Insight into your sedimentation rate.
The erythrocyte sedimentation rate (ESR) shows how quickly red blood cells settle in one hour. It is a classic, broad inflammation marker that responds slowly and therefore shows something different from CRP.
Also known as: sedimentation rate, ESR, sed rate
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Background
What is the sedimentation rate?
The erythrocyte sedimentation rate, ESR for short, measures how quickly red blood cells sink to the bottom of a tube in one hour. During inflammation the body produces more proteins that make red blood cells clump together, which makes them sink faster. The ESR therefore does not measure inflammation directly, but through the effect of those proteins on the blood.
That indirect character makes the ESR different from CRP. CRP rises and falls within hours to days and therefore responds quickly to an acute trigger. The ESR moves more slowly, stays elevated for longer and thereby gives more of a picture across weeks. In addition, the ESR is influenced by factors that have nothing to do with inflammation, such as age, sex, pregnancy and anaemia. That is precisely why ESR and CRP are often viewed together.
In brief
Classic marker
Measures how fast red blood cells settle in one hour
Indirect measure
Responds to proteins that increase during inflammation
Slow movement
Rises and falls more slowly than CRP
Context matters
Age, sex and anaemia influence the value
This marker is also included in
Testing several values in a single draw takes one blood collection and gives a more complete picture. The choice is yours.
Common reasons to test
When can insight into your ESR be valuable?
Below are some situations in which measuring ESR can provide insight.
Insight into your sedimentation rate
A test gives a broad and slow picture of inflammatory activity in the body, over a longer period than CRP.
Together with CRP
CRP responds quickly, the sedimentation rate slowly. Together they show more clearly whether something is acute or has been present for longer.
With persistent complaints
For complaints that have been present for weeks, the sedimentation rate gives context within the broader picture of your values.
Alongside a blood count
Anaemia influences the sedimentation rate. Adding a blood count clarifies whether an elevated value can be explained by it.
Ahead of a consultation
Those preparing for a conversation with their GP with a concrete question often include the sedimentation rate among the basic values.
Tracking a value over time
Because the sedimentation rate moves slowly, it is the course over weeks to months that is informative.
What your result means
Sedimentation rate too high or too low: what your value means
The sedimentation rate is expressed in millimetres per hour (mm/hour). The laboratory states the reference values that apply there alongside your result; these increase with age and differ between men and women. The ESR is a broad marker: it shows that something is going on, not what.
A low value
A low sedimentation rate rarely gives cause for concern in practice and fits with an absence of inflammatory activity. Our doctor provides explanation and context with your result.
A normal value
A sedimentation rate within the laboratory's reference values gives a reassuring picture for this marker at this moment. It cannot rule anything out: inflammation that is just starting or that stays local can go together with a normal sedimentation rate. If there are complaints, that picture remains leading, regardless of this value.
An elevated value
An elevated sedimentation rate means there are proteins in your blood that make red blood cells settle faster. That fits with an infection or inflammatory process, but also occurs with anaemia, pregnancy, increasing age and a number of other conditions. An elevated value therefore does not point anywhere specific and is not a diagnosis. Our doctor assesses the value together with your other results, such as CRP and the blood count, and explains whether a repeat test or follow-up via your GP is customary.
How we interpret your result
Our doctors interpret your sedimentation rate against the laboratory's reference values and your personal context, such as age, complaints, pregnancy, medication use and any known conditions. Where useful, they place the value alongside your CRP and your blood count.
Related tests
Often combined with ESR.
A single marker gives one perspective. For a broader picture you can combine ESR with a theme package or related markers.
+ €29 blood draw fee per orderFree from €225
Frequently asked questions
Everything you want to know
What is the difference between ESR and CRP?
CRP is a protein that rises within hours and falls quickly again after recovery; it mainly shows what is going on now. The sedimentation rate moves more slowly and stays elevated for longer, which gives more of a picture across weeks. In addition, the sedimentation rate is influenced by factors outside inflammation, such as age and anaemia. Together they complement each other.
Do I need to fast for a sedimentation rate test?
No, you do not need to fast for the sedimentation rate. Do drink water normally, as you usually would.
Does a normal sedimentation rate mean there is no inflammation?
Not with certainty. Inflammation that is just starting or that stays local can go together with a normal sedimentation rate. Conversely, the value can be elevated without inflammation being present. That is why the sedimentation rate is a marker you assess alongside other values and alongside your pattern of complaints.
Why is the sedimentation rate often higher in older people?
The sedimentation rate naturally increases with age, and also differs between men and women. The laboratory takes this into account in its reference values. Our doctor includes your age in the explanation of your result.
Do pregnancy or anaemia affect the result?
Yes, both generally go together with a higher sedimentation rate, without inflammation necessarily being present. Mention this during your intake. Adding a blood count clarifies whether anaemia plays a role.
Do anti-inflammatory medicines affect the value?
Anti-inflammatory medicines such as NSAIDs and corticosteroids can suppress inflammation markers. Mention your medication use during the intake, so our doctor assesses your result in that context.
How often can I have this measured?
Because the sedimentation rate moves slowly, re-testing within a few days is of little use. For following a course, an interval of several weeks to months is customary. Our doctor advises on this with your result.
What do I do with my result?
You receive a PDF report with your value and a personal explanation from a doctor. What you do with it, such as discussing it with your GP, remains entirely your choice.
What is a normal sedimentation rate?
There is no single figure that counts as normal for everyone. The laboratory states the reference values that apply there alongside your result, and these increase with age and differ between men and women. Our doctor assesses your sedimentation rate against those reference values and your personal context.
What does a low sedimentation rate mean?
A low sedimentation rate means that the red blood cells settle slowly. That fits with an absence of inflammatory activity and rarely gives cause for concern in practice. If you do have complaints, that picture remains leading, because inflammation that is just starting or that stays local can go together with a low or normal sedimentation rate.
What can a sedimentation rate that is too high mean?
An elevated sedimentation rate means there are proteins in your blood that make the red blood cells settle faster. That fits with an infection or an inflammatory process, but also occurs with anaemia, pregnancy and increasing age. The value therefore does not point anywhere specific and is not a diagnosis. Our doctor assesses the sedimentation rate together with your other results, such as CRP and the blood count where these are available, and explains when a repeat test or a discussion with your GP is customary.
In the Health Guide
Read more about this value
Ready for insight into your sedimentation rate?
You receive your sedimentation rate including personal explanation from a doctor, typically within 2 working days. No referral required.
Order ESR →Want to test multiple markers at once?
Combine ESR with other markers via Bloodworks Select. The blood draw and collection fee is charged once per order, and is waived from €225.
20,-
+ €29 blood draw fee+ €29 blood draw fee per order