| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Bile Acids, Total, Serum
MessageTESTING ALGORITHM
See Bile Acid-Associated Tests Ordering Guide
ORDERING GUIDANCE
This test is for evaluation of hepatobiliary dysfunction.
For evaluation of bowel dysfunction, order BA48F / Bile Acids, Bowel Dysfunction, 48 Hour, Feces.
For evaluation of patients treated with urso or cholate, order BAFS / Bile Acids, Fractionated and Total, Serum.
For evaluation of inborn errors of metabolism, order BAIPD / Bile Acids for Peroxisomal Disorders, Serum.
See Bile Acid-Associated Tests Ordering Guide
ORDERING GUIDANCE
This test is for evaluation of hepatobiliary dysfunction.
For evaluation of bowel dysfunction, order BA48F / Bile Acids, Bowel Dysfunction, 48 Hour, Feces.
For evaluation of patients treated with urso or cholate, order BAFS / Bile Acids, Fractionated and Total, Serum.
For evaluation of inborn errors of metabolism, order BAIPD / Bile Acids for Peroxisomal Disorders, Serum.
Test Code
BILAC
Alias/See Also
Epic: LAB693
Mayo: BILEA
Bile Acids, Total
Bile Salts, Total
Mayo: BILEA
Bile Acids, Total
Bile Salts, Total
CPT Codes
82239
Preferred Specimen
Specimen Type: Serum
Collection Container: Serum gel
Specimen Volume: 0.5 mL
Patient Preparation
Patient must be fasting for 12 hours. Infants and pregnant patients do not need to fast.
Minimum Volume
0.25 mL
Other Acceptable Specimens
Collection Container: Red top
Instructions
- Serum gel tubes should be centrifuged within 2 hours of collection.
- Red-top tubes should be centrifuged and serum aliquoted into plastic vial within 2 hours of collection.
Transport Container
Plastic vial
Specimen Stability
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Frozen | 30 days | ||
| Ambient | 24 hours |
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | Reject |
Methodology
Enzymatic
Setup Schedule
Monday through Sunday
Report Available
Same day/1 to 2 days
Limitations
CAUTIONS
Serum total bile acid testing is generally not suitable for differentiation among the various types of liver diseases.
Total bile acid concentration is increased after meals; samples should be collected under fasting conditions.
Serum total bile acid testing is generally not suitable for differentiation among the various types of liver diseases.
Total bile acid concentration is increased after meals; samples should be collected under fasting conditions.
Reference Range
REFERENCE VALUES
< or =10 mcmol/L
Reference interval applies to fasting total bile acid concentrations.
INTERPRETATION
Total bile acids are metabolized in the liver and can serve as a marker for normal liver function.
Increases in serum bile acids are seen in patients with acute hepatitis, chronic hepatitis, liver sclerosis, and liver cancer.
< or =10 mcmol/L
Reference interval applies to fasting total bile acid concentrations.
INTERPRETATION
Total bile acids are metabolized in the liver and can serve as a marker for normal liver function.
Increases in serum bile acids are seen in patients with acute hepatitis, chronic hepatitis, liver sclerosis, and liver cancer.
Clinical Significance
USEFUL FOR
An aid in the evaluation of liver function
Evaluation of liver function changes before the formation of more advanced clinical signs of illness such as icterus
An aid in the determination of hepatic dysfunction as a result of chemical and environmental injury
An indicator of hepatic histological improvement in chronic hepatitis C patients responding to interferon treatment
An indicator for intrahepatic cholestasis of pregnancy
CLINICAL INFORMATION
Bile acids are formed in the liver from cholesterol, conjugated primarily to glycine and taurine, stored and concentrated in the gallbladder, and secreted into the intestine after the ingestion of a meal. In the intestinal lumen, the bile acids serve to emulsify ingested fats and thereby promote digestion. During the absorptive phase of digestion, approximately 90% of the bile acids are reabsorbed.
The efficiency of the hepatic clearance of bile acids from portal blood maintains serum concentrations at low levels in normal persons. An elevated fasting level, due to impaired hepatic clearance, is a sensitive indicator of liver disease. Following meals, serum bile acid levels have been shown to increase only slightly in normal persons but markedly in patients with various liver diseases, including cirrhosis, hepatitis, cholestasis, portal-vein thrombosis, Budd-Chiari syndrome, cholangitis, Wilson disease, and hemochromatosis. No increase in bile acids will be noted in patients with intestinal malabsorption. Metabolic hepatic disorders involving organic anions (eg, Gilbert disease, Crigler-Najjar syndrome, and Dubin-Johnson syndrome) do not cause abnormal serum bile acid concentrations.
Significant increases in total bile acids in nonfasting pregnant females can aid in the diagnosis of cholestasis. Other factors, such as complete medical history, physical exam, and liver function tests should also be considered.
An aid in the evaluation of liver function
Evaluation of liver function changes before the formation of more advanced clinical signs of illness such as icterus
An aid in the determination of hepatic dysfunction as a result of chemical and environmental injury
An indicator of hepatic histological improvement in chronic hepatitis C patients responding to interferon treatment
An indicator for intrahepatic cholestasis of pregnancy
CLINICAL INFORMATION
Bile acids are formed in the liver from cholesterol, conjugated primarily to glycine and taurine, stored and concentrated in the gallbladder, and secreted into the intestine after the ingestion of a meal. In the intestinal lumen, the bile acids serve to emulsify ingested fats and thereby promote digestion. During the absorptive phase of digestion, approximately 90% of the bile acids are reabsorbed.
The efficiency of the hepatic clearance of bile acids from portal blood maintains serum concentrations at low levels in normal persons. An elevated fasting level, due to impaired hepatic clearance, is a sensitive indicator of liver disease. Following meals, serum bile acid levels have been shown to increase only slightly in normal persons but markedly in patients with various liver diseases, including cirrhosis, hepatitis, cholestasis, portal-vein thrombosis, Budd-Chiari syndrome, cholangitis, Wilson disease, and hemochromatosis. No increase in bile acids will be noted in patients with intestinal malabsorption. Metabolic hepatic disorders involving organic anions (eg, Gilbert disease, Crigler-Najjar syndrome, and Dubin-Johnson syndrome) do not cause abnormal serum bile acid concentrations.
Significant increases in total bile acids in nonfasting pregnant females can aid in the diagnosis of cholestasis. Other factors, such as complete medical history, physical exam, and liver function tests should also be considered.
Performing Laboratory
Mayo Clinic Laboratories - Rochester
3050 Superior Drive NW
Rochester, MN 55901
Additional Information
Bile Acids, Total, Serum
Last Updated: December 18, 2023
Last Review: N. Wolford, December 18, 2023