ESR Test

A Sed rate (erythrocyte sedimentation rate, also called ESR) is a simple blood test that helps to detect inflammation in the body. The test analyses the rate of fall (sedimentation) of red blood cells (erythrocytes) in a sample of blood placed in a tall vertical tube. Increased sed rate indicates inflammation.

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What is an ESR test?

A Sed rate (erythrocyte sedimentation rate, also called ESR) is a simple blood test that helps to detect inflammation in the body. The test analyses the rate of fall (sedimentation) of red blood cells (erythrocytes) in a sample of blood placed in a tall vertical tube. Increased sed rate indicates inflammation.

Sed rate tests are also used to evaluate the progress of an inflammatory disease.

This inflammation may be linked to a number of conditions, including infections, some cancers, and other autoimmune diseases.

 

What is an ESR test used for?

 Erythrocyte sedimentation rate (ESR or sed rate) is a relatively simple, inexpensive, non-specific test that has been used for many years to help detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases.

 

The ESR test is said to be a non-specific test because an elevated result often indicates the presence of inflammation but does not tell the health practitioner exactly where the inflammation is there in the body or what is causing it. An ESR may be affected by other conditions besides the inflammation. For this reason, ESR is typically recommended in conjunction with other tests, such as C-reactive protein.

 

ESR test is ordered to diagnose certain specific inflammatory diseases, including temporal arteritis, systemic vasculitis, and polymyalgia rheumatic. This test might also be used to monitor the disease activity and response to therapy in both of the above diseases as well as some others, such as lupus.

 

Why do I need an ESR test?

The ESR blood test is performed on an individual who faces any kind of inflammation. This Inflammation is caused when the Red blood cells get clubbed together forming clumps. These clumps affect the sed rate at which the RBC starts sinking in a tube of blood. The RBC test lets the doctor know about the amount of clumping that has taken place. The speed at which the RBC cells sink to the bottom of the tube, the more inflammation takes place in the body.

 

Possible reasons for inflammation could be:

  • Autoimmune diseases– Our immune system prevents the body from germs attacks such as bacteria or viruses. When the body senses these germs, it sends out certain fighter cells which prevent these germs from attacking the body. Our  immune system has been built to identify the difference between foreign cells and own body cells. But when autoimmune diseases occur, the immune system mistakenly attacks our own body-like our skin or joints by releasing proteins called autoantibodies, attacking healthy cells.

  • Cancers -Cancer is a group of diseases that is caused due to abnormal cell growth having a capacity to spread to the several organs of our body. Cancer is one of the dreaded diseases that lead to innumerable deaths in the world.

  • Infections- Infection occurs when a foreign organism invades our body causing harm to a person. The organisms enter our bodies to survive themselves by multiplying and colonising. These organisms are called pathogens. Pathogens include fungi, bacteria, viruses, and prions. These pathogens are multiplied and adapted quickly.

Inflammation in the body can develop a certain condition in the body, such as:

  • RA- Rheumatoid arthritis – This arthritis causes joint pains in the arms and legs

  • SLE-Systematic Lupus Erythematosus – This is a type of autoimmune disease, also called lupus. 

 

What’s the normal range?

Men: 0-15 mm/hr

Women: 0-20 mm/hr

Who performs an ESR test?

A healthcare provider known as a phlebotomist usually performs the blood draw, including those for an ESR test, but any healthcare provider trained in drawing blood can perform this task. Your healthcare provider then sends the blood samples to a lab where a medical laboratory scientist prepares the samples and performs the tests on machines known as analysers.

How do I prepare for an ESR test?

The sed rate is a simple blood test. You do not need to be in fast for this test.

What should I expect during my ESR test?

  • A healthcare practitioner will draw an amount of blood from your vein using a small needle

  • After the needle is inserted in the vein, they will draw blood and then collect it in a vial. 

  • You may feel stung once the needle goes in and out

  • This whole process takes less than 5 minutes.

What should I expect after my ESR test?

After a healthcare provider has collected the blood sample, they will send it to a laboratory for processing. Once the test results are ready, your healthcare provider will share the results with you. 

What are the risks of an ESR test?

These blood tests are very common and don’t carry any significant risks. You may have a  slight pain like an ant bite when the needle gets inserted, and a small bruise may develop there.

What is the cost of a ESR test?

What do the results of an ESR test mean?

  • The results of an ESR will be reported as the millimeters of clear fluid (plasma) that are present at the top portion of the tube after one hour (mm/hr).

  • Since ESR test is a non-specific marker of inflammation and is affected by other factors, the results must be used along with other clinical findings, the individual's health history, and results from other laboratory tests. If the ESR and clinical findings are matched, the health practitioner may be able to confirm or rule out a suspected diagnosis.

  • A single increased ESR, without any symptoms of a specific disease, usually does not give enough information to make up a medical decision. Furthermore, the normal result does not rule out the inflammation.

  • Moderately elevated ESR might occur with inflammation but also with anaemia, infection, pregnancy, and ageing.

  • A very high sed rate (ESR) usually has obvious causes, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatic, or temporal arteritis. The health practitioner will typically use the other follow-up tests, such as blood cultures, depending on the person's symptoms. Usually, people with multiple myeloma or Waldenstrom's macroglobulinemia (tumors that make large amounts of immunoglobulins) typically have very high ESRs even if they don't have inflammation.

  • When monitoring a condition over time, rising ESRs may indicate increasing inflammation or a poor response to therapy; normal or decreasing ESRs may indicate an appropriate response to treatment.

 

What is a normal ESR test result?

The ESR test results are measured in millimeters per hour (mm/hr). The higher the number, and higher the likelihood of inflammation. And overall, females naturally have higher ESR levels.

What does a high and low ESR test result mean?

There may be multiple causes for a high ESR test result. Some of the common conditions associated with a higher rate include:

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

  • If you have tissue injury or ischemia (lack of blood to a tissue)

  • Trauma

  • Certain types of cancer, that include some types of lymphoma and multiple myeloma

  • old age

  • pregnancy

  • anaemia

  • Kidney disease  

  • diabetes

  • Heart disease

  • blood or vascular diseases

  • blood vessel inflammation (vasculitis)

  • obesity

  • Thyroid disease

An  abnormally high ESR can indicate the presence of cancerous tumors, especially if no inflammation is found.

 

Autoimmune diseases

The ESR test results which are higher than normal are also associated with autoimmune diseases, including:

  • lupus

  • Certain types of arthritis, including RA

  • Waldenstrom’s macroglobulinemia, a rare cancer

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

  • The polymyalgia rheumatic causes muscle and joint pain

  • hyperfibrinogenemia, that is too much of the protein fibrinogen in your blood

  • Allergic or necrotizing vasculitis

 

Infections

Some of the types of infection that cause ESR test results to become higher than normal are:

  • Bone infection

  • heart infections causing myocarditis (affects heart muscle), pericarditis (affecting the tissue around the heart, or the pericardium), and endocarditis (affects the lining of the heart, which can include the heart valves)

  • Rheumatic fever         

  • Skin infection

  • systemic infections

  • Tuberculosis (TB)

 

Causes of low ESR test results

A low Sed rate (ESR) test result may be due to:

  • Congestive heart failure (CHF)

  • hypofibrinogenemia, that is too little fibrinogen in the blood

  • Have low plasma protein levels (occurring in relation to liver or kidney disease)

  • Leukocytosis is a high white blood cell (WBC) count

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

  • Sickle cells anemia, a genetic disease affecting the RBCs

 

When should I know the results of my ESR test?

These reports are available via email or WhatsApp within 6 hours of the collection of the blood sample.

What are the next steps?

  • Your doctor may request a CRP test as well as other biochemistry tests, and a Full Blood Count (FBC), at the same time they order an ESR. They may also request additional tests based on the symptoms, such as the ANA (antinuclear antibody) and RF (rheumatoid factor) tests suggestive of autoimmune diseases, or cultures to investigate infection.

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