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What Is an ESR Blood Test?
Erythrocyte Sedimentation Rate (ESR) is also called Sed Rate or Sedimentation Rate. It is a simple test used to determine how much inflammation is in the body, but it cannot diagnose the specific condition causing the inflammation.
How ESR Blood Test Works
Inflammation changes the proteins in red blood cells causing them to bind to one another in clumps, making them denser than normal red blood cells. An ESR test simply notes the speed at which blood cells sink to the bottom of a test tube. The faster the blood cells fall, the more inflammation is in your body.
- Inflammation changes the proteins in red blood cells causing them to bind to one another in clumps, making them denser than normal red blood cells.
- An ESR test simply notes the speed at which blood cells sink to the bottom of a test tube.
Primary Uses of the ESR Test
A High Number of Leukocytes
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ESR tests are most often used to help diagnose rheumatoid arthritis, polymyalgia rheumatica and giant cell arteritis (GCA) 3. Rheumatoid arthritis causes inflammation of the lining of the joints, resulting in pain, joint damage and sometimes deformity.
Increased ESR
Increased ESR has many causes, including pregnancy, menstruation, infection or anemia. Many diseases such as kidney disease, syphilis, tuberculosis, thyroid disease and lupus also cause ESR rates to be higher than average. In addition, certain medications such as oral contraceptives, vitamin A, dextran and methyldopa (aldomet) can cause ESR readings to be higher than normal.
Very High ESR
What Does a High C-Reactive Protein Level Indicate?
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In addition to polymyalgia rheumatica, giant cell arteritis and rheumatoid arthritis, other common causes of a very high ESR include necrotizing vasculitis (inflammation of the blood vessel walls) and macroglobulinemia primary (cancer of the B lymphocytes, a type of white blood cell).
Low ESR
Though a low ESR is generally not a cause for concern, it is worth noting that liver or kidney disease, congestive heart failure and some protein abnormalities as well as sickle cell anemia or conditions that cause an increase in either red or white blood cells can cause a lower than normal ESR result. Medications such as aspirin, cortisone and quinine can also result in a lower ESR.
Discuss your ESR Test Results with a Doctor
Because there are so many conditions that can affect an ESR test, it is important to discuss your results with a qualified doctor who is aware of all your medical conditions and the medications you are taking 1. The ESR blood test is considered a screening test and cannot be used to diagnose any one condition. It is, however, useful in screening for certain inflammatory conditions, or in monitoring their progress.
Related Articles
References
- UCSF Medical Center: ESR
- Mayo Clinic: Sed Rate
- Lab Tests Online: ESR
- How does the sed rate (erythrocyte sedimentation rate or ESR) test work?. Cleveland Clinic. 2018.
- Castro C, Gourley M. Diagnostic testing and interpretation of tests for autoimmunity. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S238-47. doi:10.1016/j.jaci.2009.09.041
- Erythrocyte Sedimentation Rate (ESR). AACC.
- Katsanos KH, Voulgari PV, Tsianos EV. Inflammatory bowel disease and lupus: a systematic review of the literature. J Crohns Colitis. 2012;6(7):735-42. doi:10.1016/j.crohns.2012.03.005
- Hersch EC, Oh RC. Prolonged febrile illness and fever of unknown origin in adults. Am Fam Physician. 2014;90(2):91-6.
- Sed Rate (Erythrocyte Sedimentation Rate or ESR) Test. Cleveland Clinic. 2018.
- Erythrocyte Sedimentation Rate (ESR). US National Library of Medicine. 2019.
- Blood Test: Complete Blood Count. KidsHealth from Nemours.
- Comprehensive metabolic panel. US National Library of Medicine. 2019.
- Blood Test: Erythrocyte Sedimentation Rate (ESR). TeensHealth from Nemours.
- Beydoun MA, Obhi HK, Weiss J, et al. Systemic inflammation is associated with depressive symptoms differentially by sex and race: a longitudinal study of urban adults. Mol Psychiatry. 2019. doi:10.1038/s41380-019-0408-2
- ESR. Mount Sinai.
- Cheema MR, Ismaeel SM. Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder. Clin Interv Aging. 2016;11:185-8. doi:10.2147/CIA.S40919
- Bitik B, Mercan R, Tufan A, et al. Differential diagnosis of elevated erythrocyte sedimentation rate and C-reactive protein levels: a rheumatology perspective. Eur J Rheumatol. 2015;2(4):131-134. doi:10.5152/eurjrheum.2015.0113
- Kashyap B, Tiwari U, Garg A, Kaur IR. Diagnostic utility of anti-CCP antibodies and rheumatoid factor as inflammatory biomarkers in comparison with C-reactive protein and TNF-α in rheumatoid arthritis. Trop J Med Res. 2015;18:5-9.
- Diagnosing and treating lupus. Centers for Disease Control and Prevention. 2018.
- American Association for Clinical Chemistry. Erythrocyte Sedimentation Rate (ESR). Lab Tests Online. Updated July 11, 2018.
- Mayo Clinic Staff. Sed Rate (Erythrocyte Sedimentation Rate). Mayo Clinic. Updated December 30, 2017.
- MedlinePlus. ESR. U.S. National Library of Medicine. Updated May 21, 2017.
- MedlinePlus. Erythrocyte Sedimentation Rate (ESR). U.S. National Library of Medicine. Updated September 6, 2017.
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Erika Wright is a writer from California with a Master's degree in postcolonial literature. She has lived in five different countries. She enjoys the challenge of combining her love of travel and academia with the lessons and adventures of daily life in her writing.