ESR

Complete Blood CountBlood HealthBlood

Erythrocyte sedimentation rate (ESR) measures how quickly red blood cells settle to the bottom of a tube over one hour. When inflammation is present, acute-phase proteins (especially fibrinogen) cause RBCs to aggregate and settle faster. ESR is one of the oldest and simplest laboratory tests for detecting inflammation.

Why it matters: ESR is a non-specific marker of inflammation, infection, and tissue damage. It is less specific than CRP but responds to some conditions CRP does not (such as multiple myeloma or temporal arteritis). A markedly high ESR is commonly associated with infection, malignancy, autoimmune, or kidney conditions.

Reference Range
< 20.0mm/h
20NormalHigh
Symptoms of Low ESR
Typically without noticeable symptoms
Symptoms of High ESR
Symptoms typically come from the underlying cause — fever, joint pain, swelling, or fatigue
What Moves It

May increase with:

Infection (bacterial, viral, fungal)
Autoimmune diseases (RA, lupus, PMR)
Temporal (giant cell) arteritis
Malignancy (especially multiple myeloma)
Chronic kidney disease
Anemia
Pregnancy
Aging (ESR naturally rises with age)

May decrease with:

Polycythemia (high RBC count slows sedimentation)
Sickle cell disease
Heart failure
Low fibrinogen
Very high WBC count (leukocytosis)
Associated Conditions
Rheumatoid arthritisTemporal arteritisPolymyalgia rheumaticaLupusMultiple myelomaChronic infection
Related Markers
CRPWhite Blood Cells
Common questions

What is ESR?

Erythrocyte sedimentation rate (ESR) measures how quickly red blood cells settle to the bottom of a tube over one hour. When inflammation is present, acute-phase proteins (especially fibrinogen) cause RBCs to aggregate and settle faster. ESR is one of the oldest and simplest laboratory tests for detecting inflammation.

What might a high or low ESR mean?

ESR is a non-specific marker of inflammation, infection, and tissue damage. It is less specific than CRP but responds to some conditions CRP does not (such as multiple myeloma or temporal arteritis). A markedly high ESR is commonly associated with infection, malignancy, autoimmune, or kidney conditions.

What is the typical reference range for ESR?

The general-population reference range shown here is < 20 mm/h. Reference ranges describe the general population and are not a personal target — discuss your results with your physician.

What can affect ESR?

It may be higher with: Infection (bacterial, viral, fungal), Autoimmune diseases (RA, lupus, PMR), Temporal (giant cell) arteritis, Malignancy (especially multiple myeloma), Chronic kidney disease, Anemia, Pregnancy, Aging (ESR naturally rises with age). It may be lower with: Polycythemia (high RBC count slows sedimentation), Sickle cell disease, Heart failure, Low fibrinogen, Very high WBC count (leukocytosis).

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