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What is ESR ?

The ESR refers to erythrocyte sedimentation rate. It is also known as the “sed rate” or the “sedimentation rate.” A doctor will generally advise to get an ESR blood test done to verify and evaluate the extent of inflammation affecting the body, which include cancers, different types of infections, as also various autoimmune conditions and diseases. It is an easy and non-specific test that is comparative cheaper and more cost effective than other types of blood tests.

It may be noted that there are a few limitations to an ESR blood test, such as the inability to identify the reasons of inflammation occurring in the body, as also the exact position of the medical disorder. This is reason why it is considered as a non-specific blood test. However, it can be employed as a helpful tool to check on the progress of any inflammatory condition affecting the body.

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Due to the restrictive use of ESR blood test, it is typically performed with various other tests so as to come to a definite judgment about the causes and diagnosis.

ESR blood test – detailed information

The erythrocytes are fully developed blood cells which consist of hemoglobin that performs the function of transporting oxygen from the lungs to the many tissues and organs of the body. Hence, the name, i.e. ESR or erythrocyte sedimentation rate is good enough to express the meaning, which indicates the sedimentation action of the erythrocytes

An ESR test starts with the accumulation of a blood sample that is taken from the vein present in the arm of a person who wants to get the test done. The sample is then kept in a tube, which is positioned in an upright manner without disturbing it any further

With the passage of time, the RBCs begin their downward descent in a pace which is their own. This pace or descending rate of the red blood cells in a time frame of one hour helps in calculating the ESR value. The value of ESR is measured and written down millimeters per hour. In simple terms, the ESR value refers to the distance, in mm, that is travelled by the RBCs in 60 minutes or one hour.

When the body has some type of inflammation, then the content of fibrinogen is substantially increased. This results in the red blood cells attaching to one another, which is later followed by the production of stacks known as rouleaux by the blood cells. These particles have a typical tendency descend quickly. Thus, it can be deduced that a faster rate of RBC settlement or descent indicates increased presence of an inflammation in the body.

ESR Normal Range according to age

The normal values of ESR are shown in the table below:

Age categories ESR values in mm/hr
Men above 50 yrs Below 20
Men below 50 yrs Below 15
Women above 50 yrs Below 30
Women below 50 yrs Below 20
Newborns From 0 to 2
Neonatal till puberty From 3 to 13


It may be noted that the above listed ESR measurements indicate the normal range. But, there are various factors that can result in abnormal ESR values. Such factors are discussed below.

ESR High – Causes

  • When the normal levels of ESR undergo a mild or moderate manner increase in their values, then it can be regarded as signifying the presence of bodily inflammations, as also of other disorders such as cardiac abnormalities, anemia, pregnancy, aging, diabetes, and some forms of infections.
  • An extreme increase in the normal levels of ESR measurements can be regarded as signifying the presence of intense inflammations, cancers involving cells present in the immune system, severe infections, tumors in the bone marrow known as multiple myeloma, and inflammatory complications that affect the muscles. It may also indicate inflammation involving the temporal arteries which can result in headaches, chewing difficulties and occasionally impaired sight.
  • An ESR test results that have values which are gradually rising can be regarded as signifying the presence of inflammation which is steadily increasing

ESR Low – Causes

  • There is no undue importance that can be attached to lower than normal values of an ESR test. However, they can be regarded as signifying the presence of different disorders like polycythemia, sickle cell anemia, intense leukocytosis and protein irregularities

Considerations of an ESR Blood Test

  • ESR tests were done in the olden days when better techniques for measurement of body inflammations were absent.
  • It may however be noted that the various disorders listed above are some of the reasons for an abnormal ESR test value. These diseases can either decrease or increase the values of an ESR test as compared to the normal range. Also, the above discussed abnormalities are not the only conditions causing change of normal ESR values.
  • Therefore, one must consult a doctor to verify the results of an ESR test. Also, all patients should inform the health care provider about the current consumption of non-prescription or prescription drugs during these discussions.
  • The most important thing to note is the fact that people affected by medical conditions may yield normal ESR test values. Hence, an ESR test cannot be performed as a stand-alone test and should be accompanied by a battery of other relevant tests as well.
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