4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin)
and itchingare the major symptoms and signs of elevated bilirubin levels in the blood.

The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not
complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis)

have symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.
Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's
and Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin
levels.

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
 How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
 What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
 What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
 The bilirubin test is performed on a small sample of blood from the patient.
 You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
 The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.

QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.
The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.

Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

 Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.

IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images
 8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
 How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
 What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
 What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
 The bilirubin test is performed on a small sample of blood from the patient.
 You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
 The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.

QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.
The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.

Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

 Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.

IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images
 8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

9/15
What are the symptoms of high bilirubin levels in newborns?

 Readers Comments 1
 Share Your Story

High bilirubin level in the newborns usually is indicated by jaundice of the skin, usually
appearing on the face and forehead first, and later spreading to the trunk and extremities.
Other changes such as drowsiness, seizuresand altered crying may occur if high levels persist.
Some newborns may have petechiae, an enlarged spleen and anemiadue to hemolysis and can
progress to develop neurologic problems or even death.

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
 How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
  What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
 What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
 The bilirubin test is performed on a small sample of blood from the patient.
  You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
 The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.
 QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.

The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of
  abdominal pain, and/or
 abnormal red blood cells.

Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

 Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.
 IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images

8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

9/15
What are the symptoms of high bilirubin levels in newborns?

 Readers Comments 1
 Share Your Story
High bilirubin level in the newborns usually is indicated by jaundice of the skin, usually
appearing on the face and forehead first, and later spreading to the trunk and extremities.
Other changes such as drowsiness, seizuresand altered crying may occur if high levels persist.
Some newborns may have petechiae, an enlarged spleen and anemiadue to hemolysis and can
progress to develop neurologic problems or even death.

10/15

What do high bilirubin levels in a newborn mean?

High bilirubin levels in a newborn usually is the result of unconjugated bilirubin, and is not a
major problem for many newborns because they soon metabolize the unconjugated bilirubin
normally. These neonates usually clear jaundice within a week. However, very high
unconjugated bilirubin levels over time (weeks) can be neurotoxic and can even cause death
or lifelong neurological problems (kernicterus) in those who survive. Newborn jaundice may
be the result of an underlying problem, for example:

 A family history of Gilbert syndrome

 Genetic problems
 Birth trauma
 Maternal drug intake
 Viral infection or a problem with bleeding
 Liver and/or bile function

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
 How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
 What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
  What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
 The bilirubin test is performed on a small sample of blood from the patient.
 You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
  The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.

QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
 4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.

The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.
Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

 Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.
 IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images

8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

9/15
What are the symptoms of high bilirubin levels in newborns?

 Readers Comments 1
 Share Your Story
High bilirubin level in the newborns usually is indicated by jaundice of the skin, usually
appearing on the face and forehead first, and later spreading to the trunk and extremities.
Other changes such as drowsiness, seizuresand altered crying may occur if high levels persist.
Some newborns may have petechiae, an enlarged spleen and anemiadue to hemolysis and can
progress to develop neurologic problems or even death.

10/15

What do high bilirubin levels in a newborn mean?

High bilirubin levels in a newborn usually is the result of unconjugated bilirubin, and is not a
major problem for many newborns because they soon metabolize the unconjugated bilirubin
normally. These neonates usually clear jaundice within a week. However, very high
unconjugated bilirubin levels over time (weeks) can be neurotoxic and can even cause death
or lifelong neurological problems (kernicterus) in those who survive. Newborn jaundice may
be the result of an underlying problem, for example:

 A family history of Gilbert syndrome

 Genetic problems
 Birth trauma
 Maternal drug intake
 Viral infection or a problem with bleeding
 Liver and/or bile function

11/15
What is the treatment for elevated bilirubin in adults?

 Readers Comments 1
 Share Your Story

The treatment for elevated bilirubin in adults is to first determine the underlying cause for
example,

 clot reabsorption,
 hemolytic anemia, and
 liver and/or bile problems.

Experts suggest avoiding alcohol consumption to prevent further liver toxicity.

What risks are associated with the bilirubin test?

The risks associated with this test are minor; and consist of potential infection at the
blood withdrawal site, and possible bruising at the site.

What is the prognosis for newborns?

In general, newborns have a good outcome if the bilirubin levels decrease quickly
(over a few days); however, the prognosis is not good if the newborn has persistently
high bilirubin levels.

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
 How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
 What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
 What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
 The bilirubin test is performed on a small sample of blood from the patient.
 You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
 The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.

QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.
The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

 light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.

Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

 Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.

IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images
 8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

9/15
What are the symptoms of high bilirubin levels in newborns?

 Readers Comments 1
 Share Your Story

High bilirubin level in the newborns usually is indicated by jaundice of the skin, usually
appearing on the face and forehead first, and later spreading to the trunk and extremities.
Other changes such as drowsiness, seizuresand altered crying may occur if high levels persist.
Some newborns may have petechiae, an enlarged spleen and anemiadue to hemolysis and can
progress to develop neurologic problems or even death.

10/15

What do high bilirubin levels in a newborn mean?

High bilirubin levels in a newborn usually is the result of unconjugated bilirubin, and is not a
major problem for many newborns because they soon metabolize the unconjugated bilirubin
normally. These neonates usually clear jaundice within a week. However, very high
unconjugated bilirubin levels over time (weeks) can be neurotoxic and can even cause death
or lifelong neurological problems (kernicterus) in those who survive. Newborn jaundice may
be the result of an underlying problem, for example:

 A family history of Gilbert syndrome

 Genetic problems
 Birth trauma
 Maternal drug intake
  Viral infection or a problem with bleeding
 Liver and/or bile function

11/15
What is the treatment for elevated bilirubin in adults?

 Readers Comments 1
 Share Your Story

The treatment for elevated bilirubin in adults is to first determine the underlying cause for
example,

 clot reabsorption,
 hemolytic anemia, and
 liver and/or bile problems.

Experts suggest avoiding alcohol consumption to prevent further liver toxicity.

SLIDESHOW

Hepatitis C, Hep B, Hep A: Symptoms, Causes, TreatmentSee Slideshow

12/15
What risks are associated with the bilirubin test?

The risks associated with this test are minor; and consist of potential infection at the blood
withdrawal site, and possible bruising at the site.

13/15

What is the prognosis for newborns?

In general, newborns have a good outcome if the bilirubin levels decrease quickly (over a few
days); however, the prognosis is not good if the newborn has persistently high bilirubin
levels.

14/15

Can high levels of bilirubin be prevented?

High levels of bilirubin may be prevented in neonates by appropriate treatment. Primary

therapy for newborns is phototherapy, followed by exchange transfusions and intravenous
immunoglobulin. Your newborn's pediatrician will help manage your newborn's bilirubin
levels.

Management of high levels of bilirubin in adults vary with the underlying cause. In general,
though, adults with elevated bilirubin levels are urged not to drink alcohol, and to avoid any
compounds that may harm or stress the liver's function. Your health-care professional can
help you determine what you should do, and what you should avoid depending on your
underlying problem that is causing the elevated bilirubin levels.

Privacy & Trust Info

Bilirubin and Bilirubin Blood Test

 Medical Author: Charles Patrick Davis, MD, PhD

 Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

Medically Reviewed on 12/26/2018

Table of Contents

 What should I know about bilirubin and blood test?

 What is bilirubin?
 What is the bilirubin test?
 What are symptoms of high bilirubin levels in adults?
  How do I prepare for the bilirubin test?
 How is the bilirubin test performed?
 What are normal bilirubin levels in adults?
 What do high bilirubin levels in adults mean?
 What are the symptoms of high bilirubin levels in newborns?
 What do high bilirubin levels in a newborn mean?
 What is the treatment for elevated bilirubin in adults?
 What risks are associated with the bilirubin test?
 What is the prognosis for newborns?
 Can high levels of bilirubin be prevented?
 What is the prognosis for an adult with elevated bilirubin levels?
 What are other names for bilirubin?

1/15
What should I know about bilirubin and blood test?

Picture of blood test result showing Bilirubin, AST, ALT levels. by iStock

 Bilirubin is a reddish yellow pigment made during the normal breakdown of red blood cells.
 Normal levels vary slightly from lab to lab; they range from about 0.2 – 1.2 mg/dL.
 Signs and symptoms of high bilirubin levels in adults vary with the underlying cause;
however, symptoms usually include jaundice and itching.
 High bilirubin levels in adults usually means that there may be an underlying problem
involving the red blood cells, liver, or gallbladder; however, other problems also may be
found.
 Symptoms of high bilirubin levels in newborns are skin and/or scleral jaundice.
 High bilirubin levels in a newbornmeans that the neonate is not processing red cell
breakdown effectively or an underlying cause is responsible.
 The treatment for elevated bilirubin in adults depends on the underlying problems. Experts
suggest avoiding alcohol.
 The bilirubin test can chemically determine the total and if needed, the conjugated and
unconjugated levels of bilirubin in the blood.
  The bilirubin test is performed on a small sample of blood from the patient.
 You prepare for a bilirubin test by refraining from eating for a few hours and avoiding certain
compounds that influence bilirubin levels before the test.
 Risks associated with a bilirubin test are minor.
 The prognosis for an adult with elevated bilirubin levels is related to the underlying cause,
and may range from good to poor.
 The prognosis for a newborn with elevated bilirubin levels usually is good in the majority of
newborns if they rapidly reduce their bilirubin levels.
 High bilirubin levels can be prevented in neonates by early treatment, and presented in
adults by treating the underlying causes and avoiding alcohol or other substances that may
damage the liver.

2/15
What is bilirubin?

Bilirubin is a bile pigment that is orange-yellow in color. It is formed during the normal
breakdown of red blood cells (hemoglobin), and is excreted in the bile. Bilirubin can be
classified as indirect (free or unconjugated) while it is circulating and is considered as direct
after conjugation in the liver with glucuronic acid.

3/15

What is the bilirubin test?

The bilirubin test measures the total bilirubin level (unconjugated and conjugated bilirubin)
spectrophotometrically. A subset of this test is designed to measure or estimate the two major
forms of bilirubin, unconjugated and conjugated bilirubin. Although blood is usually
tested, amniotic fluid and urine also can be examined. In addition, newborns can be scanned
transcutaneously with a device to check bilirubin levels.
 QUESTION

Liver disease refers to any abnormal process that affects the liver.See Answer
4/15

What are symptoms of high bilirubin levels in adults?

In adults, jaundice (yellowish coloration of sclera the eye and/or the skin) and itchingare the
major symptoms and signs of elevated bilirubin levels in the blood.

The following are some of the potential underlying causes of elevated bilirubin and
associated and their associated symptoms and signs (this is a short list, not complete list):

Anemia (red blood cell destruction as a cause) symptoms and signs include

 weakness,
 pallor, and
 jaundice.

Viral hepatitis symptoms and signs include

 fatigue,
 mild fever,
 muscle aches,
 nausea and vomiting, and
 jaundice.

Biliary obstruction symptoms and signs include

  light-colored stools,
 dark urine,
 itching,
 pain in the right side of the abdomen,
 nausea,
 vomiting, and
 jaundice.

Signs and symptoms of infections (for example, malaria) include

 recurrent fever/chills, and

 weakness.

Genetic diseases (for example, sickle-cell disease, and hereditary spherocytosis) have
symptoms and signs of

 abdominal pain, and/or

 abnormal red blood cells.

Liver (hepatic) causes (for example, cirrhosis, liver cancers, drugs, toxins, Gilbert's and
Crigler-Najjar syndromes) include symptoms and signs of

 abnormal liver enzymes, and

 liver masses.

5/15
How do I prepare for the bilirubin test?

 In general, patients are often asked to fast (only drink water) for several hours before the
test.
 Avoid strenuous exercise before the test as this may elevate bilirubin levels.
 Avoid drugs such as caffeine, penicillin, salicylates, and others as they can decrease bilirubin
levels.

6/15
How is the bilirubin test performed?

 The test is performed by withdrawing a small amount of blood from the individual.
 This blood sample is then chemically screened for bilirubin.
 Chemically, subset test can determine both unconjugated and conjugated bilirubin levels.

7/15
What are normal bilirubin levels in adults?

 Normal values of direct bilirubin range from 0 to 0.4 mg/dL.

  Total bilirubin (direct and indirect) range from about 0.2 to 1.2 mg/dL (some lab values
range as high as 1.9 mg/dL). Medical literature sources have minor variations in "normal"
levels).
 Low levels of bilirubin may be due to certain medications such astheophylline (Elixophyllin,
Theo-24), phenobarbital, and increased vitamin Clevels.

IMAGES

Bilirubin (Bilirubin Test)See a medical illustration of the liver plus our entire medical gallery of human anatomy
and physiologySee Images

8/15

What do high bilirubin levels in adults mean?

 Readers Comments 11
 Share Your Story

High bilirubin levels in adults may indicate several types of problems, for example:

 Red blood cell breakdown is more than usual (for example, a blood transfusion reaction)
 Liver scarring
 Liver inflammation
 Other diseases of the liver such as infections
 Dysfunction of the common bile duct
 Gallstones
 Cancer of the pancreas or gallbladder

9/15
What are the symptoms of high bilirubin levels in newborns?

 Readers Comments 1
 Share Your Story

High bilirubin level in the newborns usually is indicated by jaundice of the skin, usually
appearing on the face and forehead first, and later spreading to the trunk and extremities.
Other changes such as drowsiness, seizuresand altered crying may occur if high levels persist.
Some newborns may have petechiae, an enlarged spleen and anemiadue to hemolysis and can
progress to develop neurologic problems or even death.

10/15

What do high bilirubin levels in a newborn mean?

High bilirubin levels in a newborn usually is the result of unconjugated bilirubin, and is not a
major problem for many newborns because they soon metabolize the unconjugated bilirubin
normally. These neonates usually clear jaundice within a week. However, very high
unconjugated bilirubin levels over time (weeks) can be neurotoxic and can even cause death
or lifelong neurological problems (kernicterus) in those who survive. Newborn jaundice may
be the result of an underlying problem, for example:

 A family history of Gilbert syndrome

 Genetic problems
 Birth trauma
 Maternal drug intake
 Viral infection or a problem with bleeding
 Liver and/or bile function

11/15
What is the treatment for elevated bilirubin in adults?

 Readers Comments 1
 Share Your Story

The treatment for elevated bilirubin in adults is to first determine the underlying cause for
example,

 clot reabsorption,
 hemolytic anemia, and
 liver and/or bile problems.

Experts suggest avoiding alcohol consumption to prevent further liver toxicity.

 SLIDESHOW

Hepatitis C, Hep B, Hep A: Symptoms, Causes, TreatmentSee Slideshow

12/15

What risks are associated with the bilirubin test?

The risks associated with this test are minor; and consist of potential infection at the blood
withdrawal site, and possible bruising at the site.

13/15

What is the prognosis for newborns?

In general, newborns have a good outcome if the bilirubin levels decrease quickly (over a few
days); however, the prognosis is not good if the newborn has persistently high bilirubin
levels.

14/15

Can high levels of bilirubin be prevented?

High levels of bilirubin may be prevented in neonates by appropriate treatment. Primary

therapy for newborns is phototherapy, followed by exchange transfusions and intravenous
immunoglobulin. Your newborn's pediatrician will help manage your newborn's bilirubin
levels.
Management of high levels of bilirubin in adults vary with the underlying cause. In general,
though, adults with elevated bilirubin levels are urged not to drink alcohol, and to avoid any
compounds that may harm or stress the liver's function. Your health-care professional can
help you determine what you should do, and what you should avoid depending on your
underlying problem that is causing the elevated bilirubin levels.

15/15

What is the prognosis for an adult with elevated bilirubin levels?

The prognosis in an adult with high bilirubin levels may range from good to poor, depending
upon the underlying cause of the elevation. For example, most hepatitis Apatients recover
completely while patients with liver cancer or cirrhosis may have a poorer outcome.

What are other names for bilirubin?

As stated previously, bilirubin usually exists in two forms in the body. Unfortunately, the two
forms have several different names that appear frequently in the literature. Additionally, the
medical literature frequently uses the single term "bilirubin" to describe the two forms.
Frequently, the medical literature does not distinguish between the two forms, and this can be
confusing to the reader. In an attempt to clarify the situation, below are listed the two forms
and their names and synonyms:

Bilirubin – a term that means any form of a yellowish pigment made in the liver when red
blood cells are broken down and normally excreted with the bile; also termed "total
bilirubin."

 Bilirubin can be classified as indirectwhile it is circulating in the body. In this form it may also
be termed "free" or "unconjugated bilirubin."
 Bilirubin can be classified as directafter conjugation in the liver with glucuronic acid. This
form may also be termed "conjugated bilirubin."
 Neonatal bilirubin - total bilirubin in neonates (conjugated and unconjugated bilirubin)