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ESR (Erythrocyte Sedimentation Rate)

Also referred as

SED rate

Sedimentation rate

Westergren sedimentation rate

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An ESR (Erythrocyte Sedimentation Rate) test measures the rate at which red blood cells (also known as erythrocytes) settle in a test tube over a specified period of time. This test is a marker of inflammation and helps detect or monitor various inflammatory diseases, such as infections, autoimmune disorders, certain cancers, and tissue damage.

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Understanding ESR (Erythrocyte Sedimentation Rate)

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 a disease or heal damaged tissue. Once the injury or infection is healed, the inflammatory process subsides. An ESR (Erythrocyte Sedimentation Rate) test helps assess the presence and degree of inflammation in the body. It may also be used to monitor the progression of certain chronic inflammatory diseases such as rheumatoid arthritis.

An ESR (Erythrocyte Sedimentation Rate) test may be done if you experience signs and symptoms like fever, joint stiffness, body pain, abdominal pain, or blood in the stool. It is a non-specific test; it cannot diagnose a specific disease or determine the cause of inflammation. It is usually done along with other tests to identify the underlying condition. Higher ESR values generally indicate a higher degree of inflammation or disease activity.

Elevated ESR values may be seen in infections such as bacterial, viral, or fungal infections, autoimmune conditions such as rheumatoid arthritis, systemic lupus erythematosus, and vasculitis, after a heart attack, trauma, or surgery, or in some cancers, including lymphoma and multiple myeloma. Conditions other than inflammation that may cause an increase in ESR levels include anemia, pregnancy, aging, and certain medications. A decrease in ESR values may indicate a positive response to therapy.

Usually, overnight fasting (8-12 hours) is preferred for this test; however, it is not mandatory. It would be best to inform your doctor about your medications, as some may affect your test results.

Test result ranges are approximate and may differ slightly between 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 and formulate your treatment plan.

What does ESR (Erythrocyte Sedimentation Rate) measure?

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

When there is 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. This test cannot identify the exact location of the inflammation in your body or what is causing it. Hence, an ESR test is usually performed along with a few other tests to identify or treat possible health concerns.

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FAQs related to ESR (Erythrocyte Sedimentation Rate)

What is the purpose of an ESR (Erythrocyte Sedimentation Rate) blood test?

An ESR (Erythrocyte Sedimentation Rate) blood test determines the presence of inflammation in the body due to an injury, infection, or any other disease like an immune system disorder.

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. Some people may also experience slight swelling or bruising at the site of the needle prick. Applying ice 3-4 times daily for about a week may help reduce swelling and bruising. If it does not get better, consult your doctor.

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 take, as some medications, including estrogens, birth control pills, aspirin, prednisone, etc., may affect your test results.

What are some of the common causes of high erythrocyte sedimentation rate?

Some of the common causes of high erythrocyte sedimentation rate are tissue injury, inflammatory or infectious diseases, old age, 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.

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 suggest an inflammatory disease. However, the higher the ESR levels, the greater the chances of inflammation, which might indicate an inflammatory condition or infection.

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.

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.

Content created by

Dr. Anupriya Nautiyal

MD Pathology, MBBS

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Last Updated

16th Oct 2025