Conjugated (direct) bilirubin helps show how well your liver processes and clears bile.
Conjugated (direct) bilirubin is the part of bilirubin that the liver has already processed and made water soluble, ready to be passed into bile.
Measuring it separately from total bilirubin helps show whether a raised bilirubin is a liver or bile duct problem rather than faster red cell breakdown.
A high direct bilirubin points to a problem after the liver has done its job, usually blocked or slowed bile flow from gallstones, bile duct disease, or liver damage. It is the fraction that turns urine dark.
When bilirubin is raised but the direct fraction stays low, the cause is more likely faster red cell breakdown or Gilbert's syndrome. The split between direct and indirect is the key clue.
Aniva reads your result against research-backed ranges, not just the lab's wide normal. The reference shown below is specific to this biomarker.
| Measure | Serum direct bilirubin (SI) |
| Direct (conjugated) | up to ~5 µmol/L |
Ranges are guidance only and vary by lab and assay. To convert, 1 mg/dL is about 17.1 µmol/L. Read your result against your own lab's reference interval, in line with DGKL practice.
Like total bilirubin, the sample is sensitive to light and to haemolysis. Some medicines change the result. The direct fraction is most useful when read as a share of the total bilirubin.
Best read with total bilirubin (to calculate the indirect fraction), and with ALT, AST, GGT, and alkaline phosphatase.
What does a high result mean? It often points to slowed bile flow or trouble excreting bilirubin. Your clinician may check enzymes or imaging to learn more.
Do I need to fast for this test? No. You can eat and drink normally. Avoid alcohol and very hard exercise the day before if possible.
What can affect the result? Medicines, alcohol, dehydration, long fasting, strenuous exercise, pregnancy, acute illness, and sample issues like hemolysis or light exposure.
How often should I test? Only as advised by your clinician. If abnormal, it’s often rechecked in weeks or months to track trends.
How long do results take? Results are usually ready in about 7 days.
What should I discuss with my clinician? Your medicines and supplements, alcohol intake, and symptoms like itching or pale stools. Ask if other liver tests or imaging are needed.
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