Nutrition Health Chat: Tuesday, Dec. 8th, 5-6 PM Eastern. Learn how vitamins, minerals, and phytonutrients affect your health. Free live Q&A. Join us!
Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Re: Elevated Bilirubin
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Re: Elevated Bilirubin
by HFHSM.D.-ym, Jan 01, 1995 12:00AM
Posted By HFHSM.D.-ym on January 04, 1999 at 21:44:15:
In Reply to: Elevated Bilirubin posted by Rob on January 04, 1999 at 14:13:47:
In a previous response me (posted 5/31/98), you suggested that the elevated bilirubin level of approximately 2.2 in my 19 year old son could very well be Gilbert's condition. Our dermatologist concurs with that and says there probably is no concern.
However, when our son was teething, he was given liquid Tylenol as suggested by his pediatrician. In the eight grade he had a few migraines and was given Tylenol for about six months to help alleviate that problem. Again, this was based on a neurologist's recommendation. The migraines disappeared before the ninth grade and have not returned.
The question is, would all of the Tylenol medication taken have caused any damage to his liver, i.e. the bilirubin levels to be affected? Our son has always had higher levels except for a normal blood test when he was 10 old given by his pediatrition. That "score" was 1.4. Otherwise, over the last three years the range has been 2.0 to 2.4
If there could have been an effect, what would be our next steps, if any? He is in perfect health, very athletic and is currently attending college. Maybe all is okay and we should not be concerned about all of the possibilities.
Thank You.
Rob
Dear Rob,
Gilbert's disease is characterized by isolated elevations in total and unconjugated bilirubin. The elevations in bilirubin are often seen at times of stress, fasting or after certain medications (such as narcotics). It is a benign disorder.Liver damage secondary to acetaminophen (Tylenol) most often occurs with dosages that exceed the recommended amounts or in patients who take acetaminophen with alcohol. In alcoholics acetaminophen hepatotoxicity has been described even when acetaminophen is taken in recommended amounts.In patients with acetaminophen hepatotoxicity the liver enzymes AST and ALT (also known as SGOT and SGPT) are the enzymes that are elevated. These enzymes can be markedly abnormal with acetaminophen overdose. It would be highly unusual for the acetaminophen that your son received during the periods that you described to be responsible for the hyperbilirubinemia (elevated serum bilirubin levels). In order to try and prove that the elevated serum bilirubin is secondary to Gilbert's disease one can fractionate the total bilirubin into conjugated and unconjugated forms (it's a simple blood test). If the bilirubin is mostly in the unconjugated form it is most likely Gilbert's disease. Another test is to check the bilirubin after a defined fasting period. This is not usually necessary. If other liver enzymes are elevated in addition to the bilirubin the diagnosis of Gilbert's disease is incorrect. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Moonka, one of our expert Hepatologists (Liver Specialists).
HFHSM.D.-ym
*Keywords: Gilbert's disease, elevated bilirubin, acetaminophen, liver injury
In Reply to: Elevated Bilirubin posted by Rob on January 04, 1999 at 14:13:47:
In a previous response me (posted 5/31/98), you suggested that the elevated bilirubin level of approximately 2.2 in my 19 year old son could very well be Gilbert's condition. Our dermatologist concurs with that and says there probably is no concern.
However, when our son was teething, he was given liquid Tylenol as suggested by his pediatrician. In the eight grade he had a few migraines and was given Tylenol for about six months to help alleviate that problem. Again, this was based on a neurologist's recommendation. The migraines disappeared before the ninth grade and have not returned.
The question is, would all of the Tylenol medication taken have caused any damage to his liver, i.e. the bilirubin levels to be affected? Our son has always had higher levels except for a normal blood test when he was 10 old given by his pediatrition. That "score" was 1.4. Otherwise, over the last three years the range has been 2.0 to 2.4
If there could have been an effect, what would be our next steps, if any? He is in perfect health, very athletic and is currently attending college. Maybe all is okay and we should not be concerned about all of the possibilities.
Thank You.
Rob
Dear Rob,
Gilbert's disease is characterized by isolated elevations in total and unconjugated bilirubin. The elevations in bilirubin are often seen at times of stress, fasting or after certain medications (such as narcotics). It is a benign disorder.Liver damage secondary to acetaminophen (Tylenol) most often occurs with dosages that exceed the recommended amounts or in patients who take acetaminophen with alcohol. In alcoholics acetaminophen hepatotoxicity has been described even when acetaminophen is taken in recommended amounts.In patients with acetaminophen hepatotoxicity the liver enzymes AST and ALT (also known as SGOT and SGPT) are the enzymes that are elevated. These enzymes can be markedly abnormal with acetaminophen overdose. It would be highly unusual for the acetaminophen that your son received during the periods that you described to be responsible for the hyperbilirubinemia (elevated serum bilirubin levels). In order to try and prove that the elevated serum bilirubin is secondary to Gilbert's disease one can fractionate the total bilirubin into conjugated and unconjugated forms (it's a simple blood test). If the bilirubin is mostly in the unconjugated form it is most likely Gilbert's disease. Another test is to check the bilirubin after a defined fasting period. This is not usually necessary. If other liver enzymes are elevated in addition to the bilirubin the diagnosis of Gilbert's disease is incorrect. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Moonka, one of our expert Hepatologists (Liver Specialists).
HFHSM.D.-ym
*Keywords: Gilbert's disease, elevated bilirubin, acetaminophen, liver injury
