Pathology Laboratory

Erythrocyte Sedimentation Rate (ESR)

Last updated on January 21st, 2023 at 12:00 pm

An erythrocyte sedimentation rate (ESR) test is sometimes called a sedimentation rate test or sed rate test. This blood test doesn’t diagnose one specific condition. Instead, it helps your doctor determine whether you’re experiencing inflammation.

Erythrocyte sedimentation rate

The doctor will look at ESR results along with other information or test results to help figure out a diagnosis. If you have symptoms, the tests will refer. The ESR test can also monitor inflammatory diseases.

Why ESR test is advised?

When you’re experiencing inflammation, your red blood cells (RBCs) cling together, forming clumps. This clumping affects the rate at which RBCs sink in a tube of blood.

The test lets your doctor see how much clumping is occurring. The faster the cells sink to the bottom of a test tube, the more likely it is that inflammation is present.

The test can identify and measure inflammation in your body. However, it doesn’t help pinpoint the cause of inflammation. That’s why the ESR test is rarely performed alone. Instead, your doctor will combine it with other tests to determine the cause of your symptoms.

What is the purpose for ESR test?

The ESR test can help your doctor diagnose conditions that cause inflammation, such as:

The ESR test can help your doctor monitor inflammatory conditions, such as:

Your doctor might also order this test if you have:

  • some types of arthritis
  • certain muscle problems, such as polymyalgia rheumatica

What are the symptoms and signs to do an ESR test?

You might need an ESR test if you experience symptoms of inflammatory conditions such as arthritis or inflammatory bowel disease (IBD). These symptoms can include:

  • joint pain or stiffness that lasts longer than 30 minutes in the morning
  • headaches, particularly with associated pain in the shoulders
  • abnormal weight loss
  • pain in the shoulders, neck, or pelvis
  • digestive symptoms, such as diarrhea, fever, blood in your stool, or unusual abdominal pain

Which medications and drugs which affect ESR test result?

Medications and drugs that can cause abnormally high test results to include:

  • androgens, such as testosterone
  • estrogens
  • oral contraceptives
  • dextran, which is used to treat a decrease in blood plasma
  • methyldopa, which is used for hypertension
  • methadone (Methadose, Dolophine), a pain reliever
  • heroin

Medications and drugs that can cause abnormally low test results to include:

  • aspirin (Bufferin) or other salicylates, when taken in high doses
  • cortisone
  • prednisone (Rayos, Prednisone Intensol)
  • drugs used to treat seizures, such as valproic acid (Depakene), divalproex sodium(Depakote), and phenytoin (Dilantin)
  • phenothiazines, which are antipsychotic drugs

Types of ESR test

Your pathology lab will use one of two methods to measure your erythrocyte sedimentation rate.

  • Westergren method

In this method, your doctor will draw your blood into a Westergren-Katz tube until the blood level reaches 200 millimeters (mm).

The tube will be stored vertically and sit at room temperature for an hour.

Your doctor will measure the distance between the top of the blood mixture and the top of the sedimentation of RBCs.

  • Wintrobe method

The Wintrobe method is like the Westergren method, except the tube used is 100 mm long and thinner.

An advantage of this method is that it’s less sensitive than the Westergren method, so less blood is used.

ESR test normal value

ESR test results are measured in millimeters per hour (mm/hr).

The following are normal ESR test results:

  • Women under the age of 50 should have an ESR under 20 mm/hr.
  • Men under the age of 50 should have an ESR under 9 mm/hr.
  • Children should have an ESR between 0 and 10 mm/hr.

The higher the number, the higher the level of inflammation.

This test isn’t always reliable or meaningful. Many factors can alter your results, such as:

Some causes of abnormal ESR test results are more serious than others are , but many aren’t a tremendous concern. It’s important not to worry too much if your ESR test results are abnormal. Instead, consult with your doctor to find out what’s causing your symptoms. They’ll usually order follow-up tests if your ESR results are too high or low.

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What are the causes of high ESR test result?

There are multiple causes of a high ESR test result. Some common conditions associated with high rates include:

  • advanced age
  • pregnancy
  • Anemia
  • high cholesterol
  • kidney disease
  • thyroid disease
  • certain types of cancer, including lymphoma and multiple myeloma
  • SLE
  • certain types of arthritis, including RA
  • Waldenstrom’s macroglobulinemia, a rare cancer
  • temporal arteritis, a condition in which your cranial arteries become inflamed or damaged
  • polymyalgia rheumatica, which causes muscle pain
  • hyperfibrinogenemia, or too much of the protein fibrinogen in your blood
  • allergic or necrotizing vasculitis
  • bone infection
  • heart infections such as myocarditis (affects heart muscle), pericarditis (affects the tissue around the heart, or the pericardium) and endocarditis (affects the lining of the heart, which can include the heart valves)
  • rheumatic fever
  • skin infection
  • systemic infection
  • tuberculosis (TB)

What are the causes of low ESR test result?

A low ESR test result may be due to:

  • congestive heart failure (CHF)
  • chronic fatigue syndrome (CFS)
  • hypofibrinogenemia, or too little fibrinogen in the blood
  • low plasma protein
  • leukocytosis, or a high white blood cell (WBC) count
  • polycythemia vera, a bone marrow disorder that leads to the production of excess RBCs
  • sickle cell anaemia, a genetic disease affecting the RBCs

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