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ESR blood test

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Blood tests have many different uses. They can be used to diagnose a condition, to monitor a particular organ in the body such as the kidney or liver, and they can also be used to give measurements of bodily processes such as the level of sugar in your blood or current levels of inflammation.

What does ESR measure?

Doctors will order an ESR, which stands for erythrocyte sedimentation rate, to test for inflammation or infection. The laboratory tests the speed at which red blood cells fall to the bottom of a test tube. If there are higher levels of inflammation, the cells fall faster, and the test produces a higher result. It is a good test for showing an objective level of infection or inflammation but doesn't indicate where it is coming from.

If you have inflammatory conditions such as inflammatory bowel disease, or infective endocarditis, your ESR levels will be above normal in these cases. It can be used to track response to treatment or check in on your baseline level of inflammation or infection.

Why is my doctor ordering it?

If your doctor is ordering an ESR test as part of your blood investigations, they want to get some information on levels of infection or inflammation. If you visited your doctor with joint pain symptoms, for example, a normal ESR level would be reassuring that there was not a serious amount of inflammation or infection, as in inflammatory arthritis.

It is difficult to interpret; it needs to match your symptoms. For example, swelling in multiple joints may indicate an autoimmune condition and suggest further investigations may be needed. The level of ESR can also point to how much inflammation is present. Once treatment is started, the level can be used to guide how effective treatment is over time, as you would expect the anti-inflammatory medication to reduce these levels if it's working as it should. Hopefully, your symptoms will also be improved.

How quickly does ESR rise?

ESR takes a few days to rise in response to an episode of inflammation and stay elevated while inflammation continues. This compares to another inflammatory marker, C-reactive protein (CRP), which rises quickly within a day or two and falls quickly once inflammation or infection improves. For this reason, ESR is more useful for long-term inflammatory conditions and their treatment, and CRP is a better guide for acute infection and its treatment.

Are there any special requirements for the blood test?

You do not need to be fasting for this blood test, there are no special requirements. It can be taken like any normal blood test.

Remember to press hard for a few minutes after the needle has been removed, and keep your elbow straight to prevent a nasty bruise!

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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