Norm of bilirubin in blood in men: table by age

Bilirubin is normal in men if its levels do not go beyond 3.5-18.5 µmol/l. Reasons for conducting the study may be jaundice, pain in the liver, the need to evaluate the functioning of liver cells when taking toxic medications.

The analysis is needed for an established diagnosis of viral hepatitis, cirrhosis, liver cancer, cholecystitis, cholangitis and cholelithiasis, hemolytic anemia. An increase in direct bilirubin is a typical sign of liver pathology, while indirect bilirubin is high when red blood cells and the liver are destroyed.

Why is it important to have normal bilirubin levels in men?

Normal bilirubin levels in men mean good liver function and the absence of blood and bile duct diseases. This pigment is found in bile and is formed from hemoglobin in red blood cells. In healthy people, the process of its appearance in the blood goes through several stages:

  1. Red blood cells leave the bone marrow and are destroyed after “aging” - after 3.5 months.
  2. After destruction, hemoglobin is released from red blood cells.
  3. Iron is split off from heme and then enters into biological reactions, and the protein part turns into bilirubin and penetrates into the liver with the blood.
  4. In the liver cells, the indirect (unbound) pigment is neutralized by combining with glucuronic acid, and so a direct, bound pigment appears, which passes into the intestine with the flow of bile, colors the feces and is excreted.

If there is increased destruction of red blood cells (hemolysis), liver damage or obstacles to the movement of bile (in the bile ducts, gallbladder, pancreas), then the level of bilirubin changes. Tests help make a correct diagnosis and monitor the success of treatment.

Reasons for analysis

Your doctor may give you a referral for testing if there are signs of liver dysfunction:

  • yellowness of the skin, mucous membranes;
  • dark urine;
  • light uncolored feces;
  • itchy skin;
  • general weakness;
  • fast fatiguability;
  • heaviness, pain in the right hypochondrium;
  • belching, bitterness in the mouth;
  • body aches, pain in bones and joints;
  • periodic increase in temperature;
  • nausea, vomiting;
  • decreased appetite.

The study is also necessary if there is a diagnosis of viral hepatitis or contact with patients. The test is carried out when taking medications that impair the functioning of the liver, kidneys and hemolytic anemia (diseases with the destruction of red blood cells).

How is diagnostics carried out?

The test requires blood from a vein. It is best to immediately deliver it to the laboratory in sterile boxes. The main feature of this study is careful transportation in order to prevent mechanical damage to red blood cells. Therefore, the test tube with the material should not be shaken, and exposure to direct sunlight can also damage the reliability.

The reaction to find bilirubin is to add sulfanilic acid to the blood serum. As a result, pigments are formed. Moreover, direct bilirubin (about 25% of the total amount) reacts immediately, and bound bilirubin must first be destroyed with urea or caffeine. To calculate the concentration of bilirubin, the change in color of the solution is assessed, and the test tube with the sample is placed in a photometry apparatus.

Deviation from the norm

If the parameters of an adult man have deviations from the norm, this indicates the presence of serious diseases in the body. Therefore, it is important to consult a doctor and conduct additional research to identify the cause of this phenomenon.

In some cases, bilirubin levels may increase due to poor diet and lack of vitamin B12. If a man’s diet does not contain foods containing iron, he is diagnosed with anemia, which results in abnormalities in bile pigment. Frequent consumption of alcoholic beverages also affects the indicator.

Often an increased value indicates diseases:

  • jaundice;
  • gallstones;
  • oncology of internal organs;
  • cirrhosis of the liver;
  • syphilis in acute form;
  • damage to the bile ducts;
  • presence of parasites.

If the enzyme is elevated, then the person experiences primary symptoms. These include yellowness of the skin and eyeballs. However, these signs are not immediately noticeable. If pathology is present, then bilirubin is found not only in the blood, but also in the urine.

In addition to yellowness, the following signs appear:

  • bitter taste in the mouth;
  • nausea and vomiting;
  • there is pain in the liver area;
  • urine color becomes dark;
  • stool becomes colorless.

Therefore, if there is a suspicion of a deviation from the norm, the doctor conducts an additional examination.

Usually they prescribe stool and urine samples and, if necessary, send for an ultrasound or x-ray. And only after this an accurate diagnosis is made and appropriate treatment is prescribed. In some cases, the pigment content may decrease. Therefore, you should check your cardiovascular system.

Various factors can also distort the results:

  • drinking coffee or tea;
  • nervous shock and stress;
  • smoking.

Sometimes changes in parameters can be triggered by physiological processes. And this is not a pathology if there are no symptoms of liver and biliary tract diseases.

Unlike women, men often experience deviations from the norm, and this is associated with leading an unhealthy lifestyle. They may also develop a hereditary disease such as Gilbert's syndrome, in which there is increased bilirubin in the blood.

Bilirubin norm in men by age: table

The normal level of total bilirubin in men can be accurately assessed by age; the values ​​for a healthy person in µmol/l are shown in the table.

Age range Minimum level Maximum level
From 17 to 20 years old 3,7 18
From 20 to 30 years 3,8 19
After 30 years 3,8 18,5
After 40 years 3,9 18,7
After 50 years 3,8 18,5
After 60 years 3,7 18,5
After 70 years 3,5 18,2

The normal bilirubin level in men may differ slightly from the values ​​given if the laboratory uses methods other than photocolorimetry. In this case, the acceptable range of indicators must be indicated in the form.

In what cases is an examination prescribed?

When taking a routine blood test for biochemical parameters, carefully follow your doctor’s recommendations to obtain undistorted test results. In the morning, strictly on an empty stomach, 48 hours before, it is advisable not to overuse fatty and spicy foods.

An analysis to determine the amount of bilirubin in urine or blood is prescribed if:

  • contact with someone infected with Botkin's disease,
  • diagnosis of viral hepatitis,
  • diagnosis of cholelithiasis,
  • diagnosis of cholecystitis and liver cirrhosis,
  • yellowness of the sclera and/or skin,
  • diagnosis of hemolytic anemia,
  • diagnosis of hereditary diseases (Gilbert's syndrome),
  • during a preventive examination.

When making a diagnosis, the doctor will focus not only on the level of bilirubin, but also on whether other biochemical indicators, such as ALT and AST enzymes, are normal. Therefore, when analyzing bile pigment, it is advisable to donate venous blood rather than urine.

Bilirubin level in the blood: normal in men

Simultaneously with the study of the level of total bilirubin in the blood of men, attention must be paid to the compliance with the norm of direct (bound or conjugated) and indirect (bound) indicators.

Direct, connected

The normal level of direct bilirubin, that is, associated with glucuronic acid, is 0-3.4 µmol/l. Since the process of such a connection occurs in the liver, deviations occur when its function is impaired.

If there is an obstacle to the outflow of bile, then the main excretion occurs not through the intestines, but through the kidneys. The patient's urine darkens and stool becomes lighter. This form of pigment accumulates in the skin and mucous membranes, which manifests itself in the form of jaundice. Diagnosis is indicated for suspected hepatitis, cirrhosis and liver cancer.

Indirect, not conjugated

Unconjugated indirect bilirubin should not be higher than 15.4 µmol/l. This part is very toxic, as it dissolves in fats and accumulates in the cells of the body, including the brain. Its level increases with increased destruction of red blood cells or liver damage. The study helps to find the cause of yellowness of the skin and mucous membranes. Low values ​​have no diagnostic value.

Types of bilirubin

Total bilirubin consists of two fractions:

  • direct (related, conjugated);
  • indirect (unbound, free).

Their main difference is their ability to dissolve in water.

Indirect bilirubin

It is formed in the spleen, which is responsible for the disposal of aged red blood cells. Here the blood cells are destroyed and a toxic enzyme appears. It does not dissolve in water, so the kidneys are not able to eliminate it from the body.

Indirect bilirubin combines with the blood component albumin, is sent through the vessels to the liver, where it is transformed into direct bilirubin.

It is able to dissolve in the fats of healthy cells, causing them harm through toxicity. Therefore, it is important to monitor the normal level of its content in the blood. Indirect pigment is dangerous, having the ability to disrupt cellular respiration and protein formation.


It is low toxic and practically harmless. Formed in the liver. Easily dissolves in aqueous media.

Direct bilirubin is excreted from the body through urine and feces.

How to take a correct blood test for bilirubin in men

In order to obtain a reliable blood test for bilirubin in men, it is necessary to strictly adhere to the recommendations:

  • donate blood strictly in the morning on an empty stomach, since during the day there are deviations of 10-25%;
  • during the day you cannot play sports or do heavy physical work, sunbathe under the sun or in a solarium;
  • Alcohol is prohibited for two days;
  • for 3 days before the test, nutrition is based on the exclusion of fatty and spicy foods; you cannot overeat or start strict diets;
  • the last meal and drinks with sugar should be taken no later than 10-12 hours before taking blood;
  • It is forbidden to drink coffee before the analysis;
  • for 3 days, you should exclude the use of antibiotics from the group of cephalosporins (for example, Ceftriaxone, Cefazolin), paracetamol, sleeping pills, antidepressants, anti-inflammatory drugs;
  • For 2 hours you cannot smoke, be nervous, or move actively.

Causes of increased bilirubin levels

Bilirubin does not increase just like that; there are always certain prerequisites for this.

Indirect bilirubin increases due to the following factors:

  • congenital or acquired anemia;
  • syphilis;
  • typhoid fever;
  • sepsis or internal bleeding;
  • Crigler-Najjar, Gilbert or Lucy Driscolp syndrome.

Direct bilirubin also increases due to certain prerequisites, in particular:

  1. liver diseases;
  2. hepatitis;
  3. jaundice, which is hereditary;
  4. helminthiasis

Bilirubin may also be low. This does not pose any danger to the human body, however, according to new research, a decrease in bilirubin concentration is a clear sign of heart problems, so if it is detected, it will not hurt to undergo an appropriate examination.

Also, bilirubin may decrease due to psychological factors - stressful situations, depression. Sometimes the precursor to this condition is excessive caffeine consumption. Monitoring the level of bilirubin in the body is necessary , but some symptoms allow you to see its excess without any tests. Bilirubin colors tissues and organs yellow, but this is not immediately noticeable.

Men should pay attention to the following symptoms:

Bitterness in the mouthThis phenomenon should not be caused by eating bitter foods or poor personal hygiene.
Nausea and gag reflexIf these symptoms periodically appear without any reason, you should get tested for bilirubin.
Heaviness in the liver areaThis is a signal that the liver is having a hard time coping with the increased amount of bilirubin.
Changes in color of urine and stoolFeces may lose their color, and urine, on the contrary, may become yellow or brown.

A comprehensive examination of the body must be carried out regularly; this is the only way to monitor the state of health and eliminate undesirable phenomena in a timely manner.

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Why is bilirubin abnormal in adult men?

If all factors affecting bilirubin levels in adult men are completely excluded, then only diseases can be the causes of changes. Typically, in such cases, ultrasound, liver tomography, blood, urine, and bile tests are performed.


The main reasons for increased bilirubin include:

  • viral hepatitis;
  • alcoholic liver disease;
  • Infectious mononucleosis;
  • abscess (ulcer) of the liver;
  • the use of drugs that destroy liver cells (drug-induced hepatitis);
  • destruction of red blood cells - hemolytic anemia, thalassemia, sepsis, malaria;
  • Gilbert's syndrome - hereditary jaundice with a benign course;
  • tumor of the liver, biliary tract, pancreas (primary or metastases);
  • Crigler-Nayjar syndrome is a congenital disease with brain damage caused by toxic indirect bilirubin;
  • stone in the bile ducts;
  • cirrhosis of the liver;
  • congenital anomalies of the structure of the biliary system;
  • development of echinococcosis (parasitic liver damage);
  • extensive hematomas (bruises);
  • consequences of severe long-term heart failure;
  • syphilis.


A decrease in bilirubin levels can be caused by drugs that stimulate the formation of enzymes in the liver:

  • caffeine;
  • sleeping pills from the group of barbiturates;
  • hormones;
  • antibiotics;
  • anticonvulsants.

Such a decrease has no diagnostic value and the indicators normalize when medications are discontinued. A more rare variant of a decrease in bile pigment in the blood is an extremely severe form of anemia (usually with a bone marrow tumor, leukemia), tuberculosis intoxication, and renal failure.

What is bilirubin: classification

We have already found out that bilirubin is formed during the natural breakdown of proteins containing heme - hemoglobin, myoglobin and cytochrome. This process occurs in the spleen, bone marrow and (mainly) in the liver. This pigment then enters the bile and is then removed from the body through the gastrointestinal tract.

Bilirubin is also found in blood plasma in small quantities.

This is interesting. In scientific research, one can find the assumption that bile pigment is a powerful antioxidant in the human body that prevents cell destruction by free radicals. This is another reason to ensure that the bilirubin level is normal in the tests: in an adult man or woman, an excess of free radicals increases the likelihood of developing an oncological process.

Depending on the chemical structure and functions performed, two types of bilirubin are distinguished:

    Indirect ( >

In a biochemical blood test, both types of pigment can be counted. In this case, the test is called total bilirubin (BIL-T). If its norm is exceeded or according to indications, the D-BIL and ID-BIL fractions are determined separately.

Important! Indirect bilirubin is toxic to cells and tissues of the body. It easily penetrates cytoplasmic membranes and interferes with the processes of cellular respiration and ion transport. An increase in ID-BIL is especially dangerous for the tissues of the central nervous system - the brain and spinal cord.

Recommendations for bringing indicators back to normal

If bilirubin levels deviate from the norm, it is necessary to establish the cause, but in all cases one must adhere to general recommendations:

  • food with a limit on fatty and spicy foods, smoked foods;
  • frequent meals (5-6 times a day) in small portions;
  • ban on drinking alcohol.

For treatment the following is prescribed:

  • drugs that improve liver function (Gepabene, Essentiale);
  • No-shpu, Riabal to relieve spasm of the biliary tract;
  • droppers with saline solutions and glucose to accelerate the removal of bilirubin from the blood;
  • enterosorbents that help cleanse the intestines;
  • phototherapy - irradiation with blue light lamps to convert toxic indirect bilirubin into direct bilirubin.

We recommend reading about how bilirubin is exchanged in the body. From the article you will learn about the mechanism of bilirubin formation, neutralization in the liver, excretion, metabolism of bilirubin in diseases, causes of bilirubin metabolism disorders. And here is more information about the normal levels of bilirubin in the blood of women.

The normal level of bilirubin in the blood of men occurs in the absence of liver damage, disturbances in the excretion of bile and destruction of red blood cells. In case of deviations, additional examination is required to clarify the diagnosis.

How to determine the amount of bilirubin?

Bilirubin is usually detected in peripheral blood, less often in urine. To find out its concentration in the body, it is enough to take a biochemical blood test.

Remember that for a reliable result you must come to the laboratory in the morning (usually from 8.00 to 10.00) and on an empty stomach. The test result is usually ready in 1-2 business days.

LHC with determination of BIL (total, as well as its direct and indirect fractions) is carried out when:

  • Newly identified symptom of jaundice;
  • Diagnosed liver diseases;
  • Various disorders of the outflow of bile and pathologies of the gallbladder;
  • Preventive examination.

Normalization methods

To prevent increased bilirubin levels, it is enough for men to adhere to a healthy lifestyle, eliminating risk factors such as:

  1. smoking,
  2. alcohol,
  3. unhealthy diet, including fast food,
  4. sedentary lifestyle.

It is necessary to regularly (once every two years, and after 45 years - once a year) undergo preventive examinations with tests, and at the first signs of illness, consult a doctor.

Excess weight can lead to fatty liver hepatosis, a degenerative change in cells, and causes even more harm than alcohol.

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