ESR (Erythrocyte Sedimentation Rate)

Also known as SED rate, Sedimentation rate, Westergren sedimentation rate

You need to provide

Blood

This test is for

Male, Female

Test Preparation

Overnight fasting is preferred.

Understanding ESR (Erythrocyte Sedimentation Rate)

What is ESR (Erythrocyte Sedimentation Rate)?

An ESR (Erythrocyte Sedimentation Rate) test determines the presence of inflammation due to any injury, infection, or any other disease like an immune system disorder in the body. It measures the rate at which the erythrocytes (red blood cells or RBCs) settle down or sink to the bottom of a test tube.

Inflammation is the body’s normal response to an injury or infection. It usually occurs when the body releases chemicals that trigger an immune response to fight off an infection or heal damaged tissue. Once the injury or infection is healed, the inflammatory process subsides. Chronic inflammation is an abnormal immune response in which the inflammatory process does not resolve as it should under normal conditions, or the inflammation begins even if there is no infection or injury. Over time, chronic inflammation can damage healthy cells, tissues, and organs, and this can lead to autoimmune disorders like arthritis, heart disease, diabetes, asthma, Alzheimer's disease, and even cancer.

An ESR test may be performed if you experience symptoms such as headaches; pain or stiffness in the neck, shoulder, or joints; pelvic (lower part of the stomach) pain; anemia; unexplained weight loss; and joint swelling. Such symptoms may indicate inflammation or health concerns like autoimmune disorders that may need medical intervention. This test is also used to check the progression of an existing inflammatory disease and monitor the response of ongoing treatment for inflammatory conditions like arthritis. Usually, overnight fasting (8-12 hours) is preferred for this test; however, it is not mandatory. Do not eat or drink anything except water before the test. It is also advised that you inform your doctor about the medications you are taking as some of them may affect your test results.

Test result ranges are approximate and may differ slightly between different labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. Narrate your complete medical history to help the doctor correlate your clinical and laboratory findings. The test results will help them determine your medical condition, make recommendations for lifestyle modifications such as diet and exercise, decide whether or not medication will be required to manage your condition, and formulate your overall treatment plan.

What is ESR (Erythrocyte Sedimentation Rate) used for?

An ESR test is done:

As part of routine checkups to monitor your overall health.
To detect any inflammation in the body which may be caused due to conditions such as infections, cancers, and autoimmune diseases.
To monitor the progress of inflammatory diseases.
To evaluate the treatment response of inflammatory diseases.

What does ESR (Erythrocyte Sedimentation Rate) measure?

An ESR test measures the rate at which red blood cells (erythrocytes) settle (sediment) at the bottom of a tube that contains a blood sample in one hour.

When there is any inflammation in the body, certain proteins, mainly fibrinogen, increase in the blood. This increased amount of fibrinogen causes the red blood cells to form a stack (rouleaux formation) that settles quickly due to its high density, leading to an increase in the ESR.

An ESR test is a non-specific measure of inflammation and can be affected by conditions other than inflammation also. This test cannot identify the exact location of the inflammation in your body or what is causing it. Hence, an ESR test is usually prescribed along with a few other tests to identify or treat possible health concerns.

Interpreting ESR (Erythrocyte Sedimentation Rate) results

Interpretations

The normal reference range for Erythrocyte Sedimentation Rate (ESR) is:

Men	0-15 millimetres per hour (mm/hr), or 0-20 mm/hr for men older than 50
Women	0-20 mm/hr, or 0-30 mm/hr for women older than 50
Children	0-10 mm/hr
Newborns	0-2 mm/hr

High ESR can be seen in:

Inflammatory disease such as Arthritis (Inflammation of joints), vasculitis (Inflammation of blood vessels)
Infection, such as pneumonia, pelvic inflammatory disease, appendicitis, skin infection, bone infection, heart valve infection

Autoimmune diseases, such as systemic lupus erythematosus or rheumatoid arthritis
Chronic kidney disease
Viral infections
Pregnancy
Cancer, such as lymphoma or multiple myeloma

Low ESR can be seen in:

Congestive heart failure
Polycythemia
Sickle cell disease
Severe liver disease
Hypofibrinogenemia

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about ESR (Erythrocyte Sedimentation Rate)

Frequently Asked Questions about ESR (Erythrocyte Sedimentation Rate)

Q. Is there any risk associated with an ESR test?

There is usually no risk associated with this test. However, some people may feel a slight sting when a needle is pricked and may experience some bleeding that is normal and usually not bothersome. Rarely, some people may also experience slight swelling or bruising at the site of the needle prick. Applying ice 3-4 times a day for about a week may help reduce swelling and bruising. If it does not get better, consult your doctor.

Q. Is there any preparation required before an ESR test?

Generally, overnight fasting is preferred for an ESR test. However, it is not mandatory. It is also advised that you should inform the doctor about the medications you are taking as some medications, including estrogens, birth control pills, aspirin, prednisone, etc., may affect your test results.

Q. What can be the reason for high ESR?

High ESR may be seen due to tissue injury, inflammatory or infectious diseases, old age, anemia, diabetes, thyroid problems, obesity, heart disease, anemia, etc. Sometimes, certain types of cancer, such as lymphoma and multiple myeloma systemic, may also be a reason for high ESR.

Q. Is high ESR good or bad?

A moderate ESR may be due to conditions like pregnancy, menstruation, or anemia that might be normal and may not be suggestive of an inflammatory disease. However, the higher the ESR levels, the greater the chances of inflammation and that might suggest an inflammatory condition or infection.

Q. Why are the ESR levels high in women?

Women normally have slightly higher ESR levels than men. Causes of a high ESR count in females may include anemia, pregnancy, and other hormonal imbalances.

Q. What other tests might be recommended besides an ESR test?

Along with an ESR test, your doctor may recommend a CRP test, an ANA test (antinuclear antibody test), a Rheumatoid factor test, or blood cultures to identify suspected health concerns. If serious problems like cancer are suspected, serum electrophoresis may be done to look for evidence of cancers like multiple myeloma and lymphoma.

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