ESR- Erythrocyte Sedimentation Rate

An erythrocyte sedimentation rate (ESR) test does not diagnose one specific condition. Instead, it helps your doctor determine whether you are experiencing inflammation. ESR is a blood test that can reveal inflammatory activity in your body. ESR test isn't a stand-alone diagnostic tool, but it may help your doctor diagnose or monitor the progress of an inflammatory disease. When your blood is placed in a tall, thin tube, red blood cells (erythrocytes) gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly.


The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of your immune system. The doctor will look at ESR results along with other information or test results to help figure out a diagnosis. Which tests are ordered will depend on your symptoms. Your doctor may order an ESR test to help detect inflammation in your body. This can be useful in diagnosing conditions that cause inflammation, such as autoimmune diseases, cancers, and infections. The ESR test is rarely performed alone. Instead, it will be combined with other tests to determine the cause of your symptoms.

Tell your doctor if you are taking any medications. You will be told whether you should temporarily stop taking them before the test. All this test involves is a blood draw. The skin directly over a vein will be cleaned, and a needle will be inserted to collect your blood. After the blood has been collected, the needle will be removed, and the site of the puncture will be covered to stop any bleeding. It should take only a minute or two.

An abnormal ESR result does not diagnose any particular disease. It just identifies any inflammation in your body. This test is not always reliable or meaningful and abnormal test results don’t always mean you have a disease (HHP, 2003). Many factors, such as age or medication use, can alter your results. In addition, abnormal results don’t tell your doctor what is actually wrong. Instead, they indicate a need to look further. Your doctor will usually order follow-up tests if your ESR results are too high or low.
There are multiple causes of high ESR rates. Some common conditions associated with high rates include:

• anemia
• kidney disease
• lymphoma
• multiple myeloma
• old age
• pregnancy
• temporal arteritis
• thyroid disease

Some types of infection that cause ESR rates to become higher than normal are:

• bone infection
• heart infection
• heart valve infection
• rheumatic fever
• skin infection
• systemic infection
• tuberculosis

Low ESR rates may be caused by:

• congestive heart failure
• hypofibrinogenemia (Fibrinolysis syndrome is characterized by an acute hemorrhagic state brought about by inability of the blood to clot, with massive hemorrhages into the skin producing blackish, purplish swellings and sloughing)
• leukocytosis (an increase in the number of white cells in the blood, especially during an infection)
• low plasma protein
• polycythemia (an abnormally increased concentration of haemoglobin in the blood)
• sickle cell anemia

Some causes of abnormal ESR rates are more serious than others, but many are not a huge deal. That’s why it’s important not to worry too much just because your ESR levels are abnormal. Instead, work with your doctor to find out what’s causing your symptoms.