Hi Erythrocyte sedimentation rate (ESR) is a blood test that measures how quickly erythrocytes, or red blood cells, separate from a blood sample that has been treated so the blood will not clot. During this test, a small amount of your blood will be placed in an upright tube and a laboratory specialist will measure the rate at which your red blood cells settle toward the bottom of the tube after one hour If you have a condition that causes inflammation or cell damage, your red blood cells tend to clump together, which makes them heavier, so they settle faster. The faster your red blood cells settle and fall, the higher your ESR. A high ESR tells your doctor that you may have an active disease process in your body The causes for High ESR are TB Rheumatoid Arhtritis Blood disease Heart disease Kidney disease Suggest to repeat the test in a recognized centre and confirm Wish You Good Health Regards Dr Sridhar K