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What Might Be the Reasons for a High ESR Level?

Dr Rishika Agarwal 26484 Views
Updated: 19 Jan 2024
Published: 25 Apr 2022
Reasons for a high ESR level

Erythrocyte Sedimentation Rate Test, known more popularly by its acronym ESR Test, is a test that is based on the rate of settling of RBCs (Red Blood Cells) - also known as erythrocytes, to the bottom of a test tube. This settling is called sedimentation, and is standardly measured in millimetres per hour (mm/h).

During an ESR test, when your blood is placed in a tall test tube, RBCs gradually settle to the bottom. Inflammation, however, can cause these cells to form clumps. And since these clumps are significantly thicker and denser than individual cells, they settle to the bottom more quickly, and this is accordingly reported in the ESR test results.

The primary objective of an ESR Test is to diagnose inflammation in the body. Abnormal ESR test results may arise from a number of different reasons, and that’s why when you book a blood test online, an ESR Test is often paired along for enhanced diagnostic accuracy.

Reasons why you might have a high ESR Level

An abnormally high level of ESR can be determined through ESR tests. If red blood cells fall significantly faster than expected, this may be due to their proteins sticking together (the clumps we mentioned earlier).

A number of conditions may cause a rise in ESR levels. It is highly likely that this is caused by conditions related to inflammation, though this is not always the case.

Some of the conditions that cause a significantly high ESR level include:

  1. Autoimmune conditions (Rheumatoid Arthritis, Lupus, etc.)
  2. Kidney and/or thyroid diseases
  3. Infections
  4. Tissue injury and/or trauma
  5. Anaemia
  6. Some classes of cancer

It is also a likely possibility for your ESR levels to be lower than normally expected, due to conditions like:

  1. Heart issues/likely failure
  2. Kidney and/or liver concerns
  3. RBC disorders
  4. Polycythemia
  5. Sickle cell anaemia
  6. Leukocytosis (Abnormal increase in WBC Cells)

A point worth noting is that ESR test results alone cannot diagnose any disease or medical condition. An ESR test must be used in conjunction with other tests whenever you book a blood test online or at a blood test lab near you, to detect and monitor health problems. An ESR test should also never be self-interpreted like any other test, and rather should be run by a doctor who can aptly explain its significance.

When should you get an ESR Test?

In times when you have an unexplained:

  1. Headache
  2. Fever
  3. Joint and/or muscle pain
  4. Loss of appetite
  5. Any other unclear symptom

You should immediately book a blood test online or at a blood test lab near you, and include an ESR Test as part of the comprehensive check.

Receiving test results

When you book a blood test online or at a blood test lab near you, including an ESR test in it, the test is usually performed within 2 hours after your blood sample is collected. The RBCs in the test tube are then monitored for 1 more hour as a standard procedure to determine the ESR level.

If multiple blood tests are being performed along with the ESR test, you may have to wait longer for all the results to be available and discuss them in detail and arrive at a clear conclusion with your doctor.


Because several health issues can cause an abnormal spike in your ESR levels that reflects in ESR tests, this alone cannot diagnose conditions.

However, being combined with other tests, an ESR test can help detect a wide range of health woes.

A periodic ESR test is furthermore recommended to observe the change in the patient’s inflammatory health conditions over time, once diagnosed. It also aids in assessing the patient’s response to given treatments and treatments planned for the future.

*All the info shared above is purely for educational purposes. For any kind of medical advice, we advise you to consult a doctor or visit your nearest diagnostic centre/hospital on an immediate basis.

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