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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Elevated Bilirubin Levels While Having Vitamin D Deficiency

What could be causing elevated total and indirect bilirubin levels, with normal direct levels and normal liver enzymes? Eyes do get yellow from time to time. Negative ultrasound of liver/gallbladder. Also recently diagnosed as vitamin D deficient. Any relation?
Tue, 10 May 2016
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General & Family Physician 's  Response
HI, thaks for using Health care magic. i had gone through the details provided.
your age, gender and alcohol intake history were not mentioned in the question which have importance in deciding the cause.
any anorexia, weight loss,history of fever were not mentioned.
coming to your query: elevated total and indirect( unconjungated bilirubin) with normal direct and normal liver enzymes occurs most commonly in 1 st probable diagnosis is Gliberts syndrome.
2 nd is hemolysis.
1) Gilbert s syndrome is a genetic etiology with inheritence following autosomal recessive trait. most commonly diagnosed in young adults, mostly males,.
certain conditions like Fasting, eating low calorie food, stress,menstrulation, intercurent febrile illness may increase bilirubin levels that comes to notice accidentally.
presumptive diagnosis of Gilberts can be made in patients with following features:
unconjugated hyperbilirubinemia
a normal complete blood count, blood smear and reticulocyte count which were not mentioned in your case
normal liver function tests.
no specific treatment id required for Gilberts syndrome except for increased incidence of side effects on using some drugs like irinotecan.
2) Hemolysis: due to any cause can increase unconjugated bilirubin in blood.
coming to your senario kindly do complete blood picture, peripheral smear, reticulocyte count and serum LDH to rule out hemolysis as the cause.if hemolysis is ruled out repeat LFT test after 1 month if there is persisiting indirect hyperbilirubinemia it goes more in favour of Gilberts.vit D deficiency does not cause hyperbilirubinemia.
kindly update me with reports. hope u find this useful.
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Suggest Treatment For Elevated Bilirubin Levels While Having Vitamin D Deficiency

HI, thaks for using Health care magic. i had gone through the details provided. your age, gender and alcohol intake history were not mentioned in the question which have importance in deciding the cause. any anorexia, weight loss,history of fever were not mentioned. coming to your query: elevated total and indirect( unconjungated bilirubin) with normal direct and normal liver enzymes occurs most commonly in 1 st probable diagnosis is Gliberts syndrome. 2 nd is hemolysis. 1) Gilbert s syndrome is a genetic etiology with inheritence following autosomal recessive trait. most commonly diagnosed in young adults, mostly males,. certain conditions like Fasting, eating low calorie food, stress,menstrulation, intercurent febrile illness may increase bilirubin levels that comes to notice accidentally. presumptive diagnosis of Gilberts can be made in patients with following features: unconjugated hyperbilirubinemia a normal complete blood count, blood smear and reticulocyte count which were not mentioned in your case normal liver function tests. no specific treatment id required for Gilberts syndrome except for increased incidence of side effects on using some drugs like irinotecan. 2) Hemolysis: due to any cause can increase unconjugated bilirubin in blood. coming to your senario kindly do complete blood picture, peripheral smear, reticulocyte count and serum LDH to rule out hemolysis as the cause.if hemolysis is ruled out repeat LFT test after 1 month if there is persisiting indirect hyperbilirubinemia it goes more in favour of Gilberts.vit D deficiency does not cause hyperbilirubinemia. kindly update me with reports. hope u find this useful.