Bile Acids
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Detects early hepatic dysfunction, even before other liver tests elevate
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🧪 What is the Bile Acids Test?
The Bile Acids test measures the concentration of bile acids in the blood, typically serum or plasma. Bile acids are produced by the liver and help digest and absorb dietary fats and fat-soluble vitamins in the intestine.
- In healthy individuals, bile acids are efficiently recirculated via the enterohepatic circulation.
- Elevated levels may indicate liver dysfunction or intrahepatic cholestasis (especially during pregnancy).
❓ Why is the Test Done?
To:
- Evaluate liver function, particularly bile production and flow
- Diagnose Intrahepatic Cholestasis of Pregnancy (ICP)
- Assess cholestatic liver diseases
- Investigate itching (pruritus) during pregnancy
- Monitor bile acid metabolism disorders
📊 Normal Range
Population | Normal Range (Fasting, Total Bile Acids) |
|---|---|
Non-pregnant adults | <10 μmol/L |
Pregnancy (3rd trimester) | <11 μmol/L |
ICP suspicion threshold | >19 μmol/L (moderate risk), >40 μmol/L (severe risk to fetus) |
Units: µmol/L (micromoles per liter)
📈 Interpretation of Results
Bile Acid Level | Interpretation |
|---|---|
<10 μmol/L | Normal liver and bile acid metabolism |
10–19 μmol/L | Borderline – may require repeat test or further evaluation |
>19 μmol/L | Suggestive of Intrahepatic Cholestasis of Pregnancy (ICP) or other cholestasis |
>40 μmol/L | Severe ICP; higher fetal risk (stillbirth, preterm labor) |
Persistently elevated | Indicates cholestatic liver disease (e.g., PBC, PSC) |
🧠 Associated Organs & Conditions
Organ | Conditions |
|---|---|
Liver | - Intrahepatic Cholestasis of Pregnancy (ICP) |
Gallbladder/Bile Ducts | Bile duct obstruction, cholangitis |
Intestine | Bile acid malabsorption, ileal resection |
🔄 Related / Follow-Up Tests
- Liver Function Tests (LFTs) – ALT, AST, ALP, bilirubin
- Total and Direct Bilirubin – Cholestasis marker
- Serum Albumin and PT/INR – Liver synthetic function
- Ultrasound of the Liver and Biliary Tree
- Bile Acid Profile (fractionated) – For detailed bile acid types
- Genetic testing (in inherited bile acid disorders)
✅ Fasting Required?
Test | Fasting Requirement |
|---|---|
Serum Bile Acids | ✅ Yes – 10–12 hours fasting recommended to avoid post-meal elevation |
📝 Summary Table
Parameter | Details |
|---|---|
What | Measures bile acid levels in the blood |
Why | Assess liver function, diagnose cholestasis, especially in pregnancy |
Normal Range | <10 μmol/L (non-pregnant); <11 μmol/L (pregnancy) |
High Values | Suggest ICP or liver/biliary disease |
Follow-up Tests | LFTs, bilirubin, ultrasound, bile acid profile |
Associated Conditions | ICP, hepatitis, cholestasis, PBC, PSC |
Fasting Required | ✅ Yes, 10–12 hours recommended |
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