ESR — Normal Range & Interpretation
Full name: Erythrocyte Sedimentation Rate
The erythrocyte sedimentation rate measures how quickly red blood cells settle in a tube of anticoagulated blood over one hour. Inflammation raises fibrinogen and other acute-phase proteins, which causes red cells to clump and fall faster. ESR functions as a nonspecific marker of systemic inflammation, infection, and tissue injury, and it rises and falls more slowly than C-reactive protein.
| Male | Female | Unit | Category |
|---|---|---|---|
| 0–15 | 0–20 | mm/hr | Other Common Values |
Clinical Context
The erythrocyte sedimentation rate measures how quickly red blood cells settle in a tube of anticoagulated blood over one hour. Inflammation raises fibrinogen and other acute-phase proteins, which causes red cells to clump and fall faster. ESR functions as a nonspecific marker of systemic inflammation, infection, and tissue injury, and it rises and falls more slowly than C-reactive protein.
Marked elevations point to giant cell arteritis, polymyalgia rheumatica, rheumatoid arthritis, systemic lupus erythematosus, osteomyelitis, endocarditis, and malignancies such as multiple myeloma. Pregnancy, anemia, and advancing age also raise the value, which is why the upper limit expands in older adults. Depressed values occur with polycythemia, sickle cell disease, heart failure, and hypofibrinogenemia. Clinicians pair ESR with CRP and the clinical picture rather than treating it as diagnostic on its own.
Classic AANP vignette: ESR as a screening tool in a patient with new temporal headache, jaw claudication, or vision changes, where a value above 50 mm/hr supports giant cell arteritis and triggers urgent steroids. Expect questions linking elevated ESR to polymyalgia rheumatica in older adults with shoulder and hip girdle stiffness. Know that ESR increases with age and differs by sex.
Related Labs
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