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Total Bilirubin: What Your Liver Result Means
All NiaHealth tests are processed in Canadian-certified labs, which are highly trusted by the medical community for their accuracy and reliability. Blood and urine samples are collected by licensed medical professionals and processed using state-of-the-art equipment. NiaHealth is SOC2 Type 2 certified.
What is it?
Bilirubin is a substance made when the body breaks down old red blood cells. Red blood cells contain hemoglobin, which helps carry oxygen. When hemoglobin is broken down, bilirubin is formed.
Bilirubin travels to the liver. The liver changes it into a form that can leave the body through bile. Bile then carries bilirubin into the digestive system so it can be removed in stool.
Total bilirubin measures the total amount of bilirubin in the blood. This includes:
Unconjugated bilirubin: bilirubin that has not yet been processed by the liver
Conjugated bilirubin: bilirubin that has been processed by the liver
Why it matters
High bilirubin can mean that something is not working normally in how bilirubin is made, processed, or cleared from the body.
Bilirubin may be high because of liver problems, such as hepatitis or cirrhosis. It can also rise when bile is not flowing properly. Another cause is faster-than-usual breakdown of red blood cells, which makes more bilirubin than the liver can process.
Very high bilirubin can cause jaundice, which is yellowing of the skin or eyes.
Reference ranges
Bilirubin results should be compared with the reference range from the testing lab, because ranges can vary.
Within the reference range: This usually suggests that bilirubin is being made and cleared normally.
Above the reference range: This may suggest liver dysfunction, reduced bile flow, or increased breakdown of red blood cells. The result should be interpreted alongside symptoms, medical history, and other blood tests.
Mild bilirubin elevation can sometimes happen with harmless conditions, such as Gilbert's syndrome. If bilirubin stays high or is much higher than expected, further medical evaluation is needed.
Chen, Z., He, J., Chen, C., & Lu, Q. (2021). Association of total bilirubin with all-cause and cardiovascular mortality in the general population. Frontiers in Cardiovascular Medicine, 8, 670768.
Kalakonda, A., Jenkins, B. A., & John, S. (2025). Physiology, bilirubin. In StatPearls. StatPearls Publishing.
Kipp, Z. A., Pauss, S. N., Martinez, G. J., Hinds, T. D., Jr, & Lee, W.-H. (2025). Bilirubin hepatic and intestinal transport and catabolism: Physiology, pathophysiology, and benefits. Antioxidants (Basel, Switzerland), 14(11), 1326.
Vitek, L., Hinds, T. D., Jr, Stec, D. E., & Tiribelli, C. (2023). The physiology of bilirubin: health and disease equilibrium. Trends in Molecular Medicine, 29(4), 315–328.
This information is educational and does not replace medical advice, diagnosis, or treatment. Your results should be interpreted with a qualified healthcare professional in the context of your health history.
