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What Does Altered Bilirubin Level Indicate?

Posted on Mon, 5 May 2014

Question: Bilirubin was 2.5 total 6 months ago , now within normal limits. All liver tests normal, neg hepetitis test, normal ultrasound. Why the change in bilirubin?

Answered by Dr. Dr.P.Ratnakar Kini (58 minutes later)

Hi. Glad to hear about your bilirubin. Since this is a mobile question. Will be brief. Contact through HCM for more. Bilirubin is created by the breakdown of blood cells and wastes. If there is too much. That means too much is bring made (problem with blood) or it's being obstructed on the way out. In either case if it's gone to normal. Thats a sign that the liver is dealing with the issue. Cheers

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

Follow up: Dr. Dr.P.Ratnakar Kini (83 days later)

Had retest. AST,ALT,albumin,Alk phos all are still normal. Total bili 1.6, direct 1.3, direct .25. So it has been 8 total months since first high reading.does this still sound like gilberts syndrome?

Answered by Dr. Dr.P.Ratnakar Kini (26 minutes later)

Brief Answer: More information needed Detailed Answer: Hi, It looks like XXXXXXX syndrome only. But I would like to have some more information before confirming it as XXXXXXX syndrome. 1. What is your hemoglobin level? 2. Can I have the peripheral blood smear report? 3. What is the serum ceruloplasmin level? Kindly get back to me with these information and I would give my opinion. Regards, Dr.R.K.

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

Follow up: Dr. Dr.P.Ratnakar Kini (5 minutes later)

Hemoglobin and reticulyte count were normal.Ultra sound was normal as well. I didnt test for copper. When I went to my Dr 8 months ago he said gilberts. I have been moniotoring on my own for the last 8 months. All liver tests have continued normal except for bilirubin

Answered by Dr. Dr.P.Ratnakar Kini (10 minutes later)

Brief Answer: It is XXXXXXX syndrome only Detailed Answer: Hi, Since hemoglobin and reticulocyte count were normal, the other possibility of hemolysis( including the hemolysis of XXXXXXX Disease) is ruled out. So it points towards XXXXXXX syndrome only. It is an error of bilirubin metabolism wherein the uptake of bilirubin by the liver is affected. XXXXXXX syndrome is not life threatening and so there is no need to worry. The bilirubin level will keep fluctuating. It may reach baseline at times or it may always remain slightly out of range ( but the total never crosses 4-5). Fasting and dehydration may increase the bilirubin level. But in all these circumstances it does not cross 4-5. So - 1. You have XXXXXXX syndrome 2. There is no need to worry. Let me know if I can assist you further. Regards, Dr.R.K

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

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

I tend to worry about my health a lot even though I workout and eat healthy don't drink or smoke. I forgot to mention : also negative hepatitis test, normal GGT , normal kidney test, normal cholesterol. Bilrubin seems to flucuate ( have had 5 tests in 8 months, most of the time the indirect was high, one reading both indirect and direct were high, one time both were normal.) So would you say that happens in Gilberts? thank you for your time.

Answered by Dr. Dr.P.Ratnakar Kini (3 days later)

Brief Answer: Yes, these are typical of XXXXXXX Syndrome Detailed Answer: Hi, Yes, these are typical of XXXXXXX Syndrome. The liver enzymes would be normal. The bilirubin level would fluctuate. But will not cross - 4-5. So you need not worry. Regards, Dr.R.K

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

Follow up: Dr. Dr.P.Ratnakar Kini (1 hour later)

So to finalize, if there was something more serious it would have showed on the liver function tests or ultrasound ?Thank you for your time

Answered by Dr. Dr.P.Ratnakar Kini (11 hours later)

Brief Answer: You are right Detailed Answer: Hi, Yes, you are right. If there was anything serious, then it would have showed in the liver enzymes and sometimes in the ultrasound scan of the abdomen. Let me know if I can assist you further. Regards, Dr.R.K

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