Biomarkers · Inflammation
Erythrocyte Sedimentation Rate (ESR)
Lower values go with lower risk of death. No risk curve catalogued yet.
Published risk of death1.89×markedly elevated ESR (>50 mm/h) vs non-elevated (moderate band 20-50 mm/h gives HR 1.23… (95% CI 1.38–2.60) · Rotterdam Study (1990-2014), population-based, mean age 70.3 years, Netherlands
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in ESR, study by study
2 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Two intrathyroid steroid injections in patients with painful subacute thyroiditis unresponsive to NSAIDs | ESR fell by 66.34% at week 2 and 84.43% at week 4 (vs 51.92% and 74.94% with oral prednisone) | RCT | Forkert IO, et al. Wiadomosci lekarskie (Warsaw, Poland : 1960). 2021. PAINFUL… |
| diet | Fasting then vegan/lactovegetarian plant-predominant diet (rheumatoid arthritis) | Significant fall in ESR (and CRP) vs control diet in rheumatoid arthritis, sustained at one year (effect size not reported) | RCT | Kjeldsen-Kragh J, et al. Controlled trial of fasting and one-year vegetarian… |
| diet | Anti-inflammatory Mediterranean dietary protocol | Mediterranean and other plant-based diets improved ESR, CRP and DAS28 in RA patients (effect size not reported) | systematic review | Bostan ZZ, et al. Effect of Plant-Based Diets on Rheumatoid Arthritis: A… |
| exercise | Regular resistance exercise training (rheumatoid arthritis) | Reduced ESR vs control in RA (SMD -0.86, 95% CI -1.65 to -0.07; Seventeen RCTs) | meta-analysis | Wen Z, et al. Effectiveness of resistance exercises in the treatment of… |
| pharmacologic | Intra-articular glucocorticoid added to DMARDs in active early rheumatoid arthritis | ESR significantly reduced at 3 months vs DMARDs alone (ESR magnitude not reported) | RCT | Menon N, et al. Comparison of intra-articular glucocorticoid injections with… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Uncontrolled autoimmune flare or untreated chronic infectious foci | Extreme ESR elevation strongly associated with serious disease, most often infection, collagen vascular disease or metastatic malignancy (effect size not reported) | review | Brigden ML. Am Fam Physician. 1999;60:1443-1450. |
| clinical | Chronic kidney disease on renal replacement therapy (dialysis) | ESR elevated on average (mean 51.7 mm/h) in CKD/renal replacement inpatients; highest with peritoneal dialysis (78.3 mm/h) | cross-sectional | Buckenmayer A, et al. Erythrocyte Sedimentation Rate in Patients with Renal… |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Diseases and conditions
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ Diabetic foot infection requiring amputation · mean ESR in DFI patients who underwent amputation vs those who did not | SMD +0.5 | amputation vs no amputation, diabetic foot infection · Patients with diabetic foot infection, 25 articles (1873 amputations) | meta analysis · PMID 30953392 |
| ↑ Rheumatoid arthritis-associated interstitial lung disease · RA patients with ILD vs RA patients without ILD | +7.41 mm/hr (95% CI 2.21 to 12.61) | RA-ILD vs RA without ILD · 1887 RA-ILD vs 8066 RA without ILD, 22 articles | meta analysis · PMID 37352174 |