An ESR test can help measure inflammation in your body. Doctors may use it, along with other tests, to diagnose an inflammatory condition or to monitor an existing condition like arthritis.
Erythrocyte Sedimentation Rate Test (ESR Test)
An ESR test can help measure inflammation in your body. Doctors may use it, along with other tests, to diagnose an inflammatory condition or to monitor an existing condition like arthritis.
If your doctor suspects high levels of inflammation in the body, they may recommend a blood test called an erythrocyte sedimentation rate (ESR) test. It looks at how quickly red blood cells may sink to the bottom of a test tube, with a high rate of settlement indicating high inflammation.
Also called a sedimentation rate test or sed rate test, an ESR test doesn’t diagnose one specific condition. Instead, it helps your doctor determine whether you’re experiencing inflammation and what further testing may be needed. The ESR test can also be used to monitor inflammatory diseases you already have.
Learn more about the ESR test, what the results could mean, and what information you may wish to discuss with your doctor before getting your blood drawn.
An ESR test measures the rate at which your red blood cells (RBCs) fall to the bottom of a test tube. The blood sample for this test is measured over the course of an hour.
When you’re experiencing inflammation, it can affect your RBCs in a number of ways. First, your RBCs cling together, forming clumps. This clumping affects the rate at which RBCs sink inside a tube where a blood sample is placed.
Also, if you have an acute infection or chronic inflammation, there may be more proteins in your RBCs. This can cause them to settle quicker. The faster and further the cells sink toward the bottom of a test tube, the more likely it is that inflammation is present.
In all, your ESR number is based on the rate that your RBCs settle. The faster this happens, the higher your ESR — and the more inflammation is likely in your body.
An ESR test can identify and measure inflammation, in general, in your body. However, it doesn’t help pinpoint the precise cause of inflammation. That’s why the ESR test is rarely performed alone. Instead, your doctor will likely combine it with other tests to determine the cause of your symptoms.
Also, if you already have an inflammatory condition, your doctor may order an ESR test as part of your routine lab work to make sure your current treatment plan is working.
Diagnosing conditions that cause inflammation
The ESR test can be used to help your doctor diagnose conditions that cause inflammation, such as:
Monitoring inflammatory conditions
The ESR test can help a healthcare professional monitor autoimmune inflammatory conditions, such as:
- rheumatoid arthritis (RA)
- systemic lupus erythematosus (SLE)
Your doctor might also order this test if you have:
- some types of arthritis
- certain muscle or connective tissue problems, such as polymyalgia rheumatica
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 those associated with pain in the temples and vision changes
- unintentional weight loss
- pain in the shoulders, neck, or pelvis
- digestive symptoms, such as:
- diarrhea
- fever
- blood in your stool
- unusual abdominal pain
The ESR test requires little preparation.
However, you should tell your doctor if you’re taking any medications. They may ask you to temporarily stop taking it before the test.
Certain medications may affect ESR test results. For example, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and statins may cause possible false lower ESRs . However, you should not stop taking any prescription medications unless your doctor instructs otherwise.
This test involves a simple blood draw. It should take only a minute or two.
- First, the skin directly over your vein is cleaned.
- Then, a needle is inserted to collect your blood.
- After collecting your blood, the needle is removed and the puncture site is covered to stop any bleeding.
The blood sample is taken to a lab, where your blood will be placed in a long, thin tube in which it sits for one hour. During and after this hour, the laboratory professional processing this test will assess how far the RBCs sink into the tube, how quickly they sink, and how many sink.
Inflammation can cause abnormal proteins to appear in your blood. These proteins cause your RBCs to clump together. This makes them fall more quickly.
Other tests that may be performed at the same time
Your doctor may order a C-reactive protein (CRP) test at the same time as your ESR test. CRP tests measure inflammation as well, but they can also help predict your risk of coronary artery disease (CAD) and other cardiovascular diseases.
Additionally, your doctor may order a complete blood count (CBC) test to look for other signs of inflammation or infection.
How long before results?
While wait times can vary, results from most labs done in a doctor’s office or a clinic take a few business days. Your doctor or nurse will call you with your results, along with any next steps.
There aren’t any risks directly associated with an ESR Test. However, having your blood drawn may involve minimal risks. Possible complications include:
- bleeding, from very light to excessive
- fainting
- hematoma
- bruising
- infection
- inflammation of the vein
- tenderness
- lightheadedness
You’ll probably feel mild to moderate pain when the needle pricks your skin. You might also feel throbbing at the puncture site after the test.
If you’re uncomfortable at the sight of blood, you may also experience discomfort seeing blood drawn from your body. Talk with your doctor or lab technician about these concerns before you get your blood drawn.
There are two methods for measuring your erythrocyte sedimentation rate.
Westergren method
This is the most common ESR method. In this type of test, your blood is drawn into a Westergren-Katz tube until the blood level reaches 200 millimeters (mm).
The tube is stored vertically and sits at room temperature for an hour. The distance between the top of the blood mixture and the top of the sedimentation of RBCs is measured.
Wintrobe method
The Wintrobe method is similar to the Westergren method, except the tube used is 100 mm long and thinner.
A disadvantage of this method is that it’s less sensitive than the Westergren method.
ESR test results are measured in millimeters per hour (mm/hr). The higher the number, the higher the likelihood of inflammation. Overall, females naturally have higher ESR levels.
Normal ESR test results are as follows:
Normal ESR test results Abnormal ESR test results Females under 50 between 0 and 20 mm/hr. greater than 20 Males under 50 between 0 and 15 mm/hr. greater than 15 Females over 50 between 0 and 30 mm/hr. greater than 30 Males over 50 between 0 and 20 mm/hr. greater than 20 Children between 0 and 10 mm/hr. greater than 10 Also, ESR test results that are higher than 100 mm/hr could indicate a more “active” disease, such as cancer, diabetes, or cardiovascular disease.
What Does a High Sedimentation Rate Mean?
The erythrocyte sedimentation rate (ESR, or “sed rate”) measures how quickly red blood cells fall to the bottom of a test tube. Typically, the higher the sed rate, the more inflammation there is in the body.
A sedimentation rate is a common blood test that is used to detect and monitor inflammation in the body. The sedimentation rate is also called the erythrocyte sedimentation rate because it is a measure of the speed that the red blood cells (erythrocytes) in a tube of blood fall to the bottom of the tube (form sediment). Sedimentation rate is often abbreviated as sed rate or ESR.
What Are the Reasons for Performing a Sedimentation Rate Test?
Doctors use the sedimentation rate to help to determine if inflammation is present in the patient. Additionally, the sedimentation rate can be a convenient method of monitoring the progress of treatment of diseases that are characterized by inflammation. Accordingly, a high or elevated sedimentation rate would correlate with more disease activity while a low sedimentation rate would suggest that the disease is less active.
Examples of diseases that are commonly monitored with the sedimentation rate test include
- rheumatoid arthritis,
- systemic lupus erythematosus,
- abscesses ,
- psoriatic arthritis,
- septic arthritis,
- vasculitis,
- reactive arthritis,
- polymyalgia rheumatica, and
- polymyositis.
Who Performs a Sedimentation Rate Test?
- The sedimentation rate is typically measured in a laboratory that does testing of blood samples.
- The sedimentation rare is ordered by any health-care professionals who are determining whether or not inflammation is present, and/or to what degree.
How Is a Sedimentation Rate Test Performed?
A sedimentation rate is performed by measuring how long it takes red blood cells (RBCs) to settle in a test tube. The RBCs become sediment in the bottom of the test tube over time, leaving the blood serum visible above.
- The classic sedimentation rate test is typically performed in a calibrated narrow tube.
- The sedimentation rate is measured simply by recording how far the top of the RBC layer has fallen (in millimeters) from the top of the serum layer in one hour.
- The sedimentation rate increases when more inflammation is present in the body of the person whose blood was sampled because inflammation alters certain substances on the surfaces of the red blood cells, making them tend to adhere together and more rapidly fall to the bottom of the test tube.
What Are Normal Sedimentation Rates?
- The normal sedimentation rate (Westergren method) for males is 0-15 millimeters per hour,
- for females, it is 0-20 millimeters per hour.
- The sedimentation rate can be slightly elevated in the elderly.
- Falsely low sedimentation rates can occur in the blood of people with leukemia or polycythemia rubra vera.
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