Total and direct bilirubin levels can be measured from the blood, but indirect bilirubin is calculated from the total and direct bilirubin. Indirect bilirubin is fat-soluble and direct bilirubin is water-soluble. Unconjugated bilirubin ("indirect" bilirubin) concentration is calculated by subtracting the direct-reacting fraction from total bilirubin. Direct reacting bilirubin slightly overestimates … … is defined as serum conjugated bilirubin concentration >0. 4 mg/dL (6. 8 micromol/L). Normal values of total bilirubin are from 0. 3–1. 0 mg/dL. The indirect bilirubin level in the bloodstream is the total bilirubin minus the direct bilirubin levels in the bloodstream. A bilirubin test measures total bilirubin. It can also give levels of two different types of bilirubin: unconjugated and conjugated. Unconjugated (“indirect”) bilirubin. This is the bilirubin created from red blood cell breakdown. It travels in the blood to the liver. Indirect bilirubin is the difference between total and direct bilirubin. Common causes of higher indirect bilirubin include: Hemolytic anemia. This means your body is getting rid of too many red blood cells.
If conjugated (direct) bilirubin is elevated more than unconjugated (indirect) bilirubin, there typically is a problem associated with decreased elimination of bilirubin by the liver cells. Some conditions that may cause this include: Viral hepatitis (hepatitis A, hepatitis B, hepatitis C)
This includes: Water. Drinking at least eight glasses of water a day helps your liver flush out toxins. Coffee or herbal tea. Moderate coffee consumption has been shown to improve liver health by reducing: Milk thistle. Digestive enzymes. Fruits and vegetables. Fiber.
Note: Conjugated bilirubin is often incorrectly called "direct bilirubin" and unconjugated bilirubin is incorrectly called "indirect bilirubin". Direct and indirect refer solely to how compounds are measured or detected in solution. Indirect bilirubin is fat-soluble and direct bilirubin is water-soluble.
Bilirubin test results are expressed as direct, indirect or total bilirubin. Lower than normal bilirubin levels are usually not a concern. Elevated levels may indicate liver damage or disease. Higher than normal levels of direct bilirubin in your blood may indicate your liver isn't clearing bilirubin properly.
It usually disappears by 1 to 2 weeks of age, and the levels of bilirubin are harmless.
Typically, bilirubin levels fall somewhere between 0. 3 and 1. 2 milligrams per deciliter (mg/dL). Anything above 1. 2 mg/dL is usually considered high. The condition of having high bilirubin levels is called hyperbilirubinemia. It happens because, at birth, the liver often isn't yet fully able to process bilirubin.
It is normal to have some bilirubin in the blood. A normal level is: Direct (also called conjugated) bilirubin: less than 0. 3 mg/dL (less than 5. 1 µmol/L) Total bilirubin: 0. 1 to 1. 2 mg/dL (1. 71 to 20. 5 µmol/L)
If the conjugated bilirubin levels are higher than the unconjugated bilirubin, this is typically due to a malfunction of the liver cells in conjugating the bilirubin. This is commonly seen with drug reactions, hepatitis, as well as any type of liver disease.
Jaundice is considered pathologic if it presents within the first 24 hours after birth, the total serum bilirubin level rises by more than 5 mg per dL (86 mol per L) per day or is higher than 17 mg per dL (290 mol per L), or an infant has signs and symptoms suggestive of serious illness.
Treatment. Treatment depends on the underlying cause of the high bilirubin. If the cause is known, bilirubin might be removed through treatment or lifestyle changes, such as avoiding alcohol.
Hyperbilirubinemia is an extremely common problem occurring during the newborn period. Since 97% of term babies have serum bilirubin values <13 mg/dl, all infants with a serum bilirubin level >13 mg/dl require a minimum work up.
Adults with jaundice generally have bilirubin levels greater than 2. 5 milligrams per deciliter (mg/dL). In an otherwise healthy newborn, bilirubin levels greater than 20 to 25 mg/dL may cause problems.
Total bilirubin (mg /dl) = Direct bilirubin (mg /dl) = Indirect bilirubin (mg / dl) = Total - Direct.
Urobilinogen is a colorless pigment that is produced in the gut from the metabolism of bilirubin. Some is excreted in feces, and the rest is reabsorbed and excreted in the urine. In obstructive jaundice, bilirubin does not reach the bowel, and urinary excretion of urobilinogen is diminished.