high bilirubin

[jblack97]

Just got results back from a fasting blood test. It says my total bilirubin is 2.5 (normal range given is .2-1.2 mg/dL). My platelets were slightly low and my RDW very slightly high. My AST and ALT were well within normal range. I don't go back to my Dr. for another month and a half and am wondering if there could be something really wrong with me. Everything else on the lab wrok came back normal. Any ideas?


JNB

[jblack97]

Forgot  to include I never drink.....haven't had even a glass of wine in years.

[mikesimon]

I would ask your doctor if he thinks a fractionalized bilirubin test would be appropriate.
Total bilirubin is the sum of 1) direct or conjugated bilirubin and 2) indirect or unconjugated bilirubin.
If your Total Bilirubin elevation is due to an increased direct bilirubin that would suggest a possible liver or biliary tract issue. It could also be due to a gallstone blocking a bile duct. Hemolytic anemia can also cause an increased bilirubin. Red blood cells are destroyed and release bilirubin into the blood. If this were the case I would expect to see a low hemoglobin also.
On the other hand if your elevated T Bilirubin was due to an elevation of your indirect bilirubin it would not suggest a liver problem. Elevated indirect bilirubin may be due to Gilbert's Syndrome which most doctors believe to be a benign disease due to an decreased activity of an enzyme and I really don't understand the chemistry of the disorder. As I said most people believe it is harmless.
You might simply repeat the test and see if your bilirubin is still elevated. If so I think determining whether your "direct/conjugated bilirubin" or your "indirect/unconjugated bilirubin" would be a reasonable starting point unless there are other symptoms or blood results which make a diagnosis clearer.
Personally I would not wait a month or a month and 1 half to see your doctor. Your total bilirubin is significantly elevated and I think finding out what is going on sooner is always better than later. I would push for a follow up and preferably with an experienced GI or better yet a Hepatologist. It might be Gilbert's or might be a false result but you cannot know without follow up tests. You didn't mention your platelet count but in cirrhosis there is often a decreased platelet count.
I hope I haven't alarmed you and I should make it clear that I am not a doctor or in the medical field in any capacity. I am a layman who has dealt with liver disease and I learned a little in the process. You should not rely on anything I said except to talk with your doctor and get seen sooner rather than later.
\Good luck,
Mike

[mikesimon]

In case I wasn't clear a "fractionalized bilirubin test" breaks Total Bilirubin down and gives a separate value for Direct and Indirect bilirubin which added together equals Total Bilirubin.
Sorry if it wasn't clear.
Mike