Get tested with Superpower

If you’ve been postponing blood testing for years or feel frustrated by doctor appointments and limited lab panels, you are not alone. Standard healthcare is often reactive, focusing on testing only after symptoms appear or leaving patients in the dark.

Superpower flips that approach. We give you full insight into your body with over 100 biomarkers, personalized action plans, long-term tracking, and answers to your questions, so you can stay ahead of any health issues.

With physician-reviewed results, CLIA-certified labs, and the option for at-home blood draws, Superpower is designed for people who want clarity, convenience, and real accountability - all in one place.

Key benefits of Bilirubin, Direct testing

• Spots bile duct blockages that can cause jaundice and liver damage.
• Flags conjugated hyperbilirubinemia, pointing to liver or bile flow problems.
• Clarifies whether jaundice stems from liver disease versus blood cell breakdown.
• Guides diagnosis of gallstones, hepatitis, cirrhosis, and bile duct obstruction.
• Tracks liver function during treatment for chronic liver or biliary disease.
• Explains unexplained itching, dark urine, or pale stools linked to bile issues.
• Best interpreted with total bilirubin, liver enzymes, and your symptoms.

What is Bilirubin, Direct?

Direct bilirubin is a water-soluble form of bilirubin that has been processed by the liver. It forms when the liver attaches a sugar molecule (glucuronic acid) to unconjugated bilirubin, making it ready for elimination from the body. This chemical modification is called conjugation, which is why direct bilirubin is also known as conjugated bilirubin.

The liver's export product

Once conjugated, direct bilirubin is secreted into bile and flows through the bile ducts into the intestines. From there, it is eventually excreted in stool, giving feces its characteristic brown color.

A window into bile flow

Direct bilirubin levels reflect how well the liver is processing and exporting waste. When bile ducts are blocked or the liver is damaged, direct bilirubin can back up into the bloodstream. This causes a distinct type of jaundice and signals that bile flow is impaired, pointing to conditions affecting the liver, gallbladder, or bile ducts.

Why is Bilirubin, Direct important?

Direct bilirubin measures the water-soluble form of bilirubin that has been processed by the liver, offering a window into how well your liver and bile ducts are functioning. When the liver conjugates bilirubin and sends it into bile, this marker rises in the blood only when something blocks that flow or damages liver cells. It reveals whether jaundice stems from a liver or bile duct problem rather than excessive red blood cell breakdown.

When direct bilirubin stays near zero

Healthy individuals typically have very low or undetectable direct bilirubin, reflecting smooth bile flow and intact liver processing. Values at the low end of the reference range are normal and expected. There are no symptoms or concerns tied to low direct bilirubin, as the liver efficiently clears conjugated bilirubin into the intestines.

When direct bilirubin climbs above normal

Elevated direct bilirubin signals obstruction in the bile ducts, liver inflammation, or hepatocyte injury. Gallstones, tumors, or strictures can block bile flow, causing conjugated bilirubin to back up into the bloodstream. Hepatitis, cirrhosis, and certain medications also raise this marker. Symptoms include dark urine, pale stools, itching, and yellow-tinged skin or eyes. Pregnant women with intrahepatic cholestasis of pregnancy may show elevated direct bilirubin alongside intense itching.

The bigger metabolic picture

Direct bilirubin connects liver detoxification, bile acid metabolism, and digestive fat absorption into one measurable signal. Persistently high levels warn of progressive liver disease, biliary obstruction, or systemic conditions affecting hepatobiliary function, guiding timely imaging and intervention to preserve long-term liver health.

What do my Bilirubin, Direct results mean?

Low direct bilirubin values

Low values usually reflect normal liver function and bile flow. Direct bilirubin, also called conjugated bilirubin, is the water-soluble form processed by the liver and excreted into bile. When levels are low or undetectable, it typically means the liver is efficiently conjugating bilirubin and the bile ducts are clear. This is the expected state in healthy individuals and carries no clinical concern.

Optimal direct bilirubin range

Being in range suggests your liver is conjugating bilirubin normally and bile is flowing freely from the liver through the bile ducts into the intestine. Most laboratories report direct bilirubin as a small fraction of total bilirubin, and optimal values sit at the low end of the detectable range. This reflects smooth coordination between liver cell function and biliary drainage.

High direct bilirubin values

High values usually reflect impaired bile flow or liver cell injury. When direct bilirubin rises, it indicates that conjugated bilirubin is backing up into the bloodstream rather than being excreted. This happens with bile duct obstruction, liver inflammation, or conditions affecting the small bile channels within the liver itself. The pattern often points toward a post-hepatic or hepatic problem rather than increased red blood cell breakdown.

Factors that influence direct bilirubin

Direct bilirubin rises during pregnancy-related liver conditions and with certain medications that affect bile flow. Newborns and older adults may show different patterns. Interpretation is most meaningful alongside total bilirubin and liver enzyme results.