Are your eyes and skin turning yellow? Let's learn about the bilirubin test in simple terms.

Sometimes you may feel like your eyes are a little yellow, or your body feels incredibly tired. Or when you go to see a newborn baby, you may hear people say, "The baby is a little jaundiced." Today we are going to talk about something called 'bilirubin', which can be related to all of these. Let's simply understand what it is, why it is important for our body, and what the test for it says.

Simply put, what is bilirubin?

Think of the red blood cells in our bodies as workers. These workers also have a certain lifespan. When that lifespan is over, that is, when they get old, these red blood cells break down. That's how we call bilirubin, a yellow pigment that forms when old red blood cells break down.

This bilirubin travels through our blood and goes directly to our liver. The liver is like the biggest factory in our body. It takes this bilirubin and other waste products, cleans them, and prepares them for excretion with a liquid called 'bile'. This bilirubin is what gives your stools their brown color and your bile their yellow color.

So what is this bilirubin blood test?

It's very simple. A bilirubin blood test measures the amount of bilirubin in your blood. If a doctor asks you to have this test, they will usually take a small sample of blood from a vein in your arm and send it to a lab. The lab will check to see if your bilirubin level is within the normal range.

If this level is higher (high) or lower (low) than normal , it means that there may be a small problem somewhere in the process of breaking down our red blood cells, cleaning them in the liver, and removing them from the body.

Why does bilirubin level increase? (Hyperbilirubinemia)

There are three main reasons why bilirubin can accumulate in the blood. Let's understand it this way.

Is low bilirubin levels a problem?

Low bilirubin levels are usually not considered a big problem. Some medications (e.g. antibiotics, birth control pills) can cause this. It's nothing to worry about.

What are the symptoms of increased bilirubin?

When bilirubin levels increase, our body shows several symptoms.

• Jaundice: This is the main and most obvious sign. It causes the whites of your eyes and skin to turn yellow .
• Dark urine: As excess bilirubin in the blood is filtered by the kidneys and excreted in the urine, the urine takes on a dark color, similar to the color of tea.
• Pale stool: Because bilirubin does not reach the intestines properly, stools take on a light, clay-like color instead of their normal brown color.
• Itchy skin: When bilirubin levels become too high, it can build up under the skin and cause itching (pruritus) in some people.

If you have any of these symptoms, the best thing to do is to see a doctor as soon as possible.

How to understand the test report? Direct and Indirect bilirubin

The report you receive will have a value called 'Total Bilirubin'. There are also two values ​​called 'Direct Bilirubin' and 'Indirect Bilirubin'. What is the difference?

Think of the liver as a factory that 'packs' goods.

• Indirect (Unconjugated) Bilirubin: This refers to the 'unconjugated' bilirubin that comes to the liver for purification. It is not soluble in water. Therefore, it reaches the liver attached to a protein (albumin) in the blood.
• Direct (Conjugated) Bilirubin: This refers to bilirubin that has been 'packaged' inside the liver, meaning it has been purified and made water-soluble. These are the ones that are prepared to be excreted from the body along with bile.

By looking at which of these two types is more prevalent in your report, the doctor can get an idea of ​​where the problem lies.

When does bilirubin level become serious?

The normal bilirubin level for an adult and a child is between 0.2 and 1.3 mg/dL. When it is higher than that, a doctor will start looking for the cause.

Why is this especially important for newborn babies?

Newborn babies naturally have slightly higher bilirubin levels than adults. This is called 'physiological jaundice'. It usually goes away within a few days.

However, sometimes this level becomes very high.It can be dangerous for babies. Because, during the period when their brain is developing, this excess bilirubin (especially the indirect type) can go to the brain and damage it. This is called `(Kernicterus)`. That is why doctors are very concerned about the 'jaundice' of babies. If the baby's bilirubin level seems to be reaching a dangerous level, treatment will be started.

The main treatment given to babies is 'phototherapy' . Simply put, the baby is placed under a special blue light. This light breaks down bilirubin and makes it easier for the body to remove it.

Can bilirubin levels be reduced?

To lower your bilirubin levels, you need to treat the underlying condition that caused the increase. Your doctor will find the cause and tell you what treatment is best for it.

At the same time, it is also very important to reduce the pressure on the liver in general.

• Stop drinking alcohol completely.
• Do not use unnecessary medications without the advice of a doctor.
• Eating a healthy diet.

Things like these can help protect your liver health.