Erythrocyte Sedimentation Rate (ESR)

If you’ve been feeling tired or achy for no clear reason, your doctor might suggest an ESR test. For example, if you often wake up with stiff joints or unexplained fatigue, this test can help find hidden issues like inflammation or arthritis. It’s a small step toward understanding what’s going on in your body. An erythrocyte sedimentation rate (ESR) test, also known as a sedimentation rate or sed rate test, determines how quickly red blood cells settle to the bottom of a test tube. A high pace of settlement indicates a high degree of inflammation.

Rather than diagnosing a specific ailment, an ESR test determines whether you are experiencing inflammation and what other testing may be required. It can also track inflammatory conditions.

Continue reading to learn more about the ESR test and what the results may signify.

How does an ESR blood test work?

An ESR test determines the rate at which your red blood cells (RBCs) fall to the bottom of a test tube over one hour. The faster and further the cells sink to the bottom of a test tube, the greater the likelihood of inflammation.

Inflammation can impact RBCs in a variety of ways:

• Inflammation can cause RBCs to clump together, affecting how quickly they sink inside a blood sample tube.
• An acute infection or persistent inflammation may cause an increase in particular proteins in and around your red blood cells, causing them to clump and settle fast.

The ESR number is calculated using the rate at which your RBCs settle. The faster this occurs, the higher your ESR and the greater the likelihood of inflammation in your body.

Why do physicians order an ESR blood test? 

An ESR test does not reveal the particular source of inflammation. To detect an inflammatory health condition, a doctor often orders an ESR test along with additional testing.

If you already have an inflammatory condition, your doctor may request an ESR test as part of your routine blood work to assess the success of your current treatment regimen.

Identifying conditions that produce inflammation

Doctors may request an ESR test in conjunction with other tests to assist diagnose inflammation-causing illnesses, such as:

• Temporal arteritis and autoimmune disorders.
• Cancer infections
• Arthritis and inflammatory bowel disease (IBD)

Monitoring inflammatory conditions

The ESR test can help monitor the following autoimmune inflammatory conditions:

1. Rheumatoid arthritis

2. Systemic lupus (SLE)

Your doctor may also request this test if you have:

1. Certain forms of arthritis

2. Specific muscular or connective tissue issue

3. Polymyalgia rheumatica

How does one prepare for an ESR test?

The ESR test requires minimal preparation.

If you are taking any drugs, you should tell your doctor. They may request that you temporarily discontinue certain drugs before the test.

Certain drugs can affect ESR test results. These could include:

• Steroids
• Nonsteroidal anti-inflammatory medications (NSAIDs)
• Statins

However, do not stop taking any prescription medication until your doctor tells you to. Stopping some prescription drugs abruptly can result in dangerous negative effects.

What exactly happens during an ESR test? 

This test requires a simple blood draw. It usually takes 1-2 minutes.

The blood sample is then sent to a lab and kept in a long, thin tube for one hour.

• Your doctor may prescribe additional tests along with your ESR test. This may include:
• C-reactive protein (CRP) test to assess inflammation and estimate your risk of coronary artery disease (CAD) and other cardiovascular illnesses.
• A complete blood count (CBC) test to determine other markers of inflammation or infection.

While wait periods vary, most test results obtained at a doctor's office or clinic take a few business days. Your healthcare expert may contact you to explain the results or schedule an appointment to discuss the next steps. You may also be able to access your findings via an online portal.

Are there any hazards to performing an ESR test? 

An ESR test carries no direct dangers. However, having your blood drawn may provide minor hazards such as bleeding, bruising, or pain where the needle was put.

Before having your blood drawn, discuss any concerns with your doctor or lab technician.

What are the different types of ESR tests?

There are two primary ways to determine your erythrocyte sedimentation rate. Some hospitals may also employ automated approaches to assess clumping rather than segmentation.

Westergren Method

This is the most popular ESR approach. This test involves drawing blood into a Westergren-Katz tube until the blood level reaches 200 millimetres (mm).

The tube is kept upright and left at room temperature for an hour. The distance between the top of the blood mixture and the sedimentation of RBCs is measured.

Wintrobe-Landsberg Method

The Wintrobe method is identical to the Westergren method, except the tube is 100 mm longer and thinner.

One downside of this method is that it is slower than the Westergren method.

What do the typical ESR test results look like?

The ESR test results are expressed in millimetres per hour (mm/hr). The higher the number, the greater the possibility of inflammation.

ESR test results are as follows:

Interpreting abnormal ESR results

An abnormal ESR test indicates that there may be inflammation in your body. Several factors can influence your outcomes, including:

Factors to consider include 

• Age
• Medication use
• Pregnancy
• Menstruation

If your ESR readings are abnormally high or low, your doctor will typically prescribe additional testing.

Causes of high ESR test results

A high ESR (Erythrocyte Sedimentation Rate) result can indicate inflammation or other underlying conditions. Common causes include:

1. Autoimmune Diseases

• Lupus
• Rheumatoid arthritis (RA)
• Polymyalgia rheumatica
• Temporal arteritis
• Allergic or necrotizing vasculitis

2. Blood Disorders

• Anemia
• Hyperfibrinogenemia (excess fibrinogen protein)
• Blood vessel inflammation (vasculitis)

3. Infections

• Bone infections
• Heart infections (myocarditis, pericarditis, endocarditis)
• Skin or systemic infections
• Tuberculosis (TB)

4. Chronic Diseases

• Diabetes
• Heart disease
• Kidney disease
• Thyroid problems

5. Cancer

• Lymphoma
• Multiple myeloma
• Tumours (without inflammation)

6. Other Causes

• Obesity
• Tissue injury or ischemia
• Rheumatic fever
• Trauma

Note: ESR above 100 mm/hr often signals severe conditions like vasculitis or cancer. Always consult a doctor for accurate diagnosis and treatment.

Causes of low ESR test results

A low ESR result can happen due to:

• Heart problems like congestive heart failure (CHF)
• Low fibrinogen, a blood protein needed for clotting
• Low blood protein, often linked to liver or kidney disease
• High white blood cells (WBCs) from infections or other issues
• Polycythemia vera is a condition where too many red blood cells (RBCs) are made
• Sickle cell anaemia, a genetic disorder affecting RBC shape and function

What occurs following the ESR test?

Depending on your results, your doctor may prescribe further tests, such as a second ESR test, to confirm the first results. These tests may be able to assist you in determining the cause of your inflammation. If your doctor feels an underlying illness is causing your elevated ESR, they may refer you to a specialist who can properly diagnose and treat it. If you already have a diagnosed underlying illness that causes elevated ESR levels, ESR tests can help you track the success of your therapy.

Conclusion

An ESR test checks for inflammation in the body. High or low results may mean infections, diseases, or other health issues. Regular tests can track health changes. TruePal’s health check-ups help find and manage problems early, so you stay healthy with expert care and simple wellness tips.

FAQs

1. What is an Erythrocyte Sedimentation Rate (ESR) test?

The erythrocyte sedimentation rate (ESR) is a blood test. It examines how rapidly erythrocytes, or red blood cells, separate from a blood sample after being treated to prevent clotting.

2. What does it mean if your ESR levels are high?

A high ESR test result indicates that your red blood cells sunk faster than normal. This could be due to an inflammatory condition, such as giant cell arteritis, which causes inflammation (swelling) of your arteries, most commonly in your scalp, neck, and arms.

3. How is an ESR test performed?

An ESR test involves drawing blood from a vein in your arm and placing it in a tall, thin tube. The blood is then allowed to settle before the sedimentation rate is assessed. Inflammation causes erythrocytes (red blood cells) to bind together and form clumps. These clusters are heavier than regular red blood cells.

4. What are normal ESR levels for adults?

ESR is measured in millimetres per hour (mm/h). The usual range for men is 0 to 15 mm/hr. In women, the rate ranges from 0 to 20 mm per hour.

5. Can ESR levels be affected by age and gender?

Yes, ESR levels can be affected by age and gender. Older people often have higher ESR levels. Women, especially during pregnancy or menstruation, may also have slightly higher ESR levels compared to men. These changes are normal and not always linked to health problems.

6. Is a high ESR level always a sign of inflammation?

An increased ESR is typically associated with inflammatory disorders, though it can also be brought on by other medical issues. The following are some examples of circumstances that can result in an excessively high ESR: infections. autoimmune diseases such as rheumatoid arthritis and lupus.