Total bilirubin – test, normal, slightly elevated and elevated

Testing total bilirubin is an important element of medical diagnostics, allowing the assessment of liver and hematopoietic system functions. In the article below, we will discuss what total bilirubin is, when it should be performed, how it is performed, what the norms are for different age groups, and how to interpret the results, especially in the case of elevated bilirubin.

What is total, indirect and direct bilirubin?

Bilirubin is a bile pigment that is produced as a result of the breakdown of hemoglobin – a substance contained in red blood cells, responsible for the transport of oxygen. There are three main forms of bilirubin: total, indirect (unconjugated), and direct (conjugated). Total bilirubin is the sum of indirect and direct bilirubin. Indirect bilirubin is the form of unbound bilirubin, while direct bilirubin is the converted form that is conjugated to glucuronic acid in the liver.

Total bilirubin – when should the test be performed?

A total bilirubin test is usually ordered to assess liver and hematopoietic function. It may be recommended in the following situations:

• Suspected liver diseases such as viral hepatitis, cirrhosis or alcoholic liver disease.
• Monitoring patients with already diagnosed liver diseases to assess the effectiveness of therapy.
• Diagnosis of jaundice – a condition in which the skin and mucous membranes become yellow.
• Diagnostics of hemolytic anemia – a disease characterized by premature destruction of red blood cells.
• Assessment of general health, especially in preventive examinations.

Total bilirubin – test procedure

Total bilirubin testing involves taking a blood sample from the patient. The sample is then analyzed in the laboratory, where the amount of bilirubin is measured. The result is expressed in micromoles per liter of blood (umol/L) or milligrams per deciliter (mg/dL). This test is a standard blood test, so it does not require any special preparation of the patient.

Total bilirubin – norms for children and adults

Total bilirubin levels may vary slightly from laboratory to laboratory, but generally accepted reference ranges are:

• In newborns: 1.5 – 12 mg/dL (25.65 – 205.2 umol/L).
• In children and adults: 0.2 – 1.0 mg/dL (3.42 – 17.1 umol/L).

These values may vary slightly from laboratory to laboratory, so always consider the reference ranges provided by specific medical facilities.

Total bilirubin test – interpretation of the result. what does increased bilirubin mean?

The total bilirubin test result may be elevated in various situations. Values above the reference range may indicate liver problems, excessive breakdown of red blood cells, or problems with the excretion of bilirubin. The most common cause of elevated bilirubin is inflammation of the liver, for example caused by viruses. Other causes may include cirrhosis, gallstones, or infections.

Which tests should be performed together with the bilirubin test?

It is usually worth performing additional tests to help your doctor understand the causes of elevated bilirubin. These tests may include:

• Liver enzyme tests such as AST and ALT.
• A blood count test to assess the number and appearance of red blood cells.
• Testing direct bilirubin levels to determine whether elevated total bilirubin is due to problems with the liver or biliary system.
• Imaging tests, such as ultrasound of the liver or biliary tract.

Total bilirubin – price/reimbursement, referral, your suggestions, recommended articles

The price of a total bilirubin test may vary depending on the medical facility and the region in which it is located. However, many blood tests are reimbursed by public health systems if they are ordered by a doctor for diagnostic purposes.

If the doctor deems this test necessary, he will send a referral to the appropriate laboratory. Remember that this test does not require special preparation, but it is worth following your doctor’s recommendations regarding the time in which it should be performed.

It is also worth seeking the opinion of specialists and other sources of medical information to better understand the test results and possible further steps in treatment or diagnosis.

Finally, we encourage you to read other health articles to expand your knowledge about diagnostic tests and diseases.