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Doctor's Assessment Included

Every result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.

Liver

Bilirubin (Total)

Total bilirubin monitoring is especially relevant for seniors, as age-related liver changes and multiple medication use can affect bilirubin processing. Regular testing helps identify liver or bile duct conditions that become more common with advancing age.

What It Measures

This test measures the total concentration of bilirubin in your blood, which includes both direct (conjugated) and indirect (unconjugated) forms. Bilirubin is produced when haemoglobin from old red blood cells is broken down.

The liver processes indirect bilirubin into direct bilirubin, which is then excreted through bile. Elevated total bilirubin can result from problems at any stage of this process, including excessive red blood cell breakdown, impaired liver function, or blocked bile ducts.

Why It Matters

Total bilirubin is a fundamental marker for assessing liver function and diagnosing the cause of jaundice. By comparing total bilirubin with direct bilirubin, healthcare providers can determine whether elevation is due to liver disease, bile duct obstruction, or haemolysis.

Mild elevations may occur in common and generally harmless conditions such as Gilbert syndrome, which affects approximately 5-10% of the population. However, significant elevations warrant further investigation to rule out serious underlying conditions.

When to Test

Testing is recommended when jaundice is observed, as part of a routine liver function panel, or when monitoring known liver or blood disorders.

Total bilirubin testing may also be appropriate when experiencing symptoms such as unexplained fatigue, abdominal pain, dark urine, or pale stools, or when evaluating the potential side effects of certain medications.

Symptoms

Low Levels

Low total bilirubin levels are generally not clinically significant and typically reflect normal red blood cell turnover and liver function.

High Levels

Jaundice (yellowing of skin or eyes)
Fatigue and weakness
Abdominal pain or discomfort
Nausea or loss of appetite
Dark urine and pale stools

Recommendations

Male

If Low

Normal bilirubin indicates healthy liver function. No action needed.

If High

Elevated bilirubin may indicate liver disease or Gilbert syndrome. Consult your healthcare provider for evaluation.

Female

If Low

Normal bilirubin indicates healthy liver function. No action needed.

If High

Elevated bilirubin may indicate liver disease or Gilbert syndrome. Consult your healthcare provider for evaluation.

Lifestyle Tips

Moderate your alcohol intake, as excessive consumption is a leading cause of liver damage and elevated bilirubin. Eat a balanced diet with adequate fibre to support healthy bile production and excretion.

Stay well hydrated and maintain a healthy weight to reduce the risk of fatty liver disease. If you have Gilbert syndrome, be aware that fasting, stress, and illness can temporarily raise bilirubin levels. Always discuss medications and supplements with your healthcare provider.

Frequently Asked Questions

What does elevated total bilirubin mean?
Elevated total bilirubin can indicate liver disease, bile duct obstruction, or increased breakdown of red blood cells. It may also be caused by Gilbert syndrome, a common and generally harmless genetic condition. Consult your healthcare provider for proper evaluation.
What is Gilbert syndrome?
Gilbert syndrome is a common, inherited condition where the liver processes bilirubin more slowly than usual. It typically causes mildly elevated bilirubin levels and occasional jaundice, particularly during fasting, stress, or illness, but generally does not require treatment.
Should I fast before a bilirubin test?
Fasting requirements may vary depending on your healthcare provider's instructions and whether additional tests are being performed. Fasting can raise bilirubin levels in people with Gilbert syndrome, so inform your provider if you have this condition.