The ESR blood test is a diagnostic test that doctors order and can quantify inflammation in the body. It is not a diagnosis of disease but a result that can assist doctors to determine whether and what kind of inflammatory process is taking place. Here, red blood cells (erythrocytes) are enumerated for how quickly they sediment to the bottom of a test tube within an hour.

The quicker they sediment out, the more likely that inflammation is going to occur. It is usually done as one test among a series of other tests to screen or diagnose infection, autoimmune illness, or chronic disease and to have a general idea of your health.

What is an ESR Test?

The ESR test or Erythrocyte Sedimentation Rate is a measure of how quickly red blood cells fall to the bottom of a test tube within one hour. In a state of body inflammation, red blood cells wrap themselves with these disease proteins and fall more quickly than they would otherwise.

  • It is most commonly carried out in a patient with symptoms of chronic inflammation like weakness, stiffness, or low-grade fever.
  • Though ESR is not a sensitive test, i.e., it will not provide the reason for inflammation, ESR test uses is to measure disease activity or drug response.
  • Physicians order ESR most commonly as a screening ESR in autoimmune diseases, chronic infection, and some malignancies.

Why is the ESR Test Done?

Doctors order the ESR test to assist with establishing and ESR monitoring certain diseases with an inflammatory element. ESR does not diagnose disease, but it is a first sign that there is something in the body in an abnormal manner.

  • ESR in rheumatoid arthritis and other autoimmune illnesses
  • Systemic lupus erythematosus
  • Polymyalgia rheumatica and temporal arteritis
  • Chronic infections such as tuberculosis
  • Kidney disease
  • Some malignancies, e.g., lymphoma or multiple myeloma
It can also be ordered in a patient with atypical symptoms such as fever, fatigue, inexplicable weight loss, or diffuse soreness of the body. ESR is performed to guide further examination or to find out if there's something underneath supporting it.

Preparation for an ESR Test

There is less pretesting in ESR test preparation and it is also quick and simple. Only very few general guidelines to be remembered before the test are as given below:

  • Fasting is normally not done in most cases except for the reason that your doctor might advise you to get other tests done at the same time.
  • Notify your doctor if you are on medication, particularly anti-inflammatory medication or corticosteroids since they affect the size of ESR.
  • Wear loose-fitting arm sleeves so that it will be easy for the lab technician to access when he draws blood.
  • Don't work or exercise so vigorously beforehand because in some instances it will cause a slight change in the ESR reading.

ESR Test Procedure

ESR is a routine blood test. During ESR test procedure the doctor will take a sample of your blood from one of the veins in your arm.

  • The skin is cleaned.
  • A needle is placed into a vein.
  • The blood is taken into a special tube so as to be tested for sedimentation.
  • The tube is left for one hour to observe how quickly the red cells will settle.
  • Result in mm/hr.
The actual test takes just a few 5–10 minutes, and the testing itself is painless except for an incredibly small prick where the needle enters.


What to Expect After the ESR Test?

After a blood sample is taken, regular activity can continue. No downtime and no loss of testing.

  • A tiny bruise or soreness at the injection site
  • Extremely rare risk of dizziness, temporary
The result of the test is usually returned within 24 to 48 hours after the test was administered, depending on the lab where the test was given. Your physician will match your test result with your symptoms, history, and other tests to decide what the result is indicating.

Interpretation of ESR Test Results

It is expressed as ESR result in mm/hr, decrease of tube red cells after one hour.

ESR Normal Range

  • Men younger than 50 years: 0–15 mm/hr
  • Women younger than 50 years: 0–20 mm/hr
  • Mildly elevated values above 50 are common

Elevated ESR Levels:

Causes of elevated ESR may at times be due to inflammation resulting from
  • Autoimmune disease such as rheumatoid arthritis or lupus
  • Infection, i.e., chronic bacterial infection or viral infection
  • Some form of cancer
  • Chronic kidney disease or anemia

Low ESR Results:

Far less commonly, low ESR test results are due to:

  • Diseases such as sickle cell anemia
  • Red cell count increase (polycythemia)
  • Heart failure
Remember that high ESR levels or low ESR levels is not a diagnosis but is a call for further diagnostic testing.

Diseases Diagnosed with the Assistance of ESR Test

ESR is also employed for screening and monitoring diverse inflammatory and autoimmune diseases.
They are:

  • Rheumatoid arthritis: Severity of disease as well as therapeutic outcome is assessed by ESR.
  • Lupus: With inflammation, ESR increases.
  • Temporal arteritis and polymyalgia rheumatica: Elevated ESR is a significant finding.
  • Chronic infections such as tuberculosis, abscess, or osteomyelitis.
  • Kidney disease and inflammatory bowel disease.
  • Extremely rare blood or immune system cancers.
Physicians reach a certain diagnosis with the help of ESR in combination with clinical presentation, imaging, and other investigations.

ESR Test vs CRP Test

Both ESR vs CRP tests are employed to find inflammation in the body but with a variation.

  • ESR test for inflammation is slow reacting and non-specific. It can be affected by other conditions such as age, pregnancy, or anemia. It is even more beneficial in the chronic inflammation diagnosis.
  • The CRP increases progressively sooner compared to the acute inflammation and therefore is useful in determining acute infection or exacerbation. CRP is less affected by extrinsic sources than is ESR.
  • ESR and CRP tests are also ordered by physicians on a regular basis in an effort to quantify more the size and nature of the inflammation.

Fee of ESR Test in Pakistan

The ESR test is quite inexpensive and tends to be a few hundred rupees in Pakistan's major hospitals and laboratories.
Location and lab-wise it also differs but is somewhere in the ESR normal range of PKR 400 to PKR 800. Some tests like ESR are included in some other blood tests in some labs. If included in most health insurance plans, it will normally be reimbursed. Basic phlebotomy equipment is not needed.

Book lab tests from the best-certified labs in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, and get a discount of up to 35%. For assistance, call our helpline at 03171777509 to find the right lab test for your health needs.