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Testing total bilirubin is a key element in the diagnosis of the liver and biliary system. Bilirubin values can provide important information about the functioning of these important organs. In this article, we will discuss what total bilirubin is, what the norms are for children and adults, how to interpret the test result and when it is worth ordering this test. Also find out what other tests may be useful in combination with bilirubin testing, how much this test costs and whether it can be reimbursed.
What is total, indirect and direct bilirubin?
Bilirubin is a bile pigment produced by the breakdown of hemoglobin, a protein contained in red blood cells. There are three forms of bilirubin: total bilirubin, indirect (unconjugated) bilirubin, and direct (conjugated) bilirubin.
– Total bilirubin is the sum of indirect and direct bilirubin. This is the main value we measure during the study.
– Indirect bilirubin is a form that is not bound to any other compound in the body. It is a product of the breakdown of hemoglobin.
– Direct bilirubin is a transformation of indirect bilirubin in the liver. It is the bile acid-bound form that is excreted from the body in bile.
Total bilirubin – when should the test be performed?
Total bilirubin testing may be recommended in a variety of situations:
– If you have symptoms of liver disease such as jaundice, abdominal pain, loss of appetite.
– If you suspect problems with the biliary system, e.g. gallstones.
– When monitoring patients with liver disease such as cirrhosis or viral hepatitis.
– When assessing the effects of certain medications that may affect liver function.
– For routine preventive examinations, especially in people at increased risk of liver disease, such as alcoholics or overweight people.
Total bilirubin – test procedure
Total bilirubin testing involves collecting the patient’s blood. The blood sample is then analyzed in a laboratory. The result is expressed in micromoles per liter of blood (µmol/l) or milligrams per deciliter of blood (mg/dl).
Total bilirubin – norms for children and adults
Total bilirubin levels may vary slightly depending on the laboratory that performs the test, but the following ranges are generally accepted:
– For infants: 1.7 – 20.5 mg/dl (29 – 350 µmol/l)
– For children and adults: 0.3 – 1.2 mg/dl (5 – 21 µmol/l)
It is worth noting that the norms may vary depending on the age and gender of the patient.
Total bilirubin test – interpretation of the result. what does increased bilirubin mean?
Elevated total bilirubin may indicate various health problems:
– An increase in total bilirubin may be caused by liver damage, which may result from liver disease, alcoholism or the use of certain medications.
– Gallstones or biliary system problems can also affect bilirubin levels.
– An increase in bilirubin may be associated with viral infections such as viral hepatitis.
– Sometimes elevated bilirubin can be the result of hemolysis – the breakdown of red blood cells.
It is worth emphasizing that the interpretation of the total bilirubin result requires consultation with a doctor who will take the result into account in the context of other tests and clinical symptoms.
Which tests should be performed together with the bilirubin test?
To more accurately assess the functioning of the liver and biliary system, your doctor may recommend additional tests, such as:
– Testing for liver enzymes such as ALT (alanine aminotransferase) and AST (aspartate aminotransferase).
– Indirect and direct bilirubin testing to determine which form of bilirubin is elevated.
– Gamma-glutamyltransferase (GGTP) test, which may be a marker of liver damage.
– Ultrasound examination of the liver and biliary tract to assess possible structural changes.
The choice of specific tests depends on the clinical situation and the doctor’s suspicions.
Total bilirubin – price/reimbursement, referral
The price of a total bilirubin test may vary depending on the laboratory and region. In Poland, the cost of such a test usually ranges from PLN 20 to PLN 50. In some cases, based on a referral from a doctor, bilirubin testing may be reimbursed by the National Health Fund.
A referral for a bilirubin test can be obtained from a family doctor, internist, gastroenterologist or hepatologist, depending on the patient’s situation.
Your suggestions
If you have any suspicions about the functioning of your liver or biliary system, consult your doctor immediately. He will decide whether it is necessary to test total bilirubin and possibly other liver markers. Remember that early diagnosis can help identify and treat possible health problems more quickly.
Recommended articles
If you want to learn more about the health of your liver and biliary system, we recommend reading articles about viral hepatitis, cirrhosis and gallstones.
It is also worth remembering about regular check-ups and maintaining a healthy lifestyle, which has a beneficial effect on the functioning of the liver and biliary system.