What is Erythrocyte Sedimentation Rate (ESR) Test: Purpose, Reading & Types

If a medical expert suspects a high level of inflammation in a body, they might recommend you a blood test known as the ESR test. This blood test helps to monitor inflammatory diseases.

Continue reading this article to know more about the ESR test!

An ESR test is the measurement of how quickly the red blood cells in a blood sample sinks to the bottom of the test tube. The full form of ESR is the erythrocyte sedimentation rate. It is also known as the sed rate. Usually, the red blood cells should settle down slowly. If the RBCs settle down faster than the normal rate, it might indicate inflammation in the body. Inflammation may be a symptom of an immune disorder, a chronic disease or other health conditions.

The ESR test determines if a person has a condition that causes inflammation. The conditions include vasculitis, inflammatory bowel disease or arthritis. It is also used in order to monitor any existing condition. Your doctor may recommend you an ESR test if you have the signs of inflammatory conditions. These include –

• Headaches
• Fever
• Weight loss
• Loss of appetite
• Anaemia
• Shoulder or neck pain
• Joint stiffness

1. Westergren Method

It is the most common type of ESR test. In this test, a person's blood is taken out in a Westergren-Katz tube till the blood level touches 200 millimetres. The tube is kept vertically at room temperature for an hour. Then, the distance between the top of the blood mixture and top of the sedimentation of red blood cells is measured.

2. Wintrobe Method

This method is the same as the Westergren method. However, the tube is thinner and 100 millimetres long. The drawback of this method is that it is less sensitive compared to the Westergren method.

Any individual experiencing signs of inflammatory disorders such as IBD (inflammatory bowel disease) or arthritis should take an ESR test. The symptoms of inflammatory disorders include –

• Stiffness or joint pain which lasts more than thirty minutes in the morning
• Headaches associated with vision changes and pain in temples
• Sudden weight loss
• Pain in shoulders, pelvis or neck 
• Digestive disorders such as diarrhoea, fever, blood in stool, unusual pain in the abdomen

An erythrocyte sedimentation rate test needs a little preparation. Individuals must tell their doctor if they are using any medications. They might ask to stop taking medicine temporarily before the test. Several medications affect the test results. For example, nonsteroidal anti-inflammatory drugs, steroids and statins might result in false low ESRs. However, no one should stop using any prescribed medications before the consultation with the doctor. Furthermore, fasting before the test is unnecessary.

There are multiple causes of high ESR results. The conditions which cause high ESR are as follows –

• Localised and systemic infectious and inflammatory diseases
• Ischemia or tissue injury
• Certain cancers like multiple myeloma and lymphoma
• Old age
• Pregnancy
• Obesity
• Thyroid diseases
• Autoimmune diseases such as lupus, polymyalgia rheumatica, Waldenstrom’s macroglobulinemia, Temporal arteritis and Necrotizing vasculitis
• Infections such as myocarditis, rheumatic fever, skin infections and tuberculosis

If the sedimentation rate of your blood is very high, you should work with the doctor to identify the cause of high ESR and treat the underlying conditions, if any. However, there are several lifestyle changes and strategies listed below that will help you prevent high ESR –

• Lead a hygienic and healthy lifestyle to stay protected from infections.
• Exercise regularly to decrease inflammation and ESR levels.
• Include gluten-free vegan, lacto-vegetarian foods, fish oil, Vitamin A and E in your daily diet.
• Lose weight to decrease the ESR levels.
• Use drugs that fight inflammation to reduce the ESR levels. These drugs include Tocilizumab, Levamisole, NSAIDs and Cortisone.

Disclaimer: Make sure to use drugs and supplements after consulting your doctor.

The following conditions generally cause low ESR -

• Congestive heart failure
• Low plasma protein
• Hypofibrinogenemia
• High white blood cells count
• Polycythaemia vera
• Sickle cell anaemia 

Therefore, the ESR test is a blood test that helps your doctor measure the inflammation in the body. Generally, it is done with other tests to treat or diagnose a variety of inflammatory diseases. Based on the result of the test, the doctor might recommend more testing or refer to a specialist. Individuals experiencing any symptoms of inflammatory disease must consult with their doctor at the earliest.