this happens.
• They may use pressure bandages to help stop the bleeding faster after you leave the clinic. You can remove the bandage at home after a few hours.

Be aware that the blood draw site may bruise or redden. Usually, the site will heal within 1 or 2 days, though it may remain red or even develop a bruise as it heals. This is completely normal. In rare cases, the vein where the blood was drawn might swell. While not serious, this can cause some discomfort. On the first day, you should apply an ice pack, then switch to a warm compress. Make a warm compress by microwaving a damp towel for 30-60 seconds. Apply the towel to the sore area in 20-minute intervals, several times a day.

• Test the towel's temperature by holding your hand above it. If the steam is too hot to keep your hand there, wait 10-15 seconds for it to cool slightly before testing again.

Contact your doctor if you develop a fever. If the site of the blood draw becomes more painful and swollen, you might be dealing with an infection. This is a rare reaction, but if you develop a fever, contact your doctor immediately.

• If your fever reaches 39℃ or higher, your doctor may advise you to go to the emergency room.