ESR elevation

Patient

Q: I have a quick question. I have Hashimoto's Thyroiditis, and I have been on levoxyl .75 dose for over a year now. I have extreme lower abdominal pain, that I am going to have a colonoscopy in about a month. ( I have had no symptoms, ie, a lot of bowl movements or bloody stool) My question is this: I have a SED rate of 75, since I am on Levoxyl, would the Hypothyroidism still elevate my numbers? OR is there something else going on that could be causing the inflammation in my system? All my other lab numbers came back fine ie, white blood count and so on... Thank you.

Doctor

A:   The ESR, defined as the rate (mm/hour) at which red blood cells settle when placed in a vertical tube, depends largely upon the plasma concentration of fibrinogen (blood protein). Normal values for the ESR are slightly higher among women than men. The ESR is a non-specific marker of inflammation in the body. As a patient's condition worsens or improves, the ESR changes relatively slowly. Normal ESR in mm/hr can be roughly calculated from the formula: [Age in years + 10 (if female)]/2, therefore your normal would be <20mm/hr, if you are approximately 30 years old. Hashimoto’s is an auto-immune thyroid disease, and may still influence your ESR if there is active auto-immune disease. Alternatively the ESR may be elevated due to inflammation in the gastrointestinal tract, causing your severe abdominal pain. It is difficult to know what is causing this increase. It would be helpful to view previous ESR results, and repeat the ESR in a few months to appreciate the general trend in readings. It is advisable to fully investigate your gastrointestinal symptoms.

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