A member asked:

Doc, my tbil is high i take medication for my hyperthyroid and like atenolol and ptu (propylthiouracil). but my alt and ast are normal.. ?

2 doctors weighed in across 2 answers

How high?: Hi. It sounds like you are not jaundiced and have no liver disease - correct? I bet what you have is a defect in bilirubin conjugation called Gilbert's disease, where unconjugated bilirubin is relatively high and conjugated bilirubin is relatively low. It can be confirmed by measuring direct bilirubin (conjugated) and calculating indirect bilirubin (unconjugated). Gilbert's causes no harm.

Answered 9/28/2016

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Continue workup: In the absence of markers for hepatocellular injury, look at what bilirubin component is up, and determine whether this is new. Several percent of folks have Gilbert's which raises indirect and is harmless. If direct is up, consider a cholestatic response to some medication or if longstanding, a mild genetic glitch like Dubin-Johnson. Labs by themselves mean little. Best wishes.

Answered 11/5/2017

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