What is the reason for low erythrocyte sedimentation rate

Low erythrocyte sedimentation rate may be caused by factors such as blood concentration, polycythemia, decreased fibrinogen, cardiac dysfunction, drug effects, etc. It usually does not require special treatment, but needs to be evaluated comprehensively in combination with other indicators.

1. Blood concentration: When dehydration or excessive sweating leads to a decrease in plasma volume, the proportion of red blood cells in the blood increases and the sedimentation rate slows down significantly. This situation is common in high-temperature work, failure to replenish water in a timely manner after intense exercise, or fluid loss caused by diarrhea and vomiting. By supplementing electrolyte solution and increasing water intake, the condition can be improved, and the indicators can generally return to normal within 24 hours.

2. Polycythemia:

True polycythemia or secondary polycythemia can cause an increase in blood viscosity and obstruction of erythrocyte sedimentation. These patients often have symptoms such as dark red complexion, dizziness, and headache, and need to be diagnosed through bone marrow puncture and EPO level testing. Treatment requires the use of bloodletting therapy or drugs such as hydroxyurea to control red blood cell production.

3. Decreased fibrinogen: [SEP], as a key protein that promotes red blood cell stacking, a decrease in fibrinogen levels will directly slow down the sedimentation rate. Congenital hypoalbuminemia, severe liver disease, or DIC depletion stage may present with this condition, often accompanied by abnormal coagulation function in patients. Confirmation through four coagulation tests is required, and if necessary, fresh frozen plasma should be infused for supplementation.

4. Cardiac dysfunction:

Chronic heart failure patients may experience changes in red blood cell distribution volume due to circulatory congestion, and sedimentation rate may be lower than normal. These patients usually have symptoms such as shortness of breath and lower limb edema after physical activity, which can be diagnosed through cardiac ultrasound and BNP testing. It is necessary to standardize the use of diuretics and cardiac stimulants to improve cardiac function.

5. Drug effects:

Long term use of anti-inflammatory drugs such as aspirin and glucocorticoids can inhibit fibrinogen synthesis, while nonsteroidal anti-inflammatory drugs affect aggregation by altering red blood cell membrane charge. If pathological factors are excluded, it is recommended to adjust the medication plan under the guidance of a doctor. Usually, after stopping the medication for 2 weeks, the indicators can recover on their own.

It is necessary to maintain a daily water intake of at least 2000 milliliters and avoid working in high-temperature environments for long periods of time. Individuals with abnormal heart function should limit their sodium intake and monitor their weight changes weekly. Patients with polycythemia are advised to quit smoking and undergo regular blood dilution treatment. In winter, it is recommended to keep limbs warm to prevent thrombosis. All abnormal indicators need to be comprehensively judged by combining blood routine, coagulation function and other tests to avoid overinterpretation of a single indicator. When pregnant women or elderly people experience persistent abnormalities, it is recommended to improve the rheumatism and immunity screening series.