Bilirubin blood test (total, direct and indirect)
Quick answer: A bilirubin test measures bilirubin, a yellow pigment made when red blood cells break down and cleared by the liver. Doctors order it to look into jaundice, liver and bile duct problems or faster breakdown of red blood cells; it is also used in newborns with jaundice.
- SampleBlood
- TakesAbout 5 minutes
- Before the testNo special preparation is usually needed.
How the test is done
- 1For adults, blood is drawn from a vein in the arm
- 2For newborns, a few drops are taken from a heel prick
- 3The sample is protected from light
- 4The lab measures total bilirubin and, if requested, the direct and indirect parts
What your results can mean
Reading your report
Normal ranges differ between labs and by age and sex, so discuss your result with your doctor.
If the result is outside the usual range
A high indirect bilirubin can be seen with faster breakdown of red blood cells or Gilbert's syndrome. A high direct bilirubin can be seen with liver disease or a blockage in the bile ducts.
Who usually has this test
People with yellow skin or eyes, dark urine, liver or gallbladder problems, and newborns with jaundice.
Risks and aftercare
There may be slight bruising; a newborn's heel may have a small mark that heals quickly.
Names and options
Also called: serum bilirubin, LFT bilirubin, jaundice test
Options
- Total
- Direct (conjugated)
- Indirect (unconjugated)
- Total and direct
Listed by the hospital as
- BILIRUBIN (DIRECT), SERUM
- BILIRUBIN (INDIRECT), SERUM
- BILIRUBIN (TOTAL & DIRECT)
- BILIRUBIN (TOTAL), SERUM
Questions about this test
What is the difference between direct and indirect bilirubin?
Indirect bilirubin has not yet been processed by the liver, and direct bilirubin has. Which one is high helps show whether the problem is before, in or after the liver.
What is Gilbert's syndrome?
It is a common, harmless inherited condition in which bilirubin rises a little, especially when you are fasting, ill or stressed. It usually needs no treatment.
Why do newborns often have high bilirubin?
Newborns break down red blood cells quickly and their livers are still maturing. Most newborn jaundice settles, but high levels need treatment.
Related tests
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This page explains each test in general terms so you know what to expect. It is not medical advice: your doctor decides which tests you need and what your results mean. Reference ranges differ between laboratories. Updated 4 November 2026.