Erythrocyte Sedimentation Rate
Inflammation marker
ESR
Erythrocyte Sedimentation Rate
Non-specific marker of inflammation that measures how quickly red blood cells settle in a tube. Elevated in infection, autoimmune conditions, and chronic inflammation. Slower to rise and fall than CRP.
PED Notes
Complementary to CRP — ESR rises more slowly but stays elevated longer, making it useful for detecting chronic/ongoing inflammation. AAS-induced polycythemia (high RBC/haematocrit) can actually lower ESR because more packed red cells settle slower. If ESR is elevated despite high haematocrit, it suggests significant inflammation. Not typically a primary monitoring marker for PED users, but useful alongside CRP for a complete inflammatory picture.
When high
When elevated (>15 mm/hr) -- chronic inflammation:
Supplements (anti-inflammatory stack):
- Omega-3 (EPA/DHA) -- 2-3g/day (with fat-containing meals), reduces systemic inflammation
- Curcumin (Turmeric Extract) -- 500-1000mg/day with black pepper (piperine) for absorption
- Quercetin -- 500mg 2x/day, anti-inflammatory and antioxidant
- Boswellia -- 300-500mg 2x/day, particularly effective for joint and musculoskeletal inflammation
Lifestyle:
- Ensure rest-day blood draw (intense training transiently elevates inflammatory markers)
- Improve sleep quality (7-9h) -- poor sleep is pro-inflammatory
- Reduce processed foods and sugar
- Address chronic stress
Interpretation notes:
- ESR is complementary to CRP: CRP rises and falls quickly (acute), ESR rises slowly and stays elevated longer (chronic)
- If ESR is elevated but CRP is normal, consider chronic low-grade inflammation or autoimmune conditions
- AAS-induced polycythemia can falsely lower ESR -- an elevated ESR in a polycythemic athlete is especially significant
History Chart
Reading History
Frequently Asked Questions
Reference Ranges
Standard Range