1,25-dihydroxyvitamin D (calcitriol)
This test measures 1,25-dihydroxyvitamin D, the biologically active form of vitamin D. It is used to investigate calcium imbalance, kidney disease and...
Bilirubin (Direct/Indirect)
65.00
The Bilirubin (Direct/Indirect) blood test measures different forms of bilirubin in the blood. It helps assess liver function, bile duct health and causes of jaundice or abnormal liver tests.
Turnaround time
1 day
Biomarkers count
1
Same-Day Appointments
UKAS Accredited Labs
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Under 18? Patients under 18 can only be seen at GB Medlabs and Clinilabs, Monday to Friday only.
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Details about Bilirubin (Direct/Indirect)
What is the Bilirubin (Direct / Indirect) Blood Test?
The Bilirubin (Direct / Indirect) blood test measures bilirubin, a yellow pigment produced during the normal breakdown of red blood cells. Bilirubin is processed by the liver and excreted through bile.
This test measures three related markers:
- Total Bilirubin – the total amount of bilirubin in the blood
- Direct (Conjugated) Bilirubin – bilirubin that has been processed by the liver
- Indirect (Unconjugated) Bilirubin – bilirubin before liver processing
By separating bilirubin into these components, the test helps identify whether raised bilirubin is linked to liver processing issues, bile flow obstruction, or increased red blood cell breakdown.
Why do I need a Bilirubin (Direct / Indirect) Blood Test?
This test is commonly used when jaundice or abnormal liver-related symptoms are present, or when bilirubin abnormalities have been identified on routine blood tests.
You may benefit from this test if you have:
- Yellowing of the skin or eyes (jaundice)
- Dark urine or pale stools
- Fatigue or unexplained weakness
- Abdominal discomfort
- Abnormal bilirubin or liver-related blood results
- Suspected bile flow problems
- Family history of bilirubin-related conditions
- Monitoring of known liver or gallbladder issues
- Unexplained high bilirubin levels
- Recurrent mild jaundice during illness or fasting
Measuring total, direct and indirect bilirubin together allows a more accurate understanding of the cause.
Benefits of the Bilirubin (Direct / Indirect) Blood Test
- Differentiates bilirubin types
Helps identify whether bilirubin elevation is direct or indirect. - Supports jaundice investigation
Essential when yellowing of skin or eyes is present. - Assesses liver processing ability
Direct bilirubin reflects liver conjugation function. - Identifies bile flow issues
Raised direct bilirubin may indicate impaired bile excretion. - Detects increased red cell breakdown
Raised indirect bilirubin may suggest haemolysis. - Useful in inherited conditions
Helps identify patterns seen in conditions like Gilbert’s syndrome. - Simple and fast blood test
Minimally invasive and easy to perform. - Supports monitoring over time
Useful for tracking changes in bilirubin levels.
Step-by-Step – How the Test is Performed
- Book your blood test appointment online
- Attend your chosen UK clinic
- A healthcare professional collects a blood sample
- The procedure takes only a few minutes
- Results are reviewed once available
Optional home blood collection may be available in selected areas.
Your Bilirubin Results Explained
Normal Results
What this means:
- Total, direct and indirect bilirubin are within reference ranges
What it suggests:
Normal bilirubin production and processing.
Raised Indirect Bilirubin
What this may indicate:
- Increased red blood cell breakdown
- Reduced liver uptake of bilirubin
Common associations:
- Gilbert’s syndrome
- Fasting, illness or stress
Raised Direct Bilirubin
What this may indicate:
- Impaired bile flow
- Reduced bilirubin excretion from the liver
Common associations:
- Biliary obstruction
- Liver-related conditions
Raised Total Bilirubin
What this may indicate:
- Elevation of either direct or indirect bilirubin
- Requires interpretation of individual components
How It Works
Simple steps to get your results
1
Book Online
Choose your test online and book in seconds. Select your preferred clinic location or home visit option.
2
Visit or Test at Home
Attend one of our UK or London clinics, arrange a home nurse visit, or use a finger-prick kit where available.
3
Get Your Results
Your sample is analysed by accredited UK laboratories, with secure results delivered directly to you.
Take control of your health with London Blood Tests
WhatsApp UsHow to Prepare for Your Test
Follow these guidelines for accurate results
Sample Timing
Where possible, attend your blood test between 7am and 12pm. Please wait until any short-term illness or infection has fully resolved before testing. Avoid intense exercise for 24–48 hours beforehand, as this can affect certain markers.
Fasting & Hydration
Fasting is not always required, but some tests may recommend it. If fasting is advised, avoid food for 8–12 hours before your appointment and drink water only. Stay well hydrated, as this helps with sample collection and accuracy.
Medications & Supplements
Continue prescribed medications unless advised otherwise by your clinician. Avoid vitamin, mineral, or biotin supplements for at least 24–48 hours before your test, as these can interfere with results. If you are unsure about any medication or supplement, please let us know before your appointment.
Hormones & Menstrual Cycle
For hormone-related tests, timing within your menstrual cycle may be important. If relevant, follow any specific guidance provided on your test page.
If you have any questions or special circumstances, our team is happy to advise before your appointment.
Frequently Asked Questions
It measures total bilirubin, direct bilirubin, and indirect bilirubin.
Fasting is not usually required, unless combined with other tests.
Common causes include liver processing issues, bile flow problems or increased red blood cell breakdown.
Yes. Illness, fasting, dehydration and stress can temporarily increase bilirubin.
It helps identify abnormalities, but diagnosis usually requires clinical correlation.
Indirect bilirubin is unprocessed; direct bilirubin has been processed by the liver.
No. It is a benign inherited condition but can cause intermittent jaundice.
Yes. Some medications can alter bilirubin metabolism.
Testing frequency depends on symptoms and monitoring needs.
You may be advised on repeat testing, lifestyle changes or further investigation.
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