Total bilirubin 2.5 (Elevated), Direct bilirubin 0.5 (Elevated), Indirect bilirubin 2.0 (Elevated) All other liver enzymes normal. What causes this?

Rerun test. All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, you need to re do the tests in non-fasting state. With the exception of elevated direct bilirubin, the findings are consistent with Gilbert syndrome, which is not a disease. See this site for more info:

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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??

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...