The sed rate (erythrocyte sedimentation rate or ESR) test is a type of blood test. It helps healthcare providers check for inflammation inside your body. They might use it to diagnose a condition or infection, or to monitor you for changes after starting a new treatment. It’s a quick, simple test with no special preparation and no side effects.
The erythrocyte sedimentation rate test is a blood test providers use to detect inflammation in your body. Providers usually refer to it by the shortened name sed rate test or ESR test.
Your healthcare provider might use a sed rate taste to help diagnose or monitor inflammatory conditions. Inflammation happens when your immune system activates special cells after an injury or to fight substances that shouldn’t be in your body (like viruses, bacteria or toxins).
A sed rate test can help your provider diagnose lots of inflammatory conditions, including:
A sed rate test doesn’t confirm or rule out any diseases or conditions — it can’t make a specific diagnosis. But it can show your provider whether or not there’s inflammation inside your body. They’ll use that result along with other tests, a physical exam and any symptoms you’re experiencing to narrow in a diagnosis.
ESR is a measure of your erythrocyte sedimentation rate. Erythrocyte is the medical name for red blood cells. A sedimentation rate is how long it takes a substance to fall to the bottom of a container of liquid. So, your erythrocyte sedimentation rate (ESR) is how long it takes your red blood cells to fall to the bottom of a sample of your blood in a vertical container.
Picture a lava lamp where the gel inside floats up and down as the light at the bottom heats and cools it. In this case, a vial of your blood is the lamp, and there’s no heating element. Your provider will time how long it takes your red blood cells to settle to the bottom of the test tube.
If it happens faster than usual, you might have an inflammatory condition.
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The sed rate test is a simple blood test. A phlebotomist or your healthcare provider will remove a small amount of your blood from a vein (usually in your arm).
You don’t need to do anything special to get ready for a sed rate test. You should be able to eat, drink and take all of your usual medications and supplements.
Your provider or phlebotomist will wipe an antiseptic on your arm and insert a needle into your vein. They may ask you to make a fist to help blood flow to that arm.
You might feel a sharp pinch when your provider inserts the needle. Tell your provider if you’re nervous about needles or blood tests. They’ll help you relax and stay calm.
Your provider will send the blood sample to a lab where a technician will place the sample in a special vial, and then record how long your red blood cells take to settle to the bottom of the vial.
The sed rate test is extremely safe and doesn’t have any risk of complications. It doesn’t cause side effects.
Your arm might hurt for a few hours after your test. Your provider will put a bandage on the spot where they put the needle in. It’s normal to have minor bleeding or bruising after a blood draw.
An ESR test shows how quickly your red blood cells sink to the bottom of your blood sample. Most providers use the Westergren method. They’ll put a sample of your blood into a special vial called a Westergren tube and see how long it takes your red blood cells to sink to the bottom.
Your provider will measure the rate of red blood cell sedimentation as a speed — millimeters per hour (mm/hr). It’s like a tiny version of your car’s speedometer measuring how fast you’re driving in miles or kilometers per hour.
A normal range for ESR depends on your age and sex assigned at birth:
| Age and sex assigned at birth | Normal ESR |
|---|---|
| Assigned male at birth (AMAB) younger than 50 | Less than 15 millimeters per hour (<15 mm/hr) |
| AMAB older than 50 | <20mm/hr |
| Assigned female at birth (AFAB) younger than 50 | <20mm/hr |
| AFAB older than 50 | <30mm/hr |
| Newborn babies | 0 to 2 mm/hr |
| Children who haven’t hit puberty yet | 3 to 13 mm/hr |
| Age and sex assigned at birth | |
| Assigned male at birth (AMAB) younger than 50 | |
| Normal ESR | |
| Less than 15 millimeters per hour (<15 mm/hr) | |
| AMAB older than 50 | |
| Normal ESR | |
| <20mm/hr | |
| Assigned female at birth (AFAB) younger than 50 | |
| Normal ESR | |
| <20mm/hr | |
| AFAB older than 50 | |
| Normal ESR | |
| <30mm/hr | |
| Newborn babies | |
| Normal ESR | |
| 0 to 2 mm/hr | |
| Children who haven’t hit puberty yet | |
| Normal ESR | |
| 3 to 13 mm/hr |
Typical ESR ranges can vary from person to person. Some testing labs have different standard ranges, too. Your provider will share your test results and help you understand them.
Having a higher than usual sed rate may mean there’s inflammation somewhere in your body. Your provider will talk to you about which other tests or treatments you’ll need if you have an unusually high sed rate.
People usually have a sed rate that’s lower than the thresholds listed above. But everyone’s body is different. Some people have a sed rate that’s naturally higher or lower than usual.
Having an elevated sed rate may mean there’s inflammation in your body. Your provider will monitor changes in your blood and body over time. They may do more ESR tests to see how your blood changes after you start treatment.
A sed rate test can’t diagnose any health conditions or infections. It only shows your provider if there might be inflammation in your body. Your provider will use the ESR test results as one piece of the puzzle to diagnose what’s causing any symptoms you’re experiencing.
Most providers do sed rate (ESR) tests using the Westergren method, where they put a sample of your blood in a special tube, and then measure how long it takes the red blood cells to sink to the bottom.
Other sed rate test techniques are collectively known as modified Westergren methods. Some use less of your blood, mix your blood with a sterile solution or use a centrifuge (an automatic machine that spins very fast to separate the parts of your blood) to get results faster. Which method your provider uses is usually up to their personal preference and which type of test they think will get the most accurate results.
Most providers still use the Westergren method because it has the longest, most successful track record for giving accurate results. Experts are still studying different test techniques to find ways to improve on ESR test speed and accuracy.
A sed rate test (erythrocyte sedimentation rate or ESR) can’t diagnose issues — it doesn’t confirm or rule out any conditions — but it’s a fast way for your provider to learn more about what might be causing the symptoms you’re experiencing. You might need another sed rate test in the future to see how your body is responding to treatment.
Some people are embarrassed to admit they don’t like needles or are afraid of seeing blood. Tell your provider or phlebotomist if you’re nervous. They’ll help you stay calm before, during and after your sed rate test.
Last reviewed by a Cleveland Clinic medical professional on 02/20/2024.
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