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Total bilirubin Laboratory research

Known as: Total bilirubin Laboratory research
SKU: 1048


Study material: Venous blood
Response time (working day): 1-2
The test is done on an empty stomach: Yes
Home call service: Yes
Country: Georgia

General Information

Bilirubin Is one of the major components of bile. It is produced by enzymatic catabolism of the heme fraction in macrophages from various hemoproteins.

About 80% of circulating bilirubin is derived from aged erythrocytes. When circulating erythrocytes reach the end of their normal life, after about 120 days, they are destroyed by reticuloendothelial cells, during which oxidation of the secreted heme produces biliverdin, which in turn is metabolized to bilirubin.


The remaining 15-20% of circulating bilirubin is produced from other sources: as a result of the destruction of mature erythrocytes in the bone marrow or other proteins containing heme - liver cytochromes, muscle myoglobin, metabolism of enzymes.


The bilirubin (unconjugated) thus circulated in the blood and transferred to the liver as a soluble bilirubin-albumin complex. In the liver it conjugates to glucuronic acid by exposure to UDP-glucuronyl transferases. Conjugated bilirubin includes bilirubin-monoglucuronide, which predominates in the liver, and bilirubin-diglucuronide, which predominates in bile. Conjugated bilirubin is transported to the bile ducts, from where it is excreted with bile, passes into the intestine, and is converted to urobilinogen and stercobilinogen. A small amount of stercobilinogen and urobilinogen is excreted in the feces;


Serum bilirubin levels increase when bilirubin production exceeds its metabolism and excretion. Clinically, hyperbilirubinemia manifests itself in the form of jaundice - yellow pigmentation of the skin and sclera.

When should we take the test?

  • Identify and assess the degree of bilirubinemia;
  • Hemolytic anemia;
  • Hepatocellular jaundice. Differential diagnostics of different types of jaundice (according to bilirubin fractions);
  • Extrahepatic biliary obstruction;
  • Viral hepatitis;
  • Alcoholic hepatitis;
  • Hepatic steatosis;
  • Monitoring of treatment and its outcomes.

Complaints such as:

  • Jaundice - yellowing of the skin, visible mucous membranes, sclera of the eye;
  • Pain / discomfort in the right lower extremity;
  • Complaints related to the digestive tract.

The test is prescribed by a doctor.

Your doctor may recommend testing for total bilirubin, directly with bilirubin, liver enzymes, albumin, total protein, total cholesterol, total blood count, prothrombin time, and other indicators.

Possible interpretation of the results

Increased total bilirubin concentration:

  • Increase in the intensity of hemolysis of erythrocytes;
  • All types of jaundice (study of bilirubin fractions for differential diagnostics);
  • Toxic liver damage;
  • Low activity of liver enzymes.

Reduced total bilirubin concentration:

  • Nonhemolytic anemias (chronic renal failure, tuberculosis, acute leukemia, posthemorrhagic anemia);
  • In day-old children;
  • smoke;
  • Exposure of sunlight or ultraviolet rays to a blood sample.

Additional information

Bilirubin metabolism disorders can be divided into four main categories:

  • Increased bilirubin production;
  • Reduced bilirubin absorption by the liver;
  • Inadequate hepatic conjugation;
  • Reduced excretion of conjugated pigment from liver and bile.

Two pigment fractions are measured in the laboratory - the conjugated water-soluble fraction, which is Conjugated bilirubin (As mono- and diglucuronide) and the fat-soluble fraction that represents Unconjugated bilirubin.

The first three disorders of bilirubin metabolism are associated with predominantly unconjugated bilirubinemia, while the fourth category is associated with predominantly conjugated bilirubinemia and bilirubinuria.

How to prepare for the test?

Preferably for the test on empty stomach Presence.

It is recommended to limit alcohol intake, smoking and strenuous physical activity for at least 12 hours before the test.

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