Bilirubin Total
Unit Test
Report in 16Hrs
At Home
No Fasting Required
Details
Breakdown product of hemoglobin; elevated in liver disease or hemolysis, causing jaundice.
₹49₹130
62% OFF
Bilirubin Total - Comprehensive Medical Test Information Guide
- Bilirubin Total
- Why is it done?
- Measures the total concentration of bilirubin in the blood, which is a yellowish pigment produced when hemoglobin from dead red blood cells is broken down by the liver
- Evaluates liver function and detects potential liver disease, including cirrhosis, hepatitis, and fatty liver disease
- Diagnoses hemolytic anemia and other conditions causing excessive red blood cell destruction
- Identifies bile duct obstruction or blockage in the gallbladder or pancreas
- Investigates jaundice, characterized by yellowing of the skin and whites of the eyes
- Monitors patients with known liver disease or those taking hepatotoxic medications
- Part of routine health screenings and comprehensive metabolic panels during annual physical examinations
- Normal Range
- Adult Normal Range: 0.3 to 1.2 mg/dL (milligrams per deciliter) or 5.1 to 20.5 μmol/L (micromoles per liter)
- Newborn Normal Range: Up to 20 mg/dL within the first 24-48 hours of life, decreasing to less than 2 mg/dL by one week (varies by age and risk factors)
- Interpretation - Normal Result: Indicates normal liver function, proper red blood cell turnover, and absence of significant bile duct obstruction. The liver is effectively processing and excreting bilirubin.
- Interpretation - Elevated (High) Result: Above 1.2 mg/dL may indicate liver disease, hemolysis, bile duct obstruction, or other metabolic disorders. Levels above 2.5 mg/dL often cause visible jaundice.
- Units of Measurement: mg/dL (most commonly used in North America) or μmol/L (international units)
- Reference Range Variations: Ranges may vary slightly between laboratories due to differences in equipment and calibration. Always compare results to the specific lab's reference range.
- Interpretation
- Mildly Elevated (1.2-3.0 mg/dL): May suggest mild liver dysfunction, early stages of hemolytic anemia, or minor bile duct issues. Further evaluation recommended.
- Moderately Elevated (3.0-10.0 mg/dL): Suggests significant liver disease, substantial hemolysis, or considerable bile duct obstruction. Jaundice typically visible. Immediate medical attention warranted.
- Severely Elevated (>10.0 mg/dL): Indicates severe liver disease (cirrhosis, acute hepatitis, fulminant hepatic failure), complete bile duct obstruction, or severe hemolytic anemia. Emergency evaluation necessary.
- Factors Affecting Results - Medical: Liver disease severity, hemolysis rate, bile duct patency, kidney function, pregnancy status, and age of patient
- Factors Affecting Results - Medications: Acetaminophen, antibiotics, anabolic steroids, oral contraceptives, and certain antifungal agents can elevate bilirubin levels
- Factors Affecting Results - Lifestyle: Alcohol consumption, diet, fasting state, and recent blood transfusions can influence results
- Total Bilirubin Composition: Total bilirubin consists of unconjugated (indirect) and conjugated (direct) bilirubin. If total is elevated, separate testing for direct vs indirect helps identify whether the problem is in bilirubin production or excretion.
- Clinical Significance of Patterns: Rapidly rising bilirubin suggests acute liver injury; gradually rising suggests chronic disease. Persistent elevation indicates ongoing pathology requiring intervention.
- Associated Organs
- Primary Organs Involved: Liver (primary site of bilirubin metabolism and conjugation), gallbladder (storage and bile release), pancreas (bile duct involvement), and bone marrow (red blood cell production)
- Hepatic (Liver) Diseases: Acute viral hepatitis, alcoholic hepatitis, cirrhosis, fatty liver disease (NAFLD), autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, and hepatic fibrosis
- Biliary System Diseases: Gallstones (choledocholithiasis), bile duct strictures, pancreatic cancer causing bile duct compression, cholecystitis, and cholangitis
- Hemolytic Disorders: Hemolytic anemia, sickle cell disease, thalassemia, hereditary spherocytosis, G6PD deficiency, autoimmune hemolytic anemia, and transfusion reactions
- Genetic/Metabolic Disorders: Gilbert syndrome (benign, familial unconjugated hyperbilirubinemia), Crigler-Najjar syndrome, Dubin-Johnson syndrome, Rotor syndrome, and Wilson disease
- Infectious Diseases: Hepatitis A, B, and C, Epstein-Barr virus (EBV), cytomegalovirus (CMV), malaria, tuberculosis, and sepsis
- Potential Complications of Abnormal Results: Bilirubin encephalopathy (kernicterus in newborns), hepatic encephalopathy, acute liver failure, portal hypertension, variceal bleeding, ascites, renal failure, hepatorenal syndrome, and coagulopathy
- Chronic Risks: Progression to cirrhosis, increased infection risk, malnutrition, hepatic cancer development, and need for liver transplantation
- Follow-up Tests
- Fractionated Bilirubin Panel: Direct (conjugated) and indirect (unconjugated) bilirubin to determine the site and nature of the problem (prehepatic, hepatic, or posthepatic)
- Liver Function Tests (LFTs): Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and albumin to assess overall liver function and pattern of injury
- Viral Hepatitis Serologies: Hepatitis A (HAV), B (HBsAg, HBsAb, HBcAb), and C (HCV antibody, RNA) to rule out viral infections
- Complete Blood Count (CBC): To assess for anemia, hemolysis markers, and reticulocyte count to evaluate red blood cell production and destruction rates
- Lactate Dehydrogenase (LDH) and Haptoglobin: To confirm hemolysis (elevated LDH, low haptoglobin) as the cause of elevated bilirubin
- Coagulation Studies (PT/INR): To assess synthetic liver function and prognosis, particularly important in elevated bilirubin cases
- Abdominal Imaging: Ultrasound (initial imaging of choice), CT, or MRI/MRCP to visualize liver structure, bile ducts, and evaluate for obstruction, stones, or masses
- Liver Biopsy: May be needed to diagnose specific liver diseases, assess fibrosis severity, and determine treatment options in chronic liver disease
- Autoimmune Markers: Antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), anti-mitochondrial antibody (AMA) if autoimmune liver disease suspected
- Genetic Testing: For Gilbert syndrome confirmation or Wilson disease (ceruloplasmin, copper studies) when genetic causes suspected
- Monitoring Frequency: Acute liver injury: repeat testing daily to every few days until trend established. Chronic disease: monthly to every 3 months depending on stability. Established cirrhosis: quarterly to annually.
- Fasting Required?
- Fasting Requirement: NO - Fasting is not required for total bilirubin testing. The test can be performed regardless of meal status.
- Specimen Collection: A simple blood draw from a vein in the arm. Typically collected in a serum separator tube (SST) or plasma tube depending on lab preference.
- Specimen Handling: Protect from prolonged exposure to sunlight as bilirubin is light-sensitive and can degrade, leading to falsely low results.
- Medications to Avoid: Medications don't typically need to be held for bilirubin testing. However, inform healthcare provider of medications that may affect results (acetaminophen, antibiotics, oral contraceptives, anabolic steroids, antifungals).
- Special Instructions: No specific preparation needed. Inform phlebotomist about medications, supplements, and recent alcohol consumption. Patients may eat and drink normally.
- Newborn Screening: In newborns, bilirubin may be measured via transcutaneous bilirubinometry (non-invasive skin measurement) or heel stick blood test as part of routine screening within 24-48 hours of birth.
- Timing Considerations: Test results may be available within hours to one business day, depending on laboratory processing times and whether it's a routine or stat (emergency) order.
- Why is it done?
How our test process works!
