College of Massage Therapists of British Columbia (CMTBC) Practice Exam

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Where is bilirubin primarily broken down in the body?

Stomach
Liver
Kidneys
Spleen

The correct answer is: Liver

Bilirubin is primarily broken down in the liver. After red blood cells are broken down in the spleen, hemoglobin is released and subsequently converted into biliverdin and then into bilirubin. This bilirubin is then transported to the liver bound to albumin. In the liver, bilirubin undergoes a process of conjugation, where it is transformed into a water-soluble form, making it easier for the body to excrete it. Once in this conjugated form, bilirubin can be excreted into bile and eventually eliminated from the body through the intestines. This liver function is crucial for maintaining bilirubin levels in the blood and preventing conditions like jaundice, which can occur when bilirubin levels are elevated due to liver dysfunction.