Bilirubin but nothing else is high....

Hi,
Recovering Alcoholic of 9+ years here. Age 30 M 5-11 254 pounds I have lost 20 pounds since last visit with PCP 5 months ago.. My PCP did not test my liver function before putting me on Lipitor last year for high Cholestoral. Then after being on it  for 2 months or so we noticed slightly High Liver Enzymes after a routin blood test. I got off the med and the enzymes all went down to normal ranges. However my Bilirubin  only went down to 1.4 NON FASTING. So then this last week I get another blood workup. No Lipitor, increased Diet and Exercise. Cholestoral still high at 235. Bilirubin went up to 2.1. My Questions are these.

1. He wants me to do a Ultrasound but in past blood tests we have ruled out HEP B, C and I was negative for them. I was fasting when I took this most recent test and I know that makes the Bilirubin go up right? Basically should I do this Ultrasound like he asked? He says it is nothing he just wants to make sure?

2. With all my other Normal Blood Tests and Normal Liver Enzyemes accept Bilirubin do I need to worry? If I had something serious wouldn't I have more unusual liver results and possibly symptoms?

3. If my Ultrasound is ok should I get on a Statin is that risky?

[Kevin Pho, MD]

To answer your questions:
1) Yes, I would do the ultrasound.  This can evaluated for anatomical abnormalities and other causes of liver disease that cannot be diagnosed by blood tests alone.  This is the normal next step in the evaluation of elevated liver enzymes.

2) If everything is normal except the bilirubin, then you can consider Gilbert's disease.  This is a harmless hereditary disease of bilirubin overproduction.  If this is diagnosed by your physician, it is normally not treated.

3) If the ultrasound is normal, and the liver function tests remain normal, then it is possible that statins can be continued.  Discuss this with your personal physician.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[CRAZY BRAIN]

More Info...Glucose was 88 on NON FASTING In the first LFT test and 101 In this last one....