Red blood cells (RBCs) contain the protein hemoglobin, which helps in carrying oxygen and is responsible for the color of the RBCs. When these cells die, as a result of age or disease, this hemoglobin gets released and degrades. A component of this protein (called heme), gets converted into bilirubin (a yellow product).
Bilirubin occurs in two forms:
Increased levels of bilirubin in blood may therefore be caused by:
A test for conjugated bilirubin, directly measures blood levels of the substance, hence it is called direct bilirubin. Unconjugated bilirubin levels are obtained by subtracting this value from the total bilirubin levels - hence it is called indirect bilirubin. Ascertaining the levels of direct and indirect bilirubin, help identify the potential cause of jaundice (yellowing of skin caused by increased bilirubin levels).
A Bilirubin Blood Test is ordered by the physician in a number of scenarios, such as:
Bilirubin levels are often estimated alongside other measurements (such as alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase) to assess liver function. These maybe ordered in the evaluation of other conditions, besides the ones listed, if deemed necessary by the physician.
An individual with liver disease may also have other symptoms besides jaundice, such as dark-colored urine, abdominal pain, or swelling, prompting the physician to check bilirubin levels.
Sample required: Blood
Process:
Preparation required: Adults are generally advised not to eat/drink for 4 hours before the test sample is taken.
The normal range of bilirubin values, called the reference range, may vary slightly amongst different laboratories. Each laboratory may show the reference range used by them. A physician interprets the results based on the reference values provided.
One such standard reference range is:
In adults:
The normal value ranges in newborns are dependent on a number of factors, including whether the baby was born, after a full pregnancy or preterm. It also varies with the time elapsed since birth.
The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.
Some medicines may alter the bilirubin levels:
Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.
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