A patient seated in the chair before a blood draw
In person

Bilirubin, Total + Direct

Bilirubin split into its direct and indirect forms, from one draw.

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  • 2,000+ lab locations. Find one near you
  • Nothing due at the lab. FSA / HSA accepted
  • Ordered by a licensed clinician

At a glance

Collection
Blood draw
A standard blood draw at the lab.
Preparation
None
Nothing to do ahead of time. Water is fine.
Results
1 to 2 days
Typical turnaround after your visit.
Where
2,000+ lab locations
Nationwide, with nothing due at the lab.

About this test

This test measures total and direct bilirubin and calculates the indirect form from the two. Bilirubin is a yellow pigment from the breakdown of red blood cells, and the liver processes it so it can leave in bile. Seeing the split helps show where a high result comes from. No fasting needed.

For adults 18 and older. Test availability varies by lab location.

Who should take this test?

Adults following up on a high total bilirubin, or checking liver and bile flow, can get both bilirubin forms from one visit and review them with a healthcare provider.

Ask about this test

Not sure this is the right test?

AI-generated. For information only, not medical advice. Call 911 for an emergency.

What does this test measure?

Your results show how much bilirubin is in your blood and how it splits between the processed and unprocessed forms, which can help a healthcare provider narrow down the cause.

Bilirubin, total
Bilirubin is a yellow substance made when old red blood cells break down. Your liver processes it and sends it out in bile. Total bilirubin includes both the processed and unprocessed forms. A higher level can relate to the liver, the bile ducts, or faster breakdown of red blood cells.
Why it’s measured: Reflects how bilirubin from old red blood cells is made and cleared.
Bilirubin, direct
Direct bilirubin is the form your liver has already processed so it can leave the body in bile. Measuring it separately from total bilirubin helps a provider tell whether a raised total relates to the liver and bile ducts or to how red blood cells are being broken down.
Why it’s measured: Helps sort out where a raised total bilirubin may be coming from.
Bilirubin, indirect (calculated)
Indirect bilirubin is the form that has not yet been processed by your liver. The lab calculates it by subtracting direct bilirubin from total bilirubin. Read with the other two values, it helps a provider see where in the process a change may be happening.
Why it’s measured: Completes the bilirubin picture, calculated from total and direct.

How it works

  1. Step 1

    Order online

    Check out here. A licensed clinician in your state reviews your order and sends it to the lab.

  2. Step 2

    Visit a lab

    Bring a photo ID to any of 2,000+ lab locations. No fasting needed, and nothing is due at the lab.

  3. Step 3

    Get your results

    Results post to your account, usually in 1 to 2 days, each number next to the lab’s reference range.

Find a lab near you

Choose from 2,000+ lab locations nationwide. Your order works at any of them.

What your results tell you

Total, direct, and indirect bilirubin are each reported in milligrams per deciliter (mg/dL), with indirect calculated from the other two.

  • Each marker next to the lab’s reference range
  • Explained in plain language
  • A licensed clinician reviews your order and, if appropriate, orders the test.
  • A lab report you can download and share

A raised value in either form is a starting point, not a diagnosis. A healthcare provider reads the pattern with your other liver results.

Direct, total, or both?

Three bilirubin tests that answer slightly different questions.

Total and direct

Both results, plus the indirect form calculated from them.

Measures
Total, direct, and calculated indirect bilirubin
Useful for
Splitting a total result into its two forms
Preparation
None

Clinical-grade testing, from the comfort of home.

From the lab to your report, every step of our process meets the gold standard in medical testing.

  • CLIA-certified labs

    Every lab we partner with is certified under the Clinical Laboratory Improvement Amendments, meeting both state and federal standards with regular independent inspections.

  • We protect your health data

    We protect your health data with encryption and do not sell it. Some results must be reported to public health authorities by law. See our Privacy Notice.

  • Rigorous quality assurance

    All partner labs run regular internal quality checks, participate in proficiency testing, and comply with federal and state lab regulations.

  • Clinician-reviewed reports

    Results are reviewed by an independent, licensed clinician.

Questions

Common questions.

Anything else, our care team answers by phone, text, or email.

Indirect bilirubin is the form made when red blood cells break down, before the liver processes it. Direct bilirubin is the form after the liver has processed it.

If mostly indirect is raised, a healthcare provider may think about how quickly red cells are breaking down. If direct is raised, they may look more closely at the liver and bile flow.

The lab measures total and direct bilirubin, then calculates indirect bilirubin as the difference between them. That is why you get three numbers from one sample. Because it is calculated, the indirect value depends on the other two results.

Yellow skin or yellow whites of the eyes, called jaundice, is a reason to see a healthcare provider promptly, especially with dark urine, pale stools, or feeling unwell. Don’t wait for this test to get checked. It can be part of the follow-⁠up, but it is not a substitute for being seen.

The split points a healthcare provider in a direction, but it does not name a cause. It also does not include liver enzymes or a blood count. Other tests, such as a liver panel or a CBC, are often used alongside it to learn more.

Lab tests are informational and don’t diagnose conditions on their own. Available to adults 18 and older; test availability varies by lab location. A licensed clinician reviews your order and, if appropriate, orders the test. All testing is performed at CLIA-certified laboratories. Not for emergencies: if you think you may be having a medical emergency, call 911.