Taking Nsaid For Herniated Disc Pain. Should I Be Concerned For Elevated Bilirubin Level?

Posted on Mon, 1 Apr 2013

Question: 31 y/m received lab levels today elevated bili levels 1.8 all other labs normal. What should be my concerns at this point if any? Lad drawn today to see if they are direct or indirect. I've taken NSAIDs(mobic) and ultram for almost a year now due to herniated disc beginning pain 4 years ago from motocross racing. My doctor isn't acting alarmed in any way but still would like opinions from others. Thank you for your time.

Answered by Dr. Payman Hajiazim (33 minutes later)

Hi there, thanks for asking. Bilirubin increase is not a common finding when somebody is taking meloxicam or tramadol. Tramadol can change liver metabulism, though.
After you know if bilirubin increase is direct or indirect, it would be easier to judge about the possible cause for it.
Many people may have XXXXXXX disease (about 5 percent of the population) which is mostly diagnosed accidentally by checking the bilirubin level.
It could also back to a mild G6PD (favism) problem, since these people find elevated bilirubin level with taking medications from the class of meloxicam (mobic).
Let me know about the result of your test.
I wish you a good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Payman Hajiazim (2 days later)

Okay, had another set of labs drawn two days ago.
Total bilirubin 1.3, direct 0.3 ats 20 alt 21. All other labs normal as well. Previous day before labs drawn
I worked a 24 hour shift( work in EMS ) with minimal sleep. Would this effect bilirubin? I have no complaints, just wanting to see my labs curious I guess.
My primary wrote on the lab results liver ultrasound needed.
Everything I've read almost suggest this is still normal values, depending on the lab.
Suggestions please

Answered by Dr. Payman Hajiazim (3 hours later)

Hi there, the lab results are normal. I should say again that some people in every population have difficulty with excretion of bilirubin or its entrance to the liver cells in order to be excreted. The most common cause is XXXXXXX which you can also search it and study a little about. Interestingly, these people find transient jaundice following stress which could be even sleep deficiency. It might be a mild form of this issue. It is not XXXXXXX and you have enough time to see what it could be. I wish you a good health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar