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Dr. Anupriya Nautiyal
MD Pathology, MBBS
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Bilirubin Indirect

Also known as Bilirubin Unconjugated
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This test is for
Male, Female
Test Preparation
  1. No special preparation is required.

Understanding Bilirubin Indirect

What is Bilirubin Indirect?

The Bilirubin Indirect test measures the indirect (unconjugated) bilirubin in the blood. This test is performed if your doctor suspects a liver disorder, like jaundice, gallstones, hepatitis, etc. It may also be done as part of a routine health checkup or liver function test to monitor your liver health. 

Bilirubin is a byproduct of broken down old or damaged red blood cells, and the type of bilirubin that goes to the liver for processing is called indirect or unconjugated bilirubin (insoluble in water). This indirect bilirubin is bound to albumin, a type of protein in the blood, that helps carry it to the liver. The liver turns the bilirubin, along with other waste products, into a fluid called bile. The bile is then passed out of your body through the intestines, and bilirubin is the pigment that gives bile its distinctive yellow color.

You may need the Bilirubin Indirect test if you experience symptoms suggestive of liver problems, such as the yellowing of the skin and eyes, dark-colored urine, belly pain, chest pain, lightheadedness, nausea, or vomiting. It may also be done to monitor jaundice and neonatal jaundice in newborns. Usually, no special preparation is required for this test; you may eat and drink as per your daily routine.

Test result ranges are approximate and may differ slightly between different labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. The test results will help them determine your medical condition, make recommendations for lifestyle modifications such as diet and exercise, decide whether or not medication will be required to manage your liver health, and formulate your overall treatment plan.

What is Bilirubin Indirect used for?

The Bilirubin Indirect test is done: 

  • As part of routine health checkups.

  • As part of a liver function test.

  • To help detect liver diseases, such as jaundice or hemolytic anemia.

  • To monitor an existing liver disease and its treatment response.

  • In the case of a history of excessive alcohol drinking.

  • In case of exposure to the hepatitis virus.

  • To detect and monitor neonatal jaundice in newborns. 

  • To find out if there is a blockage in the bile duct.

What does Bilirubin Indirect measure?

The Bilirubin Indirect test measures the amount of indirect or unconjugated bilirubin in your body. Bilirubin is a yellowish byproduct primarily produced when your body breaks down aged red blood cells (RBCs). When RBCs finish their lifespan of 120 days, they break down and pass to your liver. Indirect bilirubin, a form of bilirubin that is unconjugated (not soluble in water), is bound to the protein albumin that helps transport it to the liver. When the liver processes the bilirubin, it unbinds from the albumin and binds to a sugar molecule, making it water-soluble. This water-soluble bilirubin is mixed with bile, excreted in the bile ducts, and stored in your gallbladder. Finally, bile is released into the small intestine to help digest fat and is eventually excreted with your stool as a waste product.

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Bilirubin Indirect

Frequently Asked Questions about Bilirubin Indirect

Q. Why is the Bilirubin Indirect test done?

The Bilirubin Indirect test is done to check your liver health and as part of routine health checkups. Your doctors may recommend this test to detect liver diseases, like jaundice, fatty liver, hepatitis, etc.

Q. Is fasting required before the Bilirubin Indirect test?

No, fasting is not required before the Bilirubin Indirect test. You can eat or drink normally as per your daily routine before this test.

Q. What are the signs and symptoms associated with elevated indirect bilirubin levels?

You may experience symptoms such as the yellowing of your eyes and skin, swelling and pain in the belly, chest pain, lightheadedness, and fatigue when your indirect bilirubin levels are elevated.

Q. How can I lower my high bilirubin levels?

You must consult your doctor if your bilirubin levels are high. However, staying hydrated and increasing fiber intake in your diet by adding whole grains, berries, dry fruits, broccoli, and beans can improve your bilirubin levels.

Q. What other tests are advised along with the Bilirubin Indirect test?

Other tests that are advised along with the Bilirubin Indirect test include alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase tests. In case, hemolytic anemia is suspected, then the doctor may advise tests such as complete blood count, reticulocyte count, haptoglobin, and lactate dehydrogenase.
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