Description of the blood Analysis: 

Bile acids are chemicals produced by the liver from cholesterol. They are stored in the gallbladder and released into the small intestine after you eat to help digest and absorb fats and fat-soluble vitamins (A, D, E, and K). After they finish their job in the gut, about 95% of bile acids are reabsorbed and sent back to the liver to be reused. This test measures the amount of bile acids that “leak” into the general bloodstream rather than being recycled efficiently.

What Does the Analysis Represent?

• Goal: To assess how well the liver is functioning and how effectively bile is flowing.
• Main Application: Diagnosing Intrahepatic Cholestasis of Pregnancy (ICP), detecting “silent” liver disease, and evaluating portosystemic shunts.
• Biological Process: It reflects the enterohepatic circulation (the loop between the liver and intestines). If the liver is damaged or the bile ducts are blocked, bile acids back up into the blood, often causing intense itching.

Recommendations for the Test (General)

• Fasting: Mandatory. You must fast for at least 8–12 hours. Eating causes a natural release of bile acids, which will result in a massive (and normal) spike that makes the test impossible to interpret.
• Stable State: Avoid strenuous exercise and alcohol for 24 hours before the draw.
• Material: Venous blood (serum).

What Can Affect the Results?

• Recent Meals: This is the most common cause of a “false high” result. Even a tiny snack can trigger bile release.
• Medications: Some drugs (like cholestyramine) are designed to bind bile acids and can lower results, while others may cause liver stress and raise them.
• Pregnancy: Hormonal changes in the third trimester can slow down bile flow in sensitive individuals.

When to Take the Test?

• Pregnancy Itching: If you are pregnant and experience intense itching, especially on the palms of the hands and soles of the feet (even without a rash).
• Unexplained Jaundice: If your skin or eyes are yellowing, but standard liver tests (like ALT/AST) are only mildly elevated.
• Chronic Liver Disease Monitoring: To check the progress of conditions like Primary Biliary Cholangitis (PBC).

How to Interpret the Results?

Important: Interpretation of bile acid levels is the sole responsibility of your doctor, especially in obstetric cases. Elevated Levels: High concentrations suggest bile is not flowing correctly, which is a key marker for Intrahepatic Cholestasis of Pregnancy (ICP). Normal Range: Indicates healthy hepatic clearance and proper bile acid recycling.

Possible Further Investigations

• Liver Function Panel: Checking Bilirubin, ALP, and GGT to see if the problem is a blockage or liver cell damage.
• Abdominal Ultrasound: To look for gallstones or dilated bile ducts.
• INR/Prothrombin Time: Since bile acids are needed to absorb Vitamin K, high levels (indicating poor fat absorption) can eventually affect how well your blood clots.

When Does the Next Step Make Sense? 

The next step is urgent for pregnant women experiencing itching, as high bile acids can be toxic to the baby. For non-pregnant individuals, an elevated result is a very sensitive early indicator that the liver’s “plumbing” is not working correctly. It often catches liver issues before they show up on a standard physical exam.

👉 If necessary, you can discuss the results of the analysis with a specialist, such as a Gastroenterologist (Doctors – TAMC).