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What should be the normal bilirubin level? - Online Doctor Chats

Date : 22-Feb-2014
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1373 Questions
User:i have just had a liver function test, bilirubin is 24. see below
BILIRUBIN     * 24     umol/L     0 - 20

ALKALINE PHOSPHATASE     83     IU/L     40 - 129

ASPARTATE TRANSFERASE     28     IU/L     0 - 37

ALANINE TRANSFERASE     28     IU/L     10 - 50

GAMMA GT     33     IU/L     10 - 71

TOTAL PROTEIN     72     g/L     63 - 83

ALBUMIN     49     g/L     34 - 50

GLOBULIN     23     g/L     19 - 35

My skin itches, often get bloated and lethagic.

can you advise?
Doctor:Please give me a minute to go through your concern
Doctor:Normal value for total bilirubin level is less than 21 umol/L
User:My alcohol consumption has been high for about the past 4 years, most days a bottle of wine, only odd days abstinence. Not drunk now for 8 days.
Doctor:All your results are normal except Total bilirubin
Doctor:Alcohol does cause liver damage
User:Do you think that the alcohol could cause the itching and the bloating and lethargy? in that I have damaged my liver?
Doctor:and chronic liver damage that is caused by alcohol leads to chronic liver failure
Doctor:I don't think it is alcohol that is causing itching, or lethargy
User:yes i understand that, but at reading of 24 is that likely?
Doctor:I think it is because of liver damage
Doctor:that is alcohol is indirectly causing the itching, by damaging the liver
Doctor:It is unlikely at 24 umol/L
User:ok, at a reading of 24 I dont need to be alarmed?? But cut down?
Doctor:You need to be alarmed
Doctor:because all other tests are normal
Doctor:that means you have chronic damage
User:You are saying that I need to be alarmed? Worried? what must I do?
Doctor:Maybe early cirrhosis
Doctor:You must stop alcohol completely
User:ok. what can i do to help my condition?
Doctor:get an ultrasound scan done to see the condition of the liver
Doctor:Abstinence from alcohol is sufficient
Doctor:at this level
User:ok. Can this be reversed? Must I never drink again?
Doctor:If there is cirrhosis, then it can not be reversed
Doctor:but it can be halted at the current level by completely stopping drinking
User:you think there could be at 24, another doctor had said that 24 was just over
Doctor:Yes, 24 is just above the normal level,
Doctor:but the thing with bilirubin is that, it will start increasing only if half of the liver is damaged
User:so it really is likely at just above? Is that because everything else is normal?
Doctor:You do need further investigations to find out the exact nature
Doctor:of your condition
User:ok thank you. I will make an appointment for more tests
Doctor:It is really just above normal
Doctor:And if it is due to alcohol consumption, which I think it is
User:so worried or alarmed?? I am alarmed at what you have said
Doctor:by abstaining from alcohol completely, you can get it to normal
Doctor:It is intended
Doctor:I want to make sure that you understand that if you continue to drink alcohol, there will come a day when you will need a new liver
User:ok. I understand.
Doctor:Generally in acute liver injury due to alcohol consumption the pattern we see is, all other liver enzymes will be elevated, but bilirubin will not be elevated
Doctor:hence my suspicion of liver cirrhosis
User:so you are saying that this is not acute
User:everything else is not elevated but bilirubin is?
Doctor:But, my opinion is not final, because to completely know the condition of liver, we do want to look at the liver by ultrasound scan
Doctor:yes, everything else is within normal limits, only bilirubin is elevated, it suggests that there is chronic liver injury
Doctor:which is not too aggressive, typical of long standing alcohol use
Doctor:Please go ahead and get an ultrasound done
User:ok thank you for your help
Doctor:if ultrasound shows that you do not have any cirrhosis, then you can continue alcohol consumption
Doctor:but only in minimal quantities
Doctor:You are welcome
Doctor:is there anything else I can help you with?
User:No thank you
Doctor:Take care and have a great day ahead
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