Hi,

i have recently had some blood tests and the results show elevated levels of ESR 44 and CRP 25.

After my bloods I then found the NSD. This I commenced 3 days ago and already feel a difference in my body.

My question
Has anyone experience with NSD and ESR and CRP?

I would like to know as I am seeing Rheumy who is pro TNF!

Thank you

Good that you had some blood tests done as a baseline, and then started the NSD very soon afterwards. In a lot of ways its lucky that you did show high levels in ESR and CRP because that will give something you can measure "inflammation" with.

Your rheumy may be sceptical about NSD and pro-biologics, but its really down to what works for you. Can you agree with rheumy to continue without anti-tnfs for maybe three months and then recheck ESR and CRP and see if the NSD has made a measurable difference apart from just feeling better?

Hi, ScottP and WELCOME:

There is a lot of reading material here, and happy You have found the NSD:

Tzero and 90-day LSD ESR measurements
From: The Etiopathogenesis of Ankylosing Spondylitis and the Cross-Tolerance Hypothesis.


Several people have done very well with the combination of anti-TNF-a agents plus their own version of LSD/NSD.

HEALTH,
John

My ESR normalized after I made dietary changes (not quite as strict as NSD but not running as loose as LSD). It was high normal, but normal. CRP, not so much. I don't know why. It very well may be something different.

At my worst ESR was 50 and CRP 25.

After a few months on NSD both normalized, that is - ESR down to 11 and CRP <1 - where they have remained ever since.

My last ESR was a 1 which doesn't seem right. I was NSD at the time but I don't think 1 exists.

Does it go to 1 if they leave too much time between blood taking and actual testing of the blood? Either that or I can't judge my inflammation through ESR.

Hi Inflammator

There is such a thing as an abnormally low ESR

The ESR (Erythrocyte Sedimentation Rate) is dependent on:
- the zeta potential – refers to the net negative charge on the surface of red cells that thereby prevent red cells from aggregating and forming rouleaux
- the repulsion of negatively charged red cells for one another is overcome by macromolecules – namely plasma proteins, particularly fibrinogen
- the shape of red cells – abnormally shaped red cells tend not to rouleaux as much and hence will tend to reduce the ESR

ESR’s exceeding 100 mm/hr are usually due to
- infection - 50%
- connective tissue disorders (mainly arthritis) - 25%
- malignancy – 20%
- unknown cause – 2% (follow up tests required)

Factors tending to lower the ESR
- red cell factors – high red cell count (polycythaemia) will reduce the ESR
- plasma factors – cryoglobulins will reduce ESR
- since fibrinogen is the main controlling factor of the ESR then in DIC (Disseminated Intravascular Clotting) the fibrinogen concentration will be greatly reduced and the ESR will approach 0
-therapy NSAID’s will cause a low ESR

Factors tending to raise the ESR
- anaemia – red cells have mare plasma to fall through – hence increased ESR
- high fibrinogen concentration
- increased globulin concentration (not as great an effect as fibrinogen)
- albumin concentration has only a slight effect on ESR
- para proteins – myeloma – increased protein – hence increased ESR
- cold agglutination

Clinical conditions associated with a low ESR
- polycythaemia
- haemoglobinopathies eg. Thalassaemia
- hypofibrinogenaemia
- hypoproteinaemia
- hypochromic microcytic anaemia (probably due to variable shape rather than smallness of the red cells
- congestive heart failure
- anti-inflammatory drugs

Thanks for the info. I took no NSAID's at the time but I had no pain due to diet. I just assumed they were connected until I found out very few here have had ESR's of 1 regardless of diet.

It leads me to wonder if I was off the diet and in a lot of pain, would that be enough to elevate it and counter anything that is giving me a abnormally low ESR?

I have a super high ESR!!!! My last check was in December last year and it was 119!!!!! At my worst it was 131!

Is this an indication of the level of disease activity?

My CRP was 1.89 when I was diagnosed... I was in extreme pain at that time.. the next time it was texted I was 1.48.

I started the LSD after this and the next ones I had were tiny. The last one was 0.04.