What does elevated bilirubin indicate?

[frozenborderline]

This is one of my only basic labs that has come up abnormal.

 

[pattismith]

when bilirubin is elevated, it can produce icterus (jaundice).
The causes can be either pre-hepatic (for example hemolysis), or intra-hepatic (liver disease), or post hepatic (bile flow impaired).
Did you have ultrasound for gall bladder evaluation?

 

[pattismith]

I forgot to mention the Gilbert syndrome:

https://forums.phoenixrising.me/threads/gilberts-syndrome.2294/#post-875107

--

 

[frozenborderline]

I have never had a gallbladder ultrasound done. I still need to find a PCP

 

[taniaaust1]

I had that abnormality on my blood tests back in my early years of ME/CFS.. due to that they thought for a bit that I had hepatitis (but that turned out not to be the case. Im sure it was just caused by the ME/CFS)

 

[taniaaust1]

I just found something which could be helpful to you.

looking back with that abnormality and the fact I also had abnormal anti-nuclear antibody too but with a different doctor (non of the doctors worked together with things) but that doctor ignored the abnormal ANA as a follow up testing of that at a later date came back okay.. I suspect that I may of had https://www.healthline.com/health/autoimmune-hepatitis#diagnosis which was missed (as they only ruled out viral hepatitis at the time and never ruled out the other kind after suspecting i had hepatitis due to the elevated bilirubin). Anyway all this was in first few years of ME.

 

[Judee]

My understanding is that it means that the liver is having a hard time clearing the bilirubin from your system.

Has your skin and/or eyes become yellowish. That's what happens to my mom when she is having this.

This may seem like a funny treatment but we sometimes have her sit under a professional grow light for 20-40 minutes to treat this because it is high on the blue light spectrum and similar to what they use on babies that develop jaundice in the hospital. It seems to work for her and her jaundice goes away.

We also use things to support her liver like milk thistle, artichoke, and NAC and make sure that she isn't taking anything like too many thiols or tylenol that may be overburdening her liver.

This website says:

Some conditions cause bilirubin levels to be high before it reaches the liver.

This is the pre-hepatic or "pre-liver" phase, and it can be caused by hemolytic anemia and the reabsorption of internal pools of blood by the body. Hemolytic anemia occurs when too many red blood cells are broken down before the end of their natural life cycle.
In the liver
If the liver is not working properly, it may be unable to make bilirubin water-soluble. This may result in too much bilirubin building up in the liver.
Causes include:

• viruses, such as hepatitis A
• alcoholic liver disease
• some medicine overdoses, including acetaminophen
• autoimmunity, where a disorder of the immune system causes it to attack the cells of the body rather than those that cause disease

After leaving the liver
Once the bilirubin has left the liver, levels may be high because the bilirubin is unable to leave the body.

This may be a result of blockage in one of the other organs that assist excretion, such as gallstones in the gallbladder. This is called the post-hepatic phase.
Other causes include:

• inflammation or cancer of the gallbladder, which produces bile
• pancreatitis

Hope this helps.

 

[ryan31337]

Assuming its not massively elevated and without any other clues, your PCP will probably just blame it on Gilbert's syndrome - a supposedly benign issue not requiring treatment. That has been my experience. When I looked further into it I think the literature suggested you could investigate it further by looking at conjugated vs unconjugated billirubin (only 1x is high with Gilbert's), but I doubt its something any primary doc will have heard of.

Worth noting that liver tests usually have to be elevated many, many times the normal range to be considered significant. I've had bilirubin, ALT and AST 2-3x the normal upper limit and its not worried consultants.

 

[frozenborderline]

The weird thing is that it wasn't elevated even when I was doing lot worse and living in a moldy house. In The beginners guide to mold avoidance , Lisa Petrison (@slayadragon ) auggests that the body sequesters toxins protectively while being exposed to them, and lets them out in a flood once one leaves a toxic space , causing people to suddenly have liver, kidney, and gallbladder problems after they leave mold. That could be the cause, or I guess i could've had a virus recently (i definitely have had some kind of infection).

 

[frozenborderline]

My bilirubin was elevated one other time durimg the course of my illness , after a long course of valtrex. I also wonder if it could be because any of the meds I am taking.

 

[frozenborderline]

How elevated is dangerous, or is there a "slightly elevated buf not concerning" range!

 

[frozenborderline]

noting that liver tests usually have to be elevated many, many times the normal range to be considered significant. I've had bilirubin, ALT and AST 2-3x the normal upper limit and its not worried consultants.

Ah. Mine was like 1.6 ans the upper limit of normal 1.2. And no other things off in standard tests. So maybe nothing to worry about ?

 

[ljimbo423]

Ah. Mine was like 1.6 ans the upper limit of normal 1.2. And no other things off in standard tests. So maybe nothing to worry about ?

I would agree that's not a very high level of bilirubin. I would still use things like Tylenol, etc., very judiciously, which you are probably already aware.

Things like milk thistle extract, alpha lipoic acid, NAC, artichoke extract, etc. are very helpful for the liver and can take a lot of stress off it, by boosting antioxidants, among other things, (mainly glutathione) to help it clear toxins.

 

[pamojja]

I also wonder if it could be because any of the meds I am taking.

From labtestanalyzer.com:

Elevated bilirubin can be caused by a number of factors and health conditions, including:

• Strenuous exercise. Athletes have normally elevated bilirubin levels [R, R]
• Fasting, which can increase bilirubin levels due to reduced gut flow (motility) [R]
• Alcohol consumption [R]
• Gallstones [R, R]
• Blood transfusion [R]
• Exposure to toxins such as persistent organic pollutants (POPs) [R]

These drugs can increase bilirubin levels [R, R, R]:

• Antituberculosis drugs
• Acetaminophen (Tylenol, Panadol, paracetamol)
• Antibiotics such as clindamycin (Cleocin, Dalacin, Clinacin) and neomycin

How elevated is dangerous, or is there a "slightly elevated buf not concerning" range!

mg/dL

Low < 0.19
Sub-Optimal 0.2 - 0.49
Optimal 0.5 - 0.7
Supra-optimal 0.71 - 1.2
High 1.21 - 15
Critical > 15.01

Therefore far below the critical range. Labtestanalyser also adds:

Bilirubin in this range is associated with a higher risk of all-cause mortality [R, R].

However, mildly elevated bilirubin is associated with increased antioxidant capacity, and a lower risk of heart disease and cancer [R, R].

Reduce alcohol consumption [R].

Supplements that can help:

• Zinc salts [R]
• Yin Zhi Huang, a chinese mixture of 4 herbs Artemisia capillaris, Gardenia jasminoides, Rheum officinale, and Scutellaria baicalensis. This remedy can help increase bilirubin clearance [R, R]
• Black cumin seeds (Nigella sativa) [R]
• Vanillic acid. It is abundant in Angelica sinensis, acai oil, argan oil, wine, and vinegar [R]
• Caffeine [R]