Hi tnavas,
I am assuming you want a method that will falsely elevate the sed
rate (ESR, or sedimentation rate) *before* the blood is drawn, and not
a way to mechanically *rig* the test itself.
It is pretty hard to fake an elevated sed rate test! A physician
doesn?t usually order an ESR unless she/he suspects the results will
be elevated.If the results of an ESR come back elevated, or falsely
elevated, when expected to be normal, the test will probably be
repeated on another day, along with other tests such as CRP, ANA, RF
(rheumatoid factor) and a CBC with differential.
I am unaware of anything, nor could I find any substance you could
take that would cause the ESR to be elevated enough to cause concern.
Having a very high blood lipid (fats such as cholesterol and
triglycerides) level can cause a false positive in an ESR. Being
dehydrated or anemic may elevate the test, but not by a significant
amount. You can see there is a broad range within the normal values,
from the normal values I have listed below. If an actual ESR value
were 4, and you had the test drawn while dehydrated, you may get an
ESR value of 14, still within normal limits. Certain drugs can
elevate the ESR, falsely, including dextran, methyldopa,
methylsergide, penicillamine, procainamide, theophylline,
trifluperidol, and Vitamin A may elevate the sed rate. How much
depends on the dose and the person?s condition, and is not possible to
quantitate.
http://www.healthy.net/library/books/textbook/Section2/esr.pdf
Not all labs test ESR in the same manner. There are 3 ways of running
an ESR. Two methods, the Westergren, and the Wintrobe method utilize a
graduated, narrow tube of blood. The Westergren uses a longer and
wider tube, while the Wintrobe method utilizes a smaller and narrower
tube. Some labs call for using a saline diluted blood sample. Both of
these methods work by filling the tube with sample, placing them
absolutely straight up and setting a timer for one hour. After one
hour, the line marking the cells that have fallen from the plasma is
noted.
You can see a picture of the one hour Westergren method here. Note
the graduated marks on the tubes.:
http://www.guest-medical.co.uk/html/f_lab_labcon_ESR.htm
A newer method, developed in Italy, uses a machine that systematically
rocks the blood to shorten the testing time from 60 minutes to 20
minutes. I had the ?honor? of performing comparison studies on the
analyzer, to see how it fared to the older one hour tests. I can say
that it compared well, in most cases.
A sed rate is a non-specific test for inflammatory processes in the
body. By non-specific, I mean it is not a test for a specific disease
state such as arthritis or leukemia. Many conditions and diseases
produce inflammation, giving an elevated ESR. Some conditions that
elevate the ESR are multiple myeloma, polycythemia, sickle cell,
temporal arteritis, polymyalgia rheumatica, and rheumatoid arthritis.
Red cells carry a negative ionic charge,and normally repel each other
at a fairly constant rate, known as the Zeta Potential. Protein
molecules, associated with inflammation carry a positive charge,
affecting the Zeta Potential of the red blood cells, causing them to
stack, rather than repel, thus causing an increased ESR.
Inflammatory processes cause a change in the ionic charge of red blood
cells, causing the rate at which the red cells repel each other, known
as the Zeta potential, to change. This causes the red cells to fall
quicker, giving a higher result.
http://www.aafp.org/afp/991001ap/1443.html
You can see an illustration of the Zeta Potential on this page:
http://www.uwcme.org/site/courses/legacy/rheumlab/esr.php
Mechanical methods can affect the ESR in the laboratory. Using an
incorrect dilution factor (saline to blood) in setting up the test can
cause a falsely elevated ESR, as can a tilted tube, or a vibrating
centrifuge, or other vibrating equipment on the same counter where the
ESR is being run. Medical technologists running the test are careful
not to bang on the counter, set heavy items down, or otherwise cause
vibration of any kind while this test is being run. Running the test
on refrigerated blood can falsely elevate the results, as can a very
warm room.
Normal Values:
·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.
Please note that normal value ranges can vary from lab to lab. You
will need to compare your actual result to the performing lab?s normal
values for complete accuracy.
http://www.healthcentral.com/mhc/top/003638.cfm
If this answer is not what you were expecting, or if my answer is
unclear, please utilize the Answer Clarification button, before
rating. This will allow me to assist you further, if possible.
I am very curious as to why you would want to elevate a sed rate!
Regards,
crabcakes
Search Terms
ESR variables
Factors affecting sed rate
Falsely elevated sed rates |
Clarification of Answer by
crabcakes-ga
on
11 May 2004 22:10 PDT
Hi again, tnavas,
I appreciate your clarification. However, I must reiterate that it
would be extremely difficult, if at all possible, to ?fake? an
elevated ESR. A sed rate measures inflammation, and there is simply
not a way to ?fake? inflammation. This would be similar to faking a
test to determine your blood group and type-either an antigen for a
specific group and type is present, or it is not. In an ESR,
inflammation is present, or it is not. I realize there are methods
available that purport to yield a negative result for drug or alcohol
testing. Most good laboratories can detect these "interfering"
substances as well as the drug or alcohol they are supposed to mask!
Generally the only thing these ?remedies? extract is money from the
customer?s pocket.
I have worked in a clinical setting for over 25 years and am very
familiar with laboratory tests. I have never heard of any substance
that one can take to falsely elevate a sed rate. Some lab tests are
indeed sensitive to interfering substances; the best known is that
large amounts of Vitamin C can give a false positive urine glucose
result.
While I did include a list of medications that can cause a falsely
elevated ESR in my answer, it is not recommended that you take any of
them. The drugs are listed as possible causes of elevated sed rates,
so that patients taking these drugs may be aware that their
medications MAY be at fault for a rise in ESR. These are prescription
medications, and I could not and would not recommend that you try any
for the purpose of faking an ESR. The false transient rise in an ESR
would surely be detected upon being retested - a high result is
usually retested. Each prescription drug on the list has it?s own
medicinal purpose, along with various side effects. Do not take
prescription drugs that were not prescribed for you, as this is
dangerous, and could cause a potentially life threatening reaction!
Here I will explain what each medication that *can* cause an elevated ESR:
Dextran : Certain grades of dextran are used as blood plasma volume
expanders, and iron-Dextran is used to combat iron-deficiency anemia.
I am guessing it may affect the sed rate as it affects the stability
of proteins, particularly affecting fibrin, a clotting factor.
http://www.microsurgeon.org/dextran.htm
Methyldopa: is a drug used to treat high blood pressure
http://www.methyldopa.com/
Methysergide: a medication used to treat migraines and vascular headaches
http://www.migraines.org/treatment/tsmthysr.htm
Penicillamine: used to treat kidney stones, arthritis, and for
chelating excess copper in the body.
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202445.html
Procainamide: is a drug used to correct cardiac arythmias and to slow
a fast heartbeat (tachycardia).
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202483.html
Theophylline: is a medication used to treat asthma.
http://allergy.mcg.edu/advice/theoph.html
Trifluperidol: is a neuroleptic drug, used to reduce psychotic symptoms
http://www.gpnotebook.co.uk/cache/557121539.htm
Vitamin A: of course, is a fat soluble vitamin, found in whole milk,
eggs, and liver, among other foods. Because Vitamin A is fat soluble,
toxic overdose is possible.
http://www.cc.nih.gov/ccc/supplements/vita.html#what
I?m sorry but I was able to find no information on how much of the
above medications one would need to consume in order to
physiologically raise the sed rate, nor by how much. There is just no
interest in trying to artificially raise an ESR. What purpose would it
have? Ideally, an ESR would be within the normal ranges, and not high!
I hope this helps! Again, please request an Answer Clarification if
this answer is unclear.
Regards,
crabcakes
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