bilirubin test

What is bilirubin? Bilirubin is a byproduct of our old, broken-down red blood cells. When the life cycle of our red blood cells comes to an end, they break down, pass through our bloodstream and reach the liver for processing. Your liver will sort bilirubin with other waste material fluid known as bile. The bile is then removed from your body through the intestine. Bilirubin is responsible for the yellow colour of stool. What do bilirubin levels in your blood indicate? A bilirubin test is usually done to check your liver health condition. This test is very comprehensive and reveals different liver products in your blood. In case the result shows some low or high values, it indicates the struggle of your liver in some manner. Although abnormal bilirubin level doesn’t always indicate any liver problem, you may have a problem somewhere else in your body. What causes high bilirubin levels (hyperbilirubinemia)? Bilirubin level may increase in your blood if: Suppose red blood cells break down in your body too fast. It indicates overproduction of bilirubin due to blood disorders like hemolytic anaemia, which destroys the red blood cells. Your liver is unable to handle the normal load of bilirubin. Your liver may be unable to handle the normal bilirubin levels toxic load, or you might have chronic liver disease, which has affected the liver functioning. Your biliary system is unable to clear the bile effectively. You might have blockages in your bile ducts or gallbladder, which causes bile to leak or back up in the bloodstream.       What causes low bilirubin levels (hyperbilirubinemia)? Because of certain medications, your normal bilirubin levels can be lower. Such medications include antibiotics, sleeping pills, birth control pills, seizure medications, etc. You don’t have to worry much in case of a low bilirubin level. What does bilirubin do in your body? Bilirubin is a waste product that comes from old red blood cells. Normally, it exits through the intestine. Even on its way out, it may provide some health benefits to your body. As per some studies, it may work as an antioxidant to protect you from cardiovascular diseases. However, too much bilirubin is harmful to your health, as it may build up in the body and can make you ill. It may irritate and make your skin itchy. What are high bilirubin symptoms? High bilirubin causes Jaundice, a disease which will make your skin look yellow and eyes white. Jaundice is the first indication which will indicate your healthcare provider to check your bilirubin level. High bilirubin levels will leak into your urine, thus giving it a dark yellow colour. In case of less amount of bilirubin in your stool, its colour will become lighter or it will appear to be of clay-colour. Bilirubin Blood Test Procedure In the bilirubin blood test, your healthcare provider takes the blood sample from your arm. You may need to restrict eating or drinking a few hours before the blood sample is taken. They insert a needle in your arm to draw out blood into a vial. You might get a pinching sensation during this process, but it will take only a few minutes to take the sample. Then the sample is sent to the lab for further testing. You will get the results later on. In case any newborn has Jaundice, the doctor will check their bilirubin level to ensure that it is not too high. Jaundice in newborns is common and doesn’t indicate any serious concern, but a high bilirubin level can be toxic to babies. The blood sample of a newborn is taken by pricking the heel through a sterile lancet. Direct vs. indirect bilirubin (or conjugated vs. unconjugated) The bilirubin that reaches your liver for processing is called unconjugated. That implies that bilirubin is not soluble in water. It binds with a protein in your blood called albumin and further reaches your liver. While processing, the liver unbinds the bilirubin from albumin and binds it with a sugar molecule, thus making it soluble. It allows bilirubin to mix with bile and make an exit through your intestine. The bilirubin which your liver processes is the ‘conjugated’ bilirubin. It is also known as direct bilirubin. Your healthcare provider can’t measure the unconjugated bilirubin directly. Hence, it is measured by subtracting the conjugated bilirubin through the overall bilirubin present in the blood. Below is the direct and indirect bilirubin normal range: Direct bilirubin: 0.0-0.3 mg/dl Indirect bilirubin: 0.2-0.8 mg/dl Unconjugated bilirubin can also be written as ‘indirect’ bilirubin in your test report. You might be wondering what is a dangerous level of bilirubin in adults. As such, there is no defined dangerous level of bilirubin, but usually above 1.2 mg/dl is considered a high level. At what level is bilirubin a concern? There are slightly different ranges of bilirubin in different labs. Usually, an average bilirubin normal range is between 0.2 and 1.3 mg/dl. This range is normal for both children and adults. In case you exceed this level, your healthcare provider may do a further diagnosis to know the reason behind the rise. This condition may indicate a problem that needs your attention. But usually, high bilirubin treatment is not required, and the bilirubin level can come to normal range by working on its causes. Normal bilirubin level in newborns is slightly different; it may range between 1.0 and 2.0 mg/dl. Usually, the high bilirubin level in newborns is predictable and self-limited. But still, the healthcare provider will monitor such conditions to ensure that the bilirubin level will not rise too much. Such a rise may indicate a serious condition. What level of bilirubin is dangerous? Your healthcare provider will recommend treatment for newborns in case the bilirubin level rises to 15mg/dl in 48 hours or reaches 20 mg/dl in 72 hours. Such a level rise indicates that unconjugated bilirubin has increased the amount of albumin to bind it. The unconjugated bilirubin can cross the blood-brain barrier and can be harmful to the developing brain of a child. It may also lead to brain damage. Such risk is not the same for adults. In adults, the brain is quite mature, and they have less possibility of such high bilirubin levels. In newborns, the production of bilirubin happens at a faster rate, and they conjugate very slowly. In adults, conjugated hyperbilirubinemia can happen because of any other cause, and such a condition can be dangerous for adults. What does it mean when your bilirubin is high? The high level of unconjugated bilirubin indicates that your body is breaking down red blood cells at a faster rate. Such condition indicates: Hemolytic disease Adverse reaction to blood transfusion Sickle cell disease The reason behind unconjugated bilirubin in newborn includes: Premature birth Reaction to substances in breast milk Blood type mismatch between baby and parents. If your body faces trouble in clearing bilirubin, then its level will increase. It may lead to biliary disease or gallstone disease. Your body will have a higher bilirubin count if your liver gets stressed due to some temporary condition like new medicine or a higher dose of alcohol. It can also be an indication of chronic liver diseases like: Infections like mononucleosis and viral hepatitis. A genetic condition which may have an impact on bilirubin metabolism. What is the treatment for high bilirubin in newborns? In newborn babies, phototherapy is used to reduce the bilirubin level. In this, the healthcare provider will put the baby under a lamp that emits blue-spectrum or fluorescent white light. This light converts the bilirubin into a soluble format so that the body can excrete it without conjugating it in the liver. This procedure avoids the deposition of unconjugated bilirubin in the newborn’s brain tissue. How do you lower your bilirubin levels? You can lower your bilirubin level if you manage to control the condition which is causing it to rise. Your healthcare provider will let you know the way you can cure this condition. Overall, it would help if you reduced the overall stress on your liver by avoiding the consumption of alcohol or medications like over-the-counter pills. Also, you must follow a healthy diet. What is a bilirubin urine test? Your doctor may recommend a bilirubin urine test as a comprehensive part of urinalysis. Through urinalysis, you can analyse your urine content. This test can be a part of your general health checkup. Your healthcare provider may also advise a bilirubin test if you have symptoms of Jaundice or dark-coloured urine. It is abnormal to have bilirubin in urine, but such a condition may arrive if you conjugate high bilirubin levels. Conclusion In the case of Jaundice, your healthcare provider will surely recommend a bilirubin test. You may experience jaundice symptoms when your bilirubin level becomes 2-3 times more than the bilirubin normal range. You will also notice dark-coloured urine in this range. In some cases, you might not have any high bilirubin symptoms. Through a bilirubin test, you can know the exact bilirubin range, and your doctor will work on it to narrow down the high bilirubin causes.    Book your slot and trust Metropolis Lab if you want to get a bilirubin test done. You can also book a home test and our qualified blood collection technician will reach you in no time. We are trusted by many and you can find our labs in various cities across India.

What is bilirubin? Bilirubin is a a yellow pigment produced during the breakdown of old red blood cells. It is a natural byproduct of body's recycling process. Bilirubin is carried in the bloodstream to the liver, where it is processed and eventually excreted from the body through bile. The presence of bilirubin is what gives bile its characteristic yellowish colour. In normal amounts, bilirubin is harmless. However, if there is an excess of bilirubin in the blood (high bilirubin), it can lead to a condition called jaundice, where the skin and whites of the eyes take on a yellowish tinge. Bilirubin exists in two forms in the body: Unconjugated (indirect) bilirubin: This is the form that circulates in the blood before being processed by the liver. Conjugated (direct) bilirubin: This is the form that has been processed by the liver and is ready for excretion. A bilirubin test measures the levels of both these types in the blood to determine if they are within the normal range. What is a Bilirubin Test? A bilirubin test is a blood test that measures the levels of bilirubin in your blood. It is often part of a broader liver function test panel. The test is used to evaluate liver health and function and to diagnose conditions related to the liver, gallbladder, and bile ducts. What Does a Bilirubin Test Detect? The bilirubin test specifically measures two types of bilirubin: Total bilirubin: This includes both unconjugated and conjugated bilirubin Direct bilirubin: This refers to the conjugated bilirubin that has been processed by the liver Elevated levels of either type can indicate different issues: High unconjugated bilirubin may indicate haemolytic anaemia (excessive breakdown of red blood cells) or Gilbert's syndrome (a harmless genetic condition). High conjugated bilirubin direct high means there is a problem with the liver or bile ducts, such as hepatitis, cirrhosis, or gallstones. Causes of high bilirubin levels (hyperbilirubinemia) Several conditions can cause high bilirubin levels, including: Liver diseases like hepatitis, cirrhosis, or liver cancer Blockage of the bile ducts due to gallstones, tumors, or other obstructions Haemolytic anaemia, where red blood cells are destroyed faster than they can be replaced Gilbert's syndrome, a harmless inherited condition that affects bilirubin processing Crigler-Najjar syndrome, a rare inherited disorder that affects bilirubin metabolism In newborns, jaundice is common due to immature liver function and is usually harmless. However, very high levels can lead to kernicterus, a type of brain damage. Causes of low bilirubin levels (hypobilirubinemia) Low bilirubin levels are less common and not usually a cause for concern. They may result from: Drinking too much water (overhydration) Malnutrition or protein deficiency Certain medications that speed up bilirubin processing What does bilirubin do in your body? Bilirubin plays a vital role in the body's waste management system. When old red blood cells are broken down, haemoglobin is released and converted into bilirubin. The liver then processes the bilirubin, making it water-soluble so it can be excreted in bile. Bilirubin also acts as an antioxidant, helping to protect cells from damage caused by free radicals. Research suggests it may play a role in preventing oxidative stress-related diseases. Symptoms of high bilirubin The most common symptom of high bilirubin is jaundice – a yellowing of the skin and whites of the eyes. Other symptoms may include: Dark urine Pale stools Itchy skin Fatigue Abdominal pain (if liver disease is the cause) Symptoms of low bilirubin Low bilirubin levels usually do not cause any noticeable symptoms. In rare cases, very low levels could indicate severe malnutrition or protein deficiency. What does it mean when your bilirubin is high? If your bilirubin test shows high bilirubin levels, it means there is an underlying issue causing bilirubin to build up in your blood. This could be due to increased production (e.g., haemolytic anaemia), decreased liver uptake or processing (e.g., Gilbert's syndrome, cirrhosis), or decreased excretion (e.g., blocked bile ducts). Your doctor will interpret the results in the context of your symptoms, medical history, and other test results to determine the cause and appropriate treatment. It's important to note that mildly high bilirubin levels are common and often harmless. For example, Gilbert's syndrome affects 3-7% of the population but does not usually require treatment. If my test results are abnormal, what happens next? If your bilirubin test results are outside the bilirubin normal range, your healthcare provider will likely recommend additional tests to pinpoint the cause. These may include a complete blood count to check for anaemia, liver function tests to assess liver health, hepatitis virus testing, imaging tests like ultrasound or CT scans to visualise the liver and bile ducts, or liver biopsies to check for inflammation, scarring, or other abnormalities. Treatment will depend on the underlying cause. For example: Gilbert's syndrome usually requires no treatment. Hepatitis may be managed with antiviral medications or supportive care. Gallstones may require surgical removal. Severe cirrhosis may necessitate a liver transplant in advanced cases. Your doctor will work with you to develop an appropriate management plan based on your specific diagnosis. What is the treatment for high bilirubin in newborns? Newborn jaundice is very common, affecting up to 60% of infants. In most cases, it resolves on its own as the baby's liver matures. However, high bilirubin levels can be dangerous for newborns, potentially causing kernicterus (brain damage) if left untreated. Treatment options include: Phototherapy: Exposing the baby's skin to special blue light helps break down bilirubin. The baby lies under the light, wearing only a diaper and protective eye shields. Exchange transfusion: In severe cases, the baby's blood may be gradually replaced with donor blood to quickly come down to the bilirubin normal range. This is rare and only done if phototherapy is ineffective. Intravenous immunoglobulin (IVIg): If the jaundice is due to blood type incompatibility between mother and baby, IVIg may be given to reduce antibody levels and prevent haemolysis. Frequent feeding (8-12 times per day) also helps by encouraging more bowel movements, which eliminates bilirubin. Most cases of newborn jaundice resolve within 1-2 weeks with proper treatment and monitoring. How do you lower your own bilirubin levels? If you have high bilirubin, the treatment will depend on the underlying cause. However, some general measures that may help reach the bilirubin normal range include: Staying hydrated: Drinking plenty of water helps flush bilirubin out of your system. Eating a balanced diet: Adequate protein intake supports liver function. Fruits, vegetables, and whole grains provide antioxidants and fibre. Limiting alcohol: Alcohol can damage the liver and make it harder to process bilirubin. Avoid alcohol if you have liver disease. Managing underlying conditions: If you have hepatitis, cirrhosis, or other liver problems, work with your doctor to keep them under control. Avoiding unnecessary medications: Some drugs can stress the liver or contribute to haemolysis. Talk to your doctor before taking new medications. Interpreting Your Test Results Type of Bilirubin Normal Range (mg/dL) High Level Indicates Low Level Indicates Total Bilirubin 0.3 to 1.2 (adults) Liver diseases (hepatitis, cirrhosis), bile duct obstruction, haemolytic anaemia, Gilbert's syndrome Usually not clinically significant Direct (Conjugated) 0 to 0.3 Liver cell damage, bile duct blockage Rare, usually not important Indirect (Unconjugated) Calculated (Total minus Direct) Increased breakdown of red blood cells, haemolysis, Gilbert's syndrome Not clinically significant Note: Normal ranges may vary slightly by laboratory and patient's age What happens during a bilirubin blood test? A bilirubin test is a simple blood test to measure the levels of bilirubin. A healthcare provider will clean the skin on your arm and insert a small needle into a vein, usually at the bend of the arm, to collect a blood sample. The blood will be drawn into a tube and sent to a laboratory for analysis. The test measures levels of total, direct, and indirect bilirubin in the blood. For newborns, a heel stick may be used instead of a vein puncture. The entire procedure takes only a few minutes, and you can resume normal activities immediately after the test. Composition and Ingredients of the Test The bilirubin test is a laboratory blood assay that measures the concentration of bilirubin pigments in your bloodstream. It does not involve injecting any substances into your body. Instead, it analyses the naturally occurring bilirubin in a small sample of your blood. The key components of the test include: Collection of a blood sample through venipuncture (using a needle to draw blood from a vein) Laboratory reagents that chemically react with bilirubin in the blood sample to measure its concentration Biochemical methods like spectrophotometry or diazo reaction to differentiate between direct (conjugated) and indirect (unconjugated) bilirubin. Benefits of the Bilirubin Test The bilirubin test offers several important benefits in evaluating your health: Assesses liver function: Bilirubin levels reflect how efficiently your liver is processing this waste product from red blood cell breakdown. High bilirubin can be an early sign of liver problems. Detects liver diseases: High bilirubin, especially direct bilirubin, may indicate liver conditions like hepatitis, cirrhosis, or blocked bile ducts. Early diagnosis allows prompt treatment. Diagnoses anaemia: High bilirubin, particularly indirect bilirubin, can reveal haemolytic anaemia caused by excessive red blood cell destruction. The test helps identify the underlying cause. Monitors newborn jaundice: Babies are routinely screened for high bilirubin to assess the severity of jaundice and guide treatment decisions to prevent rare but serious complications. Guides further testing: Abnormal bilirubin test results can prompt additional diagnostic tests to pinpoint the specific disorder involved, ensuring appropriate care. Risks and Side Effects of the Bilirubin Test The bilirubin blood test is considered a safe and low-risk procedure. As with any blood draw, there may be some minor side effects: Slight pain or stinging sensation when the needle is inserted into your vein, Minor bruising, bleeding, or soreness at the puncture site after the test Rarely, dizziness or fainting during the blood collection In very uncommon cases, infection at the needle site However, serious complications are extremely rare, and there are no significant risks associated with the bilirubin test itself. You don't need to modify your diet or lifestyle before or after the test. For newborns undergoing a heel stick, only very small blood quantities are taken, typically with minimal discomfort. The benefits of screening for neonatal jaundice far outweigh any minor side effects. If you have a fear of needles or a history of feeling faint during blood draws, let your healthcare provider know beforehand so they can take appropriate precautions. Overall, the bilirubin test is a routine, well-tolerated diagnostic tool posing negligible risks for most individuals. FAQs What is bilirubin's normal level? The normal bilirubin level usually ranges from 0.3 to 1.2 mg/dL for total bilirubin in adults. Direct (conjugated) bilirubin should be between 0 to 0.3 mg/dL, while indirect bilirubin is calculated by subtracting the direct level from the total. These ranges may vary slightly between laboratories and can differ based on age and gender. What foods cause high bilirubin? No specific food directly causes high bilirubin, but unhealthy dietary patterns can harm liver function. Excessive alcohol, high-fat junk foods, and low-fibre diets may contribute to liver problems that indirectly raise bilirubin. A diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats helps support liver health and can aid bilirubin processing. Is 22 bilirubin high? Yes, a bilirubin level of 22 mg/dL is dangerously high and indicates serious liver issues, bile duct blockage, or rapid red blood cell breakdown. Such high levels require immediate medical attention to prevent complications like brain damage, especially in newborns. Does drinking water lower bilirubin? Drinking water alone doesn't directly lower bilirubin but supports liver function by aiding detoxification and preventing dehydration. Which fruit is best to reduce bilirubin? Fruits like citrus, berries, guava, watermelon, tomatoes, and avocados support liver health with antioxidants and anti-inflammatory properties. Including these regularly in your diet can promote better bilirubin metabolism.