Total bile acids represent the combined concentration of all bile acids circulating in the blood. They are synthesised in the liver from cholesterol and play a central role in fat digestion, nutrient absorption, and detoxification. Elevated total bile acid levels may reflect reduced bile flow, liver dysfunction, or impaired reabsorption in the intestine. Normal concentrations indicate balanced bile acid synthesis and efficient hepatic and intestinal function.

High total bile acid levels may indicate reduced bile flow (cholestasis), liver dysfunction, or impaired bile reabsorption in the intestine. Elevated concentrations can also occur when bile production or circulation is disrupted due to inflammation, toxins, or metabolic stress.
Testing can be useful for people experiencing digestive problems related to fat absorption, such as bloating, nausea after fatty meals, or pale stools. It can also help evaluate liver and gallbladder function in cases of persistent tiredness, hormonal imbalance, or suspected difficulties with detoxification.
Bile acid concentrations are influenced by liver function, bile flow, gut microbiota composition, and cholesterol metabolism. Hormonal changes, certain medications, or imbalances in gut bacteria can also affect bile acid recycling between the liver and intestines.
