Bilirubin (Total)

If your liver is healthy, it will remove most of the bilirubin from your body through your bile ducts (the tubes that carry bile from your liver). If your liver is damaged or your bile ducts are blocked, bilirubin can leak out of your liver and into your blood. When too much bilirubin gets into the bloodstream, it can cause jaundice, a condition that causes your skin and eyes to turn yellow. If you have jaundice, your health care provider may order a bilirubin blood test to check for liver disease or damage. Bilirubin testing can also help diagnose and monitor blood-cell breakdown disorders and other metabolic conditions, in addition to liver and gallbladder problems.

Bilirubin is usually tested with a blood test but can also be tested in your urine.

The 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 also depend on your sex and whether the test is being done on an infant or child.

If the results are outside your lab's reference range, you may need further testing. High bilirubin levels may mean your liver isn't working right, that red blood cells are breaking down too quickly, or that bile flow out of the liver is blocked.

Your provider may also look at the split between direct (already processed by the liver) and indirect (not yet processed) bilirubin to figure out where the problem is. A higher indirect bilirubin tends to point to faster red blood cell breakdown or inherited conditions like Gilbert syndrome, while higher direct bilirubin tends to point to liver or bile-duct problems.

In newborns, doctors track total bilirubin closely, because very high levels can affect the brain. Most newborn jaundice clears up on its own in 1 to 2 weeks; some babies need treatment with light therapy.

Low bilirubin levels (hypobilirubinemia) are not usually a cause for concern but may be due to medicines such as antibiotics, birth control pills, sleeping pills, and seizure medicines.