Other names: Bilirubin (total), Bilirubin Total, BILIRUBIN, TOTAL, TOTAL BILIRUBIN
Bilirubin is a yellow pigment produced when your body breaks down old red blood cells (from hemoglobin). The liver processes bilirubin and sends it into bile, which is stored in the gallbladder and released into the intestine to help digest fats. Most bilirubin leaves the body through stool (which gives it a brown color), while a smaller amount is excreted in urine (giving it a yellow tint).
If the liver isn’t functioning properly—or if bile flow is blocked—bilirubin can build up in the blood and cause jaundice, a yellowing of the skin and eyes.
A bilirubin test measures how much bilirubin is in your blood to help assess liver function and red blood cell turnover. Labs typically report:
Total bilirubin: The sum of direct and indirect bilirubin.
Direct (conjugated) bilirubin: Processed by the liver; water-soluble.
Indirect (unconjugated) bilirubin: Not yet processed by the liver.
Total bilirubin is often part of a Comprehensive Metabolic Panel (CMP) or Hepatic Function Panel, along with ALT, AST, ALP, albumin, and total protein.
Your clinician may order a bilirubin test to:
Evaluate jaundice, dark urine, or pale stools
Monitor liver or bile duct conditions (e.g., hepatitis, cholestasis)
Check for hemolysis (increased red blood cell breakdown)
Review medication-related liver effects
Follow up on abnormal liver enzyme results
Reference ranges vary by lab and age. Typical adult values:
Total bilirubin: 0.2–1.2 mg/dL (≈ 3–21 µmol/L)
Direct (conjugated): 0.0–0.4 mg/dL (≈ 0–7 µmol/L)
Patterns that may help identify causes:
High indirect bilirubin: hemolysis, Gilbert syndrome, or reduced hepatic uptake/conjugation
High direct bilirubin: cholestasis or bile duct obstruction (e.g., gallstones, strictures), liver injury, or certain medications
Note: Slightly abnormal results don’t always indicate disease. Exercise, fasting, certain foods, or medications can affect bilirubin levels. Clinicians interpret results alongside other tests (ALT, AST, ALP, GGT, albumin, INR) and your clinical history.
ALT, AST, ALP, GGT – assess liver injury or bile flow issues
Albumin, PT/INR – evaluate liver synthetic function
CBC, haptoglobin, LDH, reticulocyte count – assess for hemolysis
If your bilirubin is elevated—or if you notice yellowing of the skin or eyes, dark urine, pale stools, itching, fatigue, or right upper abdominal pain—discuss results with your healthcare provider. Follow-up may include repeat labs, imaging of the liver and bile ducts, and reviewing current medications or supplements.
Note on newborns:
Bilirubin testing is very common in newborns, as temporary elevations (neonatal jaundice) are frequent and usually resolve with monitoring and support.
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Bilirubin can build up when the liver can’t process it efficiently or when red blood cells break down faster than normal. A visible sign of high bilirubin is jaundice—yellowing of the skin and the whites of the eyes. Other symptoms can include dark urine, pale or gray stools, itching, fatigue, poor appetite, and upper-right abdominal discomfort.
(More often raise direct/conjugated bilirubin)
Viral hepatitis
Alcohol- or drug-related liver injury
Cholestasis or bile duct blockage (e.g., gallstones, strictures)
Cirrhosis
Medication effects (certain antibiotics, anabolic steroids, antifungals — always review with your clinician)
(More often raises indirect/unconjugated bilirubin)
Hemolytic anemia (autoimmune, inherited, infection-related, or medication-induced)
Transfusion reactions
Gilbert syndrome – a common, benign condition that can cause mild elevations during fasting, illness, or intense exercise
Labs often report total, direct (conjugated), and indirect (unconjugated) bilirubin. The pattern helps your clinician identify the likely cause.
Contact your clinician for any new jaundice or persistently elevated bilirubin.
Seek urgent or emergency care if jaundice is accompanied by:
Fever or severe abdominal pain
Confusion or drowsiness
Unusual bleeding or bruising
Rapidly worsening symptoms
Repeat or confirm labs and review related tests: ALT, AST, ALP, GGT, albumin, INR
Check for hemolysis markers: CBC, haptoglobin, LDH, reticulocyte count
Review medications and supplements, including over-the-counter and herbal products
Order imaging (e.g., abdominal ultrasound) if bile duct obstruction is suspected
Test for specific conditions, such as viral hepatitis, autoimmune liver disease, or inherited disorders
Medication adjustments if a drug effect is suspected
Gallstones or bile duct obstruction: minimally invasive procedures or surgery
Hepatitis or inflammatory liver disease: targeted therapy and supportive care
Hemolysis: treat the underlying trigger (e.g., immune therapy, infection management)
Gilbert syndrome: no specific treatment required; bilirubin may fluctuate naturally
While there’s no way to “flush out” bilirubin at home, you can help protect your liver and support recovery:
Avoid alcohol and recreational drugs
Take prescribed medications only as directed; avoid unnecessary supplements
Eat a balanced diet rich in vegetables, fiber, and lean proteins
Limit processed foods, sugar, and saturated fats
Maintain a healthy weight and exercise regularly (avoid prolonged fasting if you have Gilbert syndrome)
High bilirubin is very common in newborns and usually temporary. All infants are screened shortly after birth. Your pediatric team will guide you on monitoring and treatments (such as phototherapy) if needed. Seek care promptly for worsening jaundice, poor feeding, or lethargy.
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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.
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Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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.
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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.
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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.
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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.
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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.
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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.
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Adjusted Calcium, Alanine-aminotransferase (ALT, SGPT), Albumin, Serum, Albumin/Globulin (A/G) Ratio, Alkaline Phosphatase (ALP), Aspartate-aminotransferase (AST, SGOT), AST/ALT Ratio, Bilirubin Total, Blood urea nitrogen (BUN), Bone Isoenzymes, BUN/Creatinine Ratio, Calcium, Serum, Calcium, Total (RBCs), Calcium/ Albumin Ratio, Calcium/Phosphorous Ratio, 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, Selenium, RBC, SODIUM, RANDOM URINE, Sodium, Serum (Natrium), SODIUM/CREAT RATIO, Sodium/Potassium Ratio, Total Protein, Serum, Urea