Bilirubin

Results

A bilirubin test measures the amount of bilirubin in a blood sample. The results are usually available in 1 to 2 hours.

Normal adult values

Normal values may vary from lab to lab.

Bilirubin levels in adults

Bilirubin type	Bilirubin level
Total bilirubin	0.3–1.0 mg/dL or 5.1–17.0 mmol/L
Direct bilirubin	0.1–0.3 mg/dL or 1.7–5.1 mmol/L
Indirect bilirubin (total bilirubin level minus direct bilirubin level)	0.2–0.8 mg/dL or 3.4–12.0 mmol/L

High values

• High levels of bilirubin in the blood may be caused by:
  • Some infections, such as an infected gallbladder, or cholecystitis.
  • Some inherited diseases, such as Gilbert's syndrome, a condition that affects how the liver processes bilirubin. Although jaundice may occur in some people with Gilbert's syndrome, the condition is not harmful.
  • Diseases that cause liver damage, such as hepatitis, cirrhosis, or mononucleosis.
  • Diseases that cause blockage of the bile ducts, such as gallstones or cancer of the pancreas.
  • Rapid destruction of red blood cells in the blood, such as from sickle cell disease or an allergic reaction to blood received during a transfusion (called a transfusion reaction).
  • Medicines that may increase bilirubin levels. This includes many antibiotics, some types of birth control pills, indomethacin (Indocin), phenytoin (Dilantin), diazepam (Valium), and flurazepam (Dalmane).

Low values

Low levels of bilirubin in the blood may be caused by:

• Medicines that may decrease bilirubin levels. This includes vitamin C (ascorbic acid), phenobarbital, and theophylline (Elixophyllin).

Normal values in newborns

Normal values in newborns depend on the age of the baby in hours and whether the baby was premature or full term. Normal values may vary from lab to lab.

Total bilirubin levels in newborns less than 7 days old

Age	Premature baby	Full-term baby
Less than 24 hours	Less than 8.0 mg/dL or less than 137 mmol/L	Less than 6.0 mg/dL or less than 103 mmol/L
Less than 48 hours	Less than 12.0 mg/dL or less than 205 mmol/L	Less than 10.0 mg/dL or less than 170 mmol/L
3 to 5 days	Less than 15.0 mg/dL or less than 256 mmol/L	Less than 12.0 mg/dL or less than 205 mmol/L
7 days or older	Less than 15.0 mg/dL or less than 256 mmol/L	Less than 10.0 mg/dL or less than 170 mmol/L

 

Bilirubin levels that may require treatment in a full-term, healthy baby

Baby's age	Bilirubin level
24 hours or younger:	More than 10 mg/dL or more than 170 mmol/L
25 to 48 hours:	More than 15 mg/dL or more than 255 mmol/L
49 to 72 hours:	More than 18 mg/dL or more than 305 mmol/L
Older than 72 hours:	More than 20 mg/dL or more than 340 mmol/L

Note: A premature or sick baby with bilirubin levels lower than those listed above may need treatment.

A premature baby's liver is immature and may not be able to break down bilirubin properly in the blood. This is one of the reasons premature babies are more likely than full-term babies to develop jaundice.

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Author:	Debby Golonka, MPH	Last Updated: May 27, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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