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ESR (sedimentation rate)
How fast red cells settle in a tube — a nonspecific gauge of inflammation somewhere in the body.
Other names: Erythrocyte sedimentation rate, sed rateSection: Blood cells
Updated: August 29, 2026·MedProtect editorial team Reference information — not a diagnosis or a prescription
In shortESR measures how quickly red blood cells sink in a test tube over one hour; the more inflammation, the faster they fall. Westergren reference values are below 15 mm/hr for men under 50 and below 20 mm/hr for women under 50, rising with age. The test points to inflammation but never says where it is or what causes it.
Reference ranges
Group
Reference range
Men under 50 (Westergren)
below 15 mm/hr
Men over 50 (Westergren)
below 20 mm/hr
Women under 50 (Westergren)
below 20 mm/hr
Women over 50 (Westergren)
below 30 mm/hr
Newborns
0–2 mm/hr
Children up to puberty
3–13 mm/hr
Westergren-method values from the MedlinePlus Medical Encyclopedia. Intervals vary between laboratories — the range on the report applies.
Check your value
Enter the number from your lab report — see how it compares with the typical range. Mind the units shown in the chosen row.
A rough comparison with a typical range, not a diagnosis. Reference ranges vary between laboratories — check the range on your own report and let a clinician interpret the result.
What this marker is
In a vertical tube of blood, red cells slowly settle to the bottom, leaving clear plasma above. The ESR is the height of that clear column after one hour, in millimeters per hour. When inflammation raises certain plasma proteins — fibrinogen and immunoglobulins — the cells clump and fall faster.
The result is nonspecific by design: an elevated rate says that an inflammatory process exists somewhere, not which one. That makes the test a screening and monitoring tool rather than a diagnostic one — it is read together with symptoms, examination, and targeted tests.
The classic use cases are suspected temporal (giant cell) arteritis and polymyalgia rheumatica, where the rate is usually markedly elevated, and monitoring of known inflammatory diseases over time. It is also used with other tests when infection or an autoimmune process is suspected.
The rate rises naturally with age and runs higher in women than in men, which is why reference intervals are age- and sex-stratified. Pregnancy and anemia also raise it without any inflammation at all.
When it is high
Autoimmune disordersLupus, rheumatoid arthritis in adults and children, and polymyalgia rheumatica commonly push the rate up; very high values occur in giant cell arteritis and the vasculitides.
InfectionsSystemic infections, bone infections, infection of the heart valves, rheumatic fever, severe skin infections, and tuberculosis all accelerate settling.
AnemiaWith fewer red cells the column settles faster — anemia alone raises the rate without any inflammation.
PregnancyA physiological rise is expected and does not indicate disease.
Kidney and thyroid diseaseChronic conditions in these organs are among the standard non-inflammatory reasons for a moderately high rate.
Age and sexThe upper limit climbs with age and is higher for women — part of the reference interval itself rather than a finding.
When it is low
PolycythemiaAn excess of red cells packs the column and slows settling.
Sickle cell anemiaThe misshapen cells cannot stack and fall the way normal cells do, so the rate reads low.
Congestive heart failureOne of the recognized causes of a low sedimentation rate.
Low fibrinogen or low plasma proteinLiver or kidney disease that lowers plasma proteins removes the very proteins that make cells fall faster.
Hyperviscosity and some leukemiasChanges in blood thickness and cell composition can slow the rate.
What can skew the result
These factors can shift the value without any disease — worth considering before a retest:
Age and sexPregnancyAnemia or high red cell massMenstrual cycle phaseObesitySome medicines
How to prepare
No special preparation is needed for an ESR test. If other blood tests are ordered for the same visit, those may require fasting for several hours — the order form will say so. The provider should know about all medicines being taken.
When a retest makes sense
In known inflammatory disease the test is repeated at intervals to follow activity — a falling rate tracks recovery. A single mildly elevated result without symptoms is often simply rechecked later rather than chased.
Who usually reviews this result
A result outside the reference range is usually reviewed by: your GP or primary care doctor; a rheumatologist if an inflammatory or autoimmune disease is suspected. Bring your lab report and any previous results to the appointment.
Names used on lab reports
Your report may use any of these names: ESRSed rateSedimentation rateWestergren sedimentation rate
Units
Measured in: mm/hr
Several markers on your report?
See how MedProtect explains results in the app: the whole report, a check of the recognized values, and a clear breakdown.
Not by itself. The rate rises with common infections, anemia, pregnancy, and simply with age. Very high values — roughly above 100 mm/hr — get more attention because they cluster with arteritis, severe infection, or myeloma, but the number alone never makes the diagnosis.
Why did the report come back with age- and sex-specific ranges?
Because the rate genuinely drifts: women run higher than men, and everyone runs higher with age. A value normal for a 70-year-old woman would be elevated for a 30-year-old man.
Is ESR the same as CRP?
Both are inflammation markers, but CRP rises and falls within hours while the ESR changes over days. Providers often order them together: CRP for the acute picture, ESR for the slower trend.
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