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Doctor insights on: Elevated Total Bilirubin

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Dr. Thomas Inwood
102 doctors shared insights

Total Bilirubin (Definition)

Bilirubin, a product of hemoglobin breakdown, is present in two forms in the human body: unconjugated (indirect bilirubin, insoluble) and conjugated (direct bilirubin, soluble). Unconjugated bilirubin is conjugated in the liver and released into the small intestine in bile, the fluid in the gallbladder. Total bilirubin measures indirect bilirubin plus direct bilirubin; part of ...Read more


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Chronic Elevated Total bilirubin (2.5) direct bilirubin (0.5) and indirect bilirubin (2.0). All other liver enzymes are normal. What causes this??

Chronic Elevated Total bilirubin (2.5)  direct bilirubin (0.5) and indirect bilirubin (2.0). All other liver enzymes are normal. What causes this??

Sounds serious: Hello again Matt. If your direct bilirubin is actually 0.5 mg/dL now, then this is more than Gilbert's which I understand is diagnosed. If this is not a lab error, then I suspect you have cholestasis too for some reason and you deserve a workup by somebody who's good with liver disease. Actually, the alprazolam / Xanax you're taking occasionally causes this. You might start there. Best wishes. ...Read more

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Keep having bilirubin in urine. Cmp always normal other than elevated total bilirubin, was diagnosed with gilbert's disease. What else to do?

Other idea: If you've got bilirubin in the urine, chances are you have a conjugated hyperbilirubinemia (dubin-johnson / rotor / something else equally banal) rather than gilbert's. Many physicians like to lump these together but they're all generally trivial. Get an exact diagnosis from a gastroenterologist if you wish. ...Read more

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Could Adderall (dextroamphetamine and racemic amphetamine) cause an elevated total bilirubin?

Could Adderall (dextroamphetamine and racemic amphetamine) cause an elevated total bilirubin?

Adderall (dextroamphetamine and racemic amphetamine): Elevated bilirubin is not listed as a side effect of adderall (dextroamphetamine and racemic amphetamine). Other medications such as Acetaminophen or Ibuprofen can elevate the bilirubin. A harmless entity called gilbert's can also cause an elevated bilirubin. See your doctor for elevation. ...Read more

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Heavy/moderate drinker for 1 year. 2 Blood test show slight elevated total bilirubin of 28. Ultrasound normal. Is this due to alcohol consumption?

Unlikely: Transaminases (SGOT/AST, SGPT/ALT) rise well before the bilirubin. Several percent of folks always have mildly elevated indirect bilirubin from Gilbert's non-disease. Cholestasis from meds, low-grade hemolysis from marathon running can raise bilirubin. I'm worried about heavy drinking at age 22 rather than labs. This is a path that leads to a bad life and early, miserable death. Can we help? ...Read more

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Why would a teenager have low vitamin d, an elevated (4.5) total bilirubin, irritable bowel symptoms and fatigue?

Why would a teenager have low vitamin d, an elevated (4.5) total bilirubin, irritable bowel symptoms and fatigue?

Need testing: Low vit d is common in those who don't supplement with d during fall & winter & is easily corrected. Irritable bowel symptoms are common & often genetic. It often responds to a fodmap diet: http://cassandraforsythe.Com/blog/complete+fodmap+list+for+a+happy+gut but make sure you don't have parasites, food allergies or imbalances of flora. You need tests to find the cause of high bili.See comment:. ...Read more

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I ahev hypothyroidism and my TSH is elevated to 12 and total bilirubin is 2.1. Are they related?

I ahev hypothyroidism and my TSH is elevated to 12 and total bilirubin is 2.1. Are they related?

Could be: You apparently are not taking replacement thyroid medication. Please see your doctor for evaluation of bilirubin elevation and a prescription and take the medication for about a month or two and then repeat the tests. ...Read more

Bilirubin (Definition)

Bilirubin is the potentially toxic product of heme metabolism. It is formed by breakdown of heme present in hemoglobin, myoglobin, cytochromes, catalase, peroxidase and tryptophan pyrrolase. Eighty percent of the daily bilirubin production comes from hemoglobin. It requires conversion to a water-soluble form before elimination from the body by ...Read more