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High conjugated (direct) bilirubin
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High conjugated (direct) bilirubin


  I am in my mid 30's healthy active female.  I had jaundice when I was a baby.  Through the years my blood test have always been in range with everything except my absolute eosinophils ( I have no idea what this is, always told not to worry about it.  Now all of a sudden during a yearly check up my direct bilirubin is out of range.  History of blood test:
  prior test before 5/98
  total bilirubin        1.0, 0.9,+-always in range
  absolute eosinophils  46, 48, etc. just a little low
  
  test 6/98
  total bilirubin        1.8  (no other break down)
  absolute eosinophils  22
  those results lead to this break down test (no fasting)
  7/98
  total bilirubin        1.9
  direct bilirubin       0.7
  later 7/98
  then we tested for hepatitis a,b,c non detected, non reactive to all.
  total bilirubin        2.3
  direct bilirubin       0.8  
  albumin 4.3, alkaline phosphatase 45, ast 27, alt 13 all in range.
  Ultrasound....nothing was found.
  I have been said I MIGHT have Gilbert Syndrome....I try to explain that the research I have done suggest Gilbert Syndrome has to do with the indirect not the direct...I never get any calls back.. something to the affect no symptoms don't worry?  I am not comfortable with that. I am concerned...worried! The only thing  I have experienced is tightness, little dull pain on the right side under my ribs (abdomen), nausea.. My tolerance to alcohol seems to be a lot lower.  I am wine in the evening drinker,  with social weekend drinks.  Thanks in advance for any information or determination you could lend me.  I am so glad I found this site.
_________
Dear Louise,
Your story is very suggestive of Gilbert's disease.  In Gilbert's disease there is a slight elevation of the serum bilirubin, usually more pronounced after fasting.  Your bilirubin elevation is mainly indirect which fits with the diagnosis of Gilbert's Disease.
In general terms, an elevated conjugated (direct) bilirubin indicates either obstruction of the bile ducts or impairment of liver cell function.  An increase in the indirect bilirubin is usually the result of premature breakdown of the red cells (hemolysis).  Unfortunately, when the bilirubin levels are only slightly elevated, as in your case,one can not use the indirect and direct bilirubin values to determine the underlying cause of the liver tests increase.
If possible, you should diminish or even eliminate all alcohol use for several weeks and repeate measurements of the bilirubin.  It is possible, although very unlikely, that your alcoholuse is contributing to the liver abnormality.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-rf
*keywords: Gilbert's Disease, bilirubin,
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