Hello, ESR is a nonspecific marker of inflammation, high levels are indicative of infection (TB bacterial infection as in your case), chronic inflammatory condition, tumors, etc. To reduce high ESR level, treatment of the underlying cause of the inflammation or infection has to be done. AKT4 medications are helpful to reduce growth of the lymph node(as in your case) and also reduce inflammation and infection. It can help reduce ESR level as a secondary effect. Continue taking the medications prescribed by your treating doctor. Get follow up medical examinations to check the progress of your healing. AKT4 medications are strong and can affect your metabolism. It has potential side effects like nausea or loss of appetite. Loss of appetite and changes in dietary habits during treatment can lead to deficiencies that may exacerbate feelings of weakness. Get adequate rest during treatment. To boost energy level and to improve mood you should do light exercises and walking at least once a day. Take balanced homemade food. Take whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats to ensure you re getting essential vitamins and minerals. Do not take processed food and cut on sugars. Make sure you are adequately hydrated. Take fluids and water. Dehydration also causes fatigue. Take small meals that is high in protein & minerals throughout the day. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician