Erythrocyte sedimentation rate measurement
What is this test?
This test measures the distance that erythrocytes (red blood cells) fall from the top of a vertical tube over one hour. It is used to evaluate and manage inflammatory conditions, such as rheumatoid arthritis.
What are other names for this test?
- ESR - Erythrocyte sedimentation rate
What are related tests?
- Serum C reactive protein level
- C-reactive protein measurement
Why do I need this test?
Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:
- Acute post-streptococcal glomerulonephritis
- Ankylosing spondylitis
- Atrial myxoma
- Kawasaki disease
- Lyme disease
- Multiple myeloma
- PID - Pelvic inflammatory disease
- Polymyalgia rheumatica
- Rheumatoid arthritis
- Septic arthritis
- Subacute granulomatous thyroiditis
- Temporal arteritis
When and how often should I have this test?
When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.
Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.
The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.
How should I get ready for the test?
Before having blood collected, tell the person drawing your blood if you are allergic to latex. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Also tell the healthcare worker if you have felt nauseated, lightheaded, or have fainted while having blood drawn in the past.
Tell the person doing this test if you are pregnant.
How is the test done?
When a blood sample from a vein is needed, a vein in your arm is usually selected. A tourniquet (large rubber strap) may be secured above the vein. The skin over the vein will be cleaned, and a needle will be inserted. You will be asked to hold very still while your blood is collected. Blood will be collected into one or more tubes, and the tourniquet will be removed. When enough blood has been collected, the healthcare worker will take the needle out.
How will the test feel?
The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.
During a blood draw, you may feel mild discomfort at the location where the blood sample is being collected.
What should I do after the test?
After a blood sample is collected from your vein, a bandage, cotton ball, or gauze may be placed on the area where the needle was inserted. You may be asked to apply pressure to the area. Avoid strenuous exercise immediately after your blood draw. Contact your healthcare worker if you feel pain or see redness, swelling, or discharge from the puncture site.
What are the risks?
Blood: During a blood draw, a hematoma (blood-filled bump under the skin) or slight bleeding from the puncture site may occur. After a blood draw, a bruise or infection may occur at the puncture site. The person doing this test may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of this test.
What are normal results for this test?
Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following are considered to be normal results for this test:
- Adult males: 0-17 mm/hour 
- Adult females: 1-25 mm/hour 
- Children: 0-10 mm/hour 
What might affect my test results?
- Results increased in :
- Female gender
- Increasing age (steadily rises by 0.85 mm/hour for each 5-year increase in age)
- Pregnancy (levels rise in the 4th month of pregnancy and peaks 1 week postpartum)
- Diabetes mellitus
- Collagen renal failure
- Results decreased in :
- Increased red blood cells
- Abnormally shaped red blood cells
- Hemolytic anemia
- Pyruvate deficiency
What follow up should I do after this test?
Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.
Where can I get more information?
- National Institute of Allergy and Infectious Diseases - www3.niaid.nih.gov
- American Academy of Allergy, Asthma, and Immunology - http://www.aaaai.org
 Olshaker JS & Jerrard DA: The erythrocyte sedimentation rate. The Journal of emergency Medicine 1997; 15(6):869-874.
 American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guideline: Guidelines for the management of rheumatoid arthritis: 2002 update.. Arthritis Rheum 2002; 46(2):328-46.
 Sox HC & Liang MH: The erythrocyte sedimentation rate. Guidelines for rational use. Ann Intern Med 1986; 104(4):515-523.
 Kratz A, Ferraro M, Sluss PM, et al: Case records of the Massachusetts General Hospital: laboratory values. N Engl J Med 2004; 351(15):1549-1563.
 Tietz NW (Ed): Clinical Guide to Laboratory Tests, 3rd ed. W. B. Saunders, Philadelphia, PA, 1995.
Last Updated: 7/4/2018