It's a slight elevation that I wouldn't be too concerned about. Of course, no one likes being outside of the normal reference range so I can relate to your question. If everything else is normal - liver enzymes etc - I question whether a doctor would think it was something that warranted any investigation. But, it doesn't hurt to ask about it and I might do that. At least your doctor would be on notice about it and would know that you know your direct bilirubin is elevated. I cannot see any downside to following up with your doctor. But, I really wouldn't worry too much about it at this stage.
Total bilirubin - direct bilirubin = indirect bilirubin.
Indirect bilirubin cannot be measured in the blood. It is determined by taking the Total bilirubin and subtracting the Direct bilirubin (both of which can be measured in the blood).
Total bilirubin is an easy way to get an idea if there might be a problem. An elevated Direct bilirubin can suggest a liver or biliary system problem. A gallstone blocking a bile duct can also result in an increased Direct bilirubin.
An elevation of Indirect bilirubin suggests a non-liver issue. It can be from Gilbert's Syndrome (which is generally thought to be a benign condition) or from hemolysis (red blood cell destruction) caused by some medications.
We know that your elevation is your Direct bilirubin so that points to the liver or biliary system - bile ducts inside and outside of the liver and the gallbladder. I would not panic about this for a second but I would probably run it by a doctor just to be extra vigilant.
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