bilirubin-blood-test
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Also called: Total serum bilirubin, TSB, Total bilirubin, TBIL, Neonatal bilirubin, Direct bilirubin (conjugated bilirubin, conjugated bilirubin is direct bilirubin per source text; note: source lists direct bilirubin, conjugated bilirubin, indirect bilirubin, unconjugated bilirubin as other names but does not define them separately; they are included as aliases per source listing.)
A bilirubin blood test measures the level of bilirubin in your blood. Bilirubin is a yellowish substance made when your body breaks down old red blood cells. The test is used to check liver health, find the cause of jaundice, monitor treatment, and help diagnose newborn jaundice.
Specimen: blood
Why this test may be ordered
- If you have symptoms such as jaundice (yellow skin or eyes), dark urine, clay-colored stool, or stomach pain.
- To find out if there is a blockage in your bile ducts.
- To monitor an existing liver disease.
- To diagnose disorders related to your body breaking down red blood cells too quickly, such as hemolytic anemia.
Preparation and collection
Your provider may tell you to fast (not eat or drink) for several hours before the test. You may need to stop taking certain medicines; tell your provider about everything you take, but do not stop any medicine unless your provider tells you to.
A health care professional will take a blood sample from a vein in your arm using a small needle. For newborns, a heel stick test is done: the heel is cleaned with alcohol, poked with a small needle, and a few drops of blood are collected.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Understanding results
Results will show if the amount of bilirubin in your blood is in the normal range. Normal ranges can vary from lab to lab and may depend on your sex and whether the test is done on an infant or child. If your results are outside the lab's reference range, you may need further testing. Talk with your provider to learn what your results mean.
- Normal bilirubin level: Your liver is likely working properly. Normal results can vary based on the lab, your sex, and if the test is being done on an infant or child. Limitation: Normal results do not rule out all liver conditions. Your provider will interpret results in the context of your overall health. Next step: No further action is typically needed, but your provider may recommend other tests if symptoms persist.
- High bilirubin level (hyperbilirubinemia): May indicate your liver isn't working right. Possible causes include hemolytic anemia, liver disease, or a blockage in your bile ducts. High levels can also be caused by some medicines, certain foods, or strenuous exercise. Abnormal results don't always mean you have a medical condition that needs treatment. Limitation: This test alone cannot diagnose the specific cause. Further testing is needed. Next step: Your provider may order additional tests such as liver function tests, liver protein tests, urine tests, an ultrasound, or a liver biopsy.
- Low bilirubin level (hypobilirubinemia): Low levels are not usually a cause for concern but may be due to medicines such as antibiotics, birth control pills, sleeping pills, and seizure medicines. Limitation: Low levels are generally not considered a medical problem, but your provider will interpret results based on your situation. Next step: No specific follow-up is typically needed unless your provider identifies an underlying issue.
- Normal ranges can vary from lab to lab and may depend on your sex and whether the test is done on an infant or child.
- Abnormal results don't always mean you have a medical condition that needs treatment.
- Higher-than-normal bilirubin levels can also be caused by some medicines, certain foods, or strenuous exercise.
- A bilirubin blood test is only one measure of your liver health; other tests may be needed.
What to do next
To learn what your results mean, talk with your provider. If your provider thinks you might have a liver disease or a red blood cell disorder, you may need other tests such as liver function tests, liver protein tests, urine tests, an ultrasound, or a liver biopsy.
- What do my bilirubin levels mean for my liver health?
- Do I need any additional tests based on my results?
- Should I be concerned about jaundice or other symptoms I am having?