|Values are valid only on day of printing.|
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.
Measurement of tauro- and glycol-conjugated and unconjugated bile acid constituents in serum
May also be useful for monitoring patients receiving bile acid therapy, such as cholic acid, deoxycholic acid, or ursodeoxycholic acid
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, liver cancer, and intrahepatic cholestasis of pregnancy.
Do not use for the diagnosis of peroxisomal biogenesis disorders or inborn errors of bile acid metabolism.
This test does not measure sulfated bile acids.
Total Cholic Acid
< or =5.00
Total Chenodeoxycholic Acid
< or =6.00
Total Deoxycholic Acid
< or =6.00
Total Ursodeoxycholic Acid
< or =2.00
Total Bile Acids
< or =19.00
1. Tribe RM, Dann AT, Kenyon AP, et al: Longitudinal profiles of 15 serum bile acids in patients with intrahepatic cholestasis of pregnancy. Am J Gastroenterol 2010 Mar;105(3):585-595
2. Marschall HU: Management of intrahepatic cholestasis of pregnancy. Expert Rev Gastroenterol Hepatol 2015 Oct;9(10):1273-1279
3. Ducroq DH, Morton MS, Shadi N, et al: Analysis of serum bile acids by isotope dilution-mass spectrometry to assess the performance of routine total bile acid methods. Ann Clin Biochem 2010 Nov;47(Pt 6):535-540