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What do high bilirubin levels when diagnosed with Gilbert's syndrome indicate?

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Posted on Tue, 10 Jan 2017
Question: Hello doctor I have Gilberts Syndrome, my biliruben levels are generally above 100umol/L and have been put on Epilim 400mg per day. Doctors want me to increase to 1000mg per day. I don't believe I had a epileptic fit to start with as I was on H-pylori 7 day antibiotics medication and had extreme exhaustion and lack of sleep and food.

I am very concerned about acute liver failure due to the 150% increase in Epilim that the neurologists are prescribing. I had CAT scan. MRI, Brain wave scan and spinal tap tests and all came clear.

Any advice?
doctor
Answered by Dr. Klerida Shehu (31 minutes later)
Brief Answer:
Please follow. .

Detailed Answer:
Hi and thank you for asking on HCM.
I read carefully all your concerns and I can say as follows :
1.You are reporting that you have XXXXXXX syndrome. It is a bening conditions not harmful for liver.
2. with regards to liver damage due to medication I can say that :
- you have the same risk as other peoples to develop liver issues after medication usage.
- Epilim has side effects like elevated liver ensymes but liver failure is too rare complication.
- Otherwise Gibert syndrome doesn't affect liver and doesn't increase the risk for liver failure.
3. To my opinion since you are increasing the dosage of Epilim than I would suggest to use silimarine to protect your liver.

Hope it was helpful to you.
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Klerida Shehu (2 hours later)
More than 100 fatal cases of acute or chronic liver injury due to valproate have been reported in the literature. How is that not concerning? The liver of people with Gilberts does not process biliruben properly and it accumulates. An accumulation of biliruben leads to loss in liver excretory capacity. I don't think you understand the implications of Gilberts
doctor
Answered by Dr. Klerida Shehu (17 hours later)
Brief Answer:
Please follow. .

Detailed Answer:
Hi back,
Let me explain again:
I agree with you that valproat may cause liver enzyme elevation and liver failure but it is not related with XXXXXXX syndrome. It is related with side effects of valproat and is associated with elevated liver enzymes .
It means that valproat use can cause damage of liver cells and as a result high transaminases level and high bilirubin level.
On the other hand Giberts syndrome dosen't damage liver cells.
It is a deffect of receptors in liver cell. It means that liver receptors dosen't bind all the amount of bilirubin produced by blood.
As a result a part of bilirunin is free and may be elevated in blood.
But this condition dosen't damage liver cells and doesn't increase the risk for liver damage due to medications.

Hope I was clear!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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What do high bilirubin levels when diagnosed with Gilbert's syndrome indicate?

Brief Answer: Please follow. . Detailed Answer: Hi and thank you for asking on HCM. I read carefully all your concerns and I can say as follows : 1.You are reporting that you have XXXXXXX syndrome. It is a bening conditions not harmful for liver. 2. with regards to liver damage due to medication I can say that : - you have the same risk as other peoples to develop liver issues after medication usage. - Epilim has side effects like elevated liver ensymes but liver failure is too rare complication. - Otherwise Gibert syndrome doesn't affect liver and doesn't increase the risk for liver failure. 3. To my opinion since you are increasing the dosage of Epilim than I would suggest to use silimarine to protect your liver. Hope it was helpful to you. Dr.Klerida