Total Bilirubin Blood Test

This test measures the total amount of bilirubin (conjugated plus unconjugated) in your blood serum. Quest notes that bilirubin measurement is used in the diagnosis and treatment of liver, hemolytic, hematologic and metabolic disorders, including hepatitis and gallbladder obstruction. It does not separate direct from indirect bilirubin.

People re-checking a total bilirubin that came back high, including people who suspect or know they have Gilbert syndrome; people following bilirubin over time as their clinician advised; and people with yellowing of the skin or eyes, dark urine or pale stools, who should also see a clinician promptly. For a first assessment, the Hepatic Function Panel is usually more useful because it includes direct bilirubin and the liver enzymes.

Any time of day; no fasting is needed. If you are re-checking a high value, test under your normal routine: in people with Gilbert syndrome, skipping meals, dehydration, illness and vigorous exercise can all push bilirubin up temporarily. New jaundice should be assessed by a clinician rather than waiting for an online test.

A result within the lab's reference range is reassuring. A high total bilirubin (hyperbilirubinemia) can come from liver disease such as hepatitis or cirrhosis, from blocked bile ducts or gallbladder obstruction, from faster breakdown of red blood cells (hemolytic anemia), or from Gilbert syndrome; some medicines, certain foods and strenuous exercise can also raise it. Because these causes are very different, a high result is usually followed by direct and indirect bilirubin fractions, liver enzymes and a blood count; a raised direct (conjugated) bilirubin generally points to liver disease or bile-duct obstruction. A low bilirubin is not usually a concern. JustLabs results are informational; review them with a clinician, and seek prompt care for new jaundice.