ESR Blood Test - Meaning, Normal Range, Cost, Full Form

ESR Blood Test

Test Duration


5 Minutes

------ To ------

10 Minutes

Test Cost



------ To ------


ESR Blood Test
get the app
get the app

Experiencing symptoms like headaches, joint pain, loss of appetite, and digestive problems? These may be the signs of inflammation in the body. But how can one diagnose inflammation? With an ESR blood test! 

But when does a person need an ESR blood test? The following article discusses everything, from the ESR blood test meaning and procedure to its normal range and result interpretation. Continue reading to find out.  

Alternative Name

Erythrocyte Sedimentation Rate


Fasting not required

Test done by

General Physician


  1. For males under 50 years old: ESR ≤ 15 mm/hr

  2. For females under 50 years old: ESR ≤ 20 mm/hr

Download our App today to plan your surgery seamlessly and stress-free!

Click here for Android and Click here for iPhone

What is ESR Test?

The Erythrocyte Sedimentation Rate (ESR) test measures how fast red blood cells settle in a test tube. It is an indirect indicator of inflammation in the body. If there is an inflammation or infection in the body, extra proteins can cause the cells to settle faster. It leads to a higher ESR result. 

It is frequently carried out as part of routine blood panels. Doctors may recommend this test if a person shows signs of inflammation or infection. It helps them monitor conditions like inflammatory bowel disease, arthritis, and lupus. 

Additionally, the ESR test allows doctors to assess the effectiveness of treatment for inflammation or infection. The doctor may perform a C-reactive protein (CRP) test or a Complete Blood Count (CBC) with the ESR test. 

  1. CRP and ESR tests help measure inflammation and predict the risk of cardiovascular diseases like coronary artery disease.

  2. CBC and ESR tests detect other signs of inflammation and infection. Doctors use CBC ESR blood tests to diagnose blood and inflammation-related diseases like infection, anaemia, arthritis, bleeding disorder, and cancer.

Need for ESR Test

A person may need an ESR blood test if they experience symptoms of inflammatory diseases like arthritis or inflammatory bowel disease (IBD). The primary purpose of an ESR blood test is to diagnose and monitor inflammation in the body. 

However, the test does not identify the exact cause of inflammation. Symptoms that point towards the need for an ESR test include:

  1. Headaches as a result of pain in the temples and vision changes

  2. Joint pain or stiffness for longer than 30 minutes in the morning

  3. Unintentional weight loss

  4. Loss of appetite

  5. Neck, shoulder, or pelvis pain

  6. Digestive symptoms like:

    1. Unexplained fever

    2. Diarrhoea

    3. Unusual pain in the abdomen

    4. Blood in stool

Benefits of ESR Test

ESR levels can serve as an early warning sign, prompting further investigation to determine the underlying cause of health problems. It is a simple blood test that evaluates a person's health. The benefits of Erythrocyte Sedimentation Rate (ESR) are:

  1. Inflammation Detection: It detects various infections, such as bacterial or viral, which is crucial for timely and appropriate treatment.

  2. Health Screening: It can be part of routine health check-ups to assess general health and identify potential health concerns early on.

  3. Disease Diagnosis: It aids doctors in diagnosing and monitoring various conditions, such as autoimmune diseases and certain cancers.

  4. Treatment Monitoring: ESR allows healthcare professionals to assess the effectiveness of treatments for inflammatory or infectious diseases.

  5. Differentiating Conditions: Along with other clinical data, ESR levels help doctors distinguish between different diseases with similar symptoms. It ensures accurate diagnosis.

  6. Non-Invasive Procedure: The ESR test involves drawing a blood sample, making it a non-invasive procedure generally well-tolerated by patients.

Types of ESR Test

Different methods or techniques are employed to measure ESR. Each of them offers specific advantages. The types of Erythrocyte Sedimentation Rate methods are as follows:

  1. Westergren Method: It is the most commonly used technique, where blood is mixed with an anticoagulant and placed in a tall, narrow tube.
    The rate at which red blood cells settle in an hour is measured, giving valuable information about inflammation and potential health issues.

  2. Wintrobe Method: This is similar to the Westergren method but uses a shorter tube and a smaller blood sample. This method is useful when necessary for a smaller blood sample or a shorter test duration.

  3. Micro-ESR Method: It is a modified version of the Westergren method that requires a smaller blood sample and a specialized microhematocrit tube.

    It offers a quicker turnaround time for results and can be beneficial when immediate information is needed.

Preparation of ESR Test

Specific preparations are often required before the ESR test to ensure accurate results. These include:

  1. Fasting: Typically, no fasting is necessary for the ESR test. Patients can eat and drink as usual before the test.

  2. Medications: Inform your healthcare provider about any medications or supplements you are taking, as some drugs can affect ESR results. They may advise to discontinue certain medicines before the test temporarily.

  3. Avoiding Physical Activity: Avoid vigorous physical activity before the test, as it can temporarily elevate ESR levels. Resting before the test can help obtain more accurate results.

ESR Test Procedure

The blood sample for the ESR test is measured in a test tube for an hour. Knowing the procedure for conducting the ESR test can help patients feel more at ease. A person can expect the following during an ESR blood test:

  1. Blood Sample Collection: A healthcare professional will draw a blood sample from a vein in your arm using a small needle.

  2. Mixing with Anticoagulant: The collected blood is mixed with an anticoagulant, preventing blood clotting.

  3. Placing in a Tube: The anticoagulated blood is then placed in a tall, thin Westergren tube.

  4. Settling Time: The tube is left undisturbed upright for one hour when the red blood cells gradually settle to the bottom.

  5. Measuring the Sedimentation Rate: After one hour, the distance the red blood cells have descended is measured in millimeters. This measurement indicates the ESR value.

Aftercare of ESR Test

There is no immediate after-care required after an ESR blood test. A few aftercare measures can help ensure a smooth recovery.These include:

  1. Normal Activities: In most cases, patients can resume their normal daily activities immediately after the ESR test. There is usually no need for any specific restrictions or downtime.

  2. Apply Pressure: The healthcare professional will place a bandage or cotton ball on the puncture site after the blood draw. Gently apply pressure for a few minutes to minimize bleeding and bruising.

  3. Keep the Site Clean: Keeping the puncture site clean and dry to prevent infection. Avoid touching or scratching the area unnecessarily.

  4. Stay Hydrated: Drink plenty of water or fluids after the test to help replenish lost fluids and aid recovery.

  5. Watch for Complications: Though rare, some individuals may experience fainting or dizziness after blood tests. If you notice any unusual symptoms, seek medical attention promptly.

Schedule a follow-up consultation with your healthcare provider once the test results are available. They will discuss the results, provide further insights into your health, and recommend any necessary actions based on the findings.

Results of ESR Test

The ESR test results are typically available within 24 to 48 hours after collecting the blood sample. Patients can obtain their ESR test report by contacting their healthcare provider or through an online patient portal.

Abnormal ESR results do not help diagnose a particular condition. They only indicate potential inflammation in the body, suggesting a need to look further. An abnormal ESR test result is not always a cause for concern. 

Interpretation of the ESR Test

The reference range for the ESR may vary depending on the specific laboratory conducting the test. Generally, ESR values are slightly higher in females compared to males, and they tend to increase gradually with age. 

The normal ESR values, obtained using the Westergren method, are as follows:

  1. For males under 50 years old: ESR ≤ 15 mm/hr

  2. For females under 50 years old: ESR ≤ 20 mm/hr

  3. For males over 50 years old: ESR ≤ 20 mm/hr

  4. For females over 50 years old: ESR ≤ 30 mm/hr

  5. For children: ESR ≤ 10 mm/hr

ESR Above Normal

A higher Erythrocyte Sedimentation Rate could be a valuable tool in identifying coronary artery disease. This might be due to the association between the inflammation seen in coronary disease and elevated ESR levels. Other causes of high ESR results are:

  1. Infections: Various infections, such as bacterial, viral, or fungal, can lead to an increase in ESR levels as the body's immune system responds to the invading pathogens.

  2. Inflammatory Conditions: Autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE), and inflammatory bowel diseases (IBD) can cause chronic inflammation and elevated ESR values.

  3. Tissue Injury: Any injury or damage to body tissues, such as fractures, heart attacks, or severe burns, can cause an inflammatory response.

  4. Pregnancy: ESR levels rise during pregnancy due to changes in blood proteins and increased blood volume.

  5. Certain Cancers: Some cancers, like lymphoma or multiple myeloma, can cause elevated ESR as cancer cells release inflammatory substances in the body.

ESR Below Normal

A low Erythrocyte Sedimentation Rate result indicates that your red blood cells settled more slowly than usual. This could be due to various conditions, such as:

  1. Normal or Healthy State: A low ESR value within the normal range generally indicates no significant inflammation or infection in the body. It is a positive sign of overall good health.

  2. Certain Medical Treatments: Some medical treatments, like high-dose aspirin or corticosteroids, can lower ESR levels, particularly when used to manage inflammatory conditions.

  3. Abnormal Red Blood Cell Shape: Certain blood disorders or conditions that affect the shape of red blood cells can lead to decreased ESR values.

  4. Hyperviscosity: Conditions that increase the viscosity or thickness of the blood, such as polycythemia, may result in lower ESR readings.

  5. Chronic Liver Disease: Liver diseases that affect blood proteins can also contribute to lower ESR values.

Treatment Plan After Test

The Erythrocyte Sedimentation Rate is not a reliable or specific test for general health screening. An elevated ESR can happen in various medical situations, making it inconclusive as a single indicator. Additionally, some patients with cancer, severe infections, or inflammatory conditions may have normal ESR values, limiting usefulness as a standalone test.

Treatment of ESR Above Normal

Higher ESR values don't always mean a person has a medical condition needing treatment. Sometimes, results outside the usual range might be due to laboratory errors or factors like pregnancy, menstruation, or age. 

In cases where there's a suspicion of disease, the ESR can be useful as an indicator, especially if it's extremely elevated (above 100 mm/hr), which may point to certain causes like cancer, infection, or temporal arteritis. 

Further testing might be necessary to explore and identify the underlying health condition for mildly to moderately elevated levels without apparent reasons. Treatment modalities for conditions with High ESR include:

  1. Depending on the type of infection detected, treatment for infections typically involves antibiotics, antiviral, or antifungal medications. Following the prescribed course of treatment is crucial to reduce inflammation.

  2. Managing autoimmune conditions may involve various approaches, such as anti-inflammatory medications (e.g., corticosteroids), disease-modifying antirheumatic drugs (DMARDs), or biological therapies. These treatments aim to suppress the immune system's response and reduce inflammation.

  3. Diet and lifestyle modifications are common components of treatment plans for conditions like IBD. It aims at reducing inflammation and managing symptoms.

Treatment of ESR Below Normal

When a person's ESR is found to be low, it may signify specific health conditions that require attention and appropriate management. Treatment of Conditions with Low ESR includes:

  1. Addressing Underlying Causes: The healthcare provider may adjust the dosage or recommend alternative therapies related to medical treatment, such as high-dose aspirin or corticosteroids.

  2. Managing Associated Health Conditions: If low ESR is due to chronic liver disease or conditions affecting blood viscosity, managing the underlying condition may help normalize ESR levels. It may involve lifestyle changes, dietary adjustments, or specific medical treatments.

Risks of ESR Test

There are not many risks of an ESR blood test. However, getting blood drawn can involve some possible minimal risks, such as:

  1. Bleeding

  2. Tenderness

  3. Bruising

  4. Infection

  5. Lightheadedness

  6. Fainting

  7. Inflammation of the vein

Cost OF ESR Test

he approximate price of an ESR blood test ranges between ₹ 100 to ₹ 300. The price of the test can differ based on the diagnostic centre and city. The following table compares the prices of ESR tests in different cities. 




₹ 100 to ₹ 130


₹ 100 to ₹ 150


₹ 100 to ₹ 130


₹ 100 to ₹ 130


₹ 100 to ₹ 175

Doctors usually recommend CBC and ESR tests together. The CBC ESR test price in different cities is as follows:




₹ 300 to ₹ 500


₹ 250 to ₹ 550


₹ 280 to ₹ 500


₹ 216 to ₹ 416


₹ 200 to ₹ 475


ESR blood test detects possible chronic conditions that may cause low or high levels. The test is often performed with other lab tests like CBC to diagnose or rule out several inflammatory diseases. Depending on the test results, the doctor may order further tests. 

You must talk to your doctor or an expert at HexaHealth if you experience symptoms that may indicate a need for an ESR blood test. If you need further treatment for inflammatory conditions, we will help you connect with the best doctors at the best hospitals. So what are you waiting for? Consult a HexaHealth expert TODAY! 

Suggested Reads

CA 125 Blood Test
CBC Test
Serum Iron Test

Download our App today to plan your surgery seamlessly and stress-free!

Click here for Android and Click here for iPhone

FAQs for ESR Blood Test

ESR blood test measures how quickly red blood cells separate from a blood sample and settle at the bottom of a test tube. It detects the absence or presence of inflammation in the body.

A high ESR blood test meaning is that the patient has a medical condition or disease that may be causing inflammation. Conditions that may cause a high ESR blood test result include:

  1. Autoimmune diseases

  2. Infections

  3. Certain cancers, such as lymphoma and multiple myeloma

  4. Diabetes

  5. Anaemia

  6. Kidney disease

  7. Heart disease

 An ESR blood test is a quick, simple test to diagnose inflammatory conditions.

The doctor or nurse will clean the skin directly over a vein in your arm to perform the test. They will insert a needle in the vein to collect blood.

 ESR blood test normal range varies between males and females. The normal range of ESR for men and women is as follows:

Men under 50

0 to 15 mm/hr

Women under 50

0 to 20 mm/hr

Men over 50

0 to 20 mm/hr

Women over 50 

0 to 30 mm/hr

The higher limit for the ESR blood test normal range is 20 mm/hr for women and 15 mm/hr for men. Anything above this range may indicate inflammation in the body.

It is difficult to determine low ESR levels as they may fluctuate from one person to another. Low ESR blood test results may indicate conditions such as:

  1. Hypofibrinogenemia (too little fibrinogen protein in the blood) 

  2. Low plasma protein 

  3. Congestive heart failure 

  4. Leukocytosis (high WBC count)

  5. Sickle cell anaemia (a genetic disease affecting the RBCs) 

  6. Polycythemia vera (a bone marrow disorder causing excess RBC production)

ESR blood test full form is Erythrocyte Sedimentation Rate. The test is used to detect inflammation in the body.

The approximate cost of an ESR blood test ranges between ₹ 100 to ₹ 300. The cost may vary depending on the city and the diagnostic centre where the test is performed.

No, an ESR blood test is usually not very painful. You may experience slight pain, tenderness or bruising at the needle’s insertion site.

Yes, ESR blood test results can be affected by certain medications. Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, statins, birth control pills can cause false lower ESRs.

ESR blood test is a quick procedure that takes no more than a couple of minutes. You can get the results for the ESR blood report in about 1-2 hours after the sample is analysed for one hour in the test tube.

No, you need not fast before an ESR blood test. The test requires no special preparations. However, if the doctor ordered other tests on your blood sample, along with an ESR test, you may need to fast, depending on the test.

The ESR blood report is usually available 1-2 hours after the blood goes to the lab.

You may receive the report via mail or electronically. The doctor may call you to discuss your test results. The higher the result, the higher the possibility of inflammation in the body.

There are no special preparations required before an ESR blood test. You may not even need to fast before the test. However, make sure to inform the doctor about the medications and supplements you take since some medications may affect the test results.

 ESR is a low-risk test. There are only slight risks associated with an ESR blood test. The minimal risks of getting your blood drawn include:

  1. Bleeding

  2. Tenderness

  3. Bruising

While an abnormal ESR level may be associated with several conditions, an ESR blood test does not diagnose a specific condition. The test is only used to detect the possibility of inflammation in the body.

An ESR blood test is less accurate and reliable than other blood tests. Several factors, such as older age, pregnancy, menstruation, and medications, can affect ESR test.

The CBC ESR test price in India varies depending on the city and diagnostic centre. Generally, the test price ranges between ₹ 200 to ₹ 550.


All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Tishkowski K, Gupta V. Erythrocyte Sedimentation Rate (ESR) [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. link
  2. Hegg R, Lee AG, Tagg NT, Zimmerman MB. Statin or nonsteroidal anti-inflammatory drug use is associated with lower erythrocyte sedimentation rate in patients with giant cell arteritis. Journal of Neuro-Ophthalmology: The Official Journal of the North American Neuro-Ophthalmology Society [Internet]. 2link
  3. Ramsay ES, Lerman MA. How to use the erythrocyte sedimentation rate in paediatrics. Archives of disease in childhood - Education & practice edition. 2014 Sep 9;100(1):30–
  4. Blood Test: Erythrocyte Sedimentation Rate (ESR) (for Parents) - Nemours KidsHealth [Internet]. link
  5. Erythrocyte Sedimentation Rate - Health Encyclopedia - University of Rochester Medical Center [Internet]. link
  6. Erythrocyte Sedimentation Rate - ESR [Internet]. link
  7. Alende-Castro V, Alonso-Sampedro M, Vazquez-Temprano N, Tuñez C, Rey D, García-Iglesias C, et al. Factors influencing erythrocyte sedimentation rate in adults: New evidence for an old test. Medicine [Internet]. 2019 Aug 1;98(34):e16816. link
  8. MedlinePlus. Erythrocyte Sedimentation Rate (ESR): MedlinePlus Lab Test Information [Internet]. 2022. link


Dr Sania Datta

Dr Sania Datta

BDS (Panjab University) I MBA Hospital & Health Management (IIHMR Jaipur)

8 Years Experience

She is a high-impact healthcare management and medical content professional with enriching work experience in Parexel, HexaHealth Technologies, Apollo Munich, Credihealth and Fortis Hospital. Armed with deep and c...View More

get the app
get the app
get the app
get the app