ESR, the settling rate Erythrocyte Sedimentation Rate (ESR)
How fast your red cells settle in a tube, an old signal of inflammation.
Also printed asESR · Sed Rate · Westergren ESR
What it measures
How fast red cells sink in a tube, which rises when inflammatory proteins make them clump.
Moves slowly, so it shows whether inflammation has been going on for weeks rather than days.
Why it matters for how long you stay well
It is too vague to screen a healthy person, and its main job on this panel is to warn you that a ferritin reading may have been lifted by inflammation rather than by iron.
How it shows up in daily life
It lags days behind how you actually feel, rising once an illness has begun and staying up for weeks after you feel well again.
High and low readings
When it reads high
Inflammation somewhere, often slow to settle; anaemia and pregnancy also raise it.
When it reads low
Low is fine.
What moves it
Daily life
- a recent infection
- pregnancy
- age, which raises it naturally
- long-running inflammation
Medicines known to shift it
- steroids (lower it)
- NSAIDs (can lower it)
Listed so a result can be read in context. It is not advice to start, stop or change any medicine; that decision belongs with your physician.
Read it with
Markers that move this one, or that this one moves. One number read alone can mislead.
- Ferritin, your iron storeObserved association
As this rises, Ferritin can be misread because of it
A raised settling rate is signalling the same inflammation from a slower angle. It is a second reason to repeat the ferritin once you are properly well.
- hs-CRP, the inflammation dialObserved association
hs-CRP moves with it
Both tests pick up the same inflammation at different speeds. hs-CRP answers within a day or two, while the settling rate lags behind and takes weeks to come down.
Common questions
What does Erythrocyte Sedimentation Rate measure?
How fast red cells sink in a tube, which rises when inflammatory proteins make them clump. Moves slowly, so it shows whether inflammation has been going on for weeks rather than days.
What does a high ESR result usually mean?
Inflammation somewhere, often slow to settle; anaemia and pregnancy also raise it.
What does a low ESR result usually mean?
Low is fine.
What is the usual reference range for ESR?
A broad adult reference band is below 15 mm/hr. For women the band is below 20 mm/hr. Labs differ, so read your result against the band printed on your own report.
Educational only, not a diagnosis. A single number means little without your history and the rest of your panel, so discuss your own results with your physician.
Typical adult reference band
- Men
- below 15 mm/hr
- Women
- below 20 mm/hr
Labs differ. The band printed on your own report is the one that applies to your result.
Reported in mm/hr, mm/h
Ageing relevance
3/5
A moderate ageing association; used in clinical longevity panels.
Worth knowing
It is one of the oldest blood tests still in use, and it works by watching cells fall down a tube for an hour.
Have a report with this marker on it? Read it in context.
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Your biological age is a number you can measure.
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