Summary
| Direction in Lyme Disease | ↕ Inconsistent — reported as both higher and lower across studies, with no consistent direction |
|---|---|
| Category | Inflammatory |
| Also described as | Non-specific inflammation |
| Compared against | HC (healthy controls) |
| Associated symptoms | Often normal in Lyme |
| Test type | Blood test (serum / plasma / whole blood) |
| Source | Lantos et al. 2021 — doi:10.1016/j.idc.2021.05.001 |
| Condition atlas | Lyme Disease Biomarker Atlas |
Other conditions where ESR is reported
- ESR in Inflammatory Bowel Disease (Crohn's/UC) — ↑ elevated vs active IBD vs quiescent/baseline disease
- ESR in Rheumatoid Arthritis — ↑ elevated vs RA disease activity marker vs healthy baseline
See the cross-condition hub: ESR across conditions.
Trials, interventions and tests
In clinical-trial registrations this marker maps to the outcome term Change in Laboratory Biomarkers - Erythrocyte sedimentation rate (5 registered trials use a matching outcome measure).
Clinical trials using ESR (erythrocyte sedimentation rate) as an outcome
- NCT06437223: Study of Xiflam™ Treatment in Patients Post COVID-19 Infection Suffering From What is Known as Long COVID (LC) (Completed)
Outcome measure: Secondary Endpoint - NCT07285707: Acupuncture and Chinese Herbal Medicine for Long COVID (Recruiting)
Outcome measure: Change in Laboratory Biomarkers - Erythrocyte sedimentation rate - NCT05877508: Anti-SARS-CoV-2 Monoclonal Antibodies for Long COVID (COVID-19) (Active Not Recruiting)
Outcome measure: Erythrocyte Sedimentation Rate (ESR) - NCT06065033: Exercise Interventions in Post-acute Sequelae of Covid-19 (Withdrawn)
Outcome measure: Erythrocyte sedimentation rate (ESR) - NCT01651754: Humoral and Cellular Immune Responses After Influenza Vaccination in Patients With Postcancer Fatigue and in Patients With Chronic Fatigue Syndrome (Completed)
Outcome measure: Humoral and cellular immune responses after influenza vaccination in patients with postcancer fatigue and in patients with chronic fatigue syndrome.
Interventions studied alongside this marker
Hypothesis-generating links from trial outcome usage and literature co-occurrence. Not treatment recommendations.
- Acupuncture — 1 trial, 6 PubMed co-citations
e.g. Immunomodulatory Effects of Acupuncture on Inflammatory Markers in Patients with Musculoskeletal Pain: A… - Exercise therapy — 1 trial, 6 PubMed co-citations
e.g. Enhancing spinal mobility and functional capacity through aerobic exercise and yoga in ankylosing…
Commercial test availability
ESR (Sed Rate) — commercial laboratory test.
Links are for reference only; availability, specimen requirements and coverage vary by location.
Related Inflammatory markers in Lyme Disease
- CCL19 ↑
- C-Reactive Protein (CRP) ↕
- Interferon-γ (IFN-γ) ↑
- Interleukin-10 (IL-10) ↑
- Interleukin-6 (IL-6) ↑
Full list: Lyme Disease Biomarker Atlas.
Frequently asked questions
Is ESR (erythrocyte sedimentation rate) high or low in Lyme Disease?
Mixed. Some studies report higher and others lower ESR (erythrocyte sedimentation rate) in Lyme Disease compared with healthy controls, so no single direction is established. Source: Lantos et al. 2021.
What symptoms is ESR (erythrocyte sedimentation rate) associated with in Lyme Disease?
The cited literature associates this marker with Often normal in Lyme. These are population-level associations and do not mean the marker causes the symptoms.
Which test measures ESR (erythrocyte sedimentation rate)?
It is measured as a blood test (serum / plasma / whole blood). Commercial laboratories such as Quest Diagnostics, LabCorp, Ulta Lab Tests list an orderable assay.
Is one abnormal ESR (erythrocyte sedimentation rate) result diagnostic of Lyme Disease?
No. No single biomarker is diagnostic of Lyme Disease. ESR (erythrocyte sedimentation rate) findings come from group comparisons, overlap considerably between patients and controls, and vary with study design, timing and comparison group. A result should be interpreted by a clinician alongside symptoms, history and other tests.
Is ESR (erythrocyte sedimentation rate) specific to Lyme Disease?
No. The same marker is also reported in Inflammatory Bowel Disease (Crohn's/UC), Rheumatoid Arthritis in this atlas, so it reflects shared biology (for example inflammation or vascular stress) rather than a condition-specific signature.
Cite this page
Subscribe on Substack
Last reviewed: 2026-06-29 · Page generated from lyme.json · Browse: Lyme Disease atlas · Biomarker Index · All marker pages
Disclaimer: This page is an educational synthesis of published, peer-reviewed research and is not medical advice. Biomarker findings vary across studies with case definitions, comparison groups, timing and assay methods. Direction of change reflects the predominant finding in the cited source and does not establish a diagnostic threshold. Discuss any test result with a qualified clinician.