Rhuematoid arthritis with ESR 109

Hi, I have been diagonised with RA for last 1 year. I did my blood works and now my ESR is as high as 109. In addition I have high CRP and RA factor. I am wondering what are the natural ways i can get ESR low. How risky is 109 ESR and what should be my next course of action. I have flare ups and pain and i feel really fatigued. Thanks!