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Total Bilirubin Blood Test: What Your Results Mean

Bilirubin is a yellow pigment produced when the body breaks down old red blood cells. It is processed by the liver, combined with bile, and excreted into the intestine. Total bilirubin measures both the direct (conjugated) and indirect (unconjugated) forms. Elevated bilirubin causes jaundice — a yellowing of the skin and eyes.

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Normal Range

0.2 – 1.2 mg/dL

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Unit

mg/dL

What Your Results Mean

Normal

A normal total bilirubin level means your liver is efficiently processing and excreting bilirubin, and red blood cell breakdown is occurring at a healthy rate. There is no significant obstruction in the bile ducts and no excessive haemolysis.

High

High bilirubin (hyperbilirubinaemia) causes jaundice and may indicate liver disease (hepatitis, cirrhosis), bile duct obstruction (gallstones, tumour), or haemolytic anaemia where red blood cells are destroyed faster than the liver can process bilirubin.

Low

Very low bilirubin is not typically clinically significant and does not require treatment. Some research suggests extremely low levels may be associated with increased cardiovascular risk, but this is not a standard clinical concern.

Frequently Asked Questions

What does high total bilirubin mean? expand_more
High total bilirubin can indicate a liver problem (hepatitis, cirrhosis), a blocked bile duct (gallstones, tumours), or increased red blood cell destruction (haemolytic anaemia). The pattern of direct vs indirect bilirubin helps determine the cause.
What is jaundice and how does it relate to bilirubin? expand_more
Jaundice is a yellowing of the skin and whites of the eyes caused by excess bilirubin in the blood. It becomes visible when total bilirubin exceeds approximately 2–3 mg/dL.
What is the normal total bilirubin level? expand_more
The normal range is 0.2 to 1.2 mg/dL. Levels above 1.2 mg/dL are considered elevated. Jaundice becomes clinically apparent above roughly 2.5 mg/dL.
Do I need to fast before a bilirubin test? expand_more
Fasting for at least 4 hours before the test is often recommended because eating — particularly fatty foods — can temporarily increase bilirubin levels. Always follow your doctor's specific instructions.
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