Bilirubin, Total and Direct
A breakdown of the pigment from red blood cell turnover that signals how the liver and bile ducts are working.
Consider this test if:
- Yellowing of the skin or eyes, dark urine, or pale stools
- Following up an abnormal liver enzyme or hepatic panel result
- Tracking a known liver condition, hepatitis, or bile duct issue
- Investigating suspected hemolysis or unexplained anemia
- Distinguishing Gilbert syndrome from a true liver problem
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This test isn't offered by labs in your state yet.
Pre-test considerations
No fasting is generally required. Bilirubin can be affected by recent fasting, strenuous exercise, and certain medications, and the sample is protected from light because bilirubin degrades with light exposure. If you have had episodes of mild jaundice that come and go, note them for interpretation.
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What this test is for
Bilirubin is the yellow pigment produced when the body breaks down old red blood cells. This test reports two numbers: total bilirubin (the whole pool) and direct bilirubin (the conjugated, liver-processed fraction), and the split helps localize where a problem sits. A high direct fraction points toward liver disease or blocked bile flow (gallstones, hepatitis, bile duct obstruction), while a high total with a low direct fraction points toward increased red cell breakdown (hemolysis) or the benign, common variant Gilbert syndrome. Visible jaundice, dark urine, pale stools, itching, or right-upper-quadrant discomfort are the symptoms that most often prompt this measurement.
This two-part version reports total and direct. If you also want the indirect (unconjugated) fraction calculated, the Fractionated bilirubin test adds that, and the Hepatic Function Panel places bilirubin alongside ALT, AST, ALP, albumin, and total protein for a fuller liver assessment.
Biomarkers tested
Includes 2 biomarkers
- Specimen
- Serum or plasma
- Measures
- Mass concentration
Total bilirubin measures the pigment left over when your body breaks down old red blood cells, a job the liver clears by processing it into bile. High levels point to a liver struggling to keep up (hepatitis, fatty liver, bile duct blockage) or red cells breaking down faster than normal, and often show up as yellowing skin or eyes, dark urine, or fatigue. It pairs with ALT, AST, and ALP to pinpoint whether a problem sits in the liver cells, the bile ducts, or upstream in the blood itself, and mildly elevated results with otherwise normal liver panels usually reflect Gilbert's syndrome, a harmless and common genetic quirk.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
What you'll learn
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Insights that connect the dots. A clinician reads your whole picture, not one result in isolation, connecting family history, past results, and lifestyle into clear next steps.
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Track your trends. Upload results from any lab and see each biomarker trend over time, so you know what is working.
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Never miss a recheck. Mito tells you what is worth retesting and when, then reminds you so nothing slips.
What to expect
- 1 Book instantly
Click, book, done. Choose a convenient lab location near you. Transparent, up-front pricing.
- 2 Quick lab visit
Testing to fit your busy schedule, usually 15 minutes or less. Walk-in and appointments available.
- 3 Fast, dashboard-delivered results
Your results post straight to your dashboard as soon as the lab completes them.
- 4 Expert guidance
Included with Mito membership. A clinician reviews your results and your personalized action plan follows, with clear next steps.
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Members pay our cost on every test, with lab fees passed straight through. The full receipt is itemized, never padded.
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Upload past labs and watch your trends over time. Every marker and visit lives in one longitudinal record, so all your care stays together.
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Text anytime and get clinician-reviewed answers. When you want to go deeper, 1:1 consultations are available at affordable rates.
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Frequently asked questions
View all FAQsHow does pricing work?
Every test shows the member price next to the standard non-member price, so you can see what membership saves you. The member price is our cost, covering the lab and what it takes to run the service. It is never a profit on the test itself. Mito makes its money on the $9 membership, not on marking up your tests. Membership is $9 per month, and any applicable lab order or draw fee is itemized before you pay.
Where do I get tested?
Choose an available partner lab at checkout. If your cart contains multiple blood tests, Mito helps consolidate the eligible tests at one lab when possible. At-home kits and scans follow the collection or appointment process shown on their product page.
Is this eligible for HSA/FSA?
Yes. Eligible tests can be paid for with an HSA or FSA card at checkout.
When will I get my results?
Your results appear in your Mito dashboard after the laboratory completes processing. A clinician then reviews them before your analysis and personalized action plan are finalized. Timing varies by test, and specialty assays and at-home kits may take longer.
Do I need a doctor's order?
No. Mito provides the laboratory order when one is required, so you do not need to arrange a separate doctor visit before purchasing.
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