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Low ESR rate in a blood test

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Low ESR rate in a blood test
Last update: 27/04/2021

What is a low ESR called?

  • ESR low

What is the normal rate of ESR in a blood test?

If you need to know which are the ESR reference rates or you require more information about ESR in a blood test, you can visit normal ESR rate in a blood test

What does a low ESR in a blood test mean?

The ESR (Erythrocyte Sedimentation Rate) rate measures the speed with which RBCs settle in a tube of anticoagulated blood.

A low ESR rate is usually not clinically significant. In many labs, rates very low or near zero are considered to be in the normal range.

However, a very low rate may suggest a RBC (Red Blood Cell) disorder related to an increase in RBC number (polycythemia vera) or changes in RBC shape (sickle cell disease, spherocytosis, etc.).

Furthermore, a decrease in ESR may be a positive sign in treatment against inflammatory diseases such as rheumatoid arthritis.

  • Mild ESR decrease (< 2 mm/h in adults under 50 years old, < 3 mm/h in adults over 50 years old):

    ESR rate is low, but it is not usually a matter for concern. It is advisable to check the RBC count and hemoglobin values because they can help in the diagnosis of RBC disorders.

    It may be due to spherocytosis (red blood cells that are spherical instead of biconcave), sickle cell disease (sickle-shaped red blood cells), or acantocytosis (red blood cells with a spiked cell membrane).

    Rates near zero are typical of polycythemia vera (a high number of red blood cells in the blood).

Which factors can reduce the ESR?

There are some circumstances and drugs than can reduce your ESR:

  • Tobacco
  • Drugs
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Penicillamine
    • Antibiotics
      • Trimethoprim
    • High dose aspirin therapy (more than 3 g/day)
    • Corticosteroids
      • Cortisone
    • Steroids
    • Glucocorticoids
      • Adrenocorticotropic hormone
    • Quinine

Which diseases can reduce your ESR?

A lower than normal ESR can be due to:

  • Polycythemia vera
  • Sickle cell disease
  • Hyperviscosity syndrome
  • Hereditary spherocytosis
  • Heart failure
  • Abetalipoproteinemia
  • Acanthocytosis
  • Congenital hypofibrinogenemia

What can I do to increase the ESR rate in a blood test?

It is not convenient to increase ESR rate. If the ESR is very low is necessary to look for the underlying causes, but not try to raise the rate.

To have a low ESR does not cause any symptom and it is not a sign of disease on its own.

Where can I find more information about the ESR in a blood test?

You can visit our pages about:

Which values are considered a low ESR rate in a blood test?

The following rates are considered to be above the normal range:

IMPORTANT: These rates are expressed in mm/h (millimeter/hour). They are an example of a healthy man of about 40 years old with no known disease and not taking any medication. The rates can be different depending on the laboratory or on your personal circumstances.

ESR
Mild ESR decrease
1.9 mm/h1.8 mm/h1.7 mm/h1.6 mm/h1.5 mm/h1.4 mm/h1.3 mm/h1.2 mm/h
1.1 mm/h1 mm/h0.9 mm/h0.8 mm/h0.7 mm/h0.6 mm/h0.5 mm/h0.4 mm/h
0.3 mm/h0.2 mm/h0.1 mm/h0 mm/h    
Medically reviewed by our Medical staff on 27/04/2021

Bibliography

  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 220.
  • Hemograma. Manual de interpretación. Renato Failace. 5ª Edición. Editorial médica Panamericana 2011 ISBN: 978-85-363-2556-9.
  • A Manual of Laboratory and Diagnostic Test. 9th edition. Frances Fischbach. Marshall B. Dunning III. 2014. Pag 106. ISBN-10: 1451190891.
  • Laboratory tests and diagnostic procedures with nursing diagnoses (8th ed), Jane Vincent Corbett, Angela Denise Banks, ISBN: 978-0-13-237332-6, Pag. 45.

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