Is indirect bilirubin dangerous? In an infant, high (usually indirect) bilirubin and jaundice
Jaundice
Characterized by a yellow discoloration of the eyes, skin, and urine.
Is an elevated indirect bilirubin level serious?
You can have an elevated Total Bilirubin and an elevated Direct Bilirubin and yet still have a normal Indirect Bilirubin. My labs have shown this and it suggests liver/biliary disease or involvement. Thanks for the info. Please let me know whether increased Indirect Bilirubin Is serious and what is its impact? I doubt that it's serious.
What causes high bilirubin levels in blood?
Your "total" and your "direct" bilirubin levels are on the high side, so this is going to cause the "indirect" to be high. Infections such as an infected gallbladder, or cholecystitis. Inherited diseases such as Gilbert's syndrome. Diseases that damage the liver such as Hepatitis, cirrhosis.
What does it mean if your bilirubin is lower than normal?
Lower than normal bilirubin levels are usually not a concern. Elevated levels may indicate liver damage or disease. Higher than normal levels of direct bilirubin in your blood may indicate your liver isn't clearing bilirubin properly. Elevated levels of indirect bilirubin may indicate other problems.
What is the normal range for bilirubin levels?
The values are: Total Bilirubin (0.3-1.0), Direct Bilirubin (0.1-0.3), Indirect Bilirubin (0.2-0.7), all mg/dl. Your "total" and your "direct" bilirubin levels are on the high side, so this is going to cause the "indirect" to be high.
What level of indirect bilirubin is dangerous?
Typically, bilirubin levels fall somewhere between 0.3 and 1.0 milligrams per deciliter (mg/dL). Anything above 1.2 mg/dL is usually considered elevated.
What causes high indirect bilirubin levels?
Common causes of elevated indirect bilirubin include: Hemolytic anemia, or destruction of too many red blood cells. Bleeding into the skin caused by injury. Bleeding in the lung caused by a blood clot.
How do you reduce indirect bilirubin?
However, following these four tips can help you boost overall liver health in addition to medical guidance.Stay hydrated. Staying hydrated helps lower bilirubin levels by facilitating the removal of waste from the body. ... Consume fresh fruits and vegetables. ... Increase your intake of fiber. ... Avoid alcohol.
Which is more dangerous direct or indirect bilirubin?
The unmodified bilirubin binds to albumin, facilitating easy transport from blood to the liver. However, this form of indirect bilirubin is highly toxic; therefore, it is converted to direct bilirubin in the liver with the help of enzymes, which is less toxic.
At what level is bilirubin a concern?
The level of bilirubin that is harmful is around 20. Reaching a level this high is rare. High levels need to be treated with bili-lights.
Is direct or indirect bilirubin more important?
Direct Bilirubin Is More Valuable than Total Bilirubin for Predicting Prognosis in Patients with Liver Cirrhosis. Gut Liver.
What foods to avoid if you have high bilirubin?
Foods and drinks to avoid or limit during jaundice recovery include:Alcohol. Alcohol is toxic to most internal bodily tissues, including the liver. ... Refined carbohydrates. ... Packaged, canned, and smoked foods. ... Saturated and trans fats. ... Raw or undercooked fish or shellfish. ... Beef and pork.
Does fasting increase indirect bilirubin?
Fasting increases serum bilirubin levels in clinically normal, healthy males but not females: a retrospective study from phase I clinical trial participants. J Clin Pathol.
Why is it called indirect bilirubin?
Conjugated bilirubin also is called direct bilirubin because it reacts directly with the reagent, and unconjugated bilirubin is called indirect because it has to be solubilized first.
What is a dangerous level of bilirubin in adults?
Bilirubin levels higher than 20 to 25 mg/dL can be dangerous. Excess bilirubin in the blood can be neurotoxic and can damage the brain. This type of brain damage that results from high bilirubin in the blood is called kernicterus.
How long can you live with high bilirubin levels?
Ninety-five per cent confidence limits on survival time were 32-74 months. If two successive six month bilirubin values exceeded 102 mumol/l (6.0 mg/dl), calculated survival time was 25 months, and if two successive six month bilirubin values exceeded 170 mumol/l (10.0 mg/dl), survival time was 17 months.
Which bilirubin is more toxic?
Unconjugated bilirubin is toxic. Conjugated bilirubin is usually not because it can come out of the body, as long as nothing is interfering with its removal.
What underlying conditions cause high bilirubin?
Bilirubin levels may increase with stress, strain, dehydration, fasting, infection or exposure to cold. In many individuals, jaundice is only evident when one of these triggers raises the bilirubin levels.
Why is bilirubin high but everything else normal?
Normal results can vary, but high bilirubin levels may mean your liver isn't working right. However, abnormal results don't always mean you have a medical condition that needs treatment. Other things may cause higher than normal bilirubin levels, such as certain medicines and foods or strenuous exercise.
What does bilirubin indirect mean?
A bilirubin test measures total bilirubin. It can also give levels of two different types of bilirubin: unconjugated and conjugated. Unconjugated (“indirect”) bilirubin. This is the bilirubin created from red blood cell breakdown. It travels in the blood to the liver.
What diseases cause elevated bilirubin?
Gilbert syndrome is caused by a modified gene you inherit from your parents. This gene usually controls an enzyme that helps break down bilirubin in your liver. When you have an ineffective gene, your blood contains excess amounts of bilirubin because your body doesn't produce enough of the enzyme.
What is this test?
This test measures the amount of bilirubin in your blood. Your body makes bilirubin when it breaks down hemoglobin. Hemoglobin is a protein in red blood cells. The breakdown of hemoglobin is called hemolysis.
Why do I need this test?
You may need this test if the results of a total bilirubin blood test are abnormal.
What other tests might I have along with this test?
Your healthcare provider may order many other tests along with direct, indirect, and total bilirubin that assess your liver health. These tests are called liver function tests and may include:
What do my test results mean?
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
Does this test pose any risks?
Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore.
What might affect my test results?
Different things may affect bilirubin levels. Vigorous exercise can raise bilirubin levels. So can the HIV medicine atazanavir.
What is the normal bilirubin level?
Indirect and direct bilirubin make up your total bilirubin. When total bilirubin is abnormal, it is important to measure direct and indirect bilirubin levels. Bilirubin is measured in milligrams per deciliter (mg/dL). An example of normal values for adults is: Total bilirubin: 0.3 to 1.9 mg/dL. Direct bilirubin: 0.0 to 0.3 mg/dL.
Why is bilirubin so high?
High levels of bilirubin in the blood are caused by: Infections such as an infected gallbladder, or cholecystitis. Inherited diseases such as Gilbert's syndrome.
What diseases damage the liver?
Diseases that damage the liver such as Hepatitis, cirrhosis.
Can autoimmune hemolysis cause low hemoglobin?
There can also be autoimmune hemolysis. If you were having hemolysis I think you would see either a low-normal hemoglobin or a low hemoglobin depending on the rate of hemolysis. To test for hemolysis a Haptoglobin and Reticulocyte tests would probably be appropriate.
Can you have a high bilirubin level?
You can have an elevated Total Bilirubin and an elevated Direct Bilirubin and yet still have a normal Indirect Bilirubin. My labs have shown this and it suggests liver/biliary disease or involvement.
Is indirect derived from total and direct?
Again, Indirect is derived from the Total and Direct. My statement is true.
Is Gilbert's syndrome benign?
I don't know enough about Gilbert's Syndrome to have any idea how elevated the indirect bilirubin generally is. This disorder is considered to be benign without any ill affects. So, if that is the diagnosis I think you will be told that there is nothing to worry about.
Is Gilbert's syndrome a possible cause?
As you noted, Gilbert's Syndrome is a possible cause.
How to check bilirubin levels?
Bilirubin testing is usually done as part of a group of tests to check the health of your liver. Bilirubin testing may be done to: 1 Investigate jaundice — a yellowing of the skin and eyes caused by elevated levels of bilirubin. A common use of this test is to measure bilirubin levels in newborns to check for infant jaundice. 2 Determine whether there might be blockage in your bile ducts, in either the liver or the gallbladder. 3 Help detect liver disease, particularly hepatitis, or monitor its progression. 4 Help evaluate anemia caused by the destruction of red blood cells. 5 Help follow how a treatment is working. 6 Help evaluate a suspected drug toxicity.
How to know if a bilirubin needle is inserted?
Blood for bilirubin testing in newborns is usually obtained using a sharp lancet to break the skin of the heel (heel stick). There may be slight bruising at the puncture site afterward.
Why do you need bilirubin test?
Bilirubin testing is usually done as part of a group of tests to check the health of your liver. Bilirubin testing may be done to: Investigate jaundice — a yellowing of the skin and eyes caused by elevated levels of bilirubin. A common use of this test is to measure bilirubin levels in newborns to check for infant jaundice.
Why is bilirubin high?
Occasionally, higher bilirubin levels may be caused by an increased rate of destruction of red blood cells (hemolysis).
What is the normal bilirubin level?
Normal results for direct bilirubin are generally 0.3 mg/dL. These results may vary slightly from laboratory to laboratory. Normal results may be slightly different for women and children, and results may be affected by certain foods, medications or strenuous exercise.
Why is bilirubin elevated?
One common, and harmless, cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin. Your doctor may order further tests to investigate your condition. Bilirubin test results also may be used to monitor the progression of certain conditions, such as jaundice.
What is the purpose of a liver monitor?
Help detect liver disease, particularly hepatitis, or monitor its progression.
What is the normal by-product of the breakdown of hemoglobin?
Bilirubin is the normal by-product of the breakdown of hemoglobin. Bilirubin circulates in the blood bound to albumin and is taken up by hepatocytes in the liver. Within hepatocytes, bilirubin is conjugated with glucuronic acid, a process catalysed by uridine diphosphoglucuronate-glucuronyltransferase (UDP-GT). Conjugated (direct) bilirubin is secreted into bile. This process is normally highly efficient so plasma unconjugated (indirect) bilirubin concentrations remain low. Hyperbilirubinemia can be caused by conditions leading to predominantly unconjugated hyperbilirubinemia and those characterized by predominantly conjugated hyperbilirubinemia (Figure). Diseases that increase the rate of bilirubin formation (eg, hemolysis, dyserythropoiesis), reduce hepatic uptake of bilirubin (eg, medications [gemfibrozil, irinotecan and the protease inhibitors, atazanavir, and indinavir]; portosystemic shunts), or reduce the rate of bilirubin conjugation (eg, Gilbert syndrome) result in increased levels of indirect bilirubin (Figure).
What blood test showed no hemolysis?
In this patient, a peripheral blood smear, lactate dehydrogenase, and haptoglobin levels confirmed the absence of hemolysis. Repeat bilirubin measured 6 and 12 months later was elevated and a diagnosis of Gilbert syndrome was made. The patient remains well and follows up with his primary care physician for routine medical care.
Which is more likely to cause unconjugated hyperbilirubinemia?
Gilbert syndrome is the most likely cause of the unconjugated hyperbilirubinemia in the setting of normal liver enzymes and in the absence of medications that reduce hepatic uptake of bilirubin or symptoms suggesting hepatobiliary disease or hemolysis. Dubin-Johnson syndrome is another benign hereditary condition characterized by a predominantly conjugated hyperbilirubinemia but would not explain the unconjugated hyperbilirubinemia.
How long does it take to get Gilbert syndrome?
Gilbert syndrome is typically diagnosed in the first 3 decades of life and no specific management is required for most patients. The Gilbert syndrome genotype is associated with an increased risk of gallstones1,7and adverse reactions to multiple drugs, including chemotherapy.1,4,6,7It is possible but unclear if elevated serum bilirubin levels protect against cardiovascular or other diseases.8,9A recent study reported an association of Gilbert syndrome with a 50% reduction in mortality compared with the general population (24 vs 50 deaths per 10 000 person-years).10Another study suggested that Gilbert syndrome may be associated with an increased risk for breast cancer.1,4
What is Gilbert syndrome?
Gilbert syndrome is a hereditary condition characterized by a 70% reduction in the ability to conjugate bilirubin, resulting in asymptomatic intermittent unconjugated hyperbilirubinemia.
What is the role of sponsors in a manuscript?
Role of the Sponsors:The sponsors had no role in the preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
How is Gilbert syndrome diagnosed?
Gilbert syndrome is usually a diagnosis of exclusion and can be diagnosed by ruling out intrinsic hepatic disease and hemolytic states.
What happens if you take a bilirubin test and the results are not in the normal range?
If you take a Bilirubin total blood test and the results are not in the normal range (0.2-1 mg/dL), your physician may recommend more tests to figure out the problem. You might also get this test if your physician thinks you have some other disease.
What is the normal range for bilirubin?
If your Bilirubin total is in between 0.2 mg/dL and 1 mg/dL, then you need not worry as 0.2-1 mg/dL is the normal range for Bilirubin total. But if your Bilirubin total is lesser or greater than the above values, then there may be some problem in your body.
