Indirect bilirubin is a byproduct of heme breakdown that is produced in the spleen and eliminated by the liver. Abnormal levels can indicate illness, and a blood test is used to measure it. High levels of direct bilirubin can cause jaundice and indicate medical problems. Total bilirubin levels range from 1.9 to 3 mg/dL. A bilirubin test involves a small blood draw, and patients are usually asked to fast for at least four hours before the test. Results can vary between laboratories, and failure to follow directions can lead to skewed results.
Indirect bilirubin is a chemical compound formed by the breakdown of heme. It is produced in the spleen and released into the bloodstream to circulate to the liver, where it is bound to albumin so that it can be eliminated from the body, mainly in the feces. Abnormal levels of indirect bilirubin can be indicative of an illness, and a doctor may order a blood test to check bilirubin levels if there are concerns about an ongoing medical problem, especially jaundice, in which the skin and eyes they turn yellow.
When heme is broken down, the yellow-orange pigment bilirubin is one of the byproducts. Indirect bilirubin is not soluble in water, although it is soluble in fat. The spleen sends the pigment to the liver, where it is conjugated with albumin to make it water soluble. At this point, it becomes known as direct or conjugated bilirubin. High levels of direct bilirubin in the body can cause jaundice and indicate that a duct in the liver is blocked or that a patient is experiencing another medical problem. Anemia and transfusion reactions can both cause an increase in indirect bilirubin.
Laboratories determine indirect bilirubin levels by measuring total bilirubin and then subtracting direct bilirubin to see how much is left. In healthy individuals, total bilirubin ranges between 3 and 1.9 milligrams per deciliter (mg/dL). Direct bilirubin is usually less than 3 mg/dL. Higher levels of this can cause jaundice and other problems and are signs that something is wrong with the way the body processes heme and bilirubin. It’s important to determine what’s going on with the use of additional tests, medical imaging studies, and other diagnostic options.
When people take a bilirubin test, they are usually asked to fast for at least four hours before the test, and may need to temporarily stop taking certain medications. A doctor can provide specific directions for a patient. The test involves a small blood draw. Results are usually returned very quickly, especially if a doctor’s office has a laboratory, and once the test results come back, people can discuss further testing, as well as treatment options to address the increased levels of bilirubin.
Patients may want to be aware that results can vary between laboratories. If a test is unusually high and a patient appears healthy, a retest may be ordered to see if the results were a fluke. Failure to follow directions in preparing for the test can also lead to a skewed lab result.
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