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ESR (Erythrocyte Sedimentation Rate)

ESR (Erythrocyte Sedimentation Rate)

Also referred as
SED rate
Sedimentation rate
Westergren sedimentation rate
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The ESR (Erythrocyte Sedimentation Rate) test measures the speed at which your red blood cells settle in a test tube. It specifically measures the rate over one hour. This test helps find and monitor underlying inflammation in the body.

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Understanding ESR (Erythrocyte Sedimentation Rate)

Inflammation is your body's natural defense against infection, injury, or disease. When you have inflammation, certain proteins and immunoglobulins in the blood increase. This causes red blood cells (RBCs) to clump together and settle faster (sedimentation rate).

The ESR (Erythrocyte Sedimentation Rate) test measures this sedimentation rate. It is an indirect indicator of inflammation and tissue damage. The ESR (Erythrocyte Sedimentation Rate) test is non-specific. It cannot diagnose a particular disease. It also cannot determine the cause of the inflammation. It is usually done along with other tests to identify the underlying condition.

Higher ESR values usually mean more inflammation or active disease. They can be raised in:

  • Infections (bacterial, viral, or fungal)
  • Autoimmune conditions like rheumatoid arthritis or lupus
  • Blood vessel inflammation (vasculitis)
  • After a heart attack, surgery, or injury
  • Some cancers, such as lymphoma or multiple myeloma

Other factors can also increase ESR. These include anemia, pregnancy, aging, or certain medications.

Usually, fasting overnight (8-12 hours) is preferred but not required for this test. It's important to tell your doctor about all the medications and supplements you take, as some may affect your test results.

ESR test result ranges may vary across laboratories. Do not self-medicate. Always consult your doctor to understand your test results correctly.

What Are the Symptoms or Conditions That May Require the ESR (Erythrocyte Sedimentation Rate)Test?

You may need the ESR test if you experience symptoms such as:

  • Persistent fever, fatigue, or unexplained weight loss
  • Joint pain, swelling, or stiffness
  • Muscle pain or weakness
  • Headaches, especially with scalp tenderness or jaw pain (which can suggest temporal arteritis)
  • Suspected infection or autoimmune disease

Your doctor may also recommend this test to:

  • Monitor ongoing inflammatory or autoimmune disorders.
  • Track the response to treatment in conditions like rheumatoid arthritis or lupus.
  • Detect recurrence of an inflammatory disease.

When Would I Need the ESR (Erythrocyte Sedimentation Rate) Test?

You might need this test if:

  • You have unexplained fever, tiredness, or body pain.
  • Your doctor suspects an infection or an autoimmune disease, like arthritis or lupus.
  • You experience constant headaches or muscle stiffness 
  • You are being treated for an inflammatory condition and need to check if the treatment is working.
  • You have long-term illnesses, such as tuberculosis or certain cancers, that may cause inflammation.

How Do I Prepare for the ESR (Erythrocyte Sedimentation Rate) Test?

Do I need to fast or stop any medications before the ESR (Erythrocyte Sedimentation Rate) test?

Overnight fasting is usually preferred; however, it is not mandatory. It is essential to inform your doctor about any medications or supplements you are taking, as certain medications may interact with test results. Your doctor will guide you if any temporary adjustments are needed before the test.

How is the ESR (Erythrocyte Sedimentation Rate) done?

  • The ESR (Erythrocyte Sedimentation Rate) is done by collecting a small amount of blood from a vein, usually in the arm. 
  • The procedure is quick, minimally invasive, and generally causes only slight discomfort.

What happens during the ESR (Erythrocyte Sedimentation Rate) test?

  • You will be seated comfortably with your arm supported on a flat surface or armrest.
  • A tourniquet (elastic band) is tied around your upper arm to make the veins more visible and easier to locate.
  • The phlebotomist identifies a suitable vein for blood collection.
  • The puncture site is then cleaned thoroughly with an alcohol swab to reduce the risk of infection.
  • A thin, sterile needle is gently inserted into the vein, and a small amount of blood is collected into a test tube.

What happens after the ESR (Erythrocyte Sedimentation Rate) test?

  • Once enough blood is collected, the tourniquet is released and the needle is removed.
  • A cotton ball or gauze is placed on the site, followed by a small bandage or dressing to stop any bleeding.
  • The blood sample is carefully labeled with your details and sent to the laboratory for analysis.
  • You can resume your daily routine after the test is done.

Is the ESR (Erythrocyte Sedimentation Rate) test painful?

No, the ESR (Erythrocyte Sedimentation Rate) test is generally safe and painless. You may feel slight discomfort during blood sample collection. However, the chances of serious complications are extremely rare.

How Long Does the ESR (Erythrocyte Sedimentation Rate) Test Take?

The procedure is quick, simple, and safe. It requires only a small blood sample and is completed within a short duration.

When Will I Get the Results?

The availability of your test report may vary depending on your location and the laboratory where the test is conducted. In general, Tata 1mg provides the results within the stipulated time after sample collection.

Are There Any Risks Associated with the ESR (Erythrocyte Sedimentation Rate) Test?

The ESR (Erythrocyte Sedimentation Rate) test is safe, with only minimal and short-lasting effects like:

Small bruise, pinch, or slight tenderness at the puncture site

Occasional lightheadedness if you are sensitive to needles or blood

Rarely, infection or blood vessel injury

Note: If you have a bleeding disorder or take blood thinners, inform the phlebotomist beforehand.

Lifestyle Tips To Maintain Healthy ESR levels: 

🥗 Healthy Diet: Eat a balanced diet rich in anti-inflammatory foods like turmeric, ginger, garlic, green leafy vegetables, and berries.

🏃 Exercise: Stay active with moderate physical activity like walking, yoga, or swimming to improve circulation and reduce inflammation.

🚭 Avoid Smoking and Alcohol: Both habits can increase inflammation and negatively affect overall health.

😌 Limit Stress: Manage stress through relaxation, hobbies, or good sleep habits, as chronic stress can raise inflammatory markers.

👨‍⚕️ Talk to Your Doctor: Follow up regularly with your healthcare provider to monitor ESR levels, manage chronic conditions, and avoid self-medication.

❤️ Health Monitoring: Keep track of chronic conditions such as diabetes, obesity, and hypertension through regular health checkups to maintain normal ESR levels.

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What does ESR (Erythrocyte Sedimentation Rate) measure?

The ESR (Erythrocyte Sedimentation Rate) test measures how fast red blood cells (erythrocytes) settle in a tube over one hour.

When your body is inflamed, certain proteins, mainly fibrinogen, increase in the blood. These proteins cause the red blood cells to stick together in stacks. These stacks settle faster, leading to a higher ESR.

The ESR test shows that inflammation is present. However, it cannot tell you exactly where the inflammation is or what is causing it. That’s why doctors usually do this test along with other tests. This helps them understand and treat your health problems.

What Do the Results Mean?

Pathological Factors 

Test Parameter

Interpretation (possible causes)

Normal Level

  • No inflammation

Low Level

  • Polycythemia vera

  • Sickle cell anemia

  • CHF (congestive heart failure)

  • Typhoid and undulant fever, malarial paroxysm, trichinosis, pertussis, infectious

  • Mononucleosis, and uncomplicated viral diseases

  • Peptic ulcer

  • Acute allergy

High Level

  • Infections 

  • Vasculitis, including temporal arteritis

  • Inflammatory arthritis

  • Renal disease

  • Tuberculosis

  • Anemia

  • Malignancies and plasma cell dyscrasias

  • Tissue injury, including myocardial infarction

Physiological Factors

🧓 Age: ESR usually rises as people get older because of changes in blood proteins and red blood cells.

🚺 Gender: Women often have slightly higher ESR than men due to hormones and lower red blood cell levels.

🩸 Pregnancy and Menstruation: Both conditions can temporarily elevate ESR . THis can be due to hormonal fluctuations, increased plasma volume, and changes in fibrinogen concentration.

💊 Medications: Medicines such as dextran, methyldopa, oral contraceptives, penicillamine, procainamide, etc., can increase ESR, while aspirin, steroids, and quinine may decrease it.

Lifestyle Factors

🥗 Nutrition: Poor diet may influence plasma composition and affect ESR levels.

🚬 Smoking: Chronic smoking can increase oxidative stress and mildly raise ESR levels.

🏃 Physical Activity: Prolonged inactivity or chronic fatigue can influence inflammatory markers.

😴 Sleep and Stress: High stress or poor sleep may impact immune response and inflammation, indirectly affecting ESR.

Disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

What Do Normal ESR Levels Mean?

Normal ESR levels suggest that there is no significant inflammation in the body. It means your immune system is stable and there are no ongoing infections or major inflammatory conditions.

What Do High Levels of ESR Indicate?

High ESR levels usually suggest inflammation or tissue damage in the body. They can be seen in conditions like :

  • Infections
  • Inflammatory arthritis
  • Vasculitis (such as temporal arteritis)
  • Anemia
  • Kidney disease
  • Tuberculosis
  • Certain cancers, and plasma cell disorders
  • After tissue injury (like a heart attack) 
  • During allergic and autoimmune reactions

What to Do if Your ESR Is Higher Than Normal?

If your ESR level is higher than normal, your doctor may recommend further tests to find the underlying cause. Treatment focuses on managing the condition causing the inflammation. Lifestyle measures like a balanced diet, proper rest, and following prescribed medications can help reduce inflammation over time.

What Do Low Levels of ESR Indicate?

Low ESR levels are less common but may occur in conditions that reduce red blood cell sedimentation. These include:

  • Polycythemia vera
  • Sickle cell anemia
  • Congestive heart failure (CHF)
  • Certain infections like typhoid, malaria, or viral illnesses
  • In cases of peptic ulcer disease or acute allergic reactions

Can ESR Results Be Inaccurate?

Yes. ESR results can be affected by factors like pregnancy, anemia, infections, or certain medications. Errors in sample handling or delayed testing may also impact accuracy. Hence, results should be interpreted along with symptoms and additional test results.

What Factors Can Affect ESR (Erythrocyte Sedimentation Rate) Results?

Though a reliable test, several factors can influence accuracy:

Falsely Increased ESR:

  • High fibrinogen, gamma, or beta globulins
  • Age, female gender, pregnancy, or menstruation
  • Infections, autoimmune disorders, or anemia
  • Medications such as dextran, methyldopa, penicillamine, theophylline, vitamin A, and oral contraceptives
  • Hypercholesterolemia
  • High lab temperature

Falsely Decreased ESR:

  • Abnormally shaped RBCs (sickle cells, spherocytes, acanthocytes)
  • Microcytosis, HbC disease, or hypofibrinogenemia
  • Extreme leukocytosis
  • Low lab temperature or clotted blood

What Follow-Up Tests May Be Required?

If your ESR levels are high or low, your doctor may suggest additional tests to find the underlying cause. These may include: 

Table: Tests Commonly Ordered Alongside ESR Test

Test Name

Primary Purpose

CRP (C-Reactive Protein)

Detects active inflammation

CBC (Complete Blood Count)

Evaluates infection or anemia

ANA (Antinuclear Antibody)

Screens for autoimmune diseases

Rheumatoid Factor (RF)

Assesses for rheumatoid arthritis

How Does ESR Differ from Other Inflammatory Tests?

It is important to understand how the ESR (Erythrocyte Sedimentation Rate) test differs from other common inflammatory tests:

  • C-Reactive Protein (CRP): Detects acute inflammation and rises more quickly than ESR. It is useful for identifying infections and monitoring treatment response.
  • High-Sensitivity CRP (hs-CRP): Measures low-grade inflammation and helps assess cardiovascular disease risk.
  • Antinuclear Antibody (ANA): Screens for autoimmune diseases by detecting specific antibodies in the blood.
  • Rheumatoid Factor (RF): Helps diagnose rheumatoid arthritis and other autoimmune disorders.

FAQs related to ESR (Erythrocyte Sedimentation Rate)

The ESR test is done to check for inflammation in the body. It helps doctors diagnose or monitor conditions such as arthritis, infections, autoimmune diseases, and some cancers. It also helps track how well treatments are working in chronic conditions.
Your doctor may suggest this test if you have symptoms like fever, joint pain, fatigue, muscle stiffness, or unexplained weight loss. It can help identify or monitor infections and inflammatory diseases.
Usually, overnight fasting is preferred for this test; however, it is not mandatory.
The ESR test is very safe. You might feel a slight prick when the blood sample is taken, and rarely, a small bruise or mild soreness may appear at the site.
A high ESR means there may be inflammation or infection in your body. It can happen in conditions such as rheumatoid arthritis, tuberculosis, kidney disease, anemia, autoimmune disorders, or cancer.
Low ESR levels are less common but can be seen in conditions like polycythemia vera, sickle cell anemia, heart failure, or certain viral infections.
You should speak with your doctor if your ESR level is higher or lower than normal. Your doctor will interpret the results based on your symptoms, medical history, and other test findings.
No. The ESR test is a nonspecific marker of inflammation. It cannot diagnose a specific disease on its own, but helps guide further tests and clinical evaluation.
Doctors may recommend other tests to identify the underlying cause of inflammation. These may include: C-reactive protein (CRP), Complete blood count (CBC), Rheumatoid factor (RF), and ANA (antinuclear antibody).
If you have a chronic condition like arthritis or lupus, your doctor may repeat this test periodically to monitor disease activity or treatment response.
Yes. You can lower inflammation by eating anti-inflammatory foods like fruits, vegetables, turmeric, garlic, berries, fatty fish, etc. Regular exercise, enough sleep, and stress management also help maintain normal ESR levels.
Yes. Eating healthy, exercising regularly, maintaining a healthy weight, reducing stress, and staying hydrated can help control inflammation and support normal ESR levels.
The price for this test can vary depending on the location and the laboratory.
You can book ESR (Erythrocyte Sedimentation Rate) at any Tata 1mg lab near you. Simply check for the nearest lab location and schedule a convenient date and time for your test.

ESR (Erythrocyte Sedimentation Rate) test price for other cities

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Price inNew DelhiRs. 129
Price inMumbaiRs. 139
Price inKolkataRs. 109
Price inHyderabadRs. 149

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References

  1. 1
    Erythrocyte Sedimentation Rate - Health Encyclopedia - University of Rochester Medical Center. www.urmc.rochester.edu. [Accessed 10 Nov. 2025]. Available from:
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    How sleep deprivation can cause inflammation [Internet]. Harvard Medical School; 2024 April 29 [Accessed 10 Nov. 2025]. Available from:
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ESR (Erythrocyte Sedimentation Rate)