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What Does an ESR Test Indicate?

If your doctor suspects high levels of inflammation in your body, then they may suggest a blood test known as erythrocyte sedimentation rate (ESR) test. Also referred to as sed rate test or sedimentation rate test, an ESR test doesn't diagnose a specific condition on its own. Instead, it assists your doctor in assessing whether inflammation is present and determining if further testing is necessary. Additionally, ESR tests can be utilised to monitor existing inflammatory diseases. So, read on to learn more about what ESR blood test results may indicate.

How Does an ESR Test Work?

ESR stands for Erythrocyte Sedimentation Rate, which measures how quickly your red blood cells settle to the bottom of a vertical container filled with your blood sample. Erythrocyte refers to red blood cells. The sedimentation rate indicates the speed at which a substance settles in a liquid. If your erythrocyte sedimentation rate (ESR) is faster than normal, then it could indicate the presence of an inflammatory condition.

What are Normal Ranges for ESR Test Results?

ESR test results are typically measured in millimetres per hour (mm/hr). A higher value suggests a greater likelihood of inflammation. It's worth noting that females generally have naturally higher ESR levels. Here are the normal ESR test results:


Gender and Age

Normal ESR Result

Abnormal ESR Result

Males under 50

0-15 mm/hr

Over 15 mm/hr

Females under 50

0-20 mm/hr

Over 20 mm/hr

Males over 50

0-20 mm/hr

Over 20 mm/hr

Females over 50

0-30 mm/hr

Over 30 mm/hr


0-10 mm/hr

Over 10 mm/hr


0-2 mm/hr

Over 2 mm/hr


What Do ESR Blood Test Results Indicate?


An abnormal ESR result does not diagnose any specific disease. Instead, it signals potential inflammation in your body, suggesting the need for further investigation. While some causes of abnormal ESR test results may be more serious than others, many are not a cause for major concern.

What do Low ESR Test Results Indicate?

An abnormally low value would be near zero. However, it's challenging to provide an exact value because these tests can fluctuate, and what is considered too low may vary from person to person. A low ESR test result value may be caused by:

  • Hypofibrinogenemia: It is a lower than normal amount of fibrinogen in the blood.

  • Sickle Cell Anaemia: It is an inherited genetic disorder that affects RBCs.

  • Congestive heart failure (CHF): It is a long-term condition that happens when your heart can't pump blood well enough to give your body a normal supply.

  • Leukocytosis: It refers to a high white blood cell (WBC) count.

  • Low Plasma Protein: They are occurring in relation to liver or kidney disease.

  • Polycythemia Vera: It is a bone marrow disorder that leads to the production of excess RBCs.

What Do High ESR Test Results Indicate?

There are various causes of a high ESR test result value.


1. Conditions Associated with High ESR Blood Test Results


Some common conditions indicated by a higher rate include:


  • Systemic and localised infectious and inflammatory diseases (widespread or local infection)

  • Trauma

  • Tissue injury or ischemia (lack of blood to a tissue)

  • Older age

  • Certain types of cancer, including some types of multiple myeloma and lymphoma

  • Pregnancy

  • Kidney disease

  • Anaemia

  • Diabetes

  • Blood or vascular diseases

  • Heart disease

  • Blood vessel inflammation (vasculitis)

  • Thyroid disease

  • Obesity

  • A high ESR result can also indicate the presence of cancerous tumours, particularly if there is no inflammation.


2. Autoimmune Diseases Associated with High ESR Test Results


ESR blood test results that are higher than normal are also associated with autoimmune diseases, including:


  • Certain types of arthritis, including RA

  • Lupus

  • Waldenstrom’s macroglobulinemia, a rare cancer

  • Polymyalgia rheumatica, which causes muscle and joint pain

  • Temporal arteritis, a condition in which your temporal artery becomes inflamed or damaged

  • Allergic or necrotising vasculitis

  • Hyperfibrinogenemia, which is too much of the protein fibrinogen in your blood


3. Infections Associated with High ESR Test Results


Some types of infection that can cause ESR test results to rise above normal levels include:


  • Heart infections such as pericarditis (which affects tissues around the heart, or the pericardium), myocarditis (which affects heart muscles), and endocarditis (which affects the lining of the heart, including heart valves)

  • Bone infection

  • Rheumatic fever

  • Systemic infections

  • Skin infection

  • Tuberculosis (TB)

An ESR test is a blood test that your doctor may request to assess inflammation in your body. Typically, it's conducted alongside other lab tests to either exclude or confirm various inflammatory conditions. Based on the test findings, your doctor might recommend further testing or refer you to a specialist like a rheumatologist.

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