What could be the possible cause of low ESR?

Question

Hello doctor,

I had a blood test two weeks ago, and my ESR (erythrocyte sedimentation rate) was 1 mm/hr. My hemoglobin level was 17.1 g/dL, and my hematocrit was 51.2 percent. I checked on the internet that low ESR is related to polycythemia vera. As I have high hemoglobin and hematocrit, the chances are increased. I am also experiencing a bad headache, tiredness, and weakness. Should I be concerned about polycythemia vera?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. It is important to note that polycythemia is not diagnosed solely based on ESR. Dehydration can also lead to low ESR. According to the World Health Organization criteria for polycythemia, hemoglobin should be greater than 18.5 g/dl. And if hemoglobin is greater than 17, then there should be a sustained rise of hemoglobin of more than 2 gm/dl from baseline. Usually, the hematocrit in polycythemia vera is more than 55 percent. In polycythemia, the red blood cell mass (RBC) is high, and the white blood cell (WBC) and platelet count can also be high, as it is a myeloproliferative disorder. Hence, here I do not think it is a case of polycythemia vera. I would suggest you repeat your CBC (complete blood count) test after two weeks.

I hope this helps you.

Thank you.