Description of the blood Analysis:
Bilirubin is a yellowish pigment formed during the normal breakdown of red blood cells (hemolysis). After these cells reach the end of their lifespan, the hemoglobin inside them is converted into “indirect” (unconjugated) bilirubin. This travels to the liver, where it is processed into “direct” (conjugated) bilirubin, making it water-soluble so it can be excreted into the bile and eventually leave the body through stool. Total Bilirubin is the sum of both the indirect and direct forms.
What Does the Analysis Represent?
- Goal: To evaluate liver function, check for bile duct obstructions, and investigate the cause of jaundice (yellowing of the skin).
- Main Application: Diagnosing hepatitis, cirrhosis, gallstones, and hemolytic anemia, as well as monitoring newborn jaundice.
- Biological Process: It reflects the “waste management” efficiency of the liver and the health of the red blood cells.
Recommendations for the Test (General)
- Fasting: Mandatory. You should fast for 8–12 hours before the test. Eating can cause gallbladder contraction and temporarily shift bilirubin levels.
- Light Sensitivity: Bilirubin is very sensitive to light. The blood sample must be protected from bright light after it is drawn to prevent the pigment from breaking down before it is tested.
- Medications: Certain drugs can interfere with results; inform your doctor if you are taking steroids, antibiotics, or birth control pills.
- Material: Venous blood (serum).
What Can Affect the Results?
- Gilbert’s Syndrome: A common, harmless genetic condition where the liver slightly under-processes bilirubin, leading to mild elevations, especially during stress or fasting.
- Strenuous Exercise: Intense physical activity can increase the breakdown of red blood cells, causing a temporary rise.
- Alcohol: Excessive alcohol consumption stresses the liver and can cause a spike in bilirubin.
- Newborn Status: High bilirubin is very common in newborns because their livers are not yet fully developed.
When to Take the Test?
- Visual Symptoms: Yellowing of the whites of the eyes or the skin (jaundice).
- Digestive Changes: Very dark, tea-colored urine or pale, clay-colored stools.
- Pain: Pain in the upper right side of the abdomen.
- History: Known history of heavy drinking, exposure to hepatitis, or family history of blood disorders.
How to Interpret the Results?
Important: Bilirubin levels must be evaluated by a licensed physician to determine the underlying cause of jaundice or liver stress. High Total Bilirubin: Often indicates that the liver is unable to process or clear bilirubin effectively, which can be due to liver disease, bile duct blockage, or the rapid breakdown of red blood cells (hemolysis). Interpretation: If levels are elevated, a doctor will typically look at direct and indirect bilirubin fractions to pinpoint whether the issue is in the liver, gallbladder, or blood.
Possible Further Investigations
- Bilirubin Fractions (Direct/Indirect): To pinpoint if the problem is “before” or “after” the liver processing stage.
- Liver Enzymes (ALT, AST, ALP, GGT): To see if liver cell damage or bile duct obstruction is present.
- Complete Blood Count (CBC): To check for signs of anemia or abnormal red blood cell breakdown.
- Abdominal Ultrasound: To look for gallstones or structural liver changes.
When Does the Next Step Make Sense?
The next step is necessary if the total bilirubin is elevated, especially if the skin or eyes appear yellow. Because high bilirubin can be toxic (particularly to the nervous system in infants) and often signals a significant liver or gallbladder issue, it requires immediate follow-up to identify the exact cause and start treatment.
👉 If necessary, you can discuss the results of the analysis with a specialist, such as a Gastroenterologist (Doctors – TAMC), or Hematologist (Doctors – TAMC).
