High ESR Blood Test Results (Elevated RBC Sed Rate Levels)

What is sed rate?
Sed rate is a short form for Erythrocyte sedimentation rate and abbreviated to ESR Test too.
Sedimentation rate blood test is measured by letting an amount of blood to separated and settled to the bottom of a tube in a certain amount of time, so that the RBC sed rate is the volume of Red blood Cells precipitated in an hour time.
What is sed rate used for?
Why my doctor want me to take ESR blood test?
The main purpose to measure the rate of RBC sedimentation is to monitor the inflammation progress, Inflammation means normally increased body defense due to existence of injury or casual agent such as the trauma, post surgery, infection by bacteria or worms, and allergic reaction in response to immunological reasons as in Systemic Lupus Erythromatosus and Rheumatoid Fever or Non immunological causes as acquired allergies by drugs.
Such Inflammatory response triggers the body proteins and cells in so called “Exudate”, RBC become heavy and ill due to high weight blood content.
ESR usually important component of general medical checkup
ESR and C-Reactive Protein are tests used both as bio-markers of inflammation to improve diagnostic sensitivity and specificity
We can conclude why doctor choose ESR to diagnose diseases?
To clarify what causes the symptoms such as in whooping cough or pertussis.
To confirm or verify previous diagnosis of a disease such as TB.
To screen people of a high risk for a specific disease like aged people
To preliminary diagnosis such Arthritis, temporal arthritis, systemic vasculitis, and polymyalgia rheumatica.
To indicate the severity of a disease such in Sore throat and tonsillitis
To state the progression of a disease
To decide the effectiveness of a treatment especially with antibiotics
Sedimentation normal rates are:
Sed rate values is higher in women than men and more higher in older people than younger.
When Eryth. Sed. Rate exceeds predefined normal value we report that ESR is High.
Sedimentation rate Normal levels in general,
Men 0–15 millimeters per hour (mm/hr), or 0–20 mm/hourr for men older than 50
Women 0–20 mm/hr, or 0–30 mm/hr for women older than 50
Children 0–10 mm/hour
Neonatal to puberty: 3 to 13 mm/h, but other laboratories place an upper limit of 20
Newborns 0–2 mm/first hour
You can comment with your results to explain it for you.

What is sed rate westergren blood test or westerngren ESR?
A diagnostic technique used in blood measurement of Blood Sed rate.
Sed rate by modified westergren method is:
Certain long tube called westergren tube
An amount of anticoagulant usually Citrate is placed into tube.
Equivalent amount of fresh blood is mixed with anticoagulant and covered.
The tube is hanged vertically perpendicular to the ground
Record Precipitated volume every hour.Stages in erythrocyte sedimentation:
There are 3 stages in erythrocyte sedimentation 1) Stage 1 : Rouleaux formation – First 10 minutes 2) Stage 2 : Stage of sedimentation or settling – 40 mins 3) Stage 3 : Stage of packing – 10 minutes, sedimentation slows and cells start to pack at the bottom of the tube
The Westergren method is the most sensitive of the sedimentation rate methods because of the longer tube, but it requires more blood.
The Wintrobe method requires a smaller amount of blood and involves no dilution. In addition, once the ESR has been read, the Wintrobe tube can be centrifuged to obtain a macrohematocrit, and blood films can be made from the buffy coat. However, because of the shorter column of blood, the Wintrobe methods is not as sensitive as the Westergren.
WINTROBE ESR Method Normal Values
0 – 7 mm/hr
0 – 15 mm/hr
WESTERGREN ESR Method Normal Levels
Less than age 50 yrs
Male 0 – 10 mm/hr
Female 0 – 20 mm/hr
Children 4 – 14 yrs 0 – 20 mm/hr
Greater than 50 yrs age
Male 0 – 20 mm/hr
Female 0 – 30 mm/hr

Erythrocyte Sedimentation rate blood test results Explained

What does ESR test results means?
We are welcome to explain your results for free through comments, Fb & G+ pages, or Privately.

1- Causes of ESR greater than 100 mm/1st Hour
Autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, or inflammation of the thyroid gland (Graves’ disease).
Diseases caused by attack of autoantibodies to the body’s cells are called immunological auomimmuonolgical disorders, in such diseases the body antibodies attack the body cells and proteins instead of attacking foreign substances, many organs affected and the body become very ill which impact on health of Red blood cells, thus sed rate of Red cells become very high, usually ESR is over 100 mm after the first hour.
Other tests: WBC less than 4.0 *10^9 cells
RF is Positive in RA patients
LE cells test is Positive in SLE Patients.
Positive Autoantibodies Anti-dsDNA and antinuclear antibody test (ANA), over 1.0 in cut-off reports
Ani-TSH Positive test in grave’s disease.
Arthritis due to gout show Uric Acid test over than 6.0 mg/dl
Hb% may be lower than 8.0 mg/dl due to chronic inflammation Anemia.
Cancer, such as lymphoma or multiple myeloma.
Lymphoma are kind of cancers affect lymphatic tissue and caused by viruses as Epstein-bar virus or HIV and cause signs like painless enlargement of lymph nodes, in addition to feeling tired with fevers, night sweats, itchiness, and weight loss.
Multiple Myeloma or Kahler’s disease is sub-kind of lymphomas in which some kind of defensive blood cells called plasma cells become cancerous and abnormally proliferate and accumulate in bone marrow and other marrows. Plasma cells contain and produce Bence Jones proteins in excessive amounts causing inflammation of kidney, however those cells are helpful in normal levels.
Elevated ESR in malignancies is a result of excessive protein content in patient’s blood fluid.
ESR blood test usually over 100 mm after first hour however High ESR extends as the cancer persists.
Other testing results: FBC show WBC over 50.000 cells or over 500.000 cells mostly lymphocytes (normal 4 – 11 *10^9 cell/mL)
Urine Bence Jones protein test is Positive in multiple myeloma disease exclusively.
Low Hb% due to Anemia.
2-Causes of moderate high ESR results
Chronic kidney disease.
Why Sed rate increases in kidney diseases? the reasons may be due to inflammation of kidney units called Nephrons which is the the responsible organs in kidney functioning, Loss of Nephrons function leads to kidney failure to filtrating the blood of toxins and thus accumulate in the blood and cause blood cells to overburden, and this is enough to become very high blood sedimentation speed.
ESR is 50 – 75 mm/1st hour in adults, over 100 in late stages.
Other testing results:

Urea over 50 unit
Creatinine is 1.5 – 10.0 mg/dlInflammatory diseases due to Bacterial infection of Kidney, bone, joint, skin, or heart valve infections, such as pneumonia, pelvic inflammatory disease, or appendicitis.
As explained, the inflammation products cause high weight blood flow.
ESR is moderately elevated usually 15 – 40 mm/ first hour, 25 – 80 after second hour.
Other test results:CRP titres more than 12.0 mg/dl and up to 48.0 mg/dl in 24 hours
FBC show abnormal white blood cells morphology and count as well as mild anemia.Pregnancy and preeclampsia (toxemia of pregnancy).
Pregnancy is normal increase in body processes due to gestation, the matter which cause high loaded blood flow with nutrients for he fetus, causing temporarily increased sed rate, However toxemia of pregnancy caused by infiltration of fetus proteins into mother’s blood stream, which do the same role in overloading blood fluid.
ESR blood test is mild/moderate high, first hour sed rate between 20 – 40 mm.
Anemia, Hb% lower than 9.0 in such cases due to iron deficiency during pregnancy.
Other causes of high esr count
Viral infections.
Inflammation of joints (such as polymyalgia rheumatica) and blood vessels (such as giant cell arteritis).
3- Causes of low ESR values
Values of ESR between 0 – 10 and 20 mm
Sed rate are in normal ranges in certain diseases such as:
High blood sugar levels.
Sickle cell disease.
Severe liver disease.
Congestive Heart failure

Sed rate False Positive Negative Results

Please read carefully the factors and requirements to understand why ESR results may be not correct.
Best time to take ESR test is during he day, Fasting before esr test is preferred about 4 – 6 hours for those not suffering from clear complains.
Test must be set 1 hour after collection or up to 6 hours if sample refrigerated.
Read Results every 60 minutes, any delay will alter the results.
The ESR is affected by a number of mechanical and technical factors.
Anticoagulant is EDTA or Sodium Citrate (blue-top tube), other anticoagulants cause shrinkage to RBC
Tube perpendicular to surface, any Horizontal degrees will accelerate Sedimentation and end up to false high esr.
Some Newer Westergren tubes have a cotton plug in the “zero” end which prevent leakage of blood from the open end of the tube.
Because the red cell shape affects the rate of fall of the cells, it should be apparent that sickle cells and spherocytes will result in a potential falsely decreased ESR. Other conditions that result in poikilocytosis (variation in the shape of the red cells) will produce similar results.
There is considerable dispute about the effect of severe anemia on the ESR. Some laboratories correct the ESR in cases of severe anemia.

If you have abnormal results we are happy to help interpret your results for free, in comments or through my page on Facebook and Google plus.

Dr.Megan Ralf

A Medical laboratory Scientist who devoted his life to medical and laboratory sciences, writes his everyday expertise dealing with various pathological conditions through laboratory diagnosis of different body fluids, also participating in many workshops for first aids, infection control, and urgent care. Also Dr Megan Ralf coaching many medical teams.

You may also like...

36 Responses

  1. Carmen marron says:

    I have history of asta and allergies. IAty workplace several years ago, I was exposed to mold and think dust and spot in my classroom I filed a injury complaint and the workman’s comp carrier sent me for blood work and pulmonary testing. the pulmonary tests were normal, but the blood test demonstrated 31 for the sed rate and 899 for IGE, every thing else was normal
    I did not realize that I was suppose to fast for 4 to 6 hours before the test. What could these results mean?

  2. Grace says:

    Hi I’m 26 y/o, the result of my ESR is 42. Please explain what are the possible reason or possible meaning of that. Thank you

  3. Pragati says:

    I have 40 mm observe value of E.S.R wintrobe method …

  4. Shanika says:

    I’m a 28 year old female and will be 29 next month. My esr level was 28 what does that mean.

  5. Sri Priya Munipalli says:

    My ESR result is 30mm in 30 min and 40mm in 60min.I was also advised to go for uric acid test and is 4.3,my CRP result is 0.2.I am 35 year old lady.I was asked to take these tests as I was suffering from wrist pain since many days.please explain me the report.

  6. Anshika says:

    30 mm at the end of 1 s
    What does it mean ?
    For a girl of 16 years of age

  7. Sai says:

    My esr is 25 per hour and I’m only 20.
    And I got a serious injury to my leg. Leaving a flesh wound and a toe fracture. Is it bad or are there any chances.

  8. pandu says:

    this is pandu… male,…. age 27yrs….
    my esr is 20mm/hr first hour
    and esr is 45mm/hr second hour…………
    what does mean by it, please reply me

  9. pandu says:

    my esr is 20mm/hr first hour
    and esr is 45mm/hr second hour…………
    what does mean by it, please reply me

  10. pretty_fifi says:

    Hi, I’m a 34 years old female, the following are my test results:
    ANF Negative
    C-ANCA 1.3
    WBC 11.4
    RBC 4.65
    CRP 1.1
    ESR 26
    FT4 14.4
    FT3 2.8
    TSH 4.31
    I am taking Thyroxin 100 micro since a couple of years now, but I’m feeling tired and have knee pain. Also, I have some sort of rash on my cheeks that my GP prescribed me allergy pills and alfacort but even after 10 days of treatment, it did not disappear.
    Can you guide me please?

  11. Yasir Arafat says:

    Sir I am a 28 years old man and my ESR(westergren method) is 16 mm/1st hour. Is it dangerous?
    what shouls I do?

  12. rachele444 says:

    hi iam 46 years old and my ESR IS 57 mm/h what does it mean for me

  13. yvgg23 says:

    Hi. I have an 8 year old with high fevers 104+ from age 2-5 with no illnesses identified at time of fevers. Fevers have subsided now. Positive ANA titter 1:2560 finely speckled. SED rate 33 negative rheumatoid factor.

  14. Neeti Chauhan says:

    Hi. Sir/ ma’am. … I’m Neeti Chauhan. I’m 16 years old and I want to know about my blood test results. My ESR test results were 34 mm/hr. So I need to do now. Is it something very serious. Sir/ ma’am please reply soon.

  15. Kamal972reddy says:

    I am 29yrs old, male. I went to a foctor for mild joint pains. My blood teat results are as below:
    SERUS ASO TITRE: negative
    Blood for ERS: 10mm 1st hr.
    Doctor is saying that upto 5mm 1st hour is normal and i have abnormal situation and suggested for an MRI scanning. The information that you have provided says upto 15mm is normal.
    Do i still need to continue with the doctor?

  16. arxoclay says:

    My fiancé has high blood pressure and takes medication (Losartan 50 mg/day) for the same. She has been feeling dizzy lately and did an ANA test recently to see if she has an autoimmune problem. She has heavy periods and tends to be anemic.
    ANA IFA Screen with Reflex and Pattern IFA
    Positive at 1:40 titer with speckled pattern
    Red blood cell count 3.35 Million/uL
    Hemoglobin 10.2 Million/uL
    Hematocrit 30.6%
    Platelet count 431 Thousand/uL
    Sed Rate by Modified Westergren
    28 mm/h
    Does this data suggest the presence of an autoimmune disorder or a cancer?

  17. Crescendolls says:

    I am 37 years old female. My body temperature has been elevated between 36.8-37.5 for 3 weeks. I also have cold feet and cough. But the cough has been so much better now despite the elevated body temperature.
    My ESR 35
    Haemoglobin 11.9
    Neutrophil 45
    Lymphocytes 43
    Monocyte 9
    Hematocryt 35
    MCH 26
    MCHC 31
    Other results were normal including CRP
    Do you what the above means?
    Thank you.

  18. Shaik Anees says:

    hi , this is Anees, i did the hematology blood test in ESR is 40 mm / i am also suffering from fever every 15 days continuously cough mostly at evening time .. i also cant able to eat food if i take food with in 5 minits its vomiting . i just taking lite food juise or buttermilk . some times i am suffering form giddiness cant control . please i don’t know whats reason. please help me what does meaning ..

  19. Quinn Cherreguine says:

    Hi! I’m Quinn, 30 years old. I have a lot of rashes on my skin so decided to have a biopsy and result says I have lupus. I had some tests such as urinalysis, ANA, ESR..etc. I’m a bit confused with the results. Please help me out. Thank you!
    RBC count. 3.78
    Platelet count 376
    ESR. 42 mm/hr
    ANA. Negative
    C- Reactive Protein 1:2 positive
    12 mg/do
    Urinalysis: Pus cells. 5-7
    Red blood cells. 0-2
    Bacteria. Few
    Epithelial cells. Moderate

  20. Haru says:

    My father’s ESR came 150 which is very high. And he has been given antibiotics plus told to get a chest X Ray. He has cough and body pain. But the body pain maybe due to weakness. He got mild heat stroke a week ago.
    The thing is. Is this high rate due to some blood infection? And what should be done next.
    Also he had his spleen removed years ago so whenever he is ill he gets an error in blood count due to abnormal RBCs. Few years back due to the auto CBC count test he had a WBC count of 64 which is very very high…. It was false test due to his enlarged RBCs. Therefore a manual cBC was done which gave normal cell count.
    I was wondering can he get a false high ESR due to the same reason? And if yes then what should be done to check how sever his infection is.
    He is 55 years old. All blood cells are normal. Urine dr is also normal.
    He has diabetes. No hypertension.

    • Thanks for the question
      1-Automatic CBC counters give erroneous results when there are immature cells which are transitional cells and those counters not calibrated to count them.
      2-False ESR “low or high” explained in the original post.
      3-You said “All blood cells and urine is OK”, so that where is the infection you’re talking about?
      4-Progressive Diabetes can elevate ESR due to body inflammation by increased glucose around cells.
      5-Tests for inflammation include: ESR, CRP, CBC, and Plasma viscosity (PV) which replace ESR.

  21. Coquette says:

    I am a 29 yrs old women i had a history of MS and elvated aso titer, lately i had a very severe pain in my legs specially every joint in it. I did my labs and it went like that : Esr first hour 60 and secon hour 110
    What do you recommend and is it so high and if it what are the reasons?
    Thank you in advance

  22. Peter sam says:

    My wife is 29 years, she is pregnant in the 4th month
    She has been suffering from pain in her muscles all over her body from two weeks ago
    She had systemic lupus when she was 14 and got treated for one year then she told me she’s like got cured from lupus
    Now she has ESR = 105, CRP = 24
    Her haemoglobin 9.6 and WBC = 2300
    I hust want to know is what she suffering is because of systemic lupus or what ?
    And how can this afftect the baby ?
    Thanks in advance

  23. Hgb 1.7?
    just follow up with orth. doc to deal with the injury.

%d bloggers like this: