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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.

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Blood test

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How the Test is Performed

A blood sample is needed.

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 is the most common reason to check bilirubin level. The test will likely be ordered when:

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:

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:

Jaundice can also occur when more red blood cells than normal are broken down. This can be caused by:

The following liver problems may also cause jaundice or a high bilirubin level:

The following problems with gallbladder or bile ducts may cause higher bilirubin levels:

Related Information

Hemoglobin
Liver disease
Bile
Metabolism
Albumin - blood (serum) test
Sclera
Hemolytic disease of the newborn
Gilbert disease
Hemolytic anemia
Newborn jaundice
Sickle cell anemia
Transfusion reaction - hemolytic
Pernicious anemia
Bile duct obstruction
Cirrhosis
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Hepatitis
Biliary stricture
Cholangiocarcinoma
Cholangitis
Choledocholithiasis
Glucose-6-phosphate dehydrogenase deficiency
Loss of brain function - liver disease
Aplastic anemia
Immune hemolytic anemia
Wilson disease
Newborn jaundice - discharge

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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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.

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