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Have fibromyalgia. Started taking steroids. Blood test showed elevated ESR level. Any suggestion?

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Internal Medicine Specialist
Practicing since : 1996
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Hi, I had another blood test yesterday and my ESR is 102, CRP 20. My ESR has been up to 104 about 4 years ago and since then has been sitting in the high 50's to high 60. Last blood test a month ago my ESR was 78 and CRP was 15. Was put on steroids and had gone down. I've had blood test after blood test and still no answers as to why as XXXXXXX RF ect all keep coming back negative. When ESR originally went up to 104 it was 3 months after having an L4/L5 Laminectomy and had blood test after blood test and MRI's to rule out infection but no answer.

I was diagnosed with Fibromyalgia a few years ago and every time I have a flare my i get bad joint pains and know my ESR has gone up. Have explained this to dr's especially my Rheumatologist and has just brushed me off and said that my high ESR is normal for me. I know it's not normal and that Fibromyalgia doesn't cause inflammation, especially this high!!

Have started steroids again today and hoping they start working soon!! I'm also due to see a new Rheumatologist end of next month for a second opinion. I have also have Ulcerative Colitis in the family, 2 members and have had that ruled out and another family member with Lupus. Had the blood test yesterday and rang my dr for the results that night but he has now gone on away for 2 weeks and don't have an appointment with him till he comes back.

Any help will be greatly appreciated.

Posted Sat, 4 May 2013 in Bones, Muscles and Joints
Answered by Dr. Prasad Akole 1 hour later
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

ESR is a non-specific acute phase reactant and is raised in so many chronic inflammatory conditions and just indicates some inflammatory activity.

Levels are just suggestive of some chronic problem and nowadays there is not much value in following ESR or CRP.
Your rheumatologist may have meant that.

Levels also depend on which of the 2 methods of ESR estimation is used.
However,104 is quite high.

It is high in SLE (lupus), rheumatoid arthritis, granulomatous diseases like Tuberculosis, polymayalgia rheumatica, Crohn’s, and many auto-immune diseases.

With a family history of auto-immune diseases like UC and lupus, you are highly likely to have one of those diverse auto-immune diseases.

You need detailed and systematic work up like XXXXXXX by IF method, XXXXXXX blot assay, cANCA, pANCA (anti-nuclear cytoplasmic antibodies) by IF method, anti CCP antibody, hemogram, liver and kidney function tests and skeletal examination for arthritis.also Xray chest, EKG, urine routine is asked for.

Steroids are the treatment of choice for auto-immune diseases and your improvement.

You could be having variants or overlap syndromes where initial XXXXXXX etc may be negative or vary with test type and activity level.

A second rheumatology opinion may be taken.
Continue the advised steroid course till then. Further immune-suppressants are needed in some.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries.
Take care and please keep me informed of your progress at
Good Luck!
Above answer was peer-reviewed by
Follow-up: Have fibromyalgia. Started taking steroids. Blood test showed elevated ESR level. Any suggestion? 31 minutes later
Thankyou for your reply.

When my ESR originally went up to 104 a few years ago I went through extensive blood tests by Physcian, have extensive bloodwork by a Haematologist, was hospitalised for a week for extensive tests and that's when the diagnosis of Fibromyalgia was made. There was some thought of PMR before the hospitalisation. I have also had TB of my lymph nodes in my neck at age 2 so had been retested for that also.

I had changed GP's just over 6 months ago as my old dr had been ignoring my symptoms and not listening to a think I was saying. My new GP had been fabulous and after 3 years of doctor's not doing anything he has put me on steroids when I do have a bad flare up and my ESR goes up. This makes a huge difference in my pain levels.

I am also due to have an ECG and have a Holter Monitor on Tuesday for bad heart palpitations that I have been having lately. When I have a bad flare and I'm exhausted, when I rest can feel my heart pounding and occasionally feel it skipping a beat. I had also passed out a couple of months ago with no explantion but also had bad palpitations that afternoon and they have been getting more frequent and worse since then.

My GP is doing regular monthly blood tests to keep an eye on what's going on. My kidney's and liver are always getting checked and so far have been all good. I have also had microscopic haematura on a couple of my urine samples but they have given no reason for that either.

I also have a lot of symptoms of Lupus and know that a lot of them do overlap with Fibromyalgia. I'm just hoping that this new Rheumatologist can help me as my pain and symptoms are getting worse when I have a flare and that is when my ESR and CRP go up. I can usually guess by my pain levels as to what my ESR will be.

I'm just hoping with my latest results that they will investigate further.
Answered by Dr. Prasad Akole 21 hours later

I do understand the agony faced by people like you having chronic painful condition.
Good to know that you have been bold and perseverant !
If steroids are not controlling you well, please ask if there is need to increase the dose or get pulse steroid therapy or add immune-suppresants.
Hope you get better and the new doc helps more.

I hope my advice helps.
I would be glad to answer any further queries.
Good Luck!

It would greatly help if you could upload your new (or old) reports here using the uploading service available on this site just below the text box. You can email the reports / scans to: YYYY@YYYY with subject- (Attn: Dr. Prasad Akole)

It helps us to improve continuously if you could please write a rating review before you ‘accept’ and ‘close’ the query.
Thank you!!
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