Total Bile Acid/Bile Salts
This blood test measures total bile acids to assess liver function and bile flow. It is commonly used in liver disease, cholestasis, and pregnancy-related liver conditions.
Turnaround time
4 days
Biomarkers count
1
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Details about Total Bile Acid/Bile Salts
What is the Total Bile Acids (Bile Salts) test?
The Total Bile Acids test measures the concentration of bile acids circulating in the bloodstream. Bile acids are produced by the liver from cholesterol and are essential for digestion and absorption of fats and fat-soluble vitamins.
Under normal conditions, bile acids are efficiently recycled through the liver and intestines, with only small amounts entering the bloodstream. Elevated blood levels indicate impaired bile flow or liver dysfunction.
This test is particularly sensitive for detecting cholestasis, sometimes before standard liver enzymes become abnormal.
Why do I need a Total Bile Acids test?
Disruption in bile production or flow can cause symptoms and complications that may not be detected by routine liver tests alone.
You may need this test if you experience:
- Persistent or unexplained itching
- Jaundice (yellowing of skin or eyes)
- Right upper abdominal discomfort
- Abnormal liver function tests
- Suspected cholestatic liver disease
- Monitoring known liver or biliary conditions
- Symptoms of liver dysfunction with normal standard tests
- Pregnancy-related itching (suspected intrahepatic cholestasis of pregnancy)
Testing helps identify bile flow problems and supports earlier detection of liver-related conditions.
Benefits of the test
- Sensitive marker of bile flow impairment
Detects cholestasis earlier than routine liver enzymes. - Supports liver disease assessment
Useful in chronic and acute liver conditions. - Important in pregnancy-related liver disorders
Key test for suspected intrahepatic cholestasis of pregnancy. - Explains unexplained itching
Elevated bile acids are a common cause. - Complements liver function tests
Adds functional insight beyond standard markers. - Useful for disease monitoring
Tracks progression or response over time. - Simple blood-based testing
Requires only a blood sample. - Improves diagnostic confidence
Helps clarify ambiguous liver test results.
Step-by-step: How we offer testing
Clinic-based testing (UK-wide)
- Choose your nearest UK clinic
- Attend your appointment
- A clinician draws a blood sample
- Sample is sent to the laboratory
- Results are issued once analysis is complete
Home or hotel visit (+£60, UK-wide)
- Book a mobile phlebotomist
- Blood sample taken at your home or hotel
- No need to attend a clinic
- Sample securely transported to the laboratory
Your results explained
Normal bile acids
- Bile acid levels within reference range
- UK standard (typical): <10 µmol/L
- Suggests normal bile production and flow
Mildly elevated bile acids
- Levels above reference range
- UK standard: 10–40 µmol/L
- May indicate early cholestasis or liver dysfunction
High bile acids
- Markedly elevated levels
- UK standard: >40 µmol/L
- Suggests significant bile flow impairment or liver disease
Interpretation should consider symptoms, pregnancy status, and other liver tests.
How It Works
Simple steps to get your results
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Choose your test online and book in seconds. Select your preferred clinic location or home visit option.
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.
Get Your Results
Your sample is analysed by accredited UK laboratories, with secure results delivered directly to you.
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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.