test Details

Hepatitis, cirrhosis of the liver, neonatal jaundice, hemolytic anaemia, erythroblastosis foetalis, cancer of the liver

The serum bilirubin test measures the bilirubin levels in the blood sample.

Bilirubin is a yellow pigment, processed in the liver. It is formed as a result of red blood cell breakdown. Old and abnormal red blood cells undergo destruction in the liver. In this normal process, bilirubin is liberated into the bile juice. This bilirubin then travels through bile ducts into the intestine. Your body requires bile juice for fat digestion.

After fat digestion, the liver excretes bilirubin with the stool and the digestive waste. Bilirubin gives your stool and urine a yellow colour. Bilirubin is present in two forms:

• Conjugated/ direct bilirubin
• Unconjugated/indirect bilirubin

Both of these together form total bilirubin.

A healthy liver will remove most of the Bilirubin from the body. In conditions with liver dysfunction, bilirubin leaks out and enters blood circulation. Jaundice is a condition that results due to excess bilirubin in the bloodstream.

Excess Bilirubin in blood gives yellow tinge colour to skin and eyes. Signs of jaundice along with bilirubin values help the doctor detect liver abnormalities. Bilirubin is used for the diagnosis of liver functioning. Bilirubin is used for the diagnosis of neonatal jaundice in newborn babies.

In India, one in five people gets affected by liver diseases. Each year, over 10 lakh patients with liver cirrhosis get diagnosed in the country.

Other Names of Bilirubin Test

• Total serum bilirubin
• TSB
• Serum bilirubin
• Total bilirubin - blood
• Unconjugated bilirubin - blood
• Indirect bilirubin - blood
• Conjugated bilirubin - blood
• Direct bilirubin - blood
• Jaundice - bilirubin blood test
• Hyperbilirubinemia - bilirubin blood test

What Does the Bilirubin Test Detect/Measure? Who is the Bilirubin Test Prescribed To?

The Bilirubin test measures levels of bilirubin in the blood sample.

A bilirubin test is prescribed for:

• People with symptoms of anaemia
• People with symptoms of hepatic inflammation
• Those with a history of recurrent gallstones
• Those who have had exposure to the hepatitis virus
• Those who have symptoms of jaundice
• Those who have Structural blockage of bile ducts
• Assessment of the severity of drug toxicity
• Suspected cases of transfusion reactions
• People with a history of alcohol consumption
• Routine screening of newborns
• Monitoring hepatitis treatment
• Prognosis of cirrhosis treatment
• Assessing treatment of jaundice

Bilirubin is prescribed in people with symptoms of high bilirubin such as:

• Dark urine
• Stomach pain
• Yellow skin discolouration
• Yellow discolouration of eyes
• Decreased appetite
• Fatigue
• Itchy skin
• abdominal swelling
• Chills
• Fever
• Lightheadedness
• Nausea
• Bilious vomiting

Some disease conditions in which physician advises bilirubin test are

• Gilbert syndrome
• Cirrhosis of liver
• Hepatitis
• Gallbladder cancer
• Pancreatic cancer
• Cholelithiasis
• Choledocholithiasis

Haemolytic anaemia is another condition in which a bilirubin test is essential. Haemolytic anaemia could be due to autoimmune diseases, genetic defects and infection.

What are the symptoms of high bilirubin?

High bilirubin values in a person can show the following symptoms

• Dark urine
• Yellow skin and eyes
• Abdominal pain
• Loss of appetite
• Fever
• Chills

How can I lower my bilirubin fast?

Treating underlying diseases with appropriate medications can lower bilirubin values.

Along with the medicines, following the appropriate diet could help in lowering bilirubin fast. Some of the tips are

• Keep yourself hydrated.
• Add milk thistle to your diet.
• Consume food rich in digestive enzymes like papaya, and mango.
• Eat more vegetables and fruits.
• Consume a nutrient-dense diet like oats, almonds etc.

Bilirubin's normal range in different age groups is

The usual range of total and direct bilirubin is

The indirect bilirubin standard range value gets calculated by deducting the direct bilirubin value from the total bilirubin value.

The laboratories use different methods for testing samples. Therefore, the results of bilirubin charts can slightly vary in various laboratories. In addition, males tend to have higher bilirubin values than females.

Increased bilirubin values indicate some problem with liver or blood function.

In infants (moderately high)

In the first few hours of birth, bilirubin values will be in a normal range. But after 24 hours, bilirubin levels rise due to immature liver.

In infants (extreme high)

Bilirubin range abnormally high in children could be due to

• Sickle cell anaemia
• Mismatch blood between mother and baby
• Genetic protein defects
• Bruising in the delivery process
• Inherited infection
• Premature newborn
• Erythroblastosis foetalis

In adults

High levels of direct bilirubin indicate the liver is not able to eliminate bilirubin. Therefore, there could be a problem with liver function.

High levels of indirect bilirubin indicate the liver is processing bilirubin. Therefore, there could be either a blood disorder or obstruction in bile transfer.

High levels of total bilirubin indicate excessive bilirubin circulating in the blood.

It indicates either a liver disorder or blood disorder or disorders with bilirubin elimination.

An abnormal bilirubin result doesn't always mean a serious medical condition. Some factors, such as medications like allopurinol, anabolic steroids, antimalarials, some antibiotics, diuretics, methyldopa, MAO inhibitors, and some food substances like alcohol, beef, pork, and body exercises, cause bilirubin range elevation.

For appropriate interpretation of bilirubin results consult the concerned physician.

Some diseases where bilirubin results are spiked up are

• Hepatitis
• Cirrhosis of liver
• Jaundice
• Diseases of gallbladder
• Gallstones
• Drug toxicity
• Transfusion reactions
• Haemolytic anaemia

The bilirubin procedure is not painful. A simple blood sample is sufficient for bilirubin detection.

Bilirubin Test Preparation

The bilirubin procedure requires preparation before you take the test. The healthcare provider will ask you not to eat or drink anything except for water for at least four hours before the test.

The doctor might also advise you to stop taking some medications before sample collection. Talking to a doctor is always essential to get appropriate instructions.

Bilirubin inclusions: What are the Parameters Included?

There are three parameters included in the bilirubin test

• Direct/conjugated bilirubin
• Indirect/unconjugated bilirubin
• Total bilirubin

A comprehensive blood test for bilirubin evaluation will yield accurate values of all three parameters in the sample.

How Frequently Should You Take the Bilirubin Test?

The Bilirubin procedure is repeated based on the symptoms and as per the advice of the doctor. For this reason, the Bilirubin test is usually repeated based on the prognosis of liver diseases.

The doctor will advise repetition to

• Monitor an existing liver disease or disorder.
• Assess the treatment for liver diseases.
• Measure liver health status.

The doctor might advise repetition of the bilirubin chart in

• Infants as a routine precaution.
• Infants with too high bilirubin at birth.
• Infants to monitor jaundice.

Based on your condition, your doctor will repeat the bilirubin test as follows:

• Liver/pancreas/bile duct/gallbladder disease - Repeat every 3-6 months for prognosis.
• Haemolytic anaemia - Repeat every month along with CBC test.
• Liver disease due to chemotherapy or alcohol - Repeat every 3-6 months for prognosis.
• Neonatal jaundice - Repeat every 2-3 days.