December 7, 2023
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When Do You Need An ESR Blood Test? Symptoms & Causes


An ESR blood test can show the presence of inflammation in your body. If your healthcare provider thinks you carry a high amount of inflammation, you may need to take an erythrocyte sedimentation (ESR) test. This test measures the rate at which red blood cells may fall to the bottom of the test tube. The faster the rate of settlement, the higher the inflammation. In this article, you will learn complete guidance about the ESR test with symptoms, causes, and the meaning of the test results. 

What is an ESR blood test?

ESR blood test is also known as sed rate test or sedimentation rate test. An ESR is a blood test that determines and indicates inflammation activity in your body. This test depicts how rapidly the erythrocytes, or red blood cells, in your blood, go to the bottom of the test tube. An ESR blood test helps to measure the amount of specific protein that allows the settlement of red blood cells. This protein amount tells about the condition of inflammation in your body. 

What is an ESR blood test

What is the basic function of an ESR blood test?

An ESR blood test calculates the time taken by your red blood cells (RBCs) to go into the test tube. If you experience inflammation in your body, it may influence your RBCs in different ways. Initially, your RBCs hold together to form a group. This holding act disturbs the time at which RBCs fall within a tube that includes your blood sample. 

When you deal with a mild infection or long-term inflammation, you may have a large number of proteins in your RBCs. It may allow RBCs to rapidly settle down. Inflammation will occur if the rate of the sink of your red blood cells goes higher inside the bottom of the test tube. 

The ESR number depends on how quickly the red blood settles into the tube. The higher ESR value occurs due to a higher settlement rate, which leads to high inflammation in your body. 

Types of ESR Test

Two types of ESR tests are available to determine the erythrocyte sedimentation rate:

Westergren method

The frequently used test collects the blood into a Westergren-kaizen tube. This tube covers the blood to 200 millimeters (mm). Generally, the tube is kept in the laboratory at room temperature for about an hour. A laboratory expert will measure the top of the blood mixture and the sedimentation rate of RBCs in the tube. 

Wintrobe method

This method works like a Westergren method. The only difference is that the tube is about 100 mm long and narrow. A Wintrobe method is generally not encouraged

due to less sensitivity compared to the Westergren method. 

When do you need an ESR blood test?

An ESR test can find and evaluate the presence of inflammation in your body. Although, this test may not define the cause of inflammation. It is the reason that the ESR test does not conduct standalone. Your healthcare provider may recommend this test, besides other tests to understand the underlying cause of your symptoms. 

In case, when you experience inflammation in your body, your healthcare provider may ask for an ESR test as a blood routine to ensure the effectiveness of treatment. 

An ESR test help in the following:

Diagnosing diseases that lead to inflammation

This test allows your doctor to detect these conditions that lead to inflammation: 

  • Cancers
  • Infections
  • Autoimmune disease
  • Temporal arteritis (Giant Cell Arteritis)
  • Types of arthritis
  • Specific muscle problems, including polymyalgia rheumatica

Observing inflammatory conditions 

The ESR test can indicate a healthcare provider to observe autoimmune inflammatory conditions, such as:

A sed rate test does not help to find the cause of inflammation in your body. A healthcare provider often uses this test with other blood tests, including the C-reactive protein (CRP) test. Besides, you may ask to order a complete blood count (CBC) to check for other signs and symptoms of infection or inflammation. 

Symptoms of inflammatory conditions

Your provider also suggests an ESR test if you have symptoms of inflammatory conditions, including inflammatory bowel disease (IBD) or arthritis. Here are the symptoms of inflammatory conditions include:

Symptoms of inflammatory conditions

  • Headaches are specifically associated with blurry vision.
  • Unexpected weight loss
  • Joint pain or stiffness that remains more than 30 minutes in the early morning
  • Pain or stiffness in the shoulders, pelvis, or neck
  • Digestive signs and symptoms include fever, diarrhea, detection of blood in the stool, and abnormal abdominal pain. 

Request an online ESR test if you experience these symptoms or inflammation in your body. 

How do I need to prepare for an ESR blood test?

This test does not need a large amount of preparation. You may need to inform your provider about any medications that you take. Your provider can ask you to stop taking these medications before the test. 

Specific medication may influence ESR test results, such as steroids, and non-steroidal inflammatory drugs (NSAIDs), which may lead to inaccurate or false ESR. 

What is the procedure for an ESR blood test?

What is the procedure for an ESR blood test?

An ESR blood test includes the following procedure:

  • After scheduling an order for this test, you may need to visit the laboratory.
  • Your provider will ask you to wear off your part of the cloth from one of your arms. 
  • A small needle will be injected into a vein of your arm to collect a small amount of blood into a test tube. 
  • The needle will be removed with a bandage applied to your puncture site after taking blood.
  • The blood sample is stored at the laboratory for detailed examination about how quickly and how much red blood cells fall into the tube. 

Are there any risks involved in this test?

An ESR blood test does not contain high risks. Although, you may experience low risk during blood collection into a test tube. These minimal risks include

  • Infection
  • Tenderness
  • Bruising
  • Vein inflammation
  • Hematoma
  • Lightheadedness
  • Fainting
  • Bleeding that may range from mild to extreme

You may feel acute to intermediate pain that develops during needle injection into a vein. Speak with a healthcare provider if you have had these conditions after the test.  

Normal ESR Blood Test:

The test results depend on certain factors, including age, gender, family history, and medical history. The ESR blood test results may also slightly change among laboratories due to the utilization of different methods for measurement. 

The test results are reported in millimeters per hour (mm/hr). You will experience a high inflammation if your ESR test result shows high numbers. Women, by nature, possess high ESR levels compared to men. 

Following are the recommended ranges of ESR that lie between for:

  • Children:  0 to 10 mm/hr
  • Males above 50: 0 to 20 mm/hr
  • Females above 50: 0 to 30 mm/hr
  • Males under 50: 0 to 15 mm/hr
  • Females under 50: 0 to 20 mm/hr

If your test results are above 100 mm/hr, you are more prone to diabetes, cancer, or heart disease. 

Causes of high ESR test results:

Many causes can lead to high ESR levels. Here are the few possible conditions that link with higher ESR levels, including

  • An infectious disease that spreads rapidly
  • Inflammation
  • Pregnancy
  • Anemia (a condition which indicates less amount of red blood cells)
  • Kidney disease
  • Diabetes
  • Increasing age
  • Specific forms of cancers, such as multiple myeloma
  • Thyroid disease
  • Heart disease
  • Obesity
  • Blood-related diseases

What are the causes of low ESR test results?

A low ESR test result may develop because of the following:

  • Leukocytosis (a condition of high white blood cell count)
  • Low plasma protein (It forms due to having a liver or kidney disease)
  • Congestive heart failure (CHF)
  • Polycythemia vera (bone marrow disease that leads to a high amount of RBCs)
  • Sickle cell anemia (a condition that originates from family influencing the RBCs)
  • Hypofibrinogenemia (low fibrinogen levels in the blood)

How to analyze abnormal ESR test results?

An abnormal ESR test result cannot diagnose specific diseases. It only detects the presence of inflammation in your body. 

Low ESR values might be about zero. Mostly, it is difficult to tell an accurate or exact value due to the variation in tests, and the range that is considered very low may vary among people. 

This test doesn’t always need to show reliable results. The factors that influence your test result may include:

  • Increasing age
  • Pregnancy
  • Menstruation
  • Use of medicines

You do not need to take tension if you receive abnormal ESR test results. A few causes of abnormal ESR test results are complicated compared to others however, they often do not indicate a health concern.  


The treatment of abnormal ESR levels depends on the cause. When a healthcare provider thinks you have an underlying condition that leads to high ESR, a specialist will recommend diagnosing, monitoring, and treating your medical condition. 


If a doctor confirms the presence of inflammation, you may need to take these medications or therapy, including

  • Non-steroidal anti-inflammatory drugs (NSAID) like naproxen or ibuprofen
  • Corticosteroid therapy

Your healthcare provider will recommend antibiotics to prevent infection if you carry a bacterial infection that develops inflammation in your body. 

Consult an online healthcare provider for further treatment for abnormal ESR levels that result in inflammation or infection. 


An ESR test is a blood test that helps to determine the amount of inflammation in your body. A healthcare provider recommends this test with other tests to diagnose inflammatory conditions. Different mild and long-term diseases affect ESR levels, including infections, autoimmune diseases, cardiovascular diseases, and other types of cancer. Speak with an online doctor if you experience symptoms of an inflammatory condition or other medical condition. 

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