why indirect bilirubin levels are elevated?

[prass12]

Hello sir,

currently I am 25 years male.....3 years back my doctor confirmed that I have Gilbert's Syndrome & at that time my bilirubin levels are Total: 2.71 mg/dl, Direct : 0.71 mg/d, indirect: 2 mg/dl.

Recently I have observed my eyes & urine are yellow, but appetite is somewhat fine, so went to lab & found the following:

TSH: 2.04 uIU/mL
Vitamin B12: 152.1 pg/ml
G6PD: 10.1 U/gHb
Serum folic Acid: 4.12 ng/mL
Reticulocyte count: 1.1%
Total Bilirubin: 3.8 mg/dl
Direct Bilirubin: 0.24 mg/dl
Indirect Bilirubin: 3.56 mg/dl
AlkalinenPhosphatase: 114 U/L
SGOT: 18 U/L
SGPT: 17 U/L
Total protiens: 7.1 gm/dl
Albumin: 4.0 gm/dl
Globulin: 3.1 gm/dl
A/G ratio: 1.29 gm/dl
U/S scan of Abdomen: Mild Heptomegaly
Upper Edoscopy: Normal
PT: 16.5 sec
Aptt: 38.0 sec
creatinine: 0.9
parasite -F: Negative

Found Indirect Bilirubin: 3.56 mg/dl, so doctor said to take injections daily on vitamin B12 for 1 week(as Vitamin B12: 152.1 pg/ml is very low). so please tell me whether my indirect bilirubin levels will fall to normal range after this week?(Also doctor said I can eat anything and live as normal but said to drink a lot of water)
Why my bilirubin levels are suddenly increased?
Is there any permanent cure for this?
I am very thin with 55 kgs 5-11', how to increase my weight?(I went to gym previously gained weight but didn't reflected in muscle)  
Thanks in advance

[Thomas D Schiano, MD]

i think that it would be safe to use some supplemets in an effort to gain weight but be cautious as some can have liver and other toxicities.  the jaundice is due to indirect bilirubin--it causes no problems.

[Thomas D Schiano, MD]

gilbert's is a genetic enzyme defect that is benign and carries no sequelae.  during periods of fasting and physical stress the levels will go up but this is inconsequential.  the levels will never normalize.

with regard weight gain, try nutritional supplements and calorie loading

[prass12]

thank you very much...very helpful response

[prass12]

Thank you very very much!

In general for jaundice the bilirubin levels will increase then we take some medicines to decrease the levels to normal range otherwise it will lead to serious conditions
but in case of gilberts you have said that levels will go up inconsequentially, Isn't that a dangerous...as without our notice it may increase levels...if we ignore...then it will become jaundice....may lead to serious conditions...without our notice....please provide some insight on this.
  
Also I found on internet that for gilberts patient cholestrol is very less deposited....so is it safe to use supplements like creatine to increase weight & gain muscle?

thanks in advance