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Liver

Total Bilirubin: Normal Values and What a High Level Means

Total bilirubin is a liver function marker that can be influenced by hormonal changes. Women using hormonal contraception, during pregnancy, or undergoing hormone therapy may experience fluctuations in bilirubin levels, making regular monitoring a valuable part of health assessment.

Doctor's Assessment Included

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Your reference range
umol/l
2 22 umol/l
Reference ranges by group, in umol/l
Female · 1–5 years 2–10 umol/l
2 10
Female · 6–12 years 3–16 umol/l
3 16
Female · 13–18 years 3–22 umol/l
3 22
Female · 19 years and older 3–19 umol/l
3 19
2 22 umol/l

Source: NVKC Reference population: Nederlandse huisartsenpopulatie (NUMBER, n=7.574.327)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

What It Measures

This test measures the total concentration of bilirubin in your blood, which includes both direct (conjugated) and indirect (unconjugated) forms. Bilirubin is produced when haemoglobin from old red blood cells is broken down.

The liver processes indirect bilirubin into direct bilirubin, which is then excreted through bile. Elevated total bilirubin can result from problems at any stage of this process, including excessive red blood cell breakdown, impaired liver function, or blocked bile ducts.

Why It Matters

Total bilirubin is a fundamental marker for assessing liver function and diagnosing the cause of jaundice. By comparing total bilirubin with direct bilirubin, healthcare providers can determine whether elevation is due to liver disease, bile duct obstruction, or haemolysis.

Mild elevations may occur in common and generally harmless conditions such as Gilbert syndrome, which affects approximately 5-10% of the population. However, significant elevations warrant further investigation to rule out serious underlying conditions.

When to Test

Testing is recommended when jaundice is observed, as part of a routine liver function panel, or when monitoring known liver or blood disorders.

Total bilirubin testing may also be appropriate when experiencing symptoms such as unexplained fatigue, abdominal pain, dark urine, or pale stools, or when evaluating the potential side effects of certain medications.

Symptoms

Low Levels

Low total bilirubin levels are generally not clinically significant and typically reflect normal red blood cell turnover and liver function.

High Levels

Jaundice (yellowing of skin or eyes)
Fatigue and weakness
Abdominal pain or discomfort
Nausea or loss of appetite
Dark urine and pale stools

Recommendations

Female

If Low

Normal bilirubin indicates healthy liver function. No action needed.

If High

Elevated bilirubin may indicate liver disease or Gilbert syndrome. Consult your healthcare provider for evaluation.

Lifestyle Tips

Moderate your alcohol intake, as excessive consumption is a leading cause of liver damage and elevated bilirubin. Eat a balanced diet with adequate fibre to support healthy bile production and excretion.

Stay well hydrated and maintain a healthy weight to reduce the risk of fatty liver disease. If you have Gilbert syndrome, be aware that fasting, stress, and illness can temporarily raise bilirubin levels. Always discuss medications and supplements with your healthcare provider.

Frequently Asked Questions

What does elevated total bilirubin mean?
Elevated total bilirubin can indicate liver disease, bile duct obstruction, or increased breakdown of red blood cells. It may also be caused by Gilbert syndrome, a common and generally harmless genetic condition. Consult your healthcare provider for proper evaluation.
What is Gilbert syndrome?
Gilbert syndrome is a common, inherited condition where the liver processes bilirubin more slowly than usual. It typically causes mildly elevated bilirubin levels and occasional jaundice, particularly during fasting, stress, or illness, but generally does not require treatment.
Should I fast before a bilirubin test?
Fasting requirements may vary depending on your healthcare provider's instructions and whether additional tests are being performed. Fasting can raise bilirubin levels in people with Gilbert syndrome, so inform your provider if you have this condition.

Test Products

This marker is included in the following test panels.

Bilirubin (Total)

€7,-