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Total Bilirubin (Blood)

Does this test have other names?

Total serum bilirubin, TSB 

What is this test?

This is a blood test that measures the amount of a substance called bilirubin. This test is used to find out how well your liver is working. It is often part of a panel of tests that measure liver function. A small amount of bilirubin in your blood is normal, but a high level may be a sign of liver disease.

The liver makes bile to help you digest food, and bile contains bilirubin. Most bilirubin comes from the body's normal process of breaking down old red blood cells. A healthy liver can normally get rid of bilirubin. But when you have liver problems, bilirubin can build up in your body to unhealthy levels. 

Why do I need this test?

You may need this test if you have symptoms of liver damage or disease. Symptoms include:

  • Yellowish skin or eyes (jaundice)

  • Stomach pain

  • Dark urine

  • Light colored stool

  • Flu-like symptoms, such as fever and chills

You may also have your bilirubin level tested regularly if you are being treated for liver disease.

Many healthy newborns also develop jaundice. Most jaundice in infants causes no problems. But babies are often tested shortly after birth because a high bilirubin level may affect the brain, lead to deafness, and cause intellectual or developmental disabilities..

What other tests might I have along with this test?

You may have other blood tests to find the cause of your liver problems. You may also have urine tests, an ultrasound or other imaging scans of your belly, or a liver biopsy.

For newborns, healthcare providers often order a urine test in addition to the bilirubin test. 

What do my test results mean?

Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

Bilirubin results depend on your age, gender, and health. Normal bilirubin levels are generally less than 1 milligram per deciliter (mg/dL). Adults with jaundice generally have bilirubin levels greater than 2.5mg/dL. In an otherwise healthy newborn, bilirubin levels greater than 15 mg/dL may cause problems.

How is the test done?

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. For a baby, the blood sample is taken from the heel with a small needle stick.

Does this test pose any risks?

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

What might affect my test results?

Medicines and herbal supplements can increase your bilirubin level. Pregnancy and drinking alcohol can also cause a buildup of bilirubin in your liver. 

How do I get ready for this test?

Follow your healthcare provider's instructions about not eating or drinking before the test. Ask your provider if there is anything else you should do to get ready for this test. Tell your provider about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use. 

Online Medical Reviewer: Chad Haldeman-Englert MD
Online Medical Reviewer: Maryann Foley RN BSN
Online Medical Reviewer: Raymond Turley Jr PA-C
Date Last Reviewed: 10/1/2020
© 2000-2020 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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