Bcz females have normally less RBC count than males. So, less negative charges on RBC , less repulsions and more chances of sedimentation and thus more ESR. Also Anemia is very common in women that is also the reason
Women generally have less Hb concentration than their men counterpart, hence relative "anemia'" leading to less negatively repulsion, therefore increase in ESR.
According to negative charge,male has more rbc so more negative charge so more repuslsion and so esr might increase but in female less no of cell ,less repulsion so more sediment rate is faster but how...??
@@MedicosisPerfectionalis : Thanks for clarifying that. I was wondering about that, when answering your question in the end. Based on that, ESR should have been lower in women
wow this video is two years ago, thank you so much it was sooo helpful well, females have higher ESR because they have less RBCs number in their blood so the rouleaux will form faster than males who have more RBCs count. thanks to you I really understood this in 12 min!
Hi medicosis! As a rheumatology fellow, I have enjoyed getting a grasp on a few concepts through your videos so thanks! Also as a rheumatology fellow, I do feel I must let you (and the public at large) know that the ESR is most definitely NOT the most useless test around. True, it's non-specific and in most cases, does not add useful knowledge. However, in rheumatology, the combination of the values of ESR and PCR are of inestimable value to distinguish between disease activity, infection, macrophage activation syndrome etc!!
@@MedicosisPerfectionalis Gladly :) First of all, as I'm learning in my residency, it can be incredibly hard to distinguish a flare in the disease activity from an infection and the implications of getting it right, are obviously huge as the treatments are opposite. Increase the immunosuppression in an infection and the germ will kill you, lower the dose in a flare and the cytokine storm will. One of the things which help hugely, is the ratio between ESR and PCR, as PCR usually does not raise in a flare, and ESR clearly does (doi: 10.1177/0961203318763732). Apart from that, we tend to see our patients every three months with lab results, and fluctuations in ESR in patients with lupus, inflammatory myopathies, arthritis etc correlates incredibly well with the disease activity! But perhaps the most useful case of the ESR is in the patient with a suspicion of macrophage activation syndrome (which can easily endanger their lives very quickly). Just yesterday we had a patient who was hospitalized because of a disease flare. He had had ESR elevated during his stay and then yesterday the ESR dropped completely and PCR went up (ESR-PCR dissociation). We did the work-up and he had a clear case of MAS. So yes, when used in the right circumstance, it is of incredible value, but I totally agree that it is DEFINITELY not for routine use.
@@MedicosisPerfectionalis ESR being an inflammatory marker can be a good tool to differentiate symptoms if they are inflammatory or non-inflammatory which, in turn, is invaluable in rheumatology to arrive at a diagnosis, and also gauge the response to therapy. It's simple, inexpensive, and yet a powerful tool provided how you use it.
Great video. A correction though: sickled cells can be present in sickle cell trait. Some people have up to 40%. Which means then, that the ESR can be raised in sickle cell trait.
@@MedicosisPerfectionalis thank you for asking. I'm under attack at the moment, and am taking my much needed rest. Mainly the reason how I got into your channel. The first time my doctor ordered for my ESR, it was at 88. Now I don't go to the doctor anymore for ESR as I now know how to listen to my body.😊
@@MedicosisPerfectionalis Had low phosphates as well. Taking a supliment for that. Decided to take Vitamin D to improve absorbtion as Chrones is in the family.
My mom's esr is more than 100 ..... She is 63 years old... What are the causes for esr so high? What should be done to reduce it? Can u please tell me?
Why does multiple myeloma has increased ESR. Is it because this disease increase the WBC number and WBC can increase inflammatory mediator secretion, antibody secretion, which can aggregate the RBC together fast and form the Rouleaux faster? I know you said that compared to the number of the RBC, the number of WBC is very very small. So the increase of the WBC number must not be the direct reason of the increased Rouleaux. That is why I believe the it is because of the cytokines, chemokine, antibodies and other mediators secreted by the increased WBC. Please correct me if I am wrong.
How a great channel is "medicosis "! thanks allot . ESR is usually higher in female because females have relatively lower RBCs count than males ,I think that but could higher .
Question: i've read everywhere that ESR of a sample is the distance between the plasma surface and the top of sedimentated in 1 h. So we should measure the yellow column in 1h? Because in this video it seems we should measure the red one. Thank you
Wow how u explain 👍👍👍👍👏🏽👏🏽👏🏽👏🏽b/c my English is poor my second language and it’s hard to understand to know medical terminology but it’s wonderful ur explanation and really I understand very well. 👏🏽👏🏽👏🏽👏🏽👏🏽👏🏽
Hi, thanks for the video! Can you please explain why leucocytosis and thrombocytosis decrease ESR (is it also the negative charges?). And also, why does cryoglobulinemia decrease ESR (I would think it should have the same consequence as increased globulins)? Thank you!
i think is because women have a lower percentage of RBC and that women are more prone to anemia, also lots of women bleed during menstruation, moreover, only women gets pregnant therefore they will have dilutional anemia. IDA is also more common in women and is the most common anemia in the world rn.
3:39 "you think the pathologist has time to measure this distance with his ruler!? No, he's in his Ferrari. The lab technician's doing all the work" --- ouch. i shouldve gone into pathology
Thankyou for your videos Generally quite informing. However, this one undoes your credibility for being very incorrect. I note that you have said you addressed this in the ESR and CRP video which is not helpful to those 223000 people learning from this one. At 3:50 the theory of sedimentation rate is flawed as it appears the red cells are rising in the tubes not falling. While it might be a nothing test , doctors request it and labs perform it results are released So please amend so I can direct my trainees back to your content.
I have read in a book that, esr is high in newborns and infants... can you please tell me the reason for that. I had actually thought that, esr would be low because they have a higher RBC count (more repulsions, so less sedimentation).
Men: women generally have a higher ESR because opposites attract. However, after marriage and a few kids, ESR increases even more due to increased weight/density of the female.
You said plasma proteins and fibrinogen increases rbcs sticking to each other. But plasma proteins have negative charges right? So in inflmn if it increases Rbcs should repel each other shouldn't they?
Sir, with reference to the video at 4:27.. I have a small doubt. As time increases, there's gonna be an increase in the sedimentation.. So the length of the plasma decreases right? So if its 10 mm n half hr it should reduce... Nd not increase n 1hr isn't it? Sir..so how would the esr still remain the same? Could u please help me out?
Question: I’m a little confused about the ESR in multiple myeloma. Since there is both rouleaux and hyperviscosity due to proteins everywhere, which one predominates? It looks like you get a high ESR with rouleaux, but a low one with hyperviscosity syndrome. Thank you so much for your videos and your help!!
Hyperviscosity there was partially incorrect. Hyperviscosity can be due to increase in RBC's ( cause most abundant cell in the blood) / increase in proteins / increase in blast cells etc - it's a very broad term. The major player in ESR is proteins, due to the positive charges on their surface. In multiple myeloma - the more aggressive is the disease - the higher is the monoclonal IG production - the higher is the ESR. Simple as that.
Women have more ESR because there is reduced -ve charges due to lesser number of RBC than in males. Less -ve charges mean less resistance and more sedimentation... let me know if I'm right :)
The total RBC count in women is less than that of men... That's why there is presence of relative anemia in women.. And that less RBC count casues less repulsion in between each RBC because of less negative charge... And that ultimately causes more rouleaux formation and thus more esr range in women...
My sister was 24 yrs old when she had rheumotid arthritis . Now she is 26 and she is taking ayurvedic medicine . Her crp is 13.6 and esr 50 is it too high or ok for her .?? Please tell me🙏🙏
Women have higher ESR because of menstruation, in which their are acute blood loss, therefore decreasing repulsions and increasing rouleaux formation, increasing settling and ESR
Any chance you could be persuaded to update this so it's correct? I love your videos and ask all my students to watch them, but I'm afraid this one will confuse them!
Also could you try speaking just a tiny bit slower through some of the more tricky stuff. Thank you. Great video otherwise, I just can't comprehend as fast as you speak and end up rewinding a lot.
Hi i hve one doubt my son is 3yeras old and actually his esr rate is 20mm per 1minute and frm fast 15 days he is suffering from ichtihing and he is suffering a lot any solution for it
Answer: Because males have higher erythrocyte concentrations, increasing the negative charges between red cells, which increases the repulsion rate making its sedimentation rate slow (LOW) . Women have a lower rbc concentration, so there's less negative charges, so red cells are able to form a roleaux faster.
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Bcz females have normally less RBC count than males. So, less negative charges on RBC , less repulsions and more chances of sedimentation and thus more ESR. Also Anemia is very common in women that is also the reason
Yeah i also think that is the reason
yay I got that right
Period and pregnancy are also the causes of high ESR!
We need more medical educational videos like this. It's formatted in a casual, yet extremely educative way.
Women generally have less Hb concentration than their men counterpart, hence relative "anemia'" leading to less negatively repulsion, therefore increase in ESR.
Brilliant 👍
Wow..i was jus serching
According to negative charge,male has more rbc so more negative charge so more repuslsion and so esr might increase but in female less no of cell ,less repulsion so more sediment rate is faster but how...??
@@mahasundar6304 due to -ve charge i.e.repulsion ESR decreases
There sure is hope for u
I don't know why but watching on this channel make me happy
thanks for making our courses easy
My pleasure 😇
I honestly love how honest you are. Ty!
My pleasure 😇
The arrow is at the wrong place at 3:00.
You measure the distance the RBCs have fallen down, so you meausre it from the top.
You’re absolutely correct...That’s a terrible mistake that I have made...Thanks for letting me know.
Yesss, that’s what I was thinking about.
Btw thanks for amazing videoo✨
Thanks for admitting the mistake. The math worked out though. Very nice video.
@@MedicosisPerfectionalis : Thanks for clarifying that. I was wondering about that, when answering your question in the end. Based on that, ESR should have been lower in women
wow this video is two years ago, thank you so much it was sooo helpful
well, females have higher ESR because they have less RBCs number in their blood so the rouleaux will form faster than males who have more RBCs count. thanks to you I really understood this in 12 min!
Gho Shta My pleasure 😇
I've watched almost all the hematology playlist and it's just amazing .. the Best explanation ever! Thank you.. you saved me!
📝 Download my handwritten notes: www.medicosisperfectionalis.com/
Pathology Playlist: th-cam.com/play/PLYcLrRDaR8_ef4PE6gduEK-Gpx4lawX2t.html&si=T45GEAcahgX_TMtB
Ur way of teaching is quite interesting... 😂😂.
Your way of teaching is littttttttt
Thank you!
Hi medicosis! As a rheumatology fellow, I have enjoyed getting a grasp on a few concepts through your videos so thanks! Also as a rheumatology fellow, I do feel I must let you (and the public at large) know that the ESR is most definitely NOT the most useless test around. True, it's non-specific and in most cases, does not add useful knowledge. However, in rheumatology, the combination of the values of ESR and PCR are of inestimable value to distinguish between disease activity, infection, macrophage activation syndrome etc!!
Can you tell me more about the last part?
@@MedicosisPerfectionalis Gladly :) First of all, as I'm learning in my residency, it can be incredibly hard to distinguish a flare in the disease activity from an infection and the implications of getting it right, are obviously huge as the treatments are opposite. Increase the immunosuppression in an infection and the germ will kill you, lower the dose in a flare and the cytokine storm will. One of the things which help hugely, is the ratio between ESR and PCR, as PCR usually does not raise in a flare, and ESR clearly does (doi: 10.1177/0961203318763732). Apart from that, we tend to see our patients every three months with lab results, and fluctuations in ESR in patients with lupus, inflammatory myopathies, arthritis etc correlates incredibly well with the disease activity! But perhaps the most useful case of the ESR is in the patient with a suspicion of macrophage activation syndrome (which can easily endanger their lives very quickly). Just yesterday we had a patient who was hospitalized because of a disease flare. He had had ESR elevated during his stay and then yesterday the ESR dropped completely and PCR went up (ESR-PCR dissociation). We did the work-up and he had a clear case of MAS.
So yes, when used in the right circumstance, it is of incredible value, but I totally agree that it is DEFINITELY not for routine use.
@@MedicosisPerfectionalis ESR being an inflammatory marker can be a good tool to differentiate symptoms if they are inflammatory or non-inflammatory which, in turn, is invaluable in rheumatology to arrive at a diagnosis, and also gauge the response to therapy. It's simple, inexpensive, and yet a powerful tool provided how you use it.
PCR what is it?
@@yes_man_lol I think he meant to say C-reactive protein
Hi brilliant teacher❤
ESR is a measure of the length of plasma on top of the erythrocyte sediment layer at 1 hour. Not hematocrit at 1hr 3:20
Exactly! How come nobody noticed?? It‘s the very definition of sedimentation :D
this is the best video i've ever seen
Thank you so much for your kind words!
Can you please help me by sharing my videos with others?
Mate you are brilliant , Respect !
Thank you!
You are literally a treasure sir
Thank you! Every topic in this channel well explained
Great video. A correction though: sickled cells can be present in sickle cell trait. Some people have up to 40%. Which means then, that the ESR can be raised in sickle cell trait.
First minute in, subscribed and notification squad alreadyyyy, im sold 😂😂😂👌
Wow 🤩
Thank you so much 😊, brother
@@MedicosisPerfectionalis
You've earned it, keep it up ❤🙌
Thanks 🙏
Imagine RBC for cars,more the cars,more time for parking,less speed or rate of parking
That's a good one :)
11:39 Maybe because females have lower hematocrit (less repulsive forces caused by relatively less negative charges ) ?
I have an exem tomorrow, you helped me , thank you!
My pleasure 😇
esr in female is higher because females have less no of rbc.so there is a less negative charge which promote rbs roulex formation.
I´m a Pathology resident currently preparing for my board exam. I can confirm that ESR is garbage and all of us in the lab despise it.
I wish you success!
Thumbs up to the maker of this vid. Shed some light about my condition called Behcet's syndrome.
Thank you so much!
Oh! I am so sorry to hear that you’re going through this.
How is your health now?
@@MedicosisPerfectionalis thank you for asking. I'm under attack at the moment, and am taking my much needed rest. Mainly the reason how I got into your channel. The first time my doctor ordered for my ESR, it was at 88. Now I don't go to the doctor anymore for ESR as I now know how to listen to my body.😊
best way of explanation. I love it.
Thank you so much 😊
3:38 As a lab Technologist, I could confirm
😅😂
Me too! Lol
thank you so much .this video is great .finally i could understand every thing about this test
Awesome 👏
This was a great video. I feel so much more informed. Hoping the high count was nothing. Getting another test in 4 months.
Good luck 🍀
@@MedicosisPerfectionalis Had low phosphates as well. Taking a supliment for that. Decided to take Vitamin D to improve absorbtion as Chrones is in the family.
I love this channel and i love you
Thank you 🙏
Easy to understand, great video on this subject.
Thank you 🙏
This channel is just amazing....you've made it easy for us😜...thanks
My pleasure 😇
Glad i read the video description after watching the video. I thought the video making me more confuse. Finally i can grab the concept thank you !!!
You’re very welcome 😊
The way u crack jokes, i just love it...😍 Awesome explanations, best of luck...❤️
Thank you 😊
My mom's esr is more than 100 ..... She is 63 years old... What are the causes for esr so high? What should be done to reduce it? Can u please tell me?
Enjoyed a lot.thanks.
My pleasure 😇
Why does multiple myeloma has increased ESR. Is it because this disease increase the WBC number and WBC can increase inflammatory mediator secretion, antibody secretion, which can aggregate the RBC together fast and form the Rouleaux faster? I know you said that compared to the number of the RBC, the number of WBC is very very small. So the increase of the WBC number must not be the direct reason of the increased Rouleaux. That is why I believe the it is because of the cytokines, chemokine, antibodies and other mediators secreted by the increased WBC. Please correct me if I am wrong.
Have you watched my videos on multiple myeloma?
@@MedicosisPerfectionalis no. Thanks. I will go watch it.
As usual loved your hard work making studies easier 😊
Thank you so much 😀
How a great channel is "medicosis "! thanks allot .
ESR is usually higher in female because females have relatively lower RBCs count than males ,I think that but could higher .
awsome,i like the way you teach.
Thank you so much 😊
Question: i've read everywhere that ESR of a sample is the distance between the plasma surface and the top of sedimentated in 1 h. So we should measure the yellow column in 1h? Because in this video it seems we should measure the red one. Thank you
ur way of teaching is very nice and its helpd me aloot tnx ☺️🤝
Thank you thank you thank you soo much!! U r the BEST!!
Thank you 🙏
This guy a legend😂😂😂
Thank you 😊
I luv the way U teach...😘😘😘
Thanks 🙏
Simply awesome...keep doing what you're doing😍😘🤩
Thank you 🙏
Wow how u explain 👍👍👍👍👏🏽👏🏽👏🏽👏🏽b/c my English is poor my second language and it’s hard to understand to know medical terminology but it’s wonderful ur explanation and really I understand very well. 👏🏽👏🏽👏🏽👏🏽👏🏽👏🏽
Thank you so much!
Would you please help me by sharing?
Omg this video going to save my life. Cuz doctors been putting me on medication because of this blood test
I wish you the best of luck!
Hi, thanks for the video! Can you please explain why leucocytosis and thrombocytosis decrease ESR (is it also the negative charges?). And also, why does cryoglobulinemia decrease ESR (I would think it should have the same consequence as increased globulins)? Thank you!
I like the way ur teaching. The vid was fun and helped me a lot thx. :)
Awesome 👏
WELL NOW IM INTRESTED
Thank you for your effort
My pleasure 😇
I've never clicked sub button that fast
Thank you so much 😊
Welcome to the tribe!
Me too bro, me too
I got the question right
There is hope for you😂
Btw amazing lecture.
Keep going❤
Thank you, I will
It’s really awesome, very clear explanation 👍🏻👍🏻 Thank you so much 🍀🎉🙏🏻
My pleasure 😇
So glad I came across this😂
What is the role of ESR in immunodeficiency?
I love this channel thankyouuuuu 🥰
Thank you 🙏
You are amazing 😍 love the way you teach
Thank you 😊
Hi , mine is 28mm/hr it says abnormal on the report . Should I be worried ?
Nice work
Thanks 🙏
i think is because women have a lower percentage of RBC and that women are more prone to anemia, also lots of women bleed during menstruation, moreover, only women gets pregnant therefore they will have dilutional anemia. IDA is also more common in women and is the most common anemia in the world rn.
3:39 "you think the pathologist has time to measure this distance with his ruler!? No, he's in his Ferrari. The lab technician's doing all the work" --- ouch. i shouldve gone into pathology
Wow your lectures helped us a lot! I hope you'll continue to share your knowledge! more power to you sir!
Kudos!!!
Thanks a ton 😊😊
love your humour!!!!!!
Thank you so much 😊
Thankyou for your videos Generally quite informing. However, this one undoes your credibility for being very incorrect. I note that you have said you addressed this in the ESR and CRP video which is not helpful to those 223000 people learning from this one. At 3:50 the theory of sedimentation rate is flawed as it appears the red cells are rising in the tubes not falling. While it might be a nothing test , doctors request it and labs perform it results are released So please amend so I can direct my trainees back to your content.
I have read in a book that, esr is high in newborns and infants... can you please tell me the reason for that. I had actually thought that, esr would be low because they have a higher RBC count (more repulsions, so less sedimentation).
That 'slowly' hit different at 9:12
Men: women generally have a higher ESR because opposites attract. However, after marriage and a few kids, ESR increases even more due to increased weight/density of the female.
You said plasma proteins and fibrinogen increases rbcs sticking to each other. But plasma proteins have negative charges right? So in inflmn if it increases
Rbcs should repel each other shouldn't they?
The negative charges matter when they are on the RBC surface, not in the plasma.
Today I had an ear section
In westergren method we calculated the esr average rate by the formula
[R1 + (R2/2)] ÷ 2
Can some one explain????
Great explanation, I benefited a lot from it, thanks for the effort
Sir, with reference to the video at 4:27.. I have a small doubt. As time increases, there's gonna be an increase in the sedimentation.. So the length of the plasma decreases right? So if its 10 mm n half hr it should reduce... Nd not increase n 1hr isn't it?
Sir..so how would the esr still remain the same? Could u please help me out?
Hm.. It shouldn't reduce... By leaving it longer, it should have pile up..
My esr is 70 , I am extremely worried, is it related to any chronic illness?
It needs to be interpreted in light of history, physical exam, and other labs.
Hii medicosis, i would like to ask why increase ig G lead to increase ESR?
If esr value is 60 in men what should he do for decrease the value... naturally or with medicine
It depends on the underlying cause.
"A jack of all trades is a master of none, but oftentimes better than a master of one"
Yup 👍
Question: I’m a little confused about the ESR in multiple myeloma. Since there is both rouleaux and hyperviscosity due to proteins everywhere, which one predominates? It looks like you get a high ESR with rouleaux, but a low one with hyperviscosity syndrome. Thank you so much for your videos and your help!!
Hyperviscosity there was partially incorrect. Hyperviscosity can be due to increase in RBC's ( cause most abundant cell in the blood) / increase in proteins / increase in blast cells etc - it's a very broad term. The major player in ESR is proteins, due to the positive charges on their surface. In multiple myeloma - the more aggressive is the disease - the higher is the monoclonal IG production - the higher is the ESR. Simple as that.
Really amazing ☺️
Vahitha vahi Thank you 😊
Women have more ESR because there is reduced -ve charges due to lesser number of RBC than in males. Less -ve charges mean less resistance and more sedimentation... let me know if I'm right :)
And the answer to the last question is the following: as female has low HCR so less RBC and less repulsion, increase sedimentation and increased ESR.
Entertaining, yet informative, you are awesome!
Thank you so much 😊
Hey because they have high estrogen therefore more of coagulating tendency of blood therefore ESR would be more than men...
Coagulation 🤔???
means viscosity of blood ....due to effect of estrogen on coagulating factors
I think by westergreen method count esr from up to down vs wintrobe method from down to upward as u shown.
You’re right!
I can't express how much I loved this video omg hahahahahaha
thanks alooot for this wonderful explanation.
The total RBC count in women is less than that of men... That's why there is presence of relative anemia in women.. And that less RBC count casues less repulsion in between each RBC because of less negative charge... And that ultimately causes more rouleaux formation and thus more esr range in women...
My sister was 24 yrs old when she had rheumotid arthritis . Now she is 26 and she is taking ayurvedic medicine . Her crp is 13.6 and esr 50 is it too high or ok for her .?? Please tell me🙏🙏
I didn't get full results yet. I have all this and I dont understand. ACE level 62 C Reactive protein 1.1 sedimentation rate westergren 41.
Mine is same like yours.i am 23.doctors are confused.can you tell me what causes yours.it may help me
Women have higher ESR because of menstruation, in which their are acute blood loss, therefore decreasing repulsions and increasing rouleaux formation, increasing settling and ESR
"its performed via automated analyzer.. you can leave the ruler at home" am dead hhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh
LMAO
Hehehehehehe 😂😂
ESR is high (like 46), is it serious?and is it risky to birth baby?
ESR alone is rarely helpful...You need to follow up with a good doctor.
Thanks
My pleasure 😇
This test is not useless:
Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body.
Any chance you could be persuaded to update this so it's correct? I love your videos and ask all my students to watch them, but I'm afraid this one will confuse them!
I have added a correction in the description, and also mentioned the correction in my video titled: “ESR and CRP”
Also could you try speaking just a tiny bit slower through some of the more tricky stuff. Thank you. Great video otherwise, I just can't comprehend as fast as you speak and end up rewinding a lot.
Hi i hve one doubt my son is 3yeras old and actually his esr rate is 20mm per 1minute and frm fast 15 days he is suffering from ichtihing and he is suffering a lot any solution for it
Fantastic doctor.....why red blood cell in ESR is stick to gather or why accur roulex
What is the normal range for a prepubescent girl, aged 11? It's been hard to find consistent info
Answer: Because males have higher erythrocyte concentrations, increasing the negative charges between red cells, which increases the repulsion rate making its sedimentation rate slow (LOW) . Women have a lower rbc concentration, so there's less negative charges, so red cells are able to form a roleaux faster.
and what about the effect of albumin on ESR ?
th-cam.com/video/4TAhYqw1mgE/w-d-xo.html