Introduction
Bilirubin is formed by the breakdown of old red blood cells and it is a yellow pigment.
Red blood cells are live about 120 days,when they age,they broken down in the spleen and hemoglobin is released which is converted into bilirubin
How the Liver Processes Bilirubin
The liver is essential for:
(1) Unconjugated (indirect) Bilirubin. (not water soluble) and travels to the liver via the bloodstream.
(2) Conjugated (direct) Bilirubin. Liver converts unconjugated Bilirubin into a water solubilized form; is excreted via bile into the intestines; and leaves through the stool and provides colour to the stool.
Total Bilirubin = Direct Bilirubin + Indirect Bilirubin.
Normal Bilirubin Levels
Normal Total bilirubin -0.3-1.2mg/dl
Elevated Bilirubin - Common Causes:
When liver cells are damaged they can’t properly breakdown bilirubin, will result in increased bilirubin.
Related Symptoms: Jaundice, Dark Urine, Abdominal pain, Fatigue
Obstruction of Bile Ducts.
Causes include: Gallstones, Tumors, and Inflammation.
This can obstruct the bile flow and result in an increase in conjugated bilirubin.
Related Symptoms: Severe Abdominal pain, Clay colored stools, Dark Urine, and Progressive Jaundice.
Requires immediate medical attention.
Hemolytic Anemia.
Increased rate of destruction of red blood cells, (i.e., sickle cell disease, thalassemia, autoimmune hemolysis, malaria), mainly leads to increased levels of indirect bilirubin.
Genetic Disorders:
Gilberts syndrome
Non-serious, low grade elevation (1.5 - 3mg/dL)
An increase in Gilbert’s syndrome levels can occur with stress or fasting
No Treatment is necessary
Isolated Genetic Disorders:
Crigler-Najjar
Dubin-Johnson
Rotor
Usually diagnosed early in life.
Symptoms of high Bilirubin
Dark tea colored urine
Pale stool
Itching
Nausea
Loss of appetite
Conclusion
Bilirubin is an integral part of the breakdown of red blood cells in the body, and your body creates it as part of this process naturally. Bilirubin being elevated is not a disease in itself, but it does indicate that there could be something going on with your liver, bile ducts, or red blood cells.
Knowing the difference between direct and indirect bilirubin, as well as signs and symptoms associated with bilirubin elevation and liver function tests, can help pinpoint a primary cause sooner rather than later. For example, the underlying condition could be Gilbert’s Syndrome (a relatively mild condition), or could involve a more serious condition such as liver disease or bile duct obstruction; early identification will make a huge difference in your treatment and outcome.
In layman’s terms, bilirubin is a signal from your body; therefore, bilirubin should never be ignored. Seeking timely medical evaluation for bilirubin elevations to determine the cause can prevent complications and safeguard your long-term liver health.
MBH/PS