Bilirubin normal range

Bilirubin is a yellowish pigment produced when hemoglobin in your red blood cells breaks down. Once it breaks down, it’s sent through your liver, gallbladder, and bile ducts before being excreted. Your doctor may order a bilirubin test as part of a typical Usually, bilirubin levels hover somewhere between 0.3 to 1.2 milligrams per deciliter (mg/dL). Read on to learn more about bilirubin and what levels below this range could mean. If you’re looking at your test results, you’ll probably notice a few kinds of bilirubin, including: • Unconjugated (indirect) bilirubin. This type is created when hemoglobin from red blood cells is broken down, bound to a protein in the blood called albumin, and transported to the liver. • Conjugated (direct) bilirubin. This type is created when bilirubin attaches to (conjugates with) glucuronic acid in the liver before being excreted. This type of bilirubin is what makes your urine yellow. • Total bilirubin. This refers to all of the bilirubin in your bloodstream. Your doctor might say you have low bilirubin levels if any of these are outside of the usual range. Low bilirubin levels usually don’t cause any symptoms and aren’t usually a cause for concern. Most people don’t even know they have low bilirubin levels until their doctor orders a blood test. If you have low bilirubin levels and notice any unusual symptoms, make an appointment with your doctor. You may have an unrelated condition that needs treatment. There aren’t any health conditions ...

Overview Laboratory assessment of the patient with suspected or clinically obvious liver disease is context dependent. For example, the acutely ill jaundiced patient with a history of prolonged alcohol ingestion requires a different laboratory assessment than the well patient in whom one or more standard liver test results are discovered to be abnormal during routine testing. Additionally, the sequence of liver tests depends heavily on the questions being asked. If it is to determine whether this well person whose brother was recently diagnosed with hemochromatosis also has this genetic disease, then a series of tests will be initiated to detect the possibility of iron overload. If it is to determine whether this spouse has been infected with hepatitis B, then blood tests related to hepatitis B will be required. Thus generic algorithms for the evaluation of liver disease need to be considered skeptically. This chapter is intended to discuss a useful way of thinking about liver tests. It emphasizes limitations of and alternative explanations for isolated abnormalities of common liver test results. It also provides information on the initial screening test to be chosen, their interpretation, and the tests needed to confirm the diagnosis of common liver disorders based on current recommendations. Information in this chapter should be combined with discussions of specific liver diseases. A final caveat relates to terminology. Tests done in clinical laboratories do not measure ...

Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include fractionated bilirubin, a complete blood count, alanine transaminase, aspartate transaminase, alkaline phosphatase, γ-glutamyltransferase, prothrombin time and/or international normalized ratio, albumin, and protein. Imaging with ultrasonography or computed tomography can differentiate between extrahepatic obstructive and intrahepatic parenchymal disorders. Ultrasonography is the least invasive and least expensive imaging method. A more extensive evaluation may include additional cancer screening, biliary imaging, autoimmune antibody assays, and liver biopsy. Unconjugated hyperbilirubinemia occurs with increased bilirubin production caused by red blood cell destruction, such as hemolytic disorders, and disorders of impaired bilirubin conjugation, such as Gilbert syndrome. Conjugated hyperbilirubinemia occurs in disorders of hepatocellular damage, such as viral and alcoholic hepatitis, and cholestatic disorders, such as choledocholithiasis and neoplastic obstruction of the biliary tree. Clinical recommendation Evidence rating References The initial laboratory evaluation of jaundice in adults should include fractionated bilirubin, complete blood count, alanine transaminase, aspartate transamina...

A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe alcoholic hepatitis is sometimes confused with cholecystitis or cholangitis. Conversely, patients who present soon after passing common bile duct stones can be misdiagnosed with acute hepatitis because aminotransferase levels often rise immediately, but alkaline phosphatase and γ-glutamyltransferase levels do not become elevated for several days. Asymptomatic patients with isolated, mild elevation of either the unconjugated bilirubin or the γ-glutamyltransferase value usually do not have liver disease and generally do not require extensive evaluation. Overall hepatic function can be assessed by applying the values for albumin, bilirubin and prothrombin time in the modified Child-Turcotte grading system. Abnormal LFTs often, but not always, indicate that something is wrong with the liver, and they can provide clues to the nature of the problem. However, normal LFTs do not always mean that the liver is normal. Patients with cirrhosis and bleeding esophageal varices can have normal LFTs. Of the routine LFTs, only serum albumin, bilirubin and prothrombin time (PT) provide useful information on how well the liver is functioning. Situation Comments Mildly elevated ALT level (less than 1.5 times norm...