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.