Bilirubin - Total (TBIL)

Clinical definition of the Bilirubin (total) test
Bilirubin is the brownish yellow pigment produced during breakdown of red blood cells in the liver. It is excreted as component of bile, a fluid produced by the liver which is essential for the metabolism of fat. Bilirubin is produced in the body when red blood cells become old and damaged and are destroyed in the spleen. Bilirubin goes in the blood from the spleen to the liver and then in bile into the small intestine. The liver converts it to a water soluble form that can be passed out in the urine.

Bilirubin test estimates the amount of bilirubin in the blood. Bilirubin is thrown out of the body through feces. It gives stool its natural brown colour. This pigment circulates in the blood in direct as well indirect form. Indirect bilirubin is the unconjugated form, which does not dissolve in water. It travels through the bloodstream to the liver, where it is converted into soluble bilirubin. Direct bilirubin is the conjugated form that is soluble in water. Total bilirubin ("TBIL") measures both BU (“unconjugated or Indirect bilirubin’) and BC (“Conjugated” or Direct bilirubin”) Total and direct bilirubin levels can be measured from the blood, but indirect bilirubin is calculated from the total and direct bilirubin. Only a small amount of bilirubin is present in the blood.

High bilirubin levels in the blood causes Jaundice, a condition in which the skin and white of the eyes appear yellow and high levels of bilirubin in the blood of a new born baby, leads to brain damage, hearing loss, eye muscle disorders and physical abnormalities. Too much bilirubin  means,  too much is being produced (usually due to increased hemolysis) or that the liver is incapable of adequately removing bilirubin in a timely manner due to blockage of bile ducts, liver diseases such as cirrhosisacute hepatitis, or inherited problems with bilirubin processing.

Why is the Biluribin test done?
The bilirubin test is performed to evaluate the functioning of the liver, to diagnose and/or monitor liver diseases, such as cirrhosis, hepatitis, or gallstones. This test is also carried out in persons diagnosed with sickle cell disease or other causes of hemolytic anemia where excessive destruction of RBC takes place.

What are the common signs/symptoms when the Bilirubin test is done?

  • Shows evidence of jaundice (skin and white of the eyes appear yellow)
  • Dark, amber-colored urine
  • Nausea/vomiting
  • Abdominal pain and/or swelling
  • Fatigue and general malaise that often accompany chronic liver disease

What should I do before the Biluribin  test?

Specimen type

Specimen collection procedure

Preparatory instructions before the test *


(Blood Sample)


(Collection of blood from a vein, usually from the arm)

Do not eat or drink for at least 4 hours before the test.

No other special preparations required.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

How do I interpret my Biluribin test results?

Reference Range*



0.00 to 0.30 mg/dL


0.1 to 0.7 mg/dL

Bilirubin-Total (male)

0.0 to 1.0 mg/dL

Bilirubin –  Total (female)

0.0 to 1.0 mg/dL

Bilirubin – Children

0 - 1 days 

< 5.1 mg/dL

1 - 2 days 

< 7.2 mg/dL

3 - 5 days 

< 10.3 mg/dL

Above 1 month  

< 0.8 mg/dL

Interpretive Data: Total and direct bilirubin levels can be measured from the blood, but indirect bilirubin is calculated from the total and direct bilirubin.
‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Diseases/conditions related to the Biluribin test

  • Hepatitis
  • Jaundice
  • Cirrhosis
  • Anemia
  • Cholecystitis

Other tests related to the Biluribin  test  

  • Liver panel
  • Gamma-glutamyl transferase
  • Alkaline phosphatase
  • Aspartate aminotransferase
  • Alanine aminotransferase
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C

Book This Test
Bilirubin (Total, Direct and Indirect) Serum