What is the Total Bilirubin test?

The Total Bilirubin test measures the total amount of bilirubin in the blood, including both unconjugated (indirect) and conjugated (direct) bilirubin. Bilirubin is a yellow pigment formed when red blood cells are broken down and processed by the liver.

Under normal circumstances, bilirubin is processed by the liver and excreted in bile. Elevated levels occur when this process is disrupted due to liver dysfunction, bile duct obstruction, or increased red blood cell breakdown.

This test is a standard component of liver function testing and is widely used in clinical assessment.

Why do I need a Total Bilirubin test?

Abnormal bilirubin levels can indicate problems with the liver, bile ducts, or blood cells. Symptoms may be subtle or obvious, depending on the cause.

You may need this test if you experience:

• Yellowing of the skin or eyes (jaundice)
• Dark urine or pale stools
• Abdominal discomfort
• Fatigue or weakness
• Abnormal liver function test results
• Suspected liver or gallbladder disease
• Monitoring known liver conditions
• Unexplained anaemia or red blood cell disorders

Testing helps identify whether bilirubin metabolism or excretion is impaired.

Benefits of the test

1. Assesses liver processing function
   Reflects how well the liver handles waste products.
2. Helps diagnose jaundice
   Identifies bilirubin-related causes of yellowing.
3. Detects bile flow obstruction
   Elevated levels may indicate cholestasis.
4. Supports investigation of anaemia
   Helps assess red blood cell breakdown.
5. Part of routine liver assessment
   Standard marker in liver function testing.
6. Useful for disease monitoring
   Tracks progression or resolution over time.
7. Simple blood-based testing
   Requires only one blood sample.
8. Widely clinically accepted
   Used across primary and secondary care.

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

Low bilirubin (usually not clinically significant)

• Bilirubin below reference range
• UK standard: <5 µmol/L
• Typically not associated with disease

Normal bilirubin

• Bilirubin within reference range
• UK standard (typical): 5–21 µmol/L
• Suggests normal bilirubin metabolism

High bilirubin

• Bilirubin above reference range
• UK standard: >21 µmol/L
• May indicate liver dysfunction, bile obstruction, or increased red cell breakdown

Further testing may differentiate direct and indirect bilirubin if levels are elevated.