Esr V3.0 Pro 15
an esr of 20 mm per hour to 40 mm per hour indicates a nonspecific inflammatory state.  some authors have suggested that the threshold for an elevated esr is 25 mm per hour.  an esr of over 40 mm per hour indicates a very high level of inflammation.  a moderate elevation of the esr (25-40 mm per hour) may indicate an underlying illness or be a nonspecific result. 
the use of an esr in screening for sickle cell disease, thalassemia, and g6pd deficiency has been questioned. a normal esr in these conditions does not rule out the possibility of a heterozygous state.  it is thought that a normal esr in these conditions is due to low levels of hemoglobin s. 
the esr can be used to assess the response to treatment. a decrease in the esr with treatment indicates improvement.   an increase in the esr after treatment may indicate the presence of a resistant infection or the development of a new, possibly malignant, tumor.  
for chronic diseases, such as rheumatoid arthritis, the esr has been used to assess the disease’s activity and to monitor the disease’s progress. the esr is also used to monitor the response to a disease-modifying antirheumatic drug.  
to test for iron deficiency, your doctor may:
- order an inexpensive serum ferritin test. this test is not as accurate as the lab tests, but is very useful to screen for iron deficiency.
- order a blood test to check hemoglobin, a protein needed to carry oxygen to your body’s cells.
- check a complete blood count, including red blood cells (rbcs), white blood cells (wbcs), and platelets. some blood tests may show changes associated with a specific disease. to learn more, see your doctor.
if the clinical suspicion is high, the test result should be interpreted in the context of the patient history, physical examination, and other laboratory testing. the esr is not particularly sensitive for diseases that damage rbcs (thalassemia, sickle cell disease, chronic hemolytic anemia). in these disorders, the mean corpuscular volume (mcv) is usually decreased, but not below the lower limit of normal. the rbc count is usually in the normal range. not surprisingly, if a patient has a low mcv or rbc count, the sedimentation rate may be increased, and vice-versa. while it is wise to consider the patient’s risk factors, this is a matter of degree. the physician should consider all risk factors and decide if the value of the esr is likely to be high or low. there is no clear cut guideline for this decision. a low mcv may warrant further laboratory tests; however, the elevated sedimentation rate could signal a very different disorder. finally, several other diseases may have a nearly normal esr.  patients with other inflammatory disorders, such as scleroderma or chronic inflammatory bowel disease, and in some instances arteriosclerotic vascular disease, may have mildly to moderately elevated esr values. this would be a normal result in these diseases and does not indicate a high risk.    because the esr reflects the number of erythrocytes that are being destroyed or damaged, these numbers are closely correlated to the erythrocyte count. the erythrocyte count may be measured in 2 ways: the mcv and the rbc count. the mcv is simply the product of the rbc count and the cube of the mean corpuscular haemoglobin concentration (mchc) (mcv = rbc x mchc). 5ec8ef588b