### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I AM A 54 YEAR OLD WOMAN..OBESE..5 FEET 4 INCHES IN HEIGHT..HPOTHYROID DIAGNOSED FROM 6 YEARS TAKING 100 MCG THYROXINE...BLOOD PRESSURE HIGH NOW CONTROLLED WITH EXFORGE 5/80 ONE A DAY AND URIC ACID CONTROLLED WITH ZYLORIC ACID OF 300 MG ONE A DAY..TAKE 1 B COMPLEX..ONE CALCIUM AND 10 MG OF FOLIC ACID AS SUPPLEMENTS...EVERYTIME I TAKE A BLOOD TEST MY ESR IS ALWAYS BETWEEN 80 AND 90..WHAT COULD BE CAUSING THIS AND HOW CAN I BRING IT DOWN..CAN U RECOMMEND A GOOD DIET THAT I MAY LOOSE SOME WEIGHT ..I DO WALK AND SWIM FOR EXERCISE THANK U SO MUCH FOR YOUR TIMEI

### output:

Hi, dear. I have gone through your question. I can understand your concern. There are many causes of high ESR.  Tuberculosis, autoimmune disease, infection, anemia, paraprotienemia, malignancies are some common causes of high ESR. Your symptoms suggest you may have some autoimmune disorder.  You should go for ANA profile. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. Don't forget to click, thank you.