Labs by Hers: The key markers that matter. Start testing

Liver health

Total Bilirubin

Also known as: Bilirubin test, Serum bilirubin, Total and direct bilirubin test, TBil or T-bilirubin

A total bilirubin test measures how much bilirubin — a yellowish pigment made when your body breaks down old red blood cells — is in your blood. Normally, your liver filters bilirubin and sends it into bile, which leaves your body in your stool. If this process is disrupted, bilirubin can build up, leading to jaundice (yellowing of the skin or eyes). Providers use this test to check liver function and help detect conditions that cause red blood cells to break down too quickly

Start testing
Learn more about Biomarkers

Key takeaways

  • Sample required: Blood

  • Tests for: Used to assess liver function and bile duct health, and to monitor certain conditions.

  • Healthy range: Less than 1 milligram per deciliter (mg/dL), although this may vary by lab.

What can a bilirubin test tell you?

A bilirubin test helps assess how well your liver and bile ducts are working and whether red blood cells are breaking down at a normal rate. It can help:

  • Investigate symptoms such as jaundice, dark urine, or pale stools

  • Evaluate for hepatitis, cirrhosis, or other liver diseases

  • Find bile duct obstructions (gallstones, tumors)

  • Identify hemolytic anemia

  • Monitor the effects of medications that impact the liver

What is being tested?

Bilirubin is made as hemoglobin (from red blood cells) breaks down. There are two main types: unconjugated bilirubin (indirect), which moves through the blood before the liver processes it, and conjugated bilirubin (direct), the form it takes after the liver converts it to be excreted in bile.

A total bilirubin test measures both types together. If levels are high, a provider may order direct and indirect bilirubin tests to see where exactly the problem lies.

Where is the bilirubin test typically included?

A bilirubin test is typically part of a liver function panel, which assesses for liver injury or bile duct blockage. It’s also part of a comprehensive metabolic panel (CMP), which helps evaluate overall metabolic and organ health.

Bilirubin testing is included as part of lab testing through Hers, designed to support a clearer understanding of your health. Results should always be reviewed with a qualified healthcare provider to guide next steps. 

Who should get a bilirubin test?

Bilirubin testing is indicated based on symptoms or risk factors, not universal screening. Your provider may recommend this test if you have:

  • Yellow skin or eyes (jaundice)

  • Dark urine or pale stools

  • Abdominal pain, nausea, or fatigue

  • A history of liver disease or heavy alcohol use

  • Abnormal results from other liver tests

How Labs by Hers works

  • 1

    Book your test

    Schedule a lab draw in the Hers app at one of more than 2,000 convenient locations.

  • 2

    Get your results

    Review your lab results to understand which areas of your health may need attention.

  • 3

    Spot early signals

    Identify potential health risks or system imbalances before they become more serious.

  • 4

    Get your action plan

    Receive expert guidance tailored to your health profile and test results.

  • 5

    Improve over time

    Track your progress through a mid-year panel and ongoing provider check-ins.

Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

Start testing

What causes changes in bilirubin levels?

High bilirubin levels may be a sign of liver disease, bile duct obstruction (such as gallstones), hemolytic anemia, or Gilbert’s syndrome (an inherited condition). They could also be due to certain medications (such as antibiotics, steroids, or chemotherapy) or chronic alcohol use.

Low bilirubin levels are not usually clinically significant.

What is a normal bilirubin level?

Usually less than 1 mg/dL, though labs may differ slightly.

Do I need to fast before testing?

You might; ask your provider for guidance.

Can I test bilirubin at home?

Yes. Some telehealth services and pharmacies offer collection kits, though lab-based confirmation is recommended.

What does a high result mean?

It can signal liver disease, bile duct blockage, or excessive breakdown of red blood cells (hemolysis).

Is it covered by insurance?

Yes, it’s typically covered if medically it’s necessary for liver or blood evaluation. Insurance is not required for lab testing available through the Hers platform.

What tests are related to this biomarker?

• Liver function panel

• Comprehensive metabolic panel (CMP)

• Direct (conjugated) bilirubin test

• Complete blood count (CBC)

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

Start testing

Alanine Transaminase (ALT)

Alanine transaminase (ALT) is an enzyme found in liver cells that helps process amino acids. This enzyme is a key marker that shows if your liver cells are healthy and working normally.

Learn more about Alanine Transaminase (ALT)

Aspartate Aminotransferase (AST)

Aspartate aminotransferase (AST) is an enzyme in the liver and muscles that helps to process amino acids. Healthy levels mean your liver and muscles are not under stress or injured.

Learn more about Aspartate Aminotransferase (AST)

Alkaline Phosphatase (ALP)

Alkaline phosphatase (ALP) is an enzyme that reflects bile flow and liver function. A healthy level indicates proper bone metabolism and that your liver and gallbladder are functioning without signs of stress.

Learn more about Alkaline Phosphatase (ALP)

Albumin

Albumin is a protein made by the liver that helps carry hormones, vitamins, and nutrients through the blood. It also helps to keep fluid in your blood vessels.

Learn more about Albumin

Total Protein

Total protein measures the combined levels of albumin and globulin proteins that support fluid balance, hormone and drug transport, and the immune system. Healthy levels mean that your body is currently maintaining a good balance of these important proteins.

Learn more about Total Protein

Globulin

Globulins are a group of proteins in your blood that include antibodies, which help your body fight infection, and other proteins that carry hormones and nutrients. Healthy levels suggest your immune system and liver are working well.

Learn more about Globulin

On your marks.

Get set.

Transform.

Find your baseline with 130+ biomarker tests, then plan for your health breakthrough.

Start testing

Supporting references

Sources

Reviewed by Felix Gussone, MD

Published 12/04/2025