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ESR measures how quickly your red blood cells settle in a tube. A high value can point to inflammation, a low value to, for example, a blood condition.[1]
On this page you can read what ESR is, what the guidelines say about a value that is too low or too high, what affects your value and which other values are best looked at alongside it.
Also known as: sedimentation rate, blood sedimentation, ESR, Westergren sedimentation. At the lab: BSG1.
ESR shows how quickly your red blood cells settle to the bottom of a tube. This blood test can show whether there is inflammation in your body. Inflammation is your immune system's response to many different conditions, such as conditions of the immune system and of the blood.[1]
The lab puts a small amount of your blood in a tall, narrow tube. Then it measures how quickly the red blood cells settle to the bottom. Normally they settle slowly, but with inflammation they stick together in clumps. Those clumps are heavier than single cells, so they settle faster.[1]
A faster ESR can point to more inflammation in your body. ESR on its own does not show which condition is causing the inflammation. Normal values vary by age and sex. So a doctor looks at your result together with your symptoms and your other results.[1]
A doctor may order an ESR test if you have symptoms that could fit with inflammation. Think of headaches, a fever with no clear cause, pain in your neck or shoulders, a poor appetite or anaemia.[1]
ESR is used together with other tests to detect conditions that involve inflammation. A doctor can also follow the value over time to see how an existing condition is developing.[1]
A normal ESR does not rule out inflammation. You can have a condition with inflammation and still get a normal result. That is why a doctor often orders other tests too, such as CRP.[1]
Labplusarts, the lab BioProfile works with, uses a reference range of 0 to 20 mm/h for ESR. The lab calls a value within these limits normal.[2]
| Result | What it can mean | Who it is for |
|---|---|---|
| Higher than normal: the red blood cells settle faster[1] | Can point to a condition that causes inflammation | Everyone; what is normal varies by age and sex |
| Normal[1] | Inflammation is not ruled out: a condition involving inflammation can also give a normal result | Everyone; what is normal varies by age and sex |
| Lower than normal: the red blood cells settle more slowly[1] | Can point to a condition of the blood, the heart, the kidneys or the liver | Everyone; what is normal varies by age and sex |
Source: MedlinePlus, U.S. National Library of Medicine. A general explanation of the ESR test without fixed cut-off values; what is normal varies by age and sex.[1]
With a low ESR, your red blood cells settle more slowly than normal. This can point to a blood condition, such as too many red blood cells making your blood thicker, or a very high number of white blood cells. A heart condition or certain kidney and liver problems can also play a part.[1]
With a high ESR, your red blood cells settle faster than normal. This can point to a condition that causes inflammation, for example of the blood vessels, the joints, the bowel, the kidneys, the heart or the immune system. An abnormal result does not always mean you have a condition that needs care.[1]
BioProfile is working on its own zones for each value, from risk to optimal. A doctor reviews those zones before they appear in your result.
Getting older, being severely overweight and your menstrual cycle can affect your result.[1]
Being pregnant can affect your ESR. Tell your doctor if you are pregnant.[1]
Drinking alcohol regularly and exercise can affect your result.[1]
Certain medicines and supplements can also affect your result. So tell your doctor which medicines or supplements you take. You don't need to fast for the ESR itself, but you sometimes do for other tests on the same blood sample.[1]
ESR is included in BioProfile 77, 87, 121 and 150.[3]
The BioProfile editorial team wrote this page on 10 October 2026 from the sources below, which we read on 10 October 2026. Every number on this page appears in one of those sources, with that source's number next to it. An expert has yet to check this page; after that check, the expert's name and the date of the check will appear at the top. This page offers explanation, not a diagnosis. Discuss a value outside the range with your GP.
