Erratic ESR levels

My ESR levels have often been high with the PsA, starting at around 20 when I first got the arthritis, and at one point peaking at 109 when I was in between meds. At that point i went on the hydroxychloroquine and slowly but surely it came down back to the 30s and I felt better, before rising again to the 50s when the tablets stopped working. During the summer, when I started MTX (and was still on steroids) it plummetted down to about 13, before rising again to the mid-20s. Five weeks later, last week’s blood test shows it to be back at 83 - while still on the MTX and the hydroxychloroquine.

That seems nuts to me. True, I have been in agony with the PsA for the last three or four weeks - equal to the worst it has ever been. Although, oddly, today my pain is half of what it was yesterday, although I have a sneaky feeling that’s because my immune system is fighting a skin infection on my leg.

But do other people have levels that shoot up and down like that? The GP didn’t seem concerned, other than that it showed the PsA was far from being under control. She said my white blood count was fine and my RBC was pretty much ok (very slightly low, but only VERY slightly), and that was the main thing. She also pointed out that the slight infection might have played a part too. There was also the suggestion that the ā€œsweatsā€ that had been put down to the MTX tablets might actually be due to the inflammation levels being so high!

But these wayward tests always put me on edge, and I normally end up panicking that it is something completely unrelated to PsA that is being missed! Am I alone with this worry?

Mine have fluctuated too darinfan. Steroids sent the ESR from 77 down to 1 almost immediately. While low is obviously good, there is some variation in ā€˜normal’ levels for each of us and I’ve heard that what can be achieved while on steroids can be a good indicator of our own personal best number. When I stopped steroids mine rose quickly, only to the 30s or so I think, though that meant something 'cos 1 seemed to be my optimum.

I sympathise with your worry that the higher levels might indicate that something else is going on. I doubt it very much because PsA meds have at times got the ESR levels down. But if you need reassurance then do ask for a thorough check-up to put your mind at rest.

When my PsA was out of control I had all the flu-like symptoms including sweats and uncontrollable shivering.

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Thanks Sybil. I think it’s just the hypochondria kicking in. It was so good to see the blood tests during the summer on the doctor’s computer screen with no red marks on them indicating something was out in some way. Back we go again. I’ve got the grrrr stage at the moment. I’m in the ā€œI want to smash some platesā€ stage! Not that I have. Yet!