Hi,

Thanks for your query.

There is mild derangement in the indirect bilirubin values.This is not serious but needs some more investigations to ascertain the safety.

Indirect bilirubin is the bilirubin which is unconjugated that means unprocessed bilirubin by the liver .

Normally red blood cells generated in the bone marrow are disposed of in the spleen when they get old or damaged. This releases hemoglobin, which is broken down to heme as the globin parts are turned into amino acids. The heme is then turned into unconjugated bilirubin in the spleen. This unconjugated bilirubin is not soluble in water. It is then bound to albumin and sent to the liver.In the liver it is conjugated with glucuronic acid , making it soluble in water (Direct bilirubin). Much of it goes into the bile and thus out into the small intestine.

There are two chances where indirect bilirubin increases in circulation

1)Excess production of Indirect bilirubin due to excess death of RBCs
2)Liver abnormality resulting in failure of conjugation


Since, The other liver parameters of the liver like SGOT and SGPT are fine I would not consider the liver having any problem here.

It could be the excess production of the Indirect bilirubin by increase death of RBCs.This can be confirmed by other blood tests like

CBC (complete blood count)
Peripheral smear test

Both the tests will give a detailed clue into why there is excess production of indirect bilirubin.

Do get back with the above test reports , we shall have a discussion on the treatment id anything is deranged.

Wish you good luck.

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Hi,

Thanks for the report.

The above readings appear absolutely normal this rules out major illness which cause death of RBCs and also rules out infections and blood related cancers.

Next would be to get the Peripheral smear done . This test shows evidence of early death of RBCs if any and can help in ruling out any major illnesses.Do go for it and get back with the report we shall have a detailed discussion then.

Wish you good health.

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