Bilirubin

[Jigger]

I had a liver panel run back in October of 2002. Everything was fine except an Alt of 81(14-63) norm. My AST was 42(0-40) norm.Alkaline Phosphate was 72 and Bilirubin Total was .8  Direct Bilirubin was .0  We found out by ultrasound that I had a fatty liver caused by excessive drinking. We redid an ultrasound and liver panel 2 months later and everthing was great. Alt 22 and Ast 20. Bilirubin total .6----  Direct .1  Albimin 4.3  and Alkaline Phosphate 70. Well I have not drank for 9 months. I had a liver panel run the other day and everthing was the same as last time except for my Bilirubin. TotalBili was 1.0  and the direct was .3!! Their lab reference ranges for bilirubin are as follows  Total .3-1.7  and  direct .0- .6.  So according to their ref range I'm still very normal. But most of the stuff that I have read on the wed say's 1.0 and .3 are normal high. My internist said we have to go by their reference range and that I should have no concerns. I'm just afraid I have cirrhosis or scarring causing metabolic problems i.e. Intra-hepatic biliary problems. Is this a significant rise in bilirubin. And are all labs different. It seems a test would be universal. Can bilirubin fluctuate? iF I had a significant problem wouldn't my other panel be off?  Thanks Concerned

[Kevin Pho, MD]

Hello - thanks for asking your question.

I agree with the assessment below.  There would be some variation between labs that can cause the differences you are seeing.  The important thing is that they are still below reference range.  

With evidence of a fatty liver on ultrasound, it is important that you continue abstinence from alcohol.  

It would be reasonable to recheck the liver function tests in 6 months to make sure that they are not rising.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Jigger]

I had an MRI that showed no fatty liver done in Febuary. I'm 33 and very healthy. I just drank more than I should have for several years. I do not plan to ever drink again. Will my liver continue to work normally as long as I abstain?

[surgeon]

Your tests are in the normal range. It's very important that you continue abstinence from alcohol: any damage that was done may not be reversible, but to the extent that it was due to alcohol, it won't get worse unless you drink again. Some lab variation can occur. It would make sense to repeat the tests in the future to be sure they remain in the normal range, but at this time there seems to be no reason to worry about the liver tests themselves.