Personal
Professional
Research
Personal Professional Research Sign Up Login Pro Login
Research Bilirubin Total
Comprehensive Metabolic Panel (CMP)

Bilirubin Total

Optimal Result: 0 - 1.2 mg/dL, or 0.00 - 20.52 µmol/L.

What is Bilirubin

Bilirubin is a yellowish substance. Bilirubin is made in the body when the hemoglobin protein in old red blood cells is broken down. The breakdown of old cells is a normal, healthy process. Bilirubin is found in bile, a fluid your liver makes that helps you digest food. Bilirubin is stored in the gallbladder and is involved in digesting food. Most bilirubin is eliminated in the feces or urine. Elevated bilirubin levels may indicate certain diseases. It is responsible for the yellow color of bruises and the yellow discoloration in jaundice. Its subsequent breakdown products, such as stercobilin, cause the brown color of feces. A different breakdown product, urobilin, is the main component of the straw-yellow color in urine. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, 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. Signs of jaundice, along with a bilirubin blood test, can help your health care provider find out if you have liver disease.

What is the bilirubin test used for?

The bilirubin test checks the health of your liver by measuring the amount of bilirubin in your blood or urine. This can help diagnose or monitor problems related to your liver or red blood cells when the bilirubin level is too high. After circulating in your blood, bilirubin then travels to your liver. In the liver, bilirubin is processed, mixed into bile, and then excreted into the bile ducts and stored in your gallbladder. Eventually, the bile is released into the small intestine to help digest fats. It’s ultimately excreted within your stool. Bilirubin attached by the liver to glucuronic acid, a glucose-derived acid, is called direct, or conjugated, bilirubin. Bilirubin not attached to glucuronic acid is called indirect, or unconjugated, bilirubin. All the bilirubin in your blood together is called total bilirubin. A comprehensive bilirubin blood test will get an accurate count of all three bilirubin levels in your blood: direct, indirect, and total. 

Testing for bilirubin in the blood is a good way of testing for liver damage. Sometimes bilirubin is measured as part of a “panel” of tests. Often, the liver is evaluated with a group of tests that also include:

- Alanine transaminase

- Aspartate aminotransferase

- Alkaline phosphatase

- Albumin

- Total protein

What do bilirubin results mean?

Your test results will also include reference ranges, the normal range of bilirubin levels. Results that fall outside the reference range, especially those above the upper normal level, may indicate the presence of disease or a need for further testing.

In an older child or adult, normal values of direct bilirubin are from 0–0.4 milligrams per deciliter (mg/dL).

Normal values of total bilirubin are from 0 - 1.2 mg/dL.

Normal results can vary, but high bilirubin levels may mean your liver isn't working right. However, abnormal results don't always mean you have a medical condition that needs treatment. Other things may cause higher than normal bilirubin levels, such as certain medicines and foods or strenuous exercise.

References:

Kalakonda A, Jenkins BA, John S. Physiology, Bilirubin. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470290/

Joseph A, Samant H. Jaundice. [Updated 2023 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544252/

Fevery J. Bilirubin in clinical practice: a review. Liver Int. 2008 May;28(5):592-605. doi: 10.1111/j.1478-3231.2008.01716.x. PMID: 18433389.

Maisels MJ, Conrad S. Transcutaneous bilirubin measurements in full-term infants. Pediatrics. 1982 Sep;70(3):464-7. PMID: 7110821.

American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297-316. doi: 10.1542/peds.114.1.297. Erratum in: Pediatrics. 2004 Oct;114(4):1138. PMID: 15231951.

What does it mean if your Bilirubin Total result is too high?

When your body has too much bilirubin, your skin and the whites of your eyes will start to yellow. This condition is called jaundice. In both adults and children, symptoms related to high bilirubin can involve jaundice, a yellowing of the skin or eyes, fatigue, itchy skin, dark urine, and low appetite. Another reason for high bilirubin levels could be that more red blood cells are being destroyed than normal. This is called hemolysis.

High bilirubin levels are usually a sign that something is not working as expected in your liver or gallbladder. Some of these conditions aren’t too serious, but it’s important to monitor and treat them.

Anyone with jaundice, which is the main sign of high bilirubin levels, should contact their doctor. If your doctor isn’t immediately sure what’s causing your high bilirubin levels, you may need to return for additional blood, liver function, or other tests.

Causes of abnormal results:

Your doctor may want to perform further blood tests or an ultrasound if high levels of bilirubin are detected in your blood. In an adult, high bilirubin may be due to problems with the liver, bile ducts, or gallbladder. Examples include:

- Liver diseases, like hepatitis

- Gilbert’s syndrome, a genetic disease

- Cirrhosis, which is scarring of the liver

- Biliary stricture, where part of the bile duct is too narrow to allow fluid to pass

- Cancer of the gallbladder or pancreas

- Gallstones

- Drug toxicity

High bilirubin may also be due to problems in the blood instead of problems in the liver.

Blood cells breaking down too fast can be caused by:

Hemolytic anemia: This occurs when too many blood cells are being destroyed from an autoimmune disease, genetic defect, drug toxicity, or infection, and the liver is unable to metabolize the amount of indirect bilirubin in the body.

Transfusion reaction: This occurs when your immune system attacks blood that was given to you through a transfusion.

Infant jaundice: In an infant, high (usually indirect) bilirubin and jaundice can be very dangerous and may be caused by several factors. There are three common types:

Physiological jaundice: at two to four days after birth, caused by a brief delay in the functioning of the liver and usually not serious 

Breastfeeding jaundice: during the first week of life, caused by a baby not nursing well or low milk supply in the mother

Breast milk jaundice: after two to three weeks of life, caused by the processing of some substances in breast milk

→ All of these can be easily treated and are usually harmless if treated. 

Some more serious conditions that cause high bilirubin and jaundice in an infant include:

- abnormal blood cell shapes, such as sickle cell anemia

- blood-type mismatch between infant and mother, leading to severe breakdown of the baby’s red blood cells, called erythroblastosis fetalis

- lack of certain important proteins due to genetic defects

- bruising due to a difficult delivery

- high levels of red blood cells due to small size, prematurity

- infections

Additional note: Infants commonly have higher bilirubin levels in the blood after birth as their livers continue to develop. As such, bilirubin testing is standard for all infants in their first 48 hours and is also often performed as a precautionary measure to monitor the change in these levels. If you are concerned about your baby’s bilirubin levels or if they are showing signs of jaundice, it is important to talk with your pediatrician.

More on Jaundice:

Elevated bilirubin levels (>2.5-3 mg/dL) cause jaundice and can be classified into different anatomical sites of pathology: 

- prehepatic (increased bilirubin production), 

- hepatic (liver dysfunction), 

- or posthepatic (duct obstruction).

Another way of approaching hyperbilirubinemia is to divide it into two general categories: 

- unconjugated hyperbilirubinemia and 

- conjugated hyperbilirubinemia. 

The prevalence of hyperbilirubinemia varies depending on the cause:

Conjugated hyperbilirubinemia is common in individuals with hepatocellular injuries and biliary obstruction and is also common in persons with sepsis. Some of the inherited diseases associated with conjugated hyperbilirubinemia are estimated to affect 4%-13% of the US population, while Dubin-Johnson syndrome (DJS) is rare except in Iranian Jews, in whom the prevalence is about 1 in 1300.

Unconjugated hyperbilirubinemia is common in newborns and is likely related to a higher hematocrit (50%-60%) with increased cell turnover (the average lifespan of a red cell is about 85 days in the neonate) combined with decreased uridine diphosphoglucuronic glucuronosyltransferase (UGT) activity. One study found that up to 6.1% of neonates had unconjugated bilirubin levels higher than 12.9 mg/dL. Breastfeeding was more common in neonates with higher levels of unconjugated hyperbilirubin.

How can high bilirubin be treated?

In adults, treatment for high bilirubin levels depends on the underlying cause. Treatment can include approaches such as stopping the use of a toxic drug, surgery, or long-term therapy.

These are a few treatment approaches:

- If high bilirubin levels are caused by drugs, a change of medication can resolve the effects.

- In cases of obstructive hyperbilirubinemia, surgery (usually laparoscopic) may be needed to remove gallstones or other sources of obstruction.

- Severe liver or pancreatic diseases would require the care of a qualified hepatologist, with treatment options ranging from drug therapies to organ transplants.

- Sometimes, hyperbilirubinemia may not require specific treatment. For example, symptoms of acute viral hepatitis typically go away on their own as the infection resolves. The same applies to Gilbert's syndrome, which is not considered harmful and does not require treatment.

If you are experiencing any symptoms of liver impairment, speak with your healthcare provider before taking any medications.

While there are no home treatments that bring bilirubin levels down, you can avoid placing additional stress on the liver by cutting out alcohol, red meat, processed foods, and refined sugar.

What does it mean if your Bilirubin Total result is too low?

A low level of total bilirubin in the blood is not a cause for concern. There are some medicines/supplements (like vitamin C) that can cause bilirubin levels to drop, but there are no detrimental effects associated with this. 

Frequently asked questions

Healthmatters is a highly-personalized health dashboard.

Instead of searching for your lab results in different places or tracking them down from different providers, Healthmatters houses, organizes, and interprets them all in one central location.

With a Healthmatters account, you can dive into the details of each biomarker and gain insights into the meaning behind your medical test data, anytime, anywhere.

For our professional users, Healthmatters provides intuitive tools that not only streamline analysis but also save valuable time when delving into your client's lab report history.

Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:

  • The GI Effects® Comprehensive Stool Profile,
  • GI-MAP,
  • The NutrEval FMV®,
  • The ION Profile,
  • Amino Acids Profile,
  • Dried Urine Test for Comprehensive Hormones (DUTCH),
  • Organic Acids Test,
  • Organix Comprehensive Profile,
  • Toxic Metals,
  • Complete Blood Count (CBC),
  • Metabolic panel,
  • Thyroid panel,
  • Lipid Panel,
  • Urinalysis,
  • And many, many more.

You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.

If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.

While we work with many popular labs, we welcome reports from lots of other places too.

It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.

If you’re on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.

There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."

Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.

For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.

We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.

Our special data entry service makes it easy to add your results to your private dashboard. Just attach an image or a file of your lab test results, and our skilled data entry team will do the work for you. It's all done by humans, ensuring that your data is entered accurately and with personal care for each client.

Depending on your account, the data entry service can be included for free or come at an additional cost of $15 per report.

For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.

Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.

Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.

The Unlimited plan is a one-time purchase for $250, and it covers your account for a lifetime with no additional payments.

For the Complete plan, the cost is $15 per month. You have the flexibility to cancel it anytime through your account settings, ensuring no further payments. To avoid charges, remember to cancel at least a day before the renewal date. Once canceled, the subscription remains active until the end of the current billing cycle.

Additionally, you can upgrade to the yearly Advanced plan from within your account. The annual cost is $79, and it comes with a data entry service for five reports.

You can always upgrade to a lifetime version with a prorated price from a monthly or yearly subscription.

Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.

Our goal has been to make your Healthmatters account as intuitive as possible.

We’ve crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.

1. Graph View:

Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.

2. All Tests View

Explore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.

3. Table View:

For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.

Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.

Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.

Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.

Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.

A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.

The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.

To learn more about Healthmatters Pro, please refer to the professional page.

Use promo code to save 10% off any plan.


We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.

Navigate to Comprehensive Metabolic Panel (CMP)

Popular search

Adjusted Calcium, Alanine-aminotransferase (ALT, SGPT), Albumin, Serum, Albumin/Globulin (A/G) Ratio, Alkaline Phosphatase (ALP), Aspartate-aminotransferase (AST, SGOT), Bilirubin Total, Blood urea nitrogen (BUN), Bone Isoenzymes, BUN/Creatinine Ratio, Calcium, Serum, Carbon Dioxide (CO2), CHLORIDE, RANDOM URINE, Chloride, Serum, CHLORIDE/CREAT RATIO, Creatine Clearance, Creatinine, Serum, eGFR - Estimated Glomerular Filtration Rate (African Am), eGFR - Estimated Glomerular Filtration Rate (Non-African Am), eGFR / Cystatin C, Fibrosis-4 (FIB-4), Globulin, Serum (aka Globulin, Total), Glucose, Glucose Non-Fasting, Intestinal Isoenzymes (Alkaline Phosphatase), Liver Isoenzymes, Macrohepatic Isoenzymes, Placental Isoenzymes, POTASSIUM, RANDOM URINE, Potassium, Serum (Kalium), POTASSIUM/CREAT RATIO, SODIUM, RANDOM URINE, Sodium, Serum (Natrium), SODIUM/CREAT RATIO, Total Protein, Serum, Urea