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Elevated direct bilirubin
hey everybody,

In August, the results of my blood test showed a slightly elevated bilirubin level (around 2.2 mg/dl). I had no symptoms whatsoever, no jaundice, nothing.
I was told it might be a gallstone but since I am assymptomatic I should just get another blood test in 3 months.
The next test in November again showed the same amount of bilirubin in my blood.
All the other liver numbers are perfectly fine so they suspected it to be Gilbert's.

Last week I had an ultrasound of my abdomen and they told me that everything is normal. Also, the doctor tested for indirect and direct bilirubin.
The result was elevated direct and indirect bilirubin so this ruled out Gilbert's.
I was also tested for hepatitis and everything liver related that can be found in the blood. Everything was perfectly normal.
I was told to see a gastroenterologist and I have an appointment right after Christmas (great way to get you into the holiday spirit btw)

I'm really worried right now. Could it be something serious?
I feel fine, the only problem I've been having lately is an intolerance to milk. Lactose itself seems to be fine, but a glass of milk or cereal gives me an upset stomach.

Any idea what might be wrong? Cancer?
Thank you all for reading this and have a great day!
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No, I wouldn't think "cancer" but I am not a doctor or in the medical field in any capacity Keep that in mind what you consider this post.

Are you certain that both unconjugated (indirect) and conjugated (direct) bilirubin are elevated?
Do you have those numbers?
What about your alkaline phosphatase and liver enzymes: ALT, AST & GGT?

In the meantime I would suggest that you relax until you talk with your gastroenterologist. I always try to avoid borrowing trouble because I have done way too much of it and it never helped me in the least.
Basically, I see no reason to get too worked up about this Julian.

Good luck,
Mike
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Hi, Mike.

Thank you for your comment.
Yes, both indirect and direct bilirubin are elevated.
Here are my numbers:
Total Bilirubin: 2.21 mg/dl
Direct Bilirubin: 0.53 mg/dl
Indirect Bilirubin: 1.68 mg/dl

Albumin: 4.64 g/dl (reference range 3.25 - 5.3)
I don't have my ALT AST GGT numbers right now but they are within normal range, as is everything else like Alpha 1 Globulin, Alpha 2 Globulin Beta Globulin, Gamma Globulin,

The lab report also says "normal protein electrophoresis".

Alkaline phosphatase 94.6 U/l (range 40 - 129)
Cholinesterase 10.2 (5.32 - 12.9)

It's hard not to worry. After the ultrasound I thought everything was fine but as soon as you start googleing for diseases it's a nightmare ;)

Oh and by the way, I'm 23 years old.

Your answers are much appreciated.

Julian
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I don't have any additional ideas.
With the exception of bilirubin the labs you show look good to me. My experience is that there are generally other lab values out of line with liver injury but, like I said, I am not in the medical field.
Please let me know what your gastro has to say.

Good luck Julian,
Mike
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