Serum Bilirubin Test -Bilirubin Total, Direct, and Indirect Serum Levels

Bilirubin Test is advised to patients with jaundice (yellowish pigmentation of the eyes and the skin), abdominal pain and tenderness, nausea, and vomiting. 
The causes of high unconjugated bilirubin are pre-hepatic destruction of RBC for e.g., haemolytic anaemia, large hematoma, megaloblastic anaemia
The causes high conjugated bilirubin include hepatitis due to alcohol, infection, drug reaction, autoimmune disorders and post hepatic causes can be gall stones, pancreatic or gall bladder cancer

The bilirubin test is typically done as part of a liver function test. This is a group of blood tests. These tests are used to check the health of the liver. The test may be done if a person has symptoms such as 

• Liver disease (Jaundice) 
• Dark urine
• Clay-coloured stools. 

Additionally, the bilirubin test may be done to monitor the progression of liver disease. It can also be done to check for a recurrence of liver disease after treatment.

Bilirubin Test measures the total, direct and indirect bilirubin levels in the blood.

The bilirubin test measures the levels of bilirubin in the blood. High levels of bilirubin can indicate a problem with the liver or other parts of the biliary system. These could be the gallbladder or the blockage of bile ducts. High levels of total bilirubin and indirect bilirubin can indicate a problem with the production or breakdown of red blood cells, such as hemolytic anaemia. 

During bilirubin test  the blood sample is taken from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a  little sting when the needle goes in or out. This usually takes less than five minutes.

High total bilirubin levels indicate either that the RBCs are being broken down at an abnormal rate or that the liver is not breaking down the bilirubin properly. This may occur due to jaundice, anaemia's or liver conditions like cirrhosis, ascites, hepatitis, or certain drug toxicities.

 High bilirubin direct levels indicate problems in liver affecting the bilirubin disposal. This may occur due to jaundice, or liver conditions. High direct bilirubin levels may also occur due to certain blockages like gall stones or certain pancreatic issues.

High bilirubin may also occur due to sickle cell or other types of anaemia.  Gilbert's syndrome is a condition leading to faulty enzyme that processes the bilirubin leading to high bilirubin levels. All these require further clinical correlation. 

Low bilirubin levels are usually not harmful.

If the total bilirubin test results are absent, it means that there is no bilirubin present in the blood. It means that the levels are very low. 

What causes high and low bilirubin levels?

High bilirubin levels can be caused by a variety of factors. These include:

• Hemolytic anaemia.
• Liver disease (conditions such as cirrhosis, hepatitis, or jaundice)
• Gilbert's syndrome: (This is a genetic disorder. It affects the liver's ability to process bilirubin)

Low bilirubin levels can be caused by a variety of factors. These include:

• Liver diseases 
• Inherited conditions that affect the production of bilirubin.
• Certain medications or supplements may cause a decrease in bilirubin levels.
• In some cases, low bilirubin levels may be due to a lack of red blood cells in the body. This is caused by anaemia or other conditions.

It is important to note that low bilirubin levels are less common than high bilirubin levels. They are usually not indicative of any health problem. However, if you suspect that you have low bilirubin levels, it is important to consult your healthcare provider for further evaluation and treatment.

Total bilirubin measures all of the bilirubin in the blood. Direct bilirubin measures bilirubin that is conjugated or bound to a protein. Indirect bilirubin measures unconjugated bilirubin, or not bound to a protein.

High bilirubin levels can indicate a problem with the liver or other parts of the biliary system, such as the gallbladder or bile ducts. High levels of direct bilirubin can indicate a problem with the liver's ability to process bilirubin. These could be liver disease or blockage of the bile ducts.

High bilirubin levels can cause jaundice (yellowing of the skin and eyes), dark urine, and clay-coloured stools. Other symptoms may include fatigue, abdominal pain, and itching.

A bilirubin test is a simple blood test. A blood sample is taken from a vein in the arm. The bilirubin levels are measured in the lab.

A bilirubin test is a simple and safe procedure with minimal risks. The most common risk is slight pain or discomfort when the blood is taken. In rare cases, there may be slight bleeding, bruising, or infection at the site where the blood was taken.

If the total bilirubin test results are present, it means that there is bilirubin present in the blood.

When the blood is collected, there may be a slight pain. In rare cases, some patients suffer from lightheadedness or fainting, infection, and bleeding

A blood sample is used to test for bilirubin levels. A tiny needle is used to take blood from a vein in the bend of your arm. Then blood is tested in a laboratory.

References:

https://www.mayoclinic.org/tests-procedures/bilirubin/

https://my.clevelandclinic.org/health/diagnostics/17845-bilirubin#test-details

https://www.webmd.com/a-to-z-guides/bilirubin-test

Total Bilirubin, Conjugated Bilirubin, Unconjugated Bilirubin, Direct Bilirubin, Indirect Bilirubin