Erythrocyte Sedimentation Rate (ESR)


In this blog, we will learn about Erythrocyte Sedimentation Rate means ESR.

It is very important blood report to rule out many chronic diseases. If ESR increases will create doubt on many diseases like tuberculosis or rheumatoid arthritis.


“Erythrocyte Sedimentation rate (ESR) is the rate at which the red blood cells settle down”.

Normally, the red blood cells remains uniformly in circulation. So,we can not measure sedimentation rate.

So, we have to mix blood with anticoagulant & allowed to stand on a vertical tube, the red blood cells settle due to gravity with clear layer of plasma seen above.

If there is any inflammatory disease in your body than blood cells stick together & falls below speedily. In this situation ESR value increases, this will create doubt for many diseases.


This test is easy, inexpensive & non specific test, which helps in diagnosis of disease as well as prognosis.

It is non specific test because it can not indicate the exact location or cause of disease. But definitely, it give clue for some diseases that doctor should look for it.

Prognosis means monitoring the course of disease & response of the patient to therapy. This way we can conclude that our treatment is going on right path or not.


In male. – 3 to 7 mm in one hour

In female – 5 to 9 mm in one hour



Physiological variation means natural variation.There is no disease condition related with fluctuation of ESR value.

You just need to remember that when Red cells are more in numbers, it settle down late. So. ESR is less in that type of situations where red blood cell increases. Contrary, when Red cells are less it numbers, it settle down quickly which give high value of ESR. This can easily understand by

  1. Age : Less Red cells in children & infant
    High ESR in children & Infant
  2. Sex : Less red cells in female
    High ESR in female compare to male
  3. Menstruation : loss of blood & RBC
    High ESR while menses
  4. Pregnancy : From 3rd month to delivery, ESR increases up to 35mm in 1 hour because of hemodilution.


Due to some disease ESR increases

  1. Tuberculosis
  2. All type of anaemia except sickle cell anaemia
  3. Malignant tumour
  4. Rheumatoid arthritis
  5. Rheumatic fever
  6. Liver diseases

Due to some disease ESR decreases

  1. Allergic conditions
  2. Sickle cell anaemia
  3. Polycythemia – more Red cells
  4. Severe leukocytosis – more White cells
  5. Peptone shock

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