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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 given as 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

  • 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 lead to deafness, retardation, and brain damage.

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. Adults with jaundice generally have bilirubin levels greater than 2.5 milligrams per deciliter (mg/dL). In an otherwise healthy newborn, bilirubin levels greater than 20 to 25 mg/dL may cause problems.

How is the test is done?

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

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?

You may not be allowed to eat or drink right before the test. Ask your healthcare provider how else you should prepare for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use. 

Medical Reviewers:

  • Freeborn, Donna, PhD, CNM, FNP
  • Haldeman-Englert, Chad, MD