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Elevated calcium, CO2 bicarbonate, ALT and bilirubin. What should be done?

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Internal Medicine Specialist
Practicing since : 2001
Answered : 2272 Questions
Good Morning, I am hoping you can help with some crazy blood tests that I have been having for the last 2 years. I will give you a break out of abnormal results and if you can think of anything that can cause all of these please let me know. I am kind of an enigma now and no one can seem to figure it out. calcium - 10.3 but has been as a high as 10.8. it is never el evated on back to back tests and drops down to 9.7 which is normal. I was tested for a parathyroid tumor even had xrays of the lungs to. check for sarcoidosis. everything come a back normal. since my albumin is on the high end my doctor thinks my calcium will be high especially if I am dehydrated since the more albumin you have the higher the calcium concentration. CO2 Bicarbonate - Slightly elevated at 30. No one has a cause since all other electrolytes are normal. anion gap is also normal as well. doctor thinks thid is from dehydration and volume depletion as it corrects itself. Total Bilirubin - 2.3 but fluctuates from high normal to barely elevated. direct bili is .3 and the indirect is high. doctor said gilberts syndrome. Alt - elevated at 47. all other liver enzymes ast, alp are normal. liver function albumin is normal if not borderline high depending on lab. 2 liver ultrasounds normal. I do take humira for crohn's and I guess it could be from this medication but since it is has been relatively stable my doctor does not want to stop the medication as the benefits outweigh the risks. I have been on this medication for 8 years and the the elevated alt started 2 years ago. thank you for your help.
Posted Fri, 22 Nov 2013 in Medicines and Side Effects
Answered by Dr. Ram Choudhary 1 hour later
Brief Answer: reports are high normal in range. Detailed Answer: Hi XXXX, Welcome to health care magic. I think the high serum calcium levels in your serum are related directly to a good level of albumin in your blood and that probably secondary to a good nutrition and good protein intake and well maintained health status. Humeira is very unlikely to be a cause behind the higher side levels of calcium or higher level of albumin. The borderline total high bilirubin level with indirect bilirubin predominance is most likely to secondary to presence of Gilbert syndrome which is a quite common metabolic problem almost seen in 4 to 5 percent of normal population. The borderline rising of SGPT doesn't make any great significance and over that SGOT is also normal so right now there is no reason to be worried and you should continue the drug humeira which you are taking already. It is very good for Crohn's and it keeps the activity of disease under control. You hardly need to do anything about this much of crazy results of investigacion. You should continue your healthy routine of life worries. I hope the advice will be helpful for you.
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