Bilirubin (Total, Direct and Indirect)

Also referred as

Bilirubin (T

D and I)

Serum bilirubin

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The Bilirubin (Total, Direct and Indirect) is a blood test that measures the levels of three different components of bilirubin including total, direct, and indirect. This test is often done as a part of a liver function test (LFT) to assess liver function and detect possible liver or blood disorders. It helps diagnose and monitor conditions primarily affecting the liver, red blood cells, and bile ducts.

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Understanding Bilirubin (Total, Direct and Indirect)

The Bilirubin (Total, Direct and Indirect) test measures the level of bilirubin, a yellowish pigment produced during the breakdown of red blood cells. It tells about how well your liver is working and the body’s ability to process and eliminate bilirubin. This test typically measures the level of three components of bilirubin namely- Total (both direct and indirect), direct (conjugated), and indirect (unconjugated) bilirubin. The total bilirubin is the summation of both direct and indirect bilirubin; direct (conjugated) bilirubin is the processed form of bilirubin and is excreted in bile; indirect (unconjugated) bilirubin is the unprocessed form of bilirubin and is bound to albumin in the blood. Deranged levels of bilirubin might indicate that some part of the process of breaking down and clearing old red blood cells isn’t working correctly which can occur in various conditions, including liver diseases, blockage of the bile duct, hemolytic anemia, Gilbert’s syndrome, and other conditions affecting bilirubin metabolism. However, it is noteworthy that abnormal bilirubin levels don’t always indicate a problem in your liver; sometimes the problem lies elsewhere in the body.

Your doctor may suggest the Bilirubin (Total, Direct and Indirect) test if you exhibit symptoms such as yellowing of the skin or eyes (jaundice), abdominal pain, nausea, vomiting, or dark-colored urine, which may suggest liver or bile duct problems. Additionally, this test can be done as a part of routine health screening or to monitor liver function in individuals with known liver disease or risk factors such as alcoholism, exposure to hepatitis viruses, cirrhosis, low red blood cells, etc. Moreover, it can be used in conjunction with other laboratory tests to evaluate suspected drug (medication) toxicity especially if a medication is known to potentially cause liver damage or if an individual exhibits symptoms of liver dysfunction after taking certain medications. Furthermore, the Bilirubin (Total, Direct and Indirect) test is commonly done in newborns to check for jaundice (Neonatal jaundice) as they often have elevated bilirubin levels due to their immature livers not efficient enough to process and excrete bilirubin.

No special preparation is required for this test. However, refrain from alcohol a day before getting tested as alcohol consumption can potentially affect the test results. Also, inform your doctor about all the medications and supplements that you may be taking as they may interfere with the test results. Your doctor may ask you to stop taking them temporarily.

Lab test results may vary across different laboratories depending on the methodology and laboratory guidelines. Do not self-medicate at home solely based on these results and always consult your doctor for proper understanding of your test results. Narrate your complete medical history to the doctor to help them relate your clinical and laboratory findings and tailor an overall treatment plan.

What does Bilirubin (Total, Direct and Indirect) measure?

Contains 3 tests

The Bilirubin (Total, Direct and Indirect) test measures the level of three forms of bilirubin such as total bilirubin, direct (conjugated bilirubin), and indirect (unconjugated) bilirubin in the blood. Total bilirubin represents the sum of direct and indirect bilirubin. Direct bilirubin is the water-soluble form of bilirubin that has been processed by the liver via a conjugation process with glucuronic acid and is ready to be excreted into the bile ducts and ultimately into the intestines. Indirect bilirubin is the water-insoluble form of bilirubin that has not yet been processed by the liver and is bound to albumin in the blood. It is formed in the spleen and liver during the breakdown of hemoglobin from old or damaged red blood cells and cannot be excreted directly by the liver. Instead, it is transported to the liver, where it undergoes conjugation to become direct bilirubin.

Getting tested with the Bilirubin (Total, Direct and Indirect) test provides valuable information into various aspects of liver function, bile duct health, and the body’s ability to break down and eliminate bilirubin.

Bilirubin Indirect

The Bilirubin Indirect test measures the amount of indirect or unconjugated bilirubin in your body. Bilirubin is a yellowish byproduct primarily produced when your body breaks down aged red blood cells (RBCs). When RBCs finish their lifespan of 120 days, they break down and pass to your liver. Indirect bilirubin, a form of bilirubin that is unconjugated (not soluble in water), is bound to the protein albumin that helps transport it to the liver. When the liver processes the bilirubin, it unbinds from the albumin and binds to a sugar molecule, making it water-soluble. This water-soluble bilirubin is mixed with bile, excreted in the bile ducts, and stored in your gallbladder. Finally, bile is released into the small intestine to help digest fat and is eventually excreted with your stool as a waste product.

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Bilirubin Direct

The Bilirubin Direct test measures the amount of direct or conjugated bilirubin present in your body. Bilirubin is a yellowish byproduct primarily produced when the body breaks down aged RBCs. When the RBCs finish their lifespan of 120 days, they break down and pass to the liver. In the liver, direct bilirubin–a form of bilirubin conjugated with glucuronic acid (sugar)–is processed, mixed with bile, and then excreted in the bile ducts and stored in your gallbladder. Finally, the bile is released into the small intestine where it is further broken down and helps digest fat. It is eventually excreted within your stool as a waste product.

Elevated levels of bilirubin can be indicative of various liver or bile duct issues. Additionally, higher bilirubin levels might result from an increased breakdown of red blood cells in the body.

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Bilirubin Total

The Bilirubin Total examination quantifies the levels of total bilirubin in the body, encompassing both indirect (unconjugated) and direct (conjugated) bilirubin. Bilirubin, a yellowish waste substance, is primarily generated during the breakdown of aging red blood cells (RBCs) in the body. After their typical lifespan of 120 days, RBCs disintegrate in the liver, leading to the production of a substantial amount of bilirubin. It is crucial for this bilirubin to be eliminated from the body.

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Packages containing Bilirubin (Total, Direct and Indirect)

Comprehensive Gold Package with ECG & USG Whole Abdomen

Contains 88 tests

Get reports within 12-15 hrs

₹3999

Comprehensive Platinum Package with ECG, USG Whole Abdomen & 2D-Echo

Contains 102 tests

Get reports within 12-15 hrs

₹6666

Comprehensive Gold Full Body Checkup with Smart Report

Contains 86 tests

Report in 7 hrs

₹2199

Good Health Silver Package with Smart Report

Contains 65 tests

Report in 7 hrs

₹749

Comprehensive Silver Full Body Checkup with Smart Report

Contains 80 tests

Report in 7 hrs

₹1799

Comprehensive Platinum Full Body Checkup with Smart Report

Contains 100 tests

Get reports within 12-24 hrs

₹3599

Good Health Platinum Package with Smart Report

Contains 74 tests

Report in 7 hrs

₹1499

Good Health Gold Package with Smart Report

Contains 72 tests

Report in 7 hrs

₹999

Winter Special Package

Contains 84 tests

Get reports within 12-24 hrs

₹2549

Fitness Advanced Package for Women with Smart Report

Contains 89 tests

Get reports within 24-36 hrs

₹3999

Test Information is reviewed by: Dr. Swati Gupta (Anand), MD Lab Medicine, MBBS and written by Dr. Lipika Khurana, PGDHHM, BDS . The test details are for information purpose only. Consult a doctor before taking any test. Last updated on: 1st Sep 2026

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Bilirubin (Total, Direct and Indirect) test price for other cities

Price in	Bangalore	Rs. 219
Price in	Mumbai	Rs. 219
Price in	Hyderabad	Rs. 220
Price in	Dehradun	Rs. 160
Price in	New Delhi	Rs. 219

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FAQs related to Bilirubin (Total, Direct and Indirect)

Why is the Bilirubin (Total, Direct and Indirect) test done?

The Bilirubin (Total, Direct and Indirect) test is done to assess liver function in newborns and adults and diagnose conditions affecting the liver, bile ducts, or red blood cells. It is also done if you have symptoms of liver disease, jaundice, or unexplained changes in urine or stool color.

Is fasting required before the Bilirubin (Total, Direct and Indirect) test?

No, fasting is not required before the Bilirubin (Total, Direct and Indirect) test. You can eat or drink as per your routine before the test.

What causes high bilirubin levels?

High bilirubin levels may be caused by liver disorders, hemolytic anemia, blockage of the bile ducts, genetic disorders, or certain medications.

What are the symptoms of high bilirubin levels?

You may experience symptoms such as the yellowing of your eyes and skin, swelling and pain in the belly, chest pain, lightheadedness, fatigue, vomiting, pale stools, dark urine, itching etc, when you have high bilirubin levels.

How can I improve my elevated bilirubin levels?

To improve upon your elevated bilirubin levels, follow your doctor’s recommendations which may include medications and lifestyle changes. Avoid alcohol consumption and non-prescription medications that can harm the liver. Maintain a healthy diet rich in fruits, vegetables and lean proteins. Staying hydrated, exercising regularly and managing your body weight can help support liver health. Additionally, reducing exposure to toxins and ensuring that you are vaccinated against hepatitis A and B can help protect and improve liver function. Ensure regular medical check-ups to monitor your bilirubin levels and overall liver health.

What other tests are advised along with the Bilirubin (Total, Direct and Indirect) test?

Other tests that are advised along with the Bilirubin (Total, Direct and Indirect) test include liver function test (LFT), alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase tests. In case hemolytic anemia is suspected, then the doctor may advise other tests, such as a complete blood count, reticulocyte count, haptoglobin, and lactate dehydrogenase test.

What does Bilirubin (Total, Direct and Indirect) test aid in diagnosing?

In case of adults and older children, the Bilirubin (Total, Direct and Indirect) test, aids to diagnose and monitor diseases of the liver and bile duct. These diseases may include cirrhosis, gallstones or hepatitis. This test also helps to evaluate the progress people with sickle cell disease or other causes of hemolytic anemia. In case of newborns with jaundice, this test is done to distinguish the causes of jaundice like physiological jaundice or pathological jaundice.

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