Bilirubin Test Results Interpretation

Adults and children

Increased total bilirubin that is mainly unconjugated (indirect) bilirubin may be a result of:

  • Hemolytic or pernicious anemia
  • Transfusion reaction
  • Cirrhosis

If conjugated (direct) bilirubin is elevated more than unconjugated (indirect) bilirubin, there typically is a problem related to decreased elimination of bilirubin by the liver cells. Some conditions that may lead to this:

  • Viral hepatitis
  • Alcoholic liver disease
  • Drug reactions

This may also occur when there is blockage of the bile ducts. For example, with:

  • Gallstones present in the bile ducts
  • Scarring of the bile ducts
  • Tumors

Low levels of bilirubin are generally not concerning and are not monitored.


An elevated bilirubin level in a newborn is mostly temporary and may recover by itself no longer than two weeks. However, if the bilirubin level is above the normal level or increases rapidly, an examination of the cause is needed to confirm the according treatment.

Increased bilirubin concentrations may be caused from the accelerated breakdown of red blood cells due to:

  • Blood type incompatibility between the mother and her newborn
  • Lack of oxygen
  • Diseases that can affect the liver
  • Certain congenital infections



In most of these conditions, only unconjugated (indirect) bilirubin is increased. An elevated conjugated (direct) bilirubin is seen in the rare conditions of biliary atresia and neonatal hepatitis. Biliary atresia requires surgical intervention to prevent liver damage.

Keywords: bilirubin test; conjugated (direct) bilirubin; unconjugated (indirect) bilirubin

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.