ESR Test: Preparation, Procedure, Purpose, Normal Result and Understanding Abnormal Values

Erythrocyte sedimentation rate is termed as ESR. It is usually known as sed rate or sedimentation rate which indirectly measures how much inflammation is in the body.

Updated: June 16, 2022


Erythrocyte sedimentation rate is termed as ESR. It is usually known as sed rate or sedimentation rate which indirectly measures how much inflammation is in the body.
ESR is often higher than normal in people with an autoimmune disorder.

Preparation for the Test:

There are no special steps needed to prepare for this test.

Procedure for ESR test:

Fasting is not required for this test. A band will be tied by a technician around your arm so that the veins of the hand are more prominent to prick the injection.The vein is punctured with a fresh, disposable syringe and the blood is withdrawn after the site is cleaned with an alcohol swab. A cotton swab will be given to you after drawing the blood to place on the place where the injection was pricked. You will be asked to apply pressure on the cotton in order to stop the bleeding. You might notice a bruise in the place where the injection was pricked on your skin. This is normal and should fade away in a few days. But if you experience unbearable pain, or if the area around the puncture becomes red and swollen, immediately follow up with your doctor. These could be signs of an infection.
A tall, thin tube holds a sample of your blood in this test. The speed at which the red blood cells fall to the bottom of the tube is measured. Inflammation can cause abnormal proteins to appear in your blood which can cause your red blood cells to clump together. This makes them fall more quickly.

Purpose of the test:

If you have unexplained fevers, certain types of arthritis, muscle symptoms or any other vague symptoms that cannot be explained, an ESR test is done. This test can be used to monitor inflammatory diseases or cancer and to monitor whether an illness is responding to treatment or not. It is only used to check the inflammation and can not be used to diagnose a specific disorder.The doctor will look at ESR results along with other information or test results to help figure out a diagnosis. Other tests that will be done along with ESR will depend on your symptoms.

The test is useful for detecting and monitoring:

  • Autoimmune disorders
  • Bone infections
  • Certain forms of arthritis
  • Inflammatory diseases that cause vague symptoms
  • Tissue death

Normal Results and Understanding the Abnormal Values:

The normal range is different for different age group of people. The normal value is also dependent on gender. The result is calculated in millimeters per hour (mm/hr) and should be 0 to 2 mm/hr for new born. For newborn to puberty children it should be 3 to 13 mm/hr.
Men under 50 years old it should be less than 15 mm/hr where as men over 50 years old it can be less than 20 mm/hr.
Women under 50 years old it should be less than 20 mm/hr where as women over 50 years old it can be less than 30 mm/hr.
The ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results.
An abnormal ESR may help with a diagnosis as it does not prove that you have a certain condition. Other tests are almost always required along with ESR test to confirm a specific disease.

An increased ESR rate may be due to:

  • Cancers such as lymphoma or multiple myeloma
  • Kidney disease
  • Pregnancy
  • Anemia
  • Thyroid disease

The immune system helps protect the body against harmful substances. When the immune system mistakenly attacks and destroys healthy body tissue, an autoimmune disorder occurs. ESR is often higher than normal in people with an autoimmune disorder. Common autoimmune disorders include Lupus and Rheumatoid arthritis in adults or children.

Very high ESR levels occur with less common autoimmune disorders, including:

  • Allergic vasculitis
  • Giant cell arteritis
  • Primary Macroglobulinemia
  • Hyperfibrinogenemia
  • Necrotizing vasculitis
  • Polymyalgia rheumatica
  • An increased ESR rate may be due to some infections, including:
  • Bodywide (systemic) infection
  • Tuberculosis
  • Infection of the heart or heart valves
  • Severe skin infections, such as erysipelas
  • Rheumatic fever
  • Bone infections

If the ESR value is lower than normal levels it could be:

  • Congestive heart failure
  • Hyperviscosity
  • Sickle cell anemia
  • Hypofibrinogenemia
  • Low plasma protein due to liver or kidney disease
  • Polycythemia
  • Leukemia


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