Table of ContentsView AllTable of ContentsCausesBilirubin’s FunctionTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Bilirubin’s Function
Treatment
In most cases, lowbilirubinlevels are not a reason for concern. The problem does not cause symptoms. In fact, how low your bilirubin count is may remain unknown until it appears on a blood test for another reason.
While havinghigh bilirubincan be a sign ofliver diseaseand other health problems, low levels rarely pose an urgent danger. There may be gains to raising levels to normal ranges. Research shows that having normal levels may provide some benefits against the risks of certain diseases.
This article defines low bilirubin levels, causes, symptoms, and ways to raise levels to normal ranges.
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Causes of Low Bilirubin on Blood Tests
To avoid these effects, you are typically advised to fast for at least four hours before taking abilirubin blood test.
Low bilirubin levels have also been linked to the following autoimmune and inflammatory conditions:
Studies also indicate a relationship between low bilirubin levels and the following:
Function of Bilirubin and Normal Levels
Bilirubin is temporarily stored in yourgallbladder, where it contributes to food digestion. A healthy liver breaks down bilirubin so it can be removed via urine and stool.
Research on bilirubin indicates that bilirubin functions as a metabolic hormone and an antioxidant before it leaves your body. While low bilirubin levels are often disregarded as a cause of concern, research shows that low bilirubin levels may be relevant to the development of the following diseases:
Bilirubin levels are measured with a bilirubin blood test. Your healthcare provider can help you interpret your results.
Normal range values can vary based on your age, gender, health history, and other health factors. In addition, different laboratories use slightly different normal value ranges.
Indirect
Indirect (unconjugated) bilirubin is developed during the breakdown of red blood cells. It is water-insoluble and very toxic to your body. Indirect bilirubin must be converted into direct bilirubin so it can be removed from your body in urine or stool.
An average adult range for indirect bilirubin is 0.2 to 0.8 milligrams per deciliter (mg/dL).
Direct
An average adult value for direct bilirubin is 0.0 to 0.3 mg/dL.
Total
Total bilirubin represents a combination of all the bilirubin in your bloodstream. It is a combination of indirect and direct bilirubin levels. An average adult value for total bilirubin normal range is 0.3 to 1.0 mg/dL.
After Low Bilirubin Blood Test: Steps to Treatment
Your healthcare provider can advise you on the best way for you to deal with a low bilirubin blood test based on your condition. Taking the following steps may help increase bilirubin to normal levels and lower your risk of problems like cardiovascular disease, diabetes, stroke, fatty liver disease, and obesity:
Consume more flavonoid-rich fruits and vegetables:Flavonoidsprovide antioxidant, anticancer, and anti-inflammatory health benefits including an increase in bilirubin levels. Flavonoid-rich foods that help reduce the risk factors of life-shortening diseases include all plant-origin foods, especially the following:
Establish and maintain a healthy weight:If you weigh more than average for your height or are experiencingobesity, weight loss has proven to increase serum bilirubin levels. In addition to weight loss, changes in body fat percentage are linked with higher bilirubin in obese people.
Participate in regular exercise:Research indicates that any type of exercise, whether habitual or irregular, can increase total bilirubin levels. However, the intensity of the exercise done can make a difference. There is evidence that training at an intensity of 50% of aerobic capacity raises serum bilirubin levels, while lower training loads have no impact.
Treat low bilirubin with medication:Certain medications can be effective in regulating serum bilirubin levels. These drugs include NSAIDs likeaspirin (acetylsalicylic acid)and COX (cyclooxygenase)inhibitors. Drugs for hyperlipidemia likestatins,fibrates, andniacincan also impact bilirubin levels.
Confused About Your Health? The Answer May Be in Your Blood
Summary
Having low bilirubin levels may not pose a health risk for most people. The problem typically does not cause symptoms or health problems. In some cases, low levels result from the impact of certain drugs on your blood test results.
However, if you are at risk of problems like heart disease or diabetes, you may benefit from raising your low bilirubin levels. This may be done without formal treatment. Making changes to your diet and exercise plans can help increase levels to normal ranges.
Consult with a healthcare provider regarding choosing the best way to deal with low bilirubin levels. Based on factors like your age, gender, and other health issues, they can help you decide how to proceed.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Poynard T, Deckmyn O, Peta V, et al.Clinical and genetic definition of serum bilirubin levels for the diagnosis of Gilbert syndrome and hypobilirubinemia.Hepatology Communications. 2023;7(10):e0245. doi:10.1097/HC9.0000000000000245MedlinePlus.Medical encyclopedia: bilirubin.Xie J, Zhang Z, Liang Y, Yang Z.Decreased bilirubin is associated with disease activity of primary Sjögren’s Syndrome.Arch Rheumatol. 2020;35(3):351-356. doi:10.46497/ArchRheumatol.2020.7633Chung JO, Park SY, Chung DJ, Chung MY.Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes.Medicine. 2019;98(43). doi:10.1097/MD.0000000000017693Higuchi S, Kabeya Y, Uchida J, Kato K, Tsukada N.Low bilirubin levels indicate a high risk of cerebral deep white matter lesions in apparently healthy subjects.Sci Rep. 2018;8(1):6473.Creeden JF, Gordon DM, Stec DE, Hinds TD.Bilirubin as a metabolic hormone: the physiological relevance of low levels.Am J Physiol Endocrinol Metab. 2021;320(2):E191-E207. doi:10.1152/ajpendo.00405.2020Mount Sinai.Bilirubin blood test.HexaHealth.Difference between conjugated and unconjugated bilirubin.University of Rochester Medical Center.Total bilirubin (blood).Žiberna L, Jenko-Pražnikar Z, Petelin A.Serum bilirubin levels in overweight and obese individuals: the importance of anti-inflammatory and antioxidant responses.Antioxidants (Basel). 2021;10(9):1352. doi:10.3390/antiox10091352Waheed Janabi AH, Kamboh AA, Saeed M, et al.Flavonoid-rich foods (Frf): A promising nutraceutical approach against lifespan-shortening diseases.Iran J Basic Med Sci. 2020;23(2):140-153. doi:10.22038/IJBMS.2019.35125.8353El-Eshmawy M.M., Mahsoub N., Asar M., Elsehely I.Association between total bilirubin levels and cardio-metabolic risk factors related to obesity.Endocr. Metab. Immune Disord. Drug Targets.2021 doi: 10.2174/1871530321999210128201259Loprinzi P.D., Abbott K.Physical activity and total serum bilirubin levels among insulin sensitive and insulin resistant U.S. adults.J. Diabetes Metab. Disord.2014;13:47. doi:10.1186/2251-6581-13-47Vitek L., Bellarosa C., Tiribelli C.Induction of mild hyperbilirubinemia: hype or real therapeutic opportunity?Clin. Pharmacol. Ther.2019;106:568–575. doi:10.1002/cpt.1341
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Poynard T, Deckmyn O, Peta V, et al.Clinical and genetic definition of serum bilirubin levels for the diagnosis of Gilbert syndrome and hypobilirubinemia.Hepatology Communications. 2023;7(10):e0245. doi:10.1097/HC9.0000000000000245MedlinePlus.Medical encyclopedia: bilirubin.Xie J, Zhang Z, Liang Y, Yang Z.Decreased bilirubin is associated with disease activity of primary Sjögren’s Syndrome.Arch Rheumatol. 2020;35(3):351-356. doi:10.46497/ArchRheumatol.2020.7633Chung JO, Park SY, Chung DJ, Chung MY.Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes.Medicine. 2019;98(43). doi:10.1097/MD.0000000000017693Higuchi S, Kabeya Y, Uchida J, Kato K, Tsukada N.Low bilirubin levels indicate a high risk of cerebral deep white matter lesions in apparently healthy subjects.Sci Rep. 2018;8(1):6473.Creeden JF, Gordon DM, Stec DE, Hinds TD.Bilirubin as a metabolic hormone: the physiological relevance of low levels.Am J Physiol Endocrinol Metab. 2021;320(2):E191-E207. doi:10.1152/ajpendo.00405.2020Mount Sinai.Bilirubin blood test.HexaHealth.Difference between conjugated and unconjugated bilirubin.University of Rochester Medical Center.Total bilirubin (blood).Žiberna L, Jenko-Pražnikar Z, Petelin A.Serum bilirubin levels in overweight and obese individuals: the importance of anti-inflammatory and antioxidant responses.Antioxidants (Basel). 2021;10(9):1352. doi:10.3390/antiox10091352Waheed Janabi AH, Kamboh AA, Saeed M, et al.Flavonoid-rich foods (Frf): A promising nutraceutical approach against lifespan-shortening diseases.Iran J Basic Med Sci. 2020;23(2):140-153. doi:10.22038/IJBMS.2019.35125.8353El-Eshmawy M.M., Mahsoub N., Asar M., Elsehely I.Association between total bilirubin levels and cardio-metabolic risk factors related to obesity.Endocr. Metab. Immune Disord. Drug Targets.2021 doi: 10.2174/1871530321999210128201259Loprinzi P.D., Abbott K.Physical activity and total serum bilirubin levels among insulin sensitive and insulin resistant U.S. adults.J. Diabetes Metab. Disord.2014;13:47. doi:10.1186/2251-6581-13-47Vitek L., Bellarosa C., Tiribelli C.Induction of mild hyperbilirubinemia: hype or real therapeutic opportunity?Clin. Pharmacol. Ther.2019;106:568–575. doi:10.1002/cpt.1341
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Poynard T, Deckmyn O, Peta V, et al.Clinical and genetic definition of serum bilirubin levels for the diagnosis of Gilbert syndrome and hypobilirubinemia.Hepatology Communications. 2023;7(10):e0245. doi:10.1097/HC9.0000000000000245MedlinePlus.Medical encyclopedia: bilirubin.Xie J, Zhang Z, Liang Y, Yang Z.Decreased bilirubin is associated with disease activity of primary Sjögren’s Syndrome.Arch Rheumatol. 2020;35(3):351-356. doi:10.46497/ArchRheumatol.2020.7633Chung JO, Park SY, Chung DJ, Chung MY.Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes.Medicine. 2019;98(43). doi:10.1097/MD.0000000000017693Higuchi S, Kabeya Y, Uchida J, Kato K, Tsukada N.Low bilirubin levels indicate a high risk of cerebral deep white matter lesions in apparently healthy subjects.Sci Rep. 2018;8(1):6473.Creeden JF, Gordon DM, Stec DE, Hinds TD.Bilirubin as a metabolic hormone: the physiological relevance of low levels.Am J Physiol Endocrinol Metab. 2021;320(2):E191-E207. doi:10.1152/ajpendo.00405.2020Mount Sinai.Bilirubin blood test.HexaHealth.Difference between conjugated and unconjugated bilirubin.University of Rochester Medical Center.Total bilirubin (blood).Žiberna L, Jenko-Pražnikar Z, Petelin A.Serum bilirubin levels in overweight and obese individuals: the importance of anti-inflammatory and antioxidant responses.Antioxidants (Basel). 2021;10(9):1352. doi:10.3390/antiox10091352Waheed Janabi AH, Kamboh AA, Saeed M, et al.Flavonoid-rich foods (Frf): A promising nutraceutical approach against lifespan-shortening diseases.Iran J Basic Med Sci. 2020;23(2):140-153. doi:10.22038/IJBMS.2019.35125.8353El-Eshmawy M.M., Mahsoub N., Asar M., Elsehely I.Association between total bilirubin levels and cardio-metabolic risk factors related to obesity.Endocr. Metab. Immune Disord. Drug Targets.2021 doi: 10.2174/1871530321999210128201259Loprinzi P.D., Abbott K.Physical activity and total serum bilirubin levels among insulin sensitive and insulin resistant U.S. adults.J. Diabetes Metab. Disord.2014;13:47. doi:10.1186/2251-6581-13-47Vitek L., Bellarosa C., Tiribelli C.Induction of mild hyperbilirubinemia: hype or real therapeutic opportunity?Clin. Pharmacol. Ther.2019;106:568–575. doi:10.1002/cpt.1341
Poynard T, Deckmyn O, Peta V, et al.Clinical and genetic definition of serum bilirubin levels for the diagnosis of Gilbert syndrome and hypobilirubinemia.Hepatology Communications. 2023;7(10):e0245. doi:10.1097/HC9.0000000000000245
MedlinePlus.Medical encyclopedia: bilirubin.
Xie J, Zhang Z, Liang Y, Yang Z.Decreased bilirubin is associated with disease activity of primary Sjögren’s Syndrome.Arch Rheumatol. 2020;35(3):351-356. doi:10.46497/ArchRheumatol.2020.7633
Chung JO, Park SY, Chung DJ, Chung MY.Relationship between anemia, serum bilirubin concentrations, and diabetic retinopathy in individuals with type 2 diabetes.Medicine. 2019;98(43). doi:10.1097/MD.0000000000017693
Higuchi S, Kabeya Y, Uchida J, Kato K, Tsukada N.Low bilirubin levels indicate a high risk of cerebral deep white matter lesions in apparently healthy subjects.Sci Rep. 2018;8(1):6473.
Creeden JF, Gordon DM, Stec DE, Hinds TD.Bilirubin as a metabolic hormone: the physiological relevance of low levels.Am J Physiol Endocrinol Metab. 2021;320(2):E191-E207. doi:10.1152/ajpendo.00405.2020
Mount Sinai.Bilirubin blood test.
HexaHealth.Difference between conjugated and unconjugated bilirubin.
University of Rochester Medical Center.Total bilirubin (blood).
Žiberna L, Jenko-Pražnikar Z, Petelin A.Serum bilirubin levels in overweight and obese individuals: the importance of anti-inflammatory and antioxidant responses.Antioxidants (Basel). 2021;10(9):1352. doi:10.3390/antiox10091352
Waheed Janabi AH, Kamboh AA, Saeed M, et al.Flavonoid-rich foods (Frf): A promising nutraceutical approach against lifespan-shortening diseases.Iran J Basic Med Sci. 2020;23(2):140-153. doi:10.22038/IJBMS.2019.35125.8353
El-Eshmawy M.M., Mahsoub N., Asar M., Elsehely I.Association between total bilirubin levels and cardio-metabolic risk factors related to obesity.Endocr. Metab. Immune Disord. Drug Targets.2021 doi: 10.2174/1871530321999210128201259
Loprinzi P.D., Abbott K.Physical activity and total serum bilirubin levels among insulin sensitive and insulin resistant U.S. adults.J. Diabetes Metab. Disord.2014;13:47. doi:10.1186/2251-6581-13-47
Vitek L., Bellarosa C., Tiribelli C.Induction of mild hyperbilirubinemia: hype or real therapeutic opportunity?Clin. Pharmacol. Ther.2019;106:568–575. doi:10.1002/cpt.1341
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