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Bilirubin is the yellow pigment produced when old red blood cells are broken down and their hemoglobin is metabolized in the spleen and liver. The liver processes bilirubin and excretes it through bile — so elevated bilirubin signals either excessive red blood cell destruction, liver dysfunction, or bile duct obstruction. Mildly elevated indirect bilirubin in otherwise healthy individuals is often benign, caused by Gilbert's syndrome, a harmless genetic variant affecting about 5% of the population.
Also known as: Bili Total, Bilirubin, Bilirubin Total, Bilirubin, Total, Direct bilirubin, T. Bili, Total bilirubin
High bilirubin causes visible jaundice above 2.5 mg/dL from hemolytic anemia, liver disease, or bile duct obstruction. Gilbert's syndrome causes benign intermittent elevations in 5-10% of people.
Standard flag is above 1.0-1.2 mg/dL. Mildly elevated bilirubin from Gilbert's syndrome is actually protective and antioxidant. Functional optimal is 0.5-1.2 mg/dL.