What is Sedimentation? What is Sedimentation Altitude?

by Abbas Jahangir · June 24, 2024

Sedimentation refers to the rate at which erythrocytes, which are red blood cells, settle to the bottom of the blood sample taken from the person and in the tube. In various diseases that typically follow an inflammatory course, red blood cells tend to collapse more rapidly.

What is Sedimentation Test?

After inflammation occurs in any part of the body, in addition to clinical findings such as pain, fever, regional redness, edema and tenderness, there are also various laboratory parameters used to define this condition. Although the blood test called erythrocyte sedimentation rate (ESR) is not specific to any health problem, it can be useful in detecting or monitoring inflammation in the body when interpreted together with various other parameters.

Erythrocyte sedimentation rate (ESR), known as blood sedimentation test, is a frequently used hematological test and is an important marker that can be increased in conditions such as autoimmune diseases, infectious diseases or tumors and allows monitoring of inflammatory activity in the body. With the sedimentation test, a general state of inflammation in the body can be detected and an idea can be obtained about its degree. However, this examination does not help to reveal the main factor causing this situation, so the sedimentation test is a parameter rarely used alone.

After applying to health institutions, if you have symptoms of various diseases such as arthritis (joint inflammation) or inflammatory bowel diseases, physicians may refer you to a sedimentation test.

There are many signs and symptoms that are considered to be related to inflammation:

Stiffness or pain in joints that lasts longer than half an hour in the morning
Headache accompanying shoulder pain
abnormal weight loss
Pain in the shoulder, neck and groin area
Digestive system complaints such as diarrhea, blood in the stool, or unusual abdominal pain

In individuals with such symptoms, a small blood sample is taken for sedimentation analysis. In this procedure, which takes approximately 1-2 minutes, the vein area to be intervened in is cleaned, and then the needle is entered into this vein. After taking a blood sample, bleeding is stopped by applying pressure to the attempted area with a cotton ball or similar material. After this process, the blood sample taken is sent to the laboratory and placed in a long, thin tube and observed at room temperature for 60 minutes. During this one-hour observation, medical personnel in the laboratory determine the rate at which red blood cells settle to the bottom and how much of them settle to the bottom.

What is Sedimentation Altitude?

The increase in inflammatory activity that occurs during infectious diseases, in autoimmune diseases where the immune system produces antibodies against its own tissues and cells, or in diseases such as cancer, results in an increase in the level of various proteins in the blood. This increase in protein causes red blood cells to clump together and tend to collapse at a faster rate. The image formed as a result of red blood cells coming together and collapsing in this way is called “roll formation”. Red blood cells in roll formation form a denser mass than separate cells and therefore move faster towards the bottom of the tube.

Sedimentation height is expressed as this hourly sedimentation degree being above the normal limits determined by age and gender.

How Much Should Sedimentation Be?

These limit values, determined as sedimentation in millimeters per hour, which answer the question of what the sedimentation value should be, are as follows:

0-20 mm/hour for women under 50
0-15 mm/hour for men under 50
0-30 mm/hour for women over 50
0-20 mm/hour for men over 50
The normal value of sedimentation in the childhood age group is 0-10 mm/hour.

Low sedimentation is a condition generally accepted as normal. However, caution should be exercised as a low level in this parameter may indicate conditions such as sickle cell anemia, congestive heart failure or fibrinogen deficiency.

If the values obtained after the examination are above these limits, it may indicate an inflammatory condition in the person. High detected values alone do not have diagnostic value for any disease. At the same time, in certain situations, various problems may arise regarding the significance and reliability of test results. Advanced age, use of various medications, pregnancy, anemia, kidney problems and thyroid diseases are among the conditions that may affect the results of the sedimentation test.

In addition to these factors, evaluation of sedimentation should be done within 2 hours at the latest after taking the blood sample. More time may cause the red blood cells to become spherical in shape, facilitating the formation of roll formation and causing the results to be higher than normal.

Why Does Sedimentation Increase?

Under normal conditions, the outer part of red blood cells is electrically negatively charged and they cannot come together by applying repulsive force to each other. The increased amount of protein in the bloodstream due to various diseases neutralizes the electrical forces on the outside of these cells, facilitating their coming together and may lead to increased sedimentation.

The underlying cause of high sedimentation values may be malignant diseases such as cancer, autoimmune disorders or various infectious conditions. It is important to exclude cancerous tumor formations, especially in people who do not have other signs and symptoms of inflammation in any part of the body despite high sedimentation values.

Disorders that occur when immune system cells produce antibodies against their own cells for various reasons and cause damage to these structures are defined as autoimmune diseases. There are many autoimmune diseases that can cause higher than normal sedimentation results:

Systemic lupus erythematosus
Rheumatic diseases such as rheumatoid arthritis
Waldenström macroglobulinemia
Temporal arteritis, which refers to inflammation of the vessels in the temples
Polymyalgia rheumatica with muscle and joint pain
Hyperfibrinogenemia, which refers to the increase in the bloodstream of fibrinogen protein, which is involved in clotting.
Allergic or necrotizing vasculitis

In addition to cancer and autoimmune diseases, various infectious diseases are among the causes of high sedimentation:

bone infections
Heart infections such as myocarditis, which affects the heart muscle, pericarditis, which affects the outer tissue of the heart, or endocarditis, which affects the inner layer and valves.
Rheumatic fever following bacterial infections
skin infections
Systemic infections
Tuberculosis

Sedimentation value may exceed 100 millimeters per hour in some severe diseases. Multiple myeloma, which is a cancer of plasma cells, Waldenström macroglobulinemia, which is a rare white blood cell cancer, temporal arteritis and polymyalgia are among the diseases in which ESR test values can be detected above 100 mm/hour.

How to Reduce Sedimentation?

People with abnormal sedimentation values may not always have an underlying health problem, so there is no need for treatment for high sedimentation levels in these people. Depending on the results obtained, physicians may request further examinations or repeat the test to clarify the underlying condition.

Once physicians identify a health problem that may be associated with a high sedimentation value, a treatment plan is made for this cause and the sedimentation value can be reduced to normal limits again. In cases of inflammation due to autoimmune diseases, physicians can control the existing inflammation with nonsteroidal anti-inflammatory drugs or corticosteroid treatments, while high sedimentation due to bacterial infection can be reduced with antibiotic treatment.

Although sedimentation values outside normal limits are not considered an overly worrying result, caution should be exercised due to the various health problems it may indicate. If you detect signs and symptoms of inflammation or infection in your body, it is recommended that you contact healthcare institutions and get support from specialist physicians.