Bilirubin Test Price in Pakistan: Rs 455 at Marham Lab

Bilirubin is a yellowish substance made during your body's normal process of breaking down old red blood cells. MedlinePlus explains that it is found in bile, the fluid your liver makes to help you digest food, and that a healthy liver removes most of it through the bile ducts. If the liver is damaged or the bile ducts are blocked, bilirubin leaks into the blood. At Marham Lab a bilirubin test costs Rs 455, reduced from Rs 650.

Why Jaundice Happens

This is the connection between the number and what you can see in the mirror.

MedlinePlus states that when too much bilirubin gets into the bloodstream it causes jaundice, a condition that turns your skin and eyes yellow. The yellow colour is the bilirubin itself. If you have jaundice, MedlinePlus notes your provider may order this test to check for liver disease or damage.

So jaundice is not a disease in itself. It is a visible sign that bilirubin is building up, and this test is the first step in finding out why.

Newborn Jaundice: Usually Harmless, Occasionally Not

Read this part carefully if you have a yellow baby, because MedlinePlus is balanced about it in a way that matters.

MedlinePlus states that many healthy babies get jaundice because their livers have not developed enough to get rid of the bilirubin, and that newborn jaundice is usually not harmful and clears up within a few weeks.

It then adds the reason testing still happens: in some cases, high bilirubin levels can lead to brain damage, so infants are often tested as a precaution.

Both halves are true at once. Most yellow babies are fine. The test exists because the small number who are not need to be found early. That is why a paediatrician asks for it rather than waiting to see.

For a baby, MedlinePlus describes a heel stick: the provider cleans the heel with alcohol, pricks it with a small needle, collects a few drops of blood and applies a bandage.

If a newborn's jaundice has not cleared in two weeks, that is also the point at which a [G6PD test](/labs/tests/g6pd-test-price) may be added, since G6PD deficiency is one cause of jaundice that persists.

Total, Direct and Indirect

Three lines appear on Pakistani prescriptions and people often assume the dearer one is better. They measure different fractions of the same substance.

MedlinePlus lists all of these among the other names for bilirubin testing. All three cost the same here, so price is not the deciding factor. Book what your doctor wrote. If the prescription says only bilirubin, the total is what is being asked for.

Our [liver function test](/labs/tests/lft-test-price) panel already includes bilirubin, so do not book these separately as well if your doctor ordered an LFT.

Symptoms That Prompt the Test

MedlinePlus says a provider may order a bilirubin test if you have jaundice, dark urine, clay coloured stool, or stomach pain, noting these could indicate hepatitis, cirrhosis or other liver diseases.

The combination of dark urine with pale stool is particularly worth reporting, since it points towards a problem with bile flow rather than the liver cells themselves.

MedlinePlus lists the other reasons for testing.

• To find out whether there is a blockage in your bile ducts
• To monitor an existing liver disease
• To diagnose disorders where the body breaks down red blood cells too quickly

On that last one it gives the example: high bilirubin may be a sign of haemolytic anaemia, a condition where your body destroys red blood cells faster than it makes them.

What the Result Can Mean

MedlinePlus is clear that normal ranges can vary from lab to lab, so read your figure against the reference interval printed next to it on your own report rather than one from a website.

High bilirubin, called hyperbilirubinaemia, may be due to haemolytic anaemia, liver disease, or a blockage in the bile ducts.

Low bilirubin is not usually a cause for concern. MedlinePlus notes it may be due to medicines such as antibiotics, birth control pills, sleeping pills and seizure medicines.

MedlinePlus adds an important caveat: abnormal results do not always mean you have a condition needing treatment, and higher than normal bilirubin can also be caused by some medicines, certain foods, or strenuous exercise.

One Test Is Not a Liver Assessment

MedlinePlus states that a bilirubin blood test is only one measure of your liver health, and that if your provider suspects liver disease or a red blood cell disorder you may need other tests. It lists liver function tests, liver protein tests, urine tests, an ultrasound, and a liver biopsy to examine tissue under a microscope.

In Pakistan the usual next step after a raised bilirubin is a full LFT alongside [hepatitis B](/labs/tests/hbsag-test-price) and [hepatitis C](/labs/tests/hepatitis-c-test-price) testing, because both are common here and both are treatable.

How to Prepare

MedlinePlus notes your provider may tell you to fast for several hours before the blood test, so ask the doctor who ordered it whether that applies to you. Bilirubin on its own does not usually require fasting, though it is frequently ordered inside a panel that does.

MedlinePlus also says you may need to stop certain medicines beforehand, so tell your provider about everything you take, and do not stop any medicine unless your provider tells you to. Since strenuous exercise can raise bilirubin, avoid a hard workout the day before.

What Happens During the Test

A trained phlebotomist takes a small blood sample from a vein in your arm using a small needle. MedlinePlus notes it usually takes less than five minutes and that you may feel a little sting as the needle goes in or out. There is very little risk beyond slight pain or bruising, which settles quickly. In Lahore the sample can be collected at your home at no extra cost, which is easier with a newborn.

اردو میں

بلیروبن ایک زردی مائل مادہ ہے جو جسم میں پرانے سرخ خلیوں کے ٹوٹنے سے بنتا ہے۔ یہ پت یعنی بائل میں پایا جاتا ہے، جو جگر ہاضمے کے لیے بناتا ہے۔ صحت مند جگر اسے پت کی نالیوں کے ذریعے جسم سے باہر نکال دیتا ہے۔

یرقان کیوں ہوتا ہے۔ اگر جگر خراب ہو یا پت کی نالیاں بند ہو جائیں تو بلیروبن خون میں جمع ہونے لگتا ہے، اور جب یہ بڑھ جاتا ہے تو جلد اور آنکھیں پیلی ہو جاتی ہیں۔ یہی یرقان ہے۔ یاد رکھیں، یرقان خود بیماری نہیں بلکہ اس بات کی علامت ہے کہ بلیروبن بڑھ رہا ہے۔

نوزائیدہ بچوں کے یرقان کے بارے میں دو باتیں ساتھ ساتھ درست ہیں۔ بہت سے صحت مند بچوں کو یرقان ہوتا ہے کیونکہ ان کا جگر ابھی مکمل طور پر کام کرنے کے قابل نہیں ہوتا، اور یہ عام طور پر نقصان دہ نہیں ہوتا اور چند ہفتوں میں ٹھیک ہو جاتا ہے۔ لیکن بعض صورتوں میں بلیروبن بہت بڑھ جانے سے دماغ کو نقصان پہنچ سکتا ہے، اسی لیے احتیاطاً بچوں کا ٹیسٹ کروایا جاتا ہے۔ بچے کا نمونہ ایڑی سے لیا جاتا ہے۔

اگر بچے کا یرقان دو ہفتے میں ختم نہ ہو تو ڈاکٹر جی سکس پی ڈی کا ٹیسٹ بھی تجویز کر سکتے ہیں۔

ٹوٹل، ڈائریکٹ اور اِن ڈائریکٹ بلیروبن ایک ہی چیز کے مختلف حصے ناپتے ہیں۔ مرہم لیب میں تینوں کی قیمت ایک ہی ہے، چار سو پچپن روپے، اس لیے قیمت کی بنیاد پر انتخاب نہ کریں، نسخے میں جو لکھا ہے وہی کروائیں۔ اگر ڈاکٹر نے ایل ایف ٹی لکھا ہے تو اس میں بلیروبن پہلے سے شامل ہوتا ہے۔

ڈاکٹر کو ضرور دکھائیں اگر پیشاب گہرا اور پاخانہ پھیکا ہو، کیونکہ یہ پت کی نالی بند ہونے کی طرف اشارہ کرتا ہے۔ ٹیسٹ سے ایک دن پہلے سخت ورزش سے گریز کریں۔ مرہم لیب میں اس ٹیسٹ کی قیمت چار سو پچپن روپے ہے اور لاہور میں گھر سے نمونہ لینے کی سہولت مفت ہے۔

Final Thoughts

Bilirubin is cheap, fast and genuinely informative, and it is the test that turns a visible symptom into a direction to investigate. Two things are worth holding on to. A yellow newborn is usually fine, and is tested anyway because the rare serious case needs catching early. And a raised bilirubin in an adult is a reason for a full liver workup rather than a diagnosis on its own, particularly here where hepatitis B and C are common and treatable.