Erythrocyte Sedimentation Rate (ESR): Definition, Normal Range & Test

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

What exactly is an erythrocyte sedimentation rate (ESR)? Find out in this lesson as we discuss the definition and normal range of an erythrocyte sedimentation rate as well as how it is done.

Joint Pain

Larry is seventy-years-old and has been having some joint pain in his fingers and knees. At a regular doctor visit, he mentions this. The doctor decides to order some blood work which includes an erythrocyte sedimentation rate to see if there is any indication of disease that is causing the pain.

What is Erythrocyte Sedimentation Rate?

Erythrocyte sedimentation rate (ESR) is a blood test. The test provides a non-specific result of the presence of inflammation in the body. This means that the result can show inflammation, but it does not locate where it is or what is causing it. An erythrocyte is a red blood cell that contains hemoglobin and is responsible for moving oxygen and carbon dioxide between tissues in the body. Sedimentation is the process of matter dropping to the bottom of a surface. Therefore the ESR test is done by measuring how fast erythrocytes drop to the bottom of the test tube. An ESR test is used to find the causes of symptoms, monitor inflammatory illnesses, or monitor cancer. Examples of indications to test the ESR are:

  • Fevers
  • Some types of arthritis
  • General and vague symptoms that are unexplained
  • Bone infections
  • Muscle pain
  • Autoimmune disorders
  • Tissue death
  • Inflammatory diseases

Larry is having his ESR tested to help determine if there is inflammation present in his body that may be causing his joint pain. This could indicate arthritis and help the doctor come up with an effective treatment plan.

How is the Erythrocyte Sedimentation Rate Tested?

The blood is usually drawn from the hand or arm using a needle and is then sent to a lab for results, which is done rather quickly. It is also usually not a standalone test and is used in combination with other types of blood tests. Other blood tests that may be done with an ESR are:

  • C-reactive protein (CRP): measures inflammation in the body
  • Comprehensive metabolic panel (CMP): tests the kidneys, liver, electrolytes, blood glucose, and blood proteins
  • Complete blood count (CBC): measures the amount of different cells in the blood including white blood cells, red blood cells, hemoglobin, hematocrit, and platelets.

Blood test in a test tube
Blood test in a test tube

Normal Range of an Erythrocyte Sedimentation Rate Test

What's considered normal range for an ESR could vary to some degree from one laboratory to the next. They are also different for men, women, children, and different age groups. The results are measured as the rate of the blood cells fall to the bottom of the test tube for an hour. A fast sedimentation rate points to inflammation. A moderately elevated result may not indicate inflammation and can occur with anemia, older aged individuals, infection, and pregnancy. A very high result may indicate a severe infection with or without the presence of inflammation. This is why other tests and information is used along with the ESR.

Normal ranges:

  1. Men under fifty years of age: less than 15mm/hr (millimeters per hour)
  2. Women under fifty years of age: less than 20mm/hr
  3. Men over fifty years of age: less than 20mm/hr
  4. Women over fifty years of age: less than 30mm/hr
  5. Newborn: 0-2mm/hr
  6. Newborn to puberty: 3-13mm/hr

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