Isolated Bilirubin

[Hol1day]

Hi guys,

Approximately 6 months ago I had a full blood panel mainly because I wanted to get an idea of my physical state. No issues or symptoms.

Anyway my results where good, the only elevation I had was for bilirubin at 26mmol (upper limit is 26). All other liver function numbers where excellent. My creatinine kinase was also very high but I had been playing football a lot for a few weeks prior to the test after a long absence and also I'm black - both are relevant factors I was told by my doc. Only other relevant info is that my cholesterol was a tad high at 5.6 (upper limit of 5).

At the time I didn't pay much attention to the bilirubin but now I have and I decided to do a retest just for the liver function. This time I asked for the direct and indirect portion for greater detail. The total bilirubin was 22 (upper limit of 20). The direct bilirubin was 6 (range of 0-5) and hence I deduced that the indirect must be 16 (range of 0-15) since total is direct plus indirect. GP said I shouldn't worry as its only slightly elevated and it's improved from the last one. Also the other liver panel numbers for the ALT, AST, Gamma, where all perfect again no issues. I have no physical problems.

I don't think it's Gilbert's syndrome because both the direct and indirect are elevated.

Does anyone one have any ideas what's going on, is it likely to take that long for bilirubin to go down from 26 to 22?

I know I shouldn't worry but I can't help it. My Bupa insurance kicks in soon as I have a new job and I'm so tempted to get a scan and see a specialist.

By the way I definitely don't have hep B as I'm immune and I don't have hep c because I tested for that before the first test and also after it. I'm also confident I don't have hep A I haven't been abroad recently. I may have been slightly dehydrated before the test and I did fast for 10 hours which could be a factor I guess.

I will retest again after a few months: if this is normal then I can assume I recovered from something. If it's still up slightly then I'm definitely getting a scan!

[Hol1day]

Sorry the upper limit on the bilirubin is 20 not 26!!

[judyt in reply to Hol1day]

Once upon a time, in another life, I was a Laboratory Technician working in a Blood Bank Laboratory. As I read your story I thought of the fact way back then that very often people of colour from tropical climes would have a higher than usual Bilirubin score. That was because they had been exposed to a disease called Yaws. You don't say whether you have ever lived in the tropics, so in this case it is just a thought from way out in left field.

[Hol1day in reply to judyt]

Hmm interesting, I did live in Ghana from birth until I was 8. I dont remember if I caught anything like yaws. I certainly don't have it today.

Are you saying that even after catching and being cured people would exhibit a higher than normal bilirubin level...

[judyt in reply to Hol1day]

Don't quote me, but as I understood it the answer is yes - don't know why and I haven't researched it lately. In my day when folks donated blood (and probably still today in some form or another) there was/is a sample attached to the bag which is used for testing. That sample would be clotted blood, a large clot surrounded by serum. In a normal case the serum is pale yellow, in a case with a high bilirubin it would be bright yellow.

[Bolly]

Bilirubin does rise if you are dehydrated or have been fasting. If you had viral hepatitis your other liver enzymes would be out of range. Doesn't sound like your docs are worried, especially with it being just one result and only a tiny bit out of range.