What is the ESR in a person's blood and the norms of this indicator

ESR is an indicator that is included in a general blood test. Explanation of the abbreviation is the rate of erythrocyte sedimentation.

The determination of ESR in the blood is considered a screening test, that is, it is not specific for any particular disease. This indicator reflects the general state of the body, namely the presence of inflammation of various origin. It can indicate infectious, inflammatory and tumor processes. It is normal to accelerate ESR during menstruation and during gestation.

How is the analysis done?

Blood is taken from the finger in the morning on an empty stomach. The day before the test, it is advisable not to eat fried and fatty and do not drink alcoholic beverages. It is recommended to quit smoking within an hour before taking blood. The procedure should appear rested and calm, the day before not engage in physical work and sports. Do not donate blood after physiotherapy, radiography and some other procedures. It is important to warn the doctor about the medications taken.

How is ESR determined?

Vessel for determination of ESR
To determine the ESR, the blood is placed in a narrow long tube with

divisions for an hour. In the blood received from the patient, a coagulant is added to prevent its coagulation and placed for one hour in a narrow, high test tube in a horizontal position. Erythrocytes have a greater specific gravity than plasma, so they begin to sink to the bottom under the action of gravity. Thus, the blood is divided into two layers: the lower one is the erythrocytes, the upper one is the plasma. The height of the plasma layer is estimated as ESR in millimeters per hour. The rate of erythrocyte sedimentation will be the number at the fission of the tube, which is located on the boundary of plasma and erythrocytes.

If a person is healthy, the speed at which red cells go down is very low. In inflammatory diseases, its level rises. This is because the content of fibrinogen increases in the acute phase of inflammation in the blood. In addition, globulins are released into the blood - protective antibodies against pathogens( fungi, viruses, bacteria, etc.). As a result, red blood cells stick together and settle more quickly into the bottom. The faster they fall, the heavier the disease.

ESR usually begins to increase in a day or two after the onset of the disease. The peak reaches the moment of recovery, it is normalized gradually and some time can be kept high, when the person is already practically healthy. Blood on the ESR is taken repeatedly, as more informative is the change in the indicator in the dynamics.

Methods for testing

There are different methods of examining blood for ESR.In international practice, the definition of ESR by Westergren was adopted. In Russia, Panchenkov's method is more common. They differ in the characteristics of the tubes and the scale of the results. It is believed that the Westergren method is more accurate.

ESR rate

Erythrocyte sedimentation rate differs in men, women and children, and also depends on age. ESR in the blood in women is normal on average up to 20 mm / h, in men - up to 15 mm / h, in children - from 1 to 20.

The child at birth has a normal value - from 1 to 2 mm / h. In the first year of life, it rises to 3-10 mm / h, from 5 to 11 years / 5 to 11 mm / h from 6 to 14 to 4-12 mm / hr.

The table below shows how much is in the norm of ESR for adults by age. It should be said that this indicator is slightly higher for women.

From 20 to 30 years From 30 to 60 years From 60 Years
Female 4-15 mm / h 8-25 mm / h 12-50 mm / h
Male 12 mm / h 14 mm /h 32 mm / h

A slight deviation from the norm( by several units) in the direction of increase is permissible and is not considered a pathology of .With an increase of 15-30 units it is an inflammation that does not pose a danger to humans. If the ESR is higher than the norm by 30-60 units, the development of a serious disease is not ruled out. If the erythrocyte sedimentation rate exceeds normal values ​​by more than 60, then this state is considered extremely severe.

Indications for delivery of analysis

This test is available and easy to perform. It is screening and is prescribed during preventive examinations and inflammatory diseases of various etiology: tumors, infarcts, connective tissue diseases, infectious diseases.

Causes of acceleration and deceleration of ESR

The ESR analysis is an auxiliary test that gives a preliminary result. To establish an accurate diagnosis it is not enough and additional studies are needed. The rate of erythrocyte sedimentation, other than normal, most often means that various pathological processes develop in the body.

Increased temperature in women
ESR increases in all inflammatory diseases accompanied by a rise in temperature

The causes of increased ESR are various diseases, among them:

  1. Acute and chronic infections and inflammations.
  2. Pneumonia.
  3. Liver diseases.
  4. Tuberculosis, syphilis.
  5. Myocardial infarction.
  6. Diseases of the kidneys.
  7. Shock status.
  8. Anemia.
  9. Skin Infectious Diseases.
  10. Lymphoma.
  11. Thyroid dysfunction.
  12. Autoimmune diseases: lupus erythematosus, rheumatoid arthritis, rheumatic fever.
  13. Fractures and injuries of bones. Necrosis of tissues.
  14. Surgical interventions.
  15. Infectious heart diseases.
  16. Consequences of taking some medications.

Very high sedimentation rate of erythrocytes is noted in autoimmune diseases:

  1. Vasculitis is allergic.
  2. Hyperfibrenogenemia.
  3. Giant cell arteritis.
Related article: Erythrocytes in the bloodstream
Reasons for an increase in red blood cells in the blood

Low level indicates such conditions as:

  • hypophybrenogenemia;
  • circulatory failure;
  • polycythemia;
  • hyperbilirubinemia;
  • reception of corticosteroids;
  • reactive erythrocytosis;
  • vegetarianism;
  • decrease in muscle mass, starvation.

ESR in pregnant women

In pregnancy, this rate rises depending on the period. This is not related to inflammation, so it is not necessary to treat. Usually, the ESR accelerates, starting from the fourth month, and reaches its highest value in the ninth month. The following values ​​are considered to be the norm:

  • 1st trimester - 15 mm / h;
  • 2nd trimester - 25 mm / h;
  • 3rd trimester - up to 45 mm / h.

ESR normalizes approximately three months after delivery.


A blood test for ESR is a very affordable and easily feasible research method that is unspecific and can not be a basis for diagnosis. A significant increase in ESR( up to 50-80 mm / h) often indicates the presence of an autoimmune disease of connective tissue( scleroderma, lupus, vasculitis, etc.) or tumoral diseases of lymphatic and haematopoietic tissue( lymphoma, leukemia).