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Bilirubin blood test
Total bilirubin - blood; Unconjugated bilirubin - blood; Indirect bilirubin - blood; Conjugated bilirubin - blood; Direct bilirubin - blood
The bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver.
Bilirubin can also be measured with a urine test .
Urine test
Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. This article is about a lab test to measure the amount of bilirubin in...
How the Test is Performed
A blood sample is needed.
Blood sample
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
How to Prepare for the Test
You should not eat or drink for at least 4 hours before the test. Your health care provider may instruct you to stop taking medicines that affect the test.
Many drugs may change the bilirubin level in your blood. Make sure your provider knows which medicines you are taking.
Why the Test is Performed
A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.
A high level of bilirubin in the blood can lead to jaundice . Jaundice is a yellow color in the skin, mucus membranes, or eyes.
Jaundice
Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jau...
Jaundice is the most common reason to check bilirubin level. The test will likely be ordered when:
- The provider is concerned about a newborn's jaundice (most newborns have some jaundice)
- Jaundice develops in older infants, children, and adults
A bilirubin test is also ordered when the provider suspects a person has liver or gallbladder problems.
Normal Results
It is normal to have some bilirubin in the blood. A normal level is:
- Direct (also called conjugated) bilirubin: 0 to 0.3 mg/dL
- Total bilirubin: 0.3 to 1.9 mg/dL
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
In newborns, bilirubin level is higher for the first few days of life. Your child's provider must consider the following when deciding whether your baby's bilirubin level is too high:
- How fast the level has been rising
- Whether the baby was born early
- The baby's age
Jaundice can also occur when more red blood cells than normal are broken down. This can be caused by:
-
A blood disorder called
erythroblastosis fetalis
Erythroblastosis fetalis
Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be life threatening. Normally, red...
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A red blood cell disorder called
hemolytic anemia
Hemolytic anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Normally, red ...
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Transfusion reaction
in which red blood cells that were given in a transfusion are destroyed by the person's immune system
Transfusion reaction
A hemolytic transfusion reaction is a serious complication that can occur after a blood transfusion. The reaction occurs when the red blood cells th...
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The following liver problems may also cause jaundice or a high bilirubin level:
-
Scarring of the liver (
cirrhosis
)
Cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
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Swollen and inflamed liver (
hepatitis
)
Hepatitis
Hepatitis is swelling and inflammation of the liver.
ImageRead Article Now Book Mark Article - Other liver disease
-
Disorder in which bilirubin is not processed normally by the liver (
Gilbert disease
)
Gilbert disease
Gilbert disease is a common disorder passed down through families. It affects the way bilirubin is processed by the liver, and causes the skin to ta...
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The following problems with gallbladder or bile ducts may cause higher bilirubin levels:
-
Abnormal narrowing of the common bile duct (
biliary stricture
)
Biliary stricture
A bile duct stricture is an abnormal narrowing of the common bile duct, the tube that moves bile from the liver to the small intestine. Bile is a su...
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Cancer of the pancreas
or gallbladder
Cancer of the pancreas
Pancreatic cancer is cancer that starts in the pancreas.
ImageRead Article Now Book Mark Article - Gallstones
References
Ives NK, Mieli-Vergani G, Hadzic N, Newell S, Sugarman I. Gastroenterology. In: Rennie JM, ed. Rennie and Robsertson's Textbook of Neonatology. 5th ed. Philadelphia, PA: Elsevier; 2012:chap 29.
Pratt DS. Liver chemistry and function tests. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.
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Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
-
Blood test - illustration
Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.
Blood test
illustration
Review Date: 2/8/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
