What is bilirubin in Blood?
A bilirubin blood test checks the level of bilirubin, a yellow waste pigment made when red blood cells break down. A higher-than-normal result may point to a problem with the liver, bile ducts, or red blood cells. Doctors use this test to check liver function and investigate jaundice. In this blog, we will explore the bilirubin blood test meaning, normal ranges, and what your results may show.
What is a Bilirubin Blood Test?
A bilirubin test is a type of blood test that indicates the levels of bilirubin in your blood. Bilirubin is a yellowish pigment that is produced during the breakdown of red blood cells. Bilirubin progresses through the liver and is finally removed from your body through pooping. Higher bilirubin levels indicate various types of liver or bile duct problems like jaundice, anemia, and liver diseases. If your bilirubin level is higher than normal, then this portrays that either your red blood cells are breaking down at an abnormal rate or that your liver is unable to filter the waste properly.
The cost of the bilirubin test is Rs. 80-Rs.150 depending on your locality. Please check the price of this test in Delhi/NCR, your nearby centers and other details.
Test Summary
| Also known as | Total Serum Bilirubin, TSB |
| Test Type | Blood |
| Urinalysis test includes | Detects whether you have any liver or bile disease |
| Preparation | No special preparation is required |
| Reporting | Within 24hrs |
| Test price | The cost of the bilirubin test is Rs. 80-Rs.150 depending on your locality. Please check the price of this test in Delhi/NCR, your nearby centers and other details. |
| Also included in | Health Insurance Plans |
| Related tests | C-Reactive protein, CBC, liver function test, prothrombin time |
Bilirubin Test Price in India
The bilirubin test price in India usually ranges from about Rs. 100 to Rs. 330. The bilirubin test cost depends on the type of test, the city, and the lab. A total bilirubin test alone is at the lower end, while the full panel with total, direct, and indirect bilirubin is at the higher end.
Bilirubin blood test price by city: The table below shows the estimated bilirubin blood test price in major Indian cities.
| City | Total bilirubin only | Total, direct and indirect bilirubin |
|---|---|---|
| Delhi / NCR | Rs. 80 to Rs. 200 | Rs. 150 to Rs. 300 |
| Mumbai / Thane | Rs. 100 to Rs. 250 | Rs. 200 to Rs. 320 |
| Bangalore | Rs. 100 to Rs. 250 | Rs. 220 to Rs. 320 |
| Hyderabad | Rs. 100 to Rs. 250 | Rs. 200 to Rs. 300 |
| Chennai | Rs. 100 to Rs. 250 | Rs. 200 to Rs. 300 |
| Kolkata | Rs. 100 to Rs. 250 | Rs. 200 to Rs. 300 |
| Pune | Rs. 100 to Rs. 250 | Rs. 200 to Rs. 300 |
Disclaimer: These are estimated price ranges, not fixed rates. The actual bilirubin test price can change with inflation, lab policies, discounts, home collection charges, taxes, and whether the test is part of a package. Please check the final price with your lab or booking platform before booking.
What affects the bilirubin test cost
- Type of test: Total bilirubin alone costs less than the panel with direct and indirect values.
- City and lab: Prices differ between metro cities and smaller towns, and between hospital labs and standalone diagnostic centres.
- Home collection: Some labs charge a collection fee, while others waive it above a minimum order value.
- Packages: The test is often bundled with a liver function test (LFT), which costs more but includes other tests.
- Discounts: Online platforms often show a lower discounted price against a higher listed price.
Why is the Bilirubin Test Recommended?
The doctors usually recommend this test as a part of a group of tests to check whether your liver is working properly or not. Bilirubin testing is done under the following conditions.
- Investigate Jaundice: During jaundice, your skin and eyes turned yellow due to the elevated levels of bilirubin. Sometimes, bilirubin levels are measured in newborns to check for infant jaundice
- To check whether there is any blockage in your bile ducts, liver or the gallbladder
- Detects liver disease, particularly hepatitis, or monitors its condition
- Helps find one of the causes of anaemia, which is the breakdown of red blood cells faster than the body can replace them (haemolytic anaemia).
- Checks how an ongoing treatment is working
- Detects a suspected drug toxicity
- Also detects whether you have sick cell disease or other conditions that cause hemolytic anemia. Under these conditions, your RBCs are destroyed quicker than they are made
Symptoms of high bilirubin
Your doctor may suggest this test if you are suffering from the below-mentioned conditions.
- Dark urine
- Nausea and vomiting
- Lower abdominal pain and swelling
- Clay-colored stools
- Extreme fatigue
What is a Total, Direct and Indirect Bilirubin Test?
A direct and indirect bilirubin test is a blood test that splits your total bilirubin into its two forms. Direct (conjugated) bilirubin is bilirubin that the liver has already processed, while indirect (unconjugated) bilirubin is bilirubin that has not yet reached the liver for processing. Comparing the two helps doctors tell whether a high result is linked to the liver, the bile ducts, or the breakdown of red blood cells.
What is a Total Bilirubin in a Blood Test?
A total bilirubin test is a blood test that measures all the bilirubin in your blood, which includes both direct (conjugated) and indirect (unconjugated) bilirubin. It helps doctors check how well your liver is working and find the cause of jaundice.
What Is Indirect Bilirubin in a Blood Test?
Indirect bilirubin, also called unconjugated bilirubin, is the form of bilirubin that is made when red blood cells break down and has not yet been processed by the liver. It cannot dissolve in water, so it travels in the blood to the liver. A normal level is usually about 0.2 to 0.8 mg/dL.
What Is Direct Bilirubin in a Blood Test?
Direct bilirubin, also called conjugated bilirubin, is the form of bilirubin that the liver has already processed so it can dissolve in water and leave the body. In a blood test, it shows how well your liver and bile ducts are clearing bilirubin. A normal level is usually below 0.3 mg/dL.
What is the Bilirubin Test Normal Range
The bilirubin test normal range for adults is about 0.3 to 1.2 mg/dL for total bilirubin, and less than about 0.3 mg/dL for direct (conjugated) bilirubin. The bilirubin normal value in blood can differ slightly between labs, so always compare your result with the range printed on your report. Men have higher bilirubin levels than females. African-Americans possess lower bilirubin levels than other races.
| Type of bilirubin | Normal range in adults (mg/dL) |
|---|---|
| Total bilirubin | 0.3 to 1.2 |
| Direct (conjugated) bilirubin | Less than 0.3 |
| Indirect (unconjugated) bilirubin | 0.2 to 0.8 |
Lower bilirubin levels don’t cause any concern. But high bilirubin may indicate liver damage or disease. If your direct bilirubin is higher than normal in your blood, then this may indicate that your liver isn't clearing bilirubin aptly. Higher levels of indirect bilirubin may portray some other health issues.
Gilbert’s syndrome is a primary cause of elevated bilirubin. But this is a harmless condition where there is a deficiency in an enzyme that breaks down bilirubin. Your doctor may recommend some other tests to diagnose your condition. Bilirubin test results also play an imperative role in the progression of certain health issues, such as jaundice.
Reasons for High Bilirubin
High total bilirubin can be caused by various health conditions including:
- Anemia
- Cirrhosis
- A reaction to a blood transfusion
- Gilbert syndrome (an inherited disease)
- Viral hepatitis
- Drug reactions
- Alcoholic liver disease
- Gallstones
- Some strenuous exercises like marathon running may enhance your bilirubin levels
Caffeine, penicillin, barbiturates, and nonsteroidal anti-inflammatory drugs (NSAIDs) called salicylates also minimize your bilirubin levels
Bilirubin Test for Newborns
A bilirubin test for newborns checks the level of bilirubin in a baby's blood or skin to look for jaundice. Many newborns have higher bilirubin in the first week because their livers are still maturing, and levels usually settle within about 2 weeks. Doctors judge the result by the baby's age in hours, not by a single normal number.
Why Newborns Have Higher Bilirubin
Newborns generally have a higher level of bilirubin, which goes down within a few days to 2 weeks. But if the level doesn’t go down, then this could be a sign of
Incompatible blood type between mother and child
- Scarcity of oxygen
- An inherited infection
- A disease affecting the liver
During the Test Procedure
For bilirubin testing, you need to give your blood sample by visiting a lab or your nearby hospital. By inserting a small needle into your vein, a lab technician collects your sample, preferably from the vein of your upper hand. A small tube is fastened to the needle to collect the blood.
You may feel a sharp pain as the needle is inserted into your arm. Some even experience a mild discomfort once the needle is removed. For newborns, the blood samples for bilirubin testing are usually obtained using a sharp lancet to break the skin of the heel (heel stick). You may notice a small bruise at the puncture site. Your sample blood will be sent to a laboratory for further analysis. You can resume your daily activities quickly once the sample is collected.
When to See a Doctor
A bilirubin test result outside the normal range is a clue, not a diagnosis, but it should not be ignored. Consult a doctor if:
- Your bilirubin report shows a high total, direct, or indirect value
- You notice yellowing of the skin or the whites of the eyes
- Your urine is dark, or your stools are pale or clay-coloured
- You have ongoing itching, tiredness, nausea, or loss of appetite
- You have pain or swelling in the upper right abdomen
- You have a known liver condition, or take medicines that affect the liver, and your levels are being monitored
Seek urgent medical care if you have:
- Severe abdominal pain, vomiting blood, or black stools
- Confusion, extreme drowsiness, or difficulty staying awake
- Fever with yellow skin or eyes
- A newborn whose jaundice appears in the first 24 hours, spreads to the belly or legs, or comes with poor feeding or unusual sleepiness
Your doctor may advise a liver function test, a complete blood count (CBC), or an ultrasound to find the cause. Do not try to lower bilirubin with home remedies or supplements before knowing the cause.
Conclusion
A bilirubin blood test helps check liver and bile duct health and find the cause of jaundice. Understanding the normal range and the difference between direct and indirect bilirubin makes your report easier to read. A high result is a clue, not a diagnosis, so consult a doctor to find the cause and the right treatment.
