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What Causes Elevated Bilirubin Levels?
Question: Hi Doctor,
I did regular blood test in Mar/Apr 2015 and my bilirubin level was 1.2 mb/dl.
I repeated the regular blood test in Oct 2016 and my bilirubin level increased to 2.1 mg/dl.
After reviewing this result with my primary care physician, he took additional blood test (hepatitis B and C). they came out to be normal but my bilirubin level got elevated to 3.1.
he then referred me to Gastroenterology doctor.
I went to gastroenterology doctor and he asked me to take to direct and indirect bilirubin level.
I took the test and direct bilirubin came as .4 mg/dl and indirect bilirubin came as 2.2 mg/dl and total bilirubin came as 2.6 mg/dl.
I am yet to see my gastroenterology doctor but i would like to get your opinion on what does these results mean.
I am really in confused state with this elevated bilirubin level. Please help to clarify this for me.
Do I need to go for any further test? or Do I need to take any medication? or is this completely normal?
I did regular blood test in Mar/Apr 2015 and my bilirubin level was 1.2 mb/dl.
I repeated the regular blood test in Oct 2016 and my bilirubin level increased to 2.1 mg/dl.
After reviewing this result with my primary care physician, he took additional blood test (hepatitis B and C). they came out to be normal but my bilirubin level got elevated to 3.1.
he then referred me to Gastroenterology doctor.
I went to gastroenterology doctor and he asked me to take to direct and indirect bilirubin level.
I took the test and direct bilirubin came as .4 mg/dl and indirect bilirubin came as 2.2 mg/dl and total bilirubin came as 2.6 mg/dl.
I am yet to see my gastroenterology doctor but i would like to get your opinion on what does these results mean.
I am really in confused state with this elevated bilirubin level. Please help to clarify this for me.
Do I need to go for any further test? or Do I need to take any medication? or is this completely normal?
Brief Answer:
kindly read detailed answer below
Detailed Answer:
Hi.
Thanks for posting query at HCM.
I thoroughly went through your question and all the reports attached along with.
You need NOT worry.
1. You had a series of blood tests including hepatitis serology. Most of them are NORMAL. all hepatitis markers are NEGATIVE and almost many uncommon causes of hepatitis are ruled out. Nothing to worry.
2. However, few components in blood test are abnormal.
- high blood glucose and slightly high HbA1c. it reflects that you maybe suffering from diabetes. I RECOMMEND you to run a Oral Glucose Tolerance Test
(OGTT ).
3. High Triglyceride ( blood test) and a fatty Liver ( seen on ultrasound examination). This maybe the underlying reason of your "SLIGHTLY ELEVATED BILIRUBIN levels".
Advise:
- avoid table sugar ( sucrose) and all sweets, polished rice
- ingest carbohydrate everyday but decrease the quantity. use brown bread instead of white bread
- avoid oily food and junk food
- avoid carbonated beverages and alcohol
- try to loose weight if your overweight or obese
- recheck the blood glucose, lipid profile ( triglyceride) and liver enzymes/bilirubin after 3 to 6 months.
- if your a pure vegetarian , take vitB12 supplements OTC, as you have slightly low vitamin B12
Hope to answer your concerns.
Further questions are welcomed.
Regards
Dr Tayyab Malik
kindly read detailed answer below
Detailed Answer:
Hi.
Thanks for posting query at HCM.
I thoroughly went through your question and all the reports attached along with.
You need NOT worry.
1. You had a series of blood tests including hepatitis serology. Most of them are NORMAL. all hepatitis markers are NEGATIVE and almost many uncommon causes of hepatitis are ruled out. Nothing to worry.
2. However, few components in blood test are abnormal.
- high blood glucose and slightly high HbA1c. it reflects that you maybe suffering from diabetes. I RECOMMEND you to run a Oral Glucose Tolerance Test
(OGTT ).
3. High Triglyceride ( blood test) and a fatty Liver ( seen on ultrasound examination). This maybe the underlying reason of your "SLIGHTLY ELEVATED BILIRUBIN levels".
Advise:
- avoid table sugar ( sucrose) and all sweets, polished rice
- ingest carbohydrate everyday but decrease the quantity. use brown bread instead of white bread
- avoid oily food and junk food
- avoid carbonated beverages and alcohol
- try to loose weight if your overweight or obese
- recheck the blood glucose, lipid profile ( triglyceride) and liver enzymes/bilirubin after 3 to 6 months.
- if your a pure vegetarian , take vitB12 supplements OTC, as you have slightly low vitamin B12
Hope to answer your concerns.
Further questions are welcomed.
Regards
Dr Tayyab Malik
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thanks Doctor for your response.
1) My Gastroenterology doctor here told me that it could be due to XXXXXXX syndrome and then asked me to take this bilirubin panel blood test.
As per my direct (.4) and indirect bilirubin (2.2) count, does it confirm that its due to XXXXXXX syndrome?
2) Does XXXXXXX syndrome have any symptom? is there any medication for this?
3) Does triglyceride and fatty liver elevate direct bilirubin also.
4) We also notice that bilirubin level keeps on increasing. Do I need to go for any other test.
Bilirubin --> 1.2 --> Mar/Apr 2015
Bilirubin --> 1.8 --> Sep 2016
Bilirubin --> 2.1 --> Oct 6th 2016
Bilirubin --> 3.1 --> Oct 18th 2016
Bilirubin --> 2.6 --> Nov 4th 2016
5) Thanks for the diet details. Can I include wheat in my diet? I have a feeling that wheat is taking long time for digestion.
6) I read it in the internet if there is a problem in the liver, walking should be avoided. Can i go for walking and jogging.
can you please help to clarify above questions.
Brief Answer:
Kindly read detailed answer below
Detailed Answer:
hi.
thanks for getting back to me.
1. firstly, your Liver finction is Normal. liver enzymes are normal. so no worries
2. secondly; your treating gastroenterologist is Probably right. merely slighted elevated bilirubin (usually uncojugated) without elevated liver enzymes usually indicates XXXXXXX Syndrome. Its a harmless disease and requires NO trerament. Fatty liver may cause increased bilirubin level; but its accompanied with elevated AST and ALT ( liver enzymes). however , AST n ALT are normal in your case, so most likely cause is XXXXXXX Syndrome.
no symptoms are observed in XXXXXXX Syndrome. the only presentation is "slightly" elevated total bilirubin that is observed on routine examination. no treatment usually required.
3. ingetsion of wheat in long term; maybe advised after results if OGTT (test) are obtained.
hope all concerns are answered
further quetsions are welcomed
regards
Dr Tayyab Malik
Kindly read detailed answer below
Detailed Answer:
hi.
thanks for getting back to me.
1. firstly, your Liver finction is Normal. liver enzymes are normal. so no worries
2. secondly; your treating gastroenterologist is Probably right. merely slighted elevated bilirubin (usually uncojugated) without elevated liver enzymes usually indicates XXXXXXX Syndrome. Its a harmless disease and requires NO trerament. Fatty liver may cause increased bilirubin level; but its accompanied with elevated AST and ALT ( liver enzymes). however , AST n ALT are normal in your case, so most likely cause is XXXXXXX Syndrome.
no symptoms are observed in XXXXXXX Syndrome. the only presentation is "slightly" elevated total bilirubin that is observed on routine examination. no treatment usually required.
3. ingetsion of wheat in long term; maybe advised after results if OGTT (test) are obtained.
hope all concerns are answered
further quetsions are welcomed
regards
Dr Tayyab Malik
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Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Answered by
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