bilirubin - total (tbil) Test

Bilirubin - Total (TBIL)

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what is bilirubin?

Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. It is excreted as component of bile, a fluid produced by the liver which is essential for the metabolism of fat. Bilirubin is produced in the body when red blood cells become old and damaged and are destroyed in the spleen. Bilirubin goes in the blood from the spleen to the liver and then in bile into the small intestine.

The liver converts it to a water-soluble form that can be passed out in the urine. This pigment circulates in the blood in direct as well as indirect form. Indirect bilirubin is the unconjugated form, which does not dissolve in water. It travels through the bloodstream to the liver, where it is converted into soluble bilirubin.

Direct bilirubin is the conjugated form that is soluble in water. Total bilirubin ("TBIL") measures both BU (“unconjugated or Indirect bilirubin’), and BC (“Conjugated” or Direct bilirubin”) Total and direct bilirubin levels can be measured from the blood, but indirect bilirubin is calculated from the total and direct bilirubin. Only a small amount of bilirubin is present in the blood.

what is bilirubin test - total (tbil)?

A bilirubin test is generally carried out to measure the amount of bilirubin present in your body. Sometimes when there is higher than normal levels of bilirubin in the body it could be an indication of liver problems.

Also, high bilirubin causes red blood cells to break down faster than normal in the body. To make a conclusive diagnosis the doctors and medical practitioners order for the test.

what are the symptoms of high bilirubin level?

Some of the bilirubin symptoms evident in patients include

  • The evidence of jaundice (skin and white of the eyes appear yellow)
  • Nausea/vomiting
  • Abdominal pain and/or swelling 
  • Dark, amber-coloured urine
  • Fatigue and general malaise that often accompanies a chronic liver disease

why do i need bilirubin test?

It is primarily carried out to check for any kind of liver abnormalities. If there are visible symptoms like the yellowing of skin and eyes or the patient suffers from acute abdominal pain, nausea and vomiting the test is prescribed. These are primary symptoms of jaundice caused by an increase in bilirubin level.

The bilirubin treatment is also carried out to check for the progression of other liver diseases like hepatitis, gallstones, liver toxicity or as a followup for a prior treatment.

how is the total bilirubin test done?

The TBIL test requires the lab technician to draw blood from the vein on your arm by inserting a small needle.

The sample blood is collected in a tube and sent for further analysis to the lab. In the case of newborns, the sample blood is generally taken by breaking the skin of the heels. This is done because the veins of the newborn are extremely small and can be damaged.

does total bilirubin test pose any risk or side effects?

The bilirubin test does not have any potential side effects or risks of leaving for light bruising and bleeding that might occur while the sample is drawn. Also, sometimes a condition called hematoma might arise wherein the blood might get accumulated under the puncture site.

In such a case, the lab technician looks for an alternative site.

how do i prepare for total bilirubin test?

As a part of the preparation for the test, the patient is required not to eat or drink anything other than water 4 hours before taking the test.

Also inform your doctor beforehand if you are already on any kind of medication. He might ask you to discontinue usage before the test.


what might effect my test results?

If you are on any kind of medication, it is very important to inform the doctor. For example, certain antibiotics like penicillin, diuretics like furosemide or sedatives like phenobarbital they can interfere with the bilirubin levels.

sample required

Specimen type: Serum(Blood Sample),

Specimen collection procedure: Venipuncture (Collection of blood from a vein, usually from the arm)

what is the bilirubin normal range?

A bilirubin test generally signifies the levels of two types of bilirubin that is unconjugated and conjugated. In simpler terms, these are called direct and indirect bilirubin. An adult who is over 18 years of age the total bilirubin normal range is 1.2 mg/dl of blood.

While those under 18 tbil of 1mg/dl is considered normal. In comparison to the indirect, the direct bilirubin normal value should be less than 0.3mg/dl.

what other tests might i have along with total bilirubin test?

There are certain other tests that the doctor might prescribe along with the bilirubin test for a clearer picture.

  • Complete Blood Count: It measures several components and features of the blood like red blood cells, white blood cells, haemoglobin, platelets and hematocrit.
  • Liver Function Tests: Includes blood tests for measuring certain enzymes and proteins in the body.
  • Albumin and Total Protein Test: Measures the total amount of albumin and globulin in the body.
  • Prothrombin Time: Deduces the clotting time of plasma.

can i do the bilirubin test at home?

Normally there is no presence of bilirubin in urine. But if there is an underlying pathological condition one might find its presence in the urine. The preliminary analysis for the presence of bilirubin in urine at home by using a test kit available at the pharmacy.

The results of the bilirubin test at home kit are based on the reaction of bilirubin with a diazonium salt. These strips should not be used for bilirubin treatment at home. Any positive signs of bilirubin indicated by the strip require further investigation.

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Bangalore, Delhi-NCR, Chennai, Hyderabad, Kolkata, Pune, Lucknow, Indore.

Understanding results ofBilirubin - Total (TBIL)

Reference RangeInterpretation
Bilirubin – Total (female)0.0 to 1.0 mg/dL
1 - 2 days< 7.2 mg/dL
Bilirubin-Total (male)0.0 to 1.0 mg/dL
Bilirubin-Indirect0.1 to 0.7 mg/dL
Bilirubin – Children0 - 1 days< 5.1 mg/dL
Bilirubin-Direct0.00 to 0.30 mg/dL
Above 1 month< 0.8 mg/dL
3 - 5 days< 10.3 mg/dL

A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’


A bilirubin test is quite helpful in treating many serious liver ailments hence is an important diagnostic tool. The bilirubin test cost might vary depending upon the place where it is carried out, like a diagnostic centre of a hospital or now at home. Before visiting the lab, you can also check for the bilirubin test price online as well.