Bilirubin explained

What is left when old red blood cells break down. The liver processes it so it dissolves, then sends it out in bile. Which of the two fractions is raised is the whole point of measuring both — it separates a harmless inherited pattern from a blockage or liver injury. Total up, direct normal: In a well person this is most often Gilbert's syndrome — a harmless inherited variation needing no treatment, most visible when fasting or run down.

Fasting: Not needed, but usually taken with a fasting panel. Best time: Morning, with the rest of the panel. Prolonged fasting genuinely raises bilirubin in people with Gilbert's syndrome — say so if you fasted longer than asked.

Commonly: gilbert's syndrome, common and harmless; prolonged fasting or recent illness, in people who have it; faster breakdown of red blood cells; obstruction of the bile ducts, including gallstones; liver inflammation from any cause. A single result is not a diagnosis. Values are read against the laboratory's own reference range and alongside your history, your symptoms and the rest of the panel — which is why every package includes a doctor to go through them with you.

At Smart Care Polyclinic, 29 Doha Centre, Al Maktoum Rd, Deira, Dubai. Walk in during opening hours or call +971 (0)4 379 3562.