Bilirubin, Total

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Also known as: Bilirubin Total, TBIL, Total bilirubin

Bilirubin, Total

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.
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The Bilirubin, Total test contains 1 test with 1 biomarker.

Brief Description: The Bilirubin Total test is a blood test that measures the total amount of bilirubin in a blood sample. Bilirubin is an orange-yellow pigment produced during the breakdown of red blood cells. It travels through the liver, where it undergoes a process to become water-soluble, and then is excreted through the feces. The liver plays a crucial role in processing bilirubin; hence, the bilirubin level can be an indicator of the liver's functionality.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When and Why a Bilirubin Total Test May Be Ordered

A healthcare provider may order a Bilirubin Total test in the following circumstances:

  1. Jaundice Symptoms: To determine the cause of yellowing of the skin or eyes.
  2. Liver Function Assessment: As a component of liver function tests or if there's a suspicion of liver disease.
  3. Hemolytic Anemia: To diagnose or monitor conditions where rapid breakdown of red blood cells occurs.
  4. Newborn Monitoring: Jaundice is common in newborns, and it's essential to ensure that bilirubin levels don't rise to dangerous levels.

What the Bilirubin Total Test Checks For

The Bilirubin Total test quantifies the total bilirubin concentration in the blood, comprising both unconjugated (indirect) and conjugated (direct) bilirubin. Elevated levels can suggest issues with liver function, bile duct obstructions, or excessive red blood cell breakdown.

Other Lab Tests Ordered Alongside the Bilirubin Total Test

When a Bilirubin Total test is ordered, it's often part of a broader evaluation of liver health and related conditions. Here are some tests commonly ordered alongside it:

  1. Liver Function Test and Gamma-Glutamyl Transferase (GGT):

    • Purpose: To assess liver health and function.
    • Why Is It Ordered: These tests provide a comprehensive picture of liver health, helping to diagnose liver diseases, monitor liver damage, and determine the cause of increased bilirubin levels.

  2. Complete Blood Count (CBC):

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: To check for anemia or other blood cell abnormalities, which can be associated with liver disease or contribute to elevated bilirubin levels.

  3. Direct (Conjugated) and Indirect (Unconjugated) Bilirubin:

    • Purpose: To differentiate between conjugated and unconjugated bilirubin.
    • Why Is It Ordered: To help determine the underlying cause of jaundice, as different patterns of bilirubin elevation can suggest different diagnoses.

  4. Hepatitis Panel (Hepatitis A, B, and C serology):

    • Purpose: To test for hepatitis viruses.
    • Why Is It Ordered: Viral hepatitis is a common cause of liver inflammation and dysfunction, leading to elevated bilirubin levels.

  5. Prothrombin Time (PT) and International Normalized Ratio (INR):

    • Purpose: To assess blood clotting function.
    • Why Is It Ordered: Liver disease can affect the synthesis of clotting factors, leading to prolonged PT/INR.

  6. Albumin:

    • Purpose: To measure the level of albumin in the blood.
    • Why Is It Ordered: Albumin is produced by the liver, and low levels can indicate impaired liver function.

  7. Ferritin and Iron Studies:

    • Purpose: To assess iron levels and storage.
    • Why Is It Ordered: Conditions like hemochromatosis (iron overload) can cause liver damage, leading to abnormal bilirubin levels.

These tests, when ordered alongside a Bilirubin Total test, provide a comprehensive evaluation of liver function and the causes of jaundice. They are crucial for diagnosing liver diseases, assessing liver damage, and determining the appropriate course of treatment. The specific combination of tests will depend on the individual’s symptoms, medical history, and the clinical context of the testing.

Conditions or Diseases that Require a Bilirubin Total Test

Several conditions or diseases might necessitate a Bilirubin Total test:

  • Liver Diseases: Such as hepatitis, cirrhosis, or liver cancer.
  • Gallbladder or Bile Duct Diseases: Including gallstones or inflammation.
  • Hemolytic Anemia: Where the body destroys red blood cells faster than it produces them.
  • Neonatal Jaundice: Common in newborns due to immature liver function.

Usage of Results from the Bilirubin Total Test by Health Care Providers

The Bilirubin Total test results are utilized as follows:

  • Diagnosis: High bilirubin levels can indicate liver dysfunction, bile duct obstructions, or hemolysis.
  • Treatment Monitoring: Monitoring bilirubin levels in patients with known liver disease can guide treatment efficacy.
  • Risk Assessment: In newborns, extremely high bilirubin levels can risk brain damage, necessitating prompt treatment.
  • Disease Differentiation: The results, when combined with other tests, can help distinguish between liver diseases, gallbladder issues, or conditions related to the breakdown of red blood cells.

In summary, the Bilirubin Total test is a fundamental diagnostic tool that provides essential insights into liver health, bile duct function, and the rate of red blood cell breakdown.

Most Common Questions About the Bilirubin Total test:

Purpose and Clinical Indications

What is the Bilirubin Total test used for?

The Bilirubin Total test is used to measure the amount of bilirubin in the blood. Bilirubin is a yellow compound that is produced when red blood cells are broken down. It's an essential test to assess liver function and to diagnose and monitor liver diseases, such as hepatitis or cirrhosis. The test can also help diagnose conditions that cause increased destruction of red blood cells, leading to conditions like jaundice.

Why would a doctor order the Bilirubin Total test?

A doctor might order the Bilirubin Total test if a patient presents with symptoms of liver dysfunction or damage. These symptoms might include jaundice (yellowing of the skin and eyes), dark urine, light-colored stools, fatigue, or abdominal pain. Additionally, it might be ordered as part of a routine liver function test panel, especially in patients with known liver diseases or those taking medications that can affect the liver.

Interpretation of Results

What does a high Bilirubin Total test result mean?

An elevated Bilirubin Total level in the blood usually indicates that the liver isn't processing bilirubin properly, either due to liver damage, inflammation, or disease. High bilirubin levels can also result from conditions that cause increased destruction of red blood cells, leading to an overproduction of bilirubin. This can cause jaundice and may be seen in conditions like hemolytic anemia.

How do the results of the Bilirubin Total test relate to jaundice?

Jaundice is a clinical sign characterized by yellowing of the skin, mucous membranes, and the whites of the eyes. It occurs due to elevated bilirubin levels in the blood. A positive Bilirubin Total test result, indicating high bilirubin levels, confirms the presence of jaundice. The test helps in determining the severity of jaundice and understanding its possible cause, be it liver dysfunction or excessive red blood cell breakdown.

Implications and Medical Management

What are the potential treatments or interventions for patients with high bilirubin levels?

The treatment for elevated bilirubin levels depends on the underlying cause. If it's due to liver disease, treatments might include medications, lifestyle changes, or, in severe cases, liver transplantation. For conditions causing increased red blood cell destruction, treatment might involve addressing the root cause of the hemolysis, which could be infections, autoimmune disorders, or medications.

Are there conditions where the Bilirubin Total test might be regularly monitored?

Yes, in patients with chronic liver diseases like hepatitis, cirrhosis, or biliary obstruction, the Bilirubin Total test might be monitored regularly as part of a liver function test panel. This helps assess the progression of the disease and the effectiveness of treatments. Similarly, in conditions where there is a risk of increased red blood cell destruction, regular monitoring might be done to ensure bilirubin levels remain within a safe range.

Post-Test Management

How often might a patient with liver disease undergo the Bilirubin Total test?

The frequency of testing will depend on the specific liver condition, its severity, and the patient's overall health status. In acute conditions or during flare-ups of chronic liver diseases, the test might be conducted more frequently to monitor the situation closely. In stable chronic liver conditions, the test might be part of regular check-ups, which could be every few months to once a year, based on the doctor's recommendation.

Can lifestyle or dietary changes affect the results of the Bilirubin Total test?

Yes, certain lifestyle factors, including alcohol consumption, can influence bilirubin levels. Chronic excessive alcohol intake can damage the liver, leading to increased bilirubin levels. Similarly, certain diets or fasting can temporarily elevate bilirubin. However, these changes are usually mild and transient. For accurate results, it's essential to inform the healthcare provider about any significant dietary or lifestyle changes before the test.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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