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Fatigue & elevated bilirubin
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Fatigue & elevated bilirubin

Hi there,

I have a history on binge drinking (5- pints of larger) on a Friday or a Saturday night. Occasionally I do a club night which includes some protracted drinking in heavier quantities. I am very fit and recently gave up amateur swimming for my city club but kept running 2 x 10km a week and various weights circuits, I also carry a body fat < 10% and my resting heart rate is 44.

About 12 weeks ago I went to the doc as I am genetically positive for Hypertrophic Cardiomyapathy. I did this after a few beers I had some pain in my neck and a few palpitations the next day and when running I got very dizzy and had chest pains. I had an eco test, ECG and physical by a Prof of Cardiovascualr medicine and all was 100% good.  

I decided to stay off the booze but 6 weeks ago went for 5 pints. I awoke the next day feeling very hungover. Since this day I have felt very fatigued and generally unwell. I have been unable to partake in any sports apart from my 6 miles cycle to work and back.

I got the fear of god in me that I had Alcoholic Hepatitis. I had some bloods done and I my Bilirubin came back as 35, which is high. My ALT/AST were fine as was everything else with my blood was perfect. I got really worried and went for an Ultrasound and a Fibroscan and both came back fine, the Fibrsocan came back at 4.8 (little or no scarring). Essentially, my liver was structurally perfect.

In short the fatigue (heavy eyes during the day) is still with me and my stamina in exercise is reduced, I am also over sleeping and getting night sweats. My GP is says I have Gilbert's syndrome (although none of my family have a history) and has put many of my symptoms down to depression and severe stress. I am indeed depressed but I put this down to the constant fatigue. I am also due to be moving to Sydney with work for 3 years in mid-October which isn't helping my stress levels. My depression is getting worse as I am petrified that I'll never be my old self.

Any advice really, really appreciated.

K
Avatar_dr_f_tn
Hello and hope you are doing well.

Was your bilirubin value 35? Its way too high. Normal levels of bilirubin are Total bilirubin: 0.3 to 1.9 mg/dL. Direct (also called conjugated) bilirubin: 0 to 0.3 mg/dL. Indirect (also called unconjugated) bilirubin: 0.2 to 0.7 mg/dL. So, if these values are persistently raised it needs to be determined, why they are raised. the raised levels could be causing your symptoms. If the liver is structurally normal and other imaging and liver function tests do not reveal anything, you may need a liver biopsy to determine the cause for hyperbilirubinemia.

Hope this helped and do keep us posted.
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