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Erythrocyte sedimentation rateFrom Wikipedia, the free encyclopediaThe erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or 'Biernacki Reaction', is a non-specific measure of inflammation that is commonly used as a medical screening test.To perform the test, anticoagulated blood is placed in an upright tube, known as a Wintrobe tube and the rate at which the red blood cells fall is measured and reported in mm/h.When an inflammatory process is present, the high proportion of fibrinogen in the blood causes red blood cells to stick to each other. The red cells form stacks called 'rouleaux' which settle faster. Rouleau formation can also occur in association with some lymphoproliferative disorders in which one or more immunoglobulins are secreted in high amounts. Rouleau formation is however a physiological finding in some equidae and can be as such in felidae and suidae species, namely the horse, cat and pig respectively.The ESR is increased by any cause or focus of inflammation. The basal ESR is slightly higher in females.HistoryThis test was invented in 1897 by the Polish doctor Edmund Biernacki.[citation needed] In 1918 the Swedish pathologist Robin Fåhræus declared the same. Fåhræus is still known as the inventor of ESR in the Western world although Fåhræus accepted that he wasn't the first[citation needed].UsesAlthough it is frequently ordered, the erythrocyte sedimentation rate (ESR) is not a useful screening test. It is only useful for diagnosing three diseases: myeloma, temporal arteritis and polymyalgia rheumatica (in which it may exceed 100 mm/hour).It is commonly used for a differential diagnosis for Kawasaki's Disease and it may be increased in some chronic infective conditions like tuberculosis and infective endocarditis. It is a component of the PDCAI, an index for assessment of severity of inflammatory bowel disease in children.The clinical usefulness of erythrocyte sedimentation rate (ESR) is limited to monitoring the response to therapy in certain inflammatory diseases such as temporal arteritis, polymyalgia rheumatica, rheumatoid arthritis. It can also be used as a crude measure of response in Hodgkin's disease.The use of the ESR as a screening test in asymptomatic persons is limited by its low sensitivity and specificity. When there is a moderate suspicion of disease, the ESR may have some value as a "sickness index."An elevated ESR in the absence of other findings should NOT trigger an extensive laboratory or radiographic evaluation.Normal ValuesNote: mm/hr. = millimeters per hour.Adults (Westergren method):Men under 50 years old: less than 15 mm/hr. Men over 50 years old: less than 20 mm/hr. Women under 50 years old: less than 20 mm/hr. Women over 50 years old: less than 30 mm/hr. It is increased in states of anemia. Children (Westergren method):Newborn: 0 to 2 mm/hr. Neonatal to puberty: 3 to 13 mm/hr.more from: http://en.wikipedia.org/wiki/Erythrocyte_sedimentation_rate
This is thyrotoxicosis, an excess of circulating thyroid hormone (thyroxine). In this case the cause is Graves Disease, which is associated with the production of an antibody that triggers the thyroid to over-produce thyroxine. Thyroxine determines metabolic rate and potentiates the action of adrenaline and adrenaline-like chemicals. Excess thyroxine causes tachycardia (fast heart rate) and arrhythmias (irregular heart rate), high blood pressure, intolerance of heat, increased appetite, weight loss, and proximal muscle wasting.The secretion of thyroxine is under the control of the brain's pituitary gland, which releases a chemical called TSH (thyroid stimulating hormone). This is part of a negative feedback loop: TSH stimulates the thyroid to release thyroxine, which then shuts off the supply of TSH from the brain.Occasionally, and more often in women, the body produces an auto-antibody that can bind to and activate the TSH receptor on cells in the thyroid. This bypasses the usual TSH control of thyroxine production and results in very low or undetectable TSH levels, because the excessive thyroxine in the blood stream shuts off TSH secretion. This is an important test to do because it rules out a problem with the pituitary (such as a tumour) producing too much TSH as the cause of the hyperthyroidism.There are several ways to manage Graves Disease. The favoured option is known as block and replace. Patients are given an anti-thyroid drug known as carbimazole (or an alternative thyro-static called propylthiouracil), which suppress thyroxine production. This is continued for 6-9 months (with monitoring of thyroxine and supplementation where required).The suppression is then withdrawn; in a number of patients the condition seems to abate. If several rounds of suppressive therapy fail then radio-iodine is given to ablate the thyroid, and the patient is given exogenenous thyroxine to take by mouth to maintain correct levels (using the TSH level to check whether they are being adequately medicated).Chris
Thanks Iko.. I thought it was different then mine.. Thanks and that's a great piece BTW!
Hey Karen,we said you needed to RELAX, didn't we?And here you overwork, plus the other 4life forum, plus who knows what...I never asked you when you started having insomnia, lack of sleep.I cannot put together the history of your left arm/shoulder ache.Did you have various pains in your joints in the recent past, problems ofuhm...diarrhea from time to time?Ops! this will keep you awake for another couple of days!Sorry, but I have my colleague Gregory on the phone and...he'd like to know these details, don't know why.ikod []
Hi Karen,I am sorry that you have to go through all these troubles.Legs can swell in hours, but it takes a long time to get rid of extra fluids!You certainly are behaving like a good patient and following all the instructions...you should move your legs too, as much as you can, to let some circulation work and avoid fluids and blood retention. A couple of enjoyable books and a wise 'switch off' for your PC would help, in my personal opinion. Healing takes time.I cannot say anything about your diagnosis, I am not an experienced clinician, and data seem to be incomplete so far. I'm getting cofused: we started with 'blood infection' and ended up with thyroid inflammation and malfunction.It's a common problem though ( http://en.wikipedia.org/wiki/Hashimoto's_thyroiditis )and so you have plenty of knowledge available for this and remedies ready to use.Unfortunately, like in many other medical conditions, we don't know the cause. You probably had your thyroid hormones tested and you are taking the right pills.My only suggestion is to stop any other type of integrators-supplement-herbal who knows what 'innocent' and 'natural' stuff, to let treatments work fine without mysterious surprises or side effects. Standard treatments work in standard conditions.Only cod liver oil (but you don't need it!) and Vitamins (especially B1) are allowed!We'll keep in touch. Take care.ikod
OK IKO, My MRI is scheduled for tomorrow at 12:45 PM. My sleep study for 6:00 PM tomorrow night! I will let you know when I find out more!