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Fluctuating esr
I did esr test 6 months back it was 47,again I did it it cane 46,2 days after again I checked it became 127.My ana blot test is negative, ra ,cpk,hla b27 is negative. My cbc ,wbc is fine ,5 days back haemoglobin was 12.5,after 5 days it became 11.7.Other factors are normal. I suffer from chronic pharyngitis, cervical spondylosis. My iron studies test are iron serum-37,transferrin-9, ferritin-22.This was done 6 months back.What can be the reason? I am having health anxiety.
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Due to inflammation
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If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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Connect to your doctor
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Thank you for your query
First of all stay calm
I assure you that nothing serious as per now
ESR is non specific marker just you need a physical check up for any Lymph node Etc
Do not check ESR on weekly basis
Meet an Medicine consultant and get a physical examination done
Thank you
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Listen ESR in the report only suggests that you either have infection or any kind of disease which cause inflammation and as you have mentioned you now have chronic pharyngitis which is an infection and cervical spondylosis can cause pain which occurs due to inflammation and in both the cases you can have elevated ESR value, no need to panic. Just consult with your nearby doctor with all the reports so that you get more detailed information about your health and which in turn will help to reduce your anxiety.
Hope this helps you.
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If u are having chronic fever and cough then go for MANTAUX test
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Hello,
I understand your concern, especially with fluctuating ESR values and ongoing symptoms.
About ESR
Erythrocyte Sedimentation Rate is a non-specific marker of inflammation. It can rise due to many benign and temporary conditions.
• Earlier values (46–47) → mildly elevated
• Sudden rise to 127 → can occur due to acute infection or inflammation, even transiently
*Important reassuring points
• Your autoimmune markers (ANA blot, RA, HLA-B27) are negative → serious autoimmune diseases are less likely
• CBC/WBC are normal → no strong evidence of severe infection or blood disorder
• Mild drop in hemoglobin (12.5 → 11.7) suggests mild anemia
*Likely contributing factors
1. Chronic infection/inflammation
• Your history of Chronic pharyngitis can intermittently raise ESR
2. Iron deficiency
• Low serum iron (37) and ferritin (22) suggest Iron Deficiency Anemia
• This itself can increase ESR significantly
3. Transient acute illness
• Even a mild viral or bacterial infection can temporarily spike ESR
*What you should do
• Repeat ESR after 2–3 weeks (don’t check too frequently)
• Get CRP test (more specific for active inflammation)
• Start/continue iron supplementation after consulting your doctor
• Maintain good hydration and nutrition
*When to worry
• Persistent very high ESR (>100) on repeat testing
• Associated symptoms like fever, weight loss, severe fatigue, joint swelling
*About your anxiety
Health anxiety can make lab fluctuations feel alarming, but in your case, there is no strong evidence of a serious underlying disease so far.
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Your reports suggest inflammation + iron deficiency, not something like cancer or a serious autoimmune disease at this stage.
Next Steps
Don’t panic, but evaluate systematically:
Repeat / check:
• CRP (more accurate than ESR)
• Peripheral smear
• Repeat iron studies
Look for source of inflammation:
• ENT evaluation (for chronic throat issue)
• Dental infection check
• Urine routine
• Chest X-ray (if symptoms suggest)
Health Tips
• ESR can fluctuate widely → one high value ≠ serious disease
• Focus on symptoms, not just numbers
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Donât worry, ESR can go up like this due to simple reasons like infection or inflammation and by itself it doesnât point to any serious problem.
Your other reports being normal is actually reassuring.
Chronic throat issues or any recent infection can cause this temporary rise. Also your hemoglobin and iron levels suggest mild iron deficiency, which can be corrected.
Better to repeat ESR after 3 weeks and see the trend instead of worrying about one value.
If you want, I can go through all your reports together and guide you properly
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Reports are not too much abnormal... your esr is basically raised due to chronic pharyngitis.... can take antibiotics ... daily twice gargle with betadine....consult ent specialist for tonsil study ...avoid cold food
As for cervical spondylitis pain killer should be taken when there is unbearable pain ....
dont use pillow under head
Physiotherapy exercise
Cervical collar
Only painkiller will not be useful physiotherapy is a must thing
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First repeat ESR to rule out falsely elevated.
If still high , at this age need to rule out autoimmune disease or tuberculosis.
Any history of contact with any tb patient ?
Please do the CT/MRI of spine to find the exact cause of spondylosis. Because osteoporosis being the most common cause is very rare at this age.
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Beside this i need some detailed history from your side.
Till then avoid spicy and junk food
Next Steps
connect and consult for further evaluations
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Raised esr only indicates some chronic health issue or inflammation. In your case could be chronic pharyngitis.Please share result of cbc.Get blood sugar done.
Along with antibiotic, do gargles with hot water and few drops of listril mouth wash.
Take some honey regularly. Avoid cold food and drinks.
Tab limcee 500mg one morning and one evening for 2 weeks, before meals.
Use face mask, while going out.
Repeat esr 2 weeks after adopting above measures.
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Indicator for inflammation.
No separate treatment for this.
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I understand that seeing such a high number can be very worrying, especially when you are already feeling anxious about your health. Let’s break this down simply to help you and your doctor find the answer.
What does an ESR of 127 mean?
ESR is a 'stress signal' from your blood. When it is very high (over 100), it tells us there is significant inflammation somewhere in the body. Since your tests for joint and autoimmune diseases (like RA and ANA) came back negative, we need to look for other common causes:
Hidden Infections: Sometimes a deep-seated infection (like a dental abscess, a urinary tract infection, or even something like Tuberculosis, which is common in India) can raise the ESR very high without causing a high fever.
Iron Levels: Your hemoglobin and iron are low. When you have low iron or anemia, the ESR can naturally appear much higher than it actually is.
Recent Illness: Even a severe viral bout or a flare-up of your pharyngitis can cause a temporary spike.
Next Steps to Ease Your Anxiety:
Instead of testing the ESR over and over, you need a few 'target' tests to find the cause:
CRP (C-Reactive Protein): This is a more accurate and 'real-time' marker of inflammation than ESR.
Urine Routine: To rule out a silent kidney or bladder infection.
Chest X-ray: To ensure your lungs are clear.
Serum Electrophoresis: A blood test that looks at proteins to see if the ESR spike is due to an imbalance in your blood's 'thickness.'
My Advice:
Please do not panic. An ESR spike is just a signpost, not a diagnosis. Take these results to an Internal Medicine Specialist (Physician). They will look at your whole body—not just the numbers—to find the source. Once the underlying inflammation or anemia is treated, that number will come back down.
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I understand your concern, but based on the reports you’ve shared, there is no strong indication of any serious disease. ESR is a very non-specific test and can fluctuate significantly even with minor infections, throat issues (like your chronic pharyngitis), or low iron levels.
Your autoimmune tests (ANA, RA, HLA-B27) being negative is very reassuring. The rise in ESR to 127 can look alarming, but in many cases, it is temporary and settles once the underlying minor inflammation improves.
Also, your iron levels and slight drop in hemoglobin can contribute to a higher ESR.
Next Steps
1. Repeat ESR with CRP after 2–3 weeks rather than frequent testing
2. Correct iron deficiency with diet and supplements if advised
3. Check for any ongoing minor infection (throat, dental, etc.)
Health Tips
-ESR alone does not diagnose any specific disease
-Avoid repeated testing in short intervals—it often increases anxiety
-Focus on how you feel clinically rather than just lab numbers
At present, your reports are overall reassuring
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Its non-specific and nonsignificant.
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Hi, ESR is a nonspecific inflammation marker and can rise due to infection, throat inflammation, anemia, chronic inflammatory conditions, or even temporary factors. Your low iron studies and falling hemoglobin suggest iron deficiency may be contributing. Negative ANA/RA/HLA-B27 is reassuring.
Health Tips
have 27 years of clinical experience. Please book a video consultation with me with all reports for detailed assessment and the right treatment plan.
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Need some more details kindly consult
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