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Why it's done
By Mayo Clinic staffBilirubin testing may be used for a variety of reasons and is usually done as part of a group of other tests that evaluate the health of your liver. Bilirubin testing may be done to:
- Investigate jaundice — elevated levels of bilirubin can cause yellowing of the whites of your eyes and yellowing of your skin (jaundice)
- Determine whether there's a blockage in your liver's bile ducts
- Help detect or monitor the progression of other liver disease, such as hepatitis
- Help detect increased destruction of red blood cells
- Help follow how a treatment is working
- Help evaluate suspected drug toxicity
Some common tests that might be done at the same time as bilirubin testing include:
- Alanine transaminase (ALT). An enzyme found mainly in liver cells, ALT helps your body metabolize protein. Normally, ALT levels in the blood are low. When the liver is damaged, ALT is released in the bloodstream, raising the ALT levels in your blood.
- Aspartate transaminase (AST). The enzyme AST plays a role in the metabolism of alanine, an amino acid. AST is found in high concentrations in liver cells. An increase in AST levels may indicate liver damage or disease.
- Alkaline phosphatase (ALP). ALP is an enzyme found in high concentrations in the liver and bile ducts, as well as some other tissues. Higher than normal levels of ALP may indicate liver damage or disease.
- Albumin and total protein. Levels of albumin — a protein made by the liver — and total protein show how well your liver is making proteins that your body needs to fight infections and perform other functions. Lower than normal levels may indicate liver damage or disease.
- Complete blood count. This test measures several components and features of your blood. Abnormalities may suggest liver disease or abnormal breakdown of blood cells.
Additional tests that may be used to evaluate the liver include:
- Gamma-glutamyltransferase (GGT). This test measures the amount of the enzyme GGT in the blood. Higher than normal levels may indicate liver or bile duct damage.
- Lactate dehydrogenase (LDH). LDH is an enzyme found in many body tissues, including the liver. Elevated levels of LDH may indicate liver damage.
- Prothrombin time (PT). This test measures the clotting time of plasma. Increased PT may indicate liver damage.
- Pratt DS. Liver chemistry and function tests. In: Feldman M, et al. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/php/208033710-3/homepage. Accessed July 6, 2010.
- Common blood tests. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/bdt/bdt_what.html. Accessed July 6, 2010.
- Bilirubin. Lab Tests Online. http://www.labtestsonline.org/understanding/analytes/bilirubin/glance.html. Accessed July 6, 2010.
- Laboratory reference values. Rochester, Minn.: Mayo Foundation for Medical Education and Research; July 1, 2010.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 7, 2010.
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