Total bilirubin blood test
In short
A typical adult total bilirubin result is 0.1 to 1.2 mg/dL. A mild rise with other liver tests in range is often due to Gilbert syndrome, a common harmless trait. A bigger rise, or one with other abnormal liver tests, matters more. Always read your result against the range printed on your own report.
A yellow pigment made when old red blood cells break down.
The liver clears bilirubin from the blood into bile, a digestive juice. The total counts both forms: indirect (not yet processed by the liver) and direct (already processed). When bilirubin builds up, the skin and eyes can turn yellow (jaundice).
Is my Total bilirubin high or low?
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Typical range
| For | Range | Unit |
|---|---|---|
| Adults | 0.1–1.2 | mg/dL |
| Adults | 2–21 | µmol/L |
Typical ranges for adults. Labs differ a little, so the range printed next to your result is the one to go by.
If your Total bilirubin is high
A mild rise with other liver tests in range is often due to Gilbert syndrome, a common harmless trait. A bigger rise, or one with other abnormal liver tests, matters more.
Common reasons
- Gilbert syndrome, a common harmless trait that slows bilirubin processing
- Fasting, dehydration, illness or hard exercise in the days before
- Some medicines, including some antibiotics and some HIV medicines
- Less often: red blood cells breaking down too fast (hemolysis)
- Less often: liver inflammation (hepatitis) or another liver condition
- Less often: a blocked bile duct, such as from gallstones or a tumor
If your Total bilirubin is low
A low bilirubin is rarely a concern, and doctors usually don't act on it.
Common reasons
- Normal variation between people
- Birth control pills or some seizure medicines
- Some antibiotics or pain relievers
What can throw it off
Fasting, illness or hard exercise before the test can raise bilirubin, especially in people with Gilbert syndrome.
Questions to take to your appointment
- 1Is this mostly direct or indirect bilirubin?
- 2Could Gilbert syndrome explain this?
- 3Are my other liver tests and blood count in range?
Read together with
Doctors rarely read Total bilirubin alone. These usually sit next to it.
- Direct bilirubinThe part of bilirubin the liver has already processed.
- Indirect bilirubinThe part of bilirubin the liver has not yet processed.
- ALTAn enzyme that lives mostly inside liver cells.
- ALPAn enzyme from the liver and bile ducts, and from bone.
- HemoglobinThe protein in red blood cells that carries oxygen.
Quick answers
What is the total bilirubin blood test?
Total bilirubin: A yellow pigment made when old red blood cells break down. The liver clears bilirubin from the blood into bile, a digestive juice. The total counts both forms: indirect (not yet processed by the liver) and direct (already processed). When bilirubin builds up, the skin and eyes can turn yellow (jaundice).
What is a normal total bilirubin level?
For most adults, total bilirubin is typically 0.1 to 1.2 mg/dL. Some countries print it in µmol/L, so check the unit first. Labs differ a little, so the range printed next to your result is the one to go by.
What does a high total bilirubin mean?
A mild rise with other liver tests in range is often due to Gilbert syndrome, a common harmless trait. A bigger rise, or one with other abnormal liver tests, matters more. Common reasons include Gilbert syndrome, a common harmless trait that slows bilirubin processing; fasting, dehydration, illness or hard exercise in the days before; some medicines, including some antibiotics and some HIV medicines; and less often: red blood cells breaking down too fast (hemolysis). A doctor reads it together with your other results and how you feel.
What does a low total bilirubin mean?
A low bilirubin is rarely a concern, and doctors usually don't act on it. Common reasons include normal variation between people; birth control pills or some seizure medicines; and some antibiotics or pain relievers.
What can affect my total bilirubin result?
Fasting, illness or hard exercise before the test can raise bilirubin, especially in people with Gilbert syndrome.
What should I ask my doctor about my total bilirubin?
Questions worth taking to the appointment: Is this mostly direct or indirect bilirubin? Could Gilbert syndrome explain this? Are my other liver tests and blood count in range?
What this page can’t do
It reads each number on its own.
Doctors read results together — ALT with AST, ferritin with hemoglobin, TSH with free T4. A pattern says more than any single flag.
It doesn't know you.
Your age, your medicines, how you feel and your last result all change what a number means.
It doesn't remember.
Close this page and your results are gone. That's on purpose: nothing was ever sent to us.
We also make Vita: Health Coach, an app for those parts. It reads your whole report with your medicines and history in mind, answers follow-up questions in plain words, and keeps your reports in one place — for you and for the people you look after.
Vita: Health Coach on the App StoreSources
- Mayo Clinic Laboratories — Bilirubin, Total, Serum
- MedlinePlus — Bilirubin blood test
- MedlinePlus Genetics — Gilbert syndrome
Stuck on a word? See the medical words. How we choose our sources. More about Vita Health Coach.