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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have High Blood Pressure And High Cholesterol. Got Elevated Bilirubin Level. Chances Of Cancer?

Hello, I am a 35 year old male, and aside from high blood pressure and high cholesterol (both treated by medication ), I am in very good health. Last week I went to my doctor for a routine physical, and he was alarmed at my total bilirubin level of 1.8. It had always been 0.6 or 0.4 in the past. He also was surprised at a 60 point jump in my cholesterol level, despite my being on medication for that, and having it be stable for many years. I am having another test done in two weeks, but now paranoia has set in as I find every on-line article about elevated bilirubin levels being potential signs of cancer (or gallstones). I could not find anywhere what the typical high total bilirubin levels are in cancer patients, so I do not know how my 1.8 level compares. I would like to know this if possible, and also, is a spike in the bilirubin level likely to happen for any other reason? It does not seem to fluctuate like sugar levels or blood pressure can, so I am worried that it is an indicator of something bad. Any information regarding that type of bilirubin level would be very greatly appreciated. And also, would there typically be other indicators present at the same time in a blood test that would indicate cancer as a possibility? Thank you very much. Sincerely, Marc YYYY@YYYY 2-23-13 UPDATE: Yesterday I had a liver function/bilirubin test. The results were that my total bilirubin came down to 1.2 (0.2 direct and 1.0 indirect). My cholesterol was not checked, but now my sugar went from 92 two weeks ago to 110 now! I am concerned that with a big jump in my sugar now and cholesterol two weeks ago, and in conjunction with a high bilirubin, this may mean that I have some liver or pancreas problem. I am extremely concerned. My doctor wants me to wait a month and then repeat the tests. Any thoughts would be extremely appreciated. Incidentally, all other tested levels were in the normal range, but I don t know if that means I can rule out a liver or pancreas problem. Thank you all so much.
Tue, 26 Feb 2013
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Gastroenterologist 's  Response
Hello, glaucus,
Let me assure you that you don't have liver or pancreas cancer.
Bilirubin is a combination of conjugated and unconjugated, that is
direct and indirect components. Usually the Direct fraction is more
than the indirect. The total can fluctuate anywhere from 1.2 -1.4 mg/dl.
In your case you have a slightly higher indirect fraction. This is very
commonly seen as a fasting hyperbilirubinemia. There are rare genetic
disorders such as Gilbert's syndrome where the indirect fraction is high.
This is a benign condition and the bilirubin levels go up more during
infections, stress etc. Condition is diagnosed by liver biopsy. Very rarely
this is associated with pigment gallstones. As for choleterol levels , if you
had a rich fatty meal the day before, even if the blood was drawn after
12 hours of fasting , the level can be high. Caffeine is known to elevate
cholesterol levels also. Blood sugar levels that you mention are also in
the normal range. Stay with a low fat, low cholesterol diet, stay on the
medication and your doctor will decide if you need a change of drug.
Continue active excercises. Stay away from smoking and alcohol.
I am sure you will do fine.
I wish you well.
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Have High Blood Pressure And High Cholesterol. Got Elevated Bilirubin Level. Chances Of Cancer?

Hello, glaucus, Let me assure you that you don t have liver or pancreas cancer. Bilirubin is a combination of conjugated and unconjugated, that is direct and indirect components. Usually the Direct fraction is more than the indirect. The total can fluctuate anywhere from 1.2 -1.4 mg/dl. In your case you have a slightly higher indirect fraction. This is very commonly seen as a fasting hyperbilirubinemia. There are rare genetic disorders such as Gilbert s syndrome where the indirect fraction is high. This is a benign condition and the bilirubin levels go up more during infections, stress etc. Condition is diagnosed by liver biopsy. Very rarely this is associated with pigment gallstones. As for choleterol levels , if you had a rich fatty meal the day before, even if the blood was drawn after 12 hours of fasting , the level can be high. Caffeine is known to elevate cholesterol levels also. Blood sugar levels that you mention are also in the normal range. Stay with a low fat, low cholesterol diet, stay on the medication and your doctor will decide if you need a change of drug. Continue active excercises. Stay away from smoking and alcohol. I am sure you will do fine. I wish you well.