Have you been asked to do an ESR test? Don't worry, let's talk about this simply! (ESR - Erythrocyte Sedimentation Rate)

Let's say you go to see a doctor and he gives you a piece of paper asking you to take a blood test. When you see the word "ESR" written in large letters on it, you may feel a little scared and curious. You may think, "What kind of test is this? Do I have some serious illness?" But don't be scared at all. This ESR test is a very simple blood test that is often done, and it also provides very important information. Today, we will talk about this ESR test in a very simple way.

What is an ESR test simply?

The full name of ESR is Erythrocyte Sedimentation Rate . Now, don't be alarmed by all these big words. Let's break it down and understand.

• Erythrocyte (pronounced: erythrocyte) is the medical name for the red blood cells in our blood.
• Sedimentation Rate is the rate at which something sinks into a liquid and reaches the bottom.

So, simply put, the ESR test measures how quickly the red blood cells in a sample of your blood placed in a specially designed test tube settle to the bottom of the tube.

Think of it this way. If we put some water in a glass and add some sand to it, the grains of sand will gradually sink to the bottom of the glass. The same thing happens in the ESR test. But here, instead of sand, we have your red blood cells. How quickly these red blood cells sink to the bottom is measured over an hour. That speed is recorded in the report as your ESR value.

Why is the doctor asking you to do this ESR test?

Now you might be thinking, "What can we learn from measuring the speed at which red blood cells sink to the bottom?" Actually, this can give you a clue about something very important. That is, whether there is inflammation somewhere in your body.

What is "Inflammation"? Let's understand it simply. Imagine that you have a small wound on your hand. The wound is a little red, swollen, and feels hot. That's what inflammation is. That means your body's immune system, that is, the body's "army", is fighting the germs that are trying to enter through the wound. This fight is what causes the area to become red and swollen.

Similarly, inflammation can occur in organs inside the body for a variety of reasons. For example, it can be due to a bacterial infection, a viral infection, or another medical condition.

Your doctor uses this ESR test in conjunction with your symptoms to get a bigger picture. It can give you clues about conditions like the following:

• Infections: Various bacterial or viral infections in the body.
• Autoimmune diseases: This is when the body's own immune system attacks the body's own healthy cells. For example, diseases like rheumatoid arthritis and lupus.
• Inflammatory arthritis: Conditions that cause swelling and pain in the joints.
• Some types of cancer: Not all cancers, but some types of cancer can cause an elevated ESR.
• Blood disorders

How should I prepare for this test?

This is the best part. You don't need to do anything special for the ESR test.

• You don't have to fast for hours like other blood tests.
• You can eat and drink normally.
• If you have any medications you take daily, you can take them as usual.

However, it is very important to tell your doctor about the medications you are taking, as some medications can have a small effect on the ESR value.

What happens during the test?

This is just like any other blood test you would normally have.

A doctor, nurse, or lab technician will take a small amount of blood from a vein in your arm into a syringe. First, they will clean the area with something like alcohol. Then, as the needle is inserted into the vein, you may feel a slight electric shock. This will go away in a few seconds.

After the blood is drawn, you will be asked to place a small plaster or piece of cotton over the needle site and hold it in place. The area may be slightly bruised, blue, or slightly sore for a few hours. This is normal.

How to interpret the ESR report? (What are normal values?)

The value on your ESR report is recorded in mm/hr . That means "millimeters per hour." Just like the speed of a car is measured in "kilometers per hour."

Normal ESR values ​​vary depending on the age and gender of the person. But remember, these are just average values. There may be slight variations between laboratories. Therefore, only your doctor can give you the best explanation for your report.

Here is a table of generally accepted values.

What does a 'high' ESR mean? Should I be worried?

If your ESR is higher than normal, it means that there is inflammation somewhere in your body. When there is inflammation in the body, certain proteins in the blood increase. These proteins cause the red blood cells to stick together, form small clumps, gain weight, and sink quickly to the bottom of the test tube. This is why the ESR is high.

An elevated ESR does not necessarily mean that you have a serious illness. There are simple things that can cause it, as well as things that need attention.

Common causes of elevated ESR:

• Infections: Infections that occur anywhere in the body, such as pneumonia, appendicitis, and tuberculosis.
• Autoimmune diseases: Conditions like rheumatoid arthritis and lupus.
• Tissue injury: After a major injury or surgery.
• Some types of cancer: such as lymphoma or multiple myeloma. (Again, an elevated ESR does not necessarily mean cancer.)
• Other conditions: pregnancy, anemia (blood deficiency), aging, thyroid disease, kidney disease.

The doctor will come to a conclusion by comparing your ESR value with your symptoms (such as fever, body aches, weight loss), a physical examination, and other tests if necessary (such as CRP, Full Blood Count).

What if the ESR value is 'Low'?

A lower than normal ESR is usually not a problem. Healthy people usually have a low ESR. So there is no reason to worry about a low ESR.

However, very rarely, some specific medical conditions can cause an abnormally low ESR. For example, conditions such as polycythemia, a disease in which red blood cells are produced excessively, or sickle cell anemia. But these are very rare. If your doctor suspects this, he or she will perform the necessary tests.

What is the difference between the Westergren method and other methods?

Your report may mention the "Westergren method." This is the most widely used standard method for performing the ESR test worldwide. It involves placing blood in a special test tube, leaving it for an hour, and measuring the distance that the red blood cells settle.

In addition, there are methods called "Modified Westergren methods". Some require less blood, some use machines (centrifuges) and give results faster. But the Westergren method mentioned earlier is still the most trusted and used. It doesn't matter to you which method your laboratory uses. What matters is the result you get and how the doctor interprets it.