Sat. Jul 20th, 2024
The erythrocyte sedimentation rate is commonly called a "sed rate."

The Erythrocyte Sedimentation Rate (ESR) is a blood test that measures the rate at which red blood cells settle at the bottom of a vertical tube over a specific period of time. It is a non-specific indicator of inflammation in the body. When there is inflammation, certain proteins in the blood cause red blood cells to stick together and form stacks, which then settle faster.

The ESR is often used as a general marker of inflammation, but it doesn’t pinpoint the cause of the inflammation. It can be influenced by various conditions, including infections, autoimmune diseases, and certain cancers.

The test is typically used in conjunction with other clinical and laboratory findings to help diagnose and monitor various inflammatory conditions.

In depth

A high ESR does not necessarily indicate a specific disease, but it suggests that there is some inflammatory process occurring in the body. Conversely, a normal ESR does not rule out the presence of disease, as some conditions may not significantly affect the sedimentation rate. The test is considered more of a screening tool rather than a definitive diagnostic tool.

Instead, it serves as a general marker of inflammation or other underlying health issues.

Here are some common reasons for a high ESR:

  1. Inflammatory Conditions: Various inflammatory conditions can lead to an elevated ESR. This includes infections, autoimmune diseases (such as rheumatoid arthritis, lupus, or vasculitis), and inflammatory bowel diseases (such as Crohn’s disease or ulcerative colitis).
  2. Infections: Acute or chronic infections, whether bacterial, viral, or fungal, can cause an increase in ESR. The body’s immune response to an infection often involves inflammation, which is reflected in the sedimentation rate.
  3. Tissue Injury or Damage: Any condition that results in tissue injury or damage can lead to an elevated ESR. This can include trauma, surgery, burns, or heart attacks.
  4. Certain Cancers: Some cancers, particularly those associated with inflammation, can cause an increase in ESR. However, ESR is not a specific marker for cancer and is used in conjunction with other diagnostic tests.
  5. Chronic Kidney Disease: Conditions affecting the kidneys, such as chronic kidney disease, can influence ESR levels.
  6. Pregnancy: ESR tends to be higher in pregnant women. This is considered a normal physiological change, and it usually returns to baseline after childbirth.

A low Erythrocyte Sedimentation Rate (ESR) is generally less common than an elevated ESR, and it may not be as diagnostically significant as a high ESR.

There are various reasons why ESR levels might be lower than normal:

  1. Polycythemia: Polycythemia is a condition where there is an increased number of red blood cells in the blood. In such cases, the blood may clot more quickly, leading to a lower ESR.
  2. Hyperviscosity of Blood: Conditions that increase the viscosity (thickness) of blood, such as high levels of certain proteins or lipids, can affect the sedimentation rate.
  3. Hypofibrinogenemia: Fibrinogen is a blood clotting factor, and lower levels of fibrinogen can lead to a reduced ESR.
  4. Sickle Cell Anemia: In individuals with sickle cell anemia, the shape and characteristics of red blood cells may affect the sedimentation rate.
  5. Congestive Heart Failure: In some cases of congestive heart failure, ESR may be lower than normal.

Treatment for high ESR

Treatment for a high Erythrocyte Sedimentation Rate (ESR) depends on the underlying cause of the elevated levels. ESR is a non-specific marker of inflammation, and addressing the root cause is essential. Here are some general approaches to managing high ESR:

  1. Address the Underlying Condition: Identify and treat the specific condition causing the inflammation. This may involve antibiotics for infections, anti-inflammatory medications for autoimmune diseases, cancer or other targeted therapies based on the diagnosis.
  2. Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or other anti-inflammatory medications may be prescribed to reduce inflammation and, subsequently, lower ESR levels. However, these medications are often used cautiously and for specific conditions, as they can have side effects.
  3. Disease-Modifying Antirheumatic Drugs (DMARDs): In cases of autoimmune diseases like rheumatoid arthritis, DMARDs may be prescribed to modify the course of the disease and reduce inflammation.
  4. Lifestyle Modifications: Adopting a healthy lifestyle can contribute to overall well-being and may help manage inflammation. This includes maintaining a balanced diet, regular exercise, managing stress, and getting adequate sleep.
  5. Monitoring: Regular monitoring of ESR levels and other relevant laboratory markers is crucial to track the progress of treatment and adjust interventions as needed.


It’s important to note that a low ESR is not typically as indicative of a specific condition as a high ESR. It is just one marker among many used in medical evaluations.

If you have concerns about your ESR levels or if you are experiencing symptoms, it’s recommended to consult with a healthcare professional. They can consider your complete medical history, symptoms, and other diagnostic tests to provide a comprehensive assessment of your health.

It’s important to emphasize that while ESR is a valuable tool in indicating the presence of inflammation, it doesn’t provide specific information about the cause of inflammation. Therefore, further diagnostic tests and a comprehensive clinical evaluation are typically necessary to identify the underlying condition.

By Parvathy Sukumaran

Parvathy Sukumaran is a Content Creator and Editor at JustCare Health. She is an Educator and a Language Lecturer. She holds a Bachelor's Degree in Education and an M.A in English Literature. She is passionate about writing, archaeology, music and cooking.

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