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Unconjugated Bilirubin

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General Information:
Bilirubin is a substance produced during the breakdown of hemoglobin in red blood cells (erythrocytes).

Erythrocytes have a lifespan of approximately 120 days. When they reach the end of their life cycle, they are destroyed, and new erythrocytes are generated. During this process, hemoglobin, a protein found in red blood cells, is broken down, resulting in the production of bilirubin. The bilirubin enters the bloodstream and is transported to the liver. In the liver, bilirubin undergoes conjugation, which prepares it for excretion. From the liver, conjugated bilirubin travels through the bile ducts into the gallbladder and eventually into the small intestine. The body excretes bilirubin through the stool.

There are different subtypes of bilirubin: conjugated bilirubin, unconjugated bilirubin, and total bilirubin.

  • Unconjugated Bilirubin (Free or Indirect Bilirubin):
    This is the form of bilirubin produced immediately after the breakdown of hemoglobin and released into the bloodstream. It is transported in the blood bound to albumin.
  • The test requires a blood sample drawn from a vein.
  • Fasting for 8–14 hours before the test is recommended.
  • The test can be done 4 hours after a light meal.
  • Avoid physical and emotional stress, as well as alcohol consumption, before the test.
  • Liver diseases.
  • Hemolytic anemia.
  • Assessment of the severity and progression of various types of jaundice.

Elevated Unconjugated Bilirubin:

When bilirubin levels are elevated, symptoms may vary depending on the underlying cause. Common symptoms include:

  • Abdominal pain or bloating.
  • Chills and fever.
  • Chest pain.
  • Weakness.
  • Dizziness.
  • Nausea and vomiting.
  • Dark-colored urine.

Low Bilirubin Levels:

  • Low bilirubin levels typically do not cause symptoms.
  • They are often detected incidentally during routine blood tests.
  • No specific diseases are associated with reduced bilirubin levels. However, certain factors may temporarily lower bilirubin levels, including:
    • Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or barbiturates such as caffeine and aspirin.
    • Consumption of caffeine or medications before the test.