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Digestive Disorders




I would like to ask a question about bilirubin. I`m a 30 year old male. I took blood work Feb 07 and my doctor said everything is fine except my bilirubin level. I asked him, can he explain to me what is bilirubin? All he told me was it`s hard to explain but not to worry. But he wanted me to take another blood test. I took the test in Aug 07 and my bilirubin level went up. My first reading was (total bilirubin 1.9) and my last reading was (total bilirubin 2.1). Can you explain to me what those readings mean and can you tell me what is a normal bilirubin level for an adult? I switched my doctor cause he was not telling me anything and I have to wait until Oct to see my new doctor. What is bilirubin and what causes it?


Bilirubin, in general, is derived from the breakdown of red cells. Red cells are what gives your blood such color and provides the capacity to transfer oxygen to all the cells of your body. The bilirubin tests are used as a measure of liver function. The liver contains special enzymes which complex the bilirubin to make it more water soluble, so that you can eliminate the breakdown products of red cells via the kidney. Laboratory tests also measure the indirect and direct components of bilirubin. The direct bilirubin (conjugated bilirubin) measures that part of bilirubin which is water soluble, while the indirect refers to the fat soluble portion of bilirubin, which is also sometimes referred to as unconjugated bilirubin. Bilirubin is conjugated to other molecules in the liver, by part of the liver enzyme machinery.

To fully answer your question, as to what that level of elevation means, we would need to know what the direct and indirect components of the bilirubin are. Nonetheless, a total bilirubin of 2.1 is abnormal. For a male, a total bilirubin of greater than 1 would be considered high. People do not start to shows signs of elevated bilirubin not until the value gets greater than 4 to 5 mg/dl.

The causes of an increased bilirubin are many. Some of these include: Gilbert’s syndrome, medications, the abnormal breakdown of red cells, hepatitis, cirrhosis, and many other liver disorders.

Overall, I do think that that level of increased bilirubin should be looked into further. However, there are many reasons for such an elevation, many of which are benign. I hope this helps you.

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Response by:

Steven  M Rudich, MD, PhD, FACS Steven M Rudich, MD, PhD, FACS
Professor of Surgery, Director of Liver Transplat and Hepatobiliary Surgery
College of Medicine
University of Cincinnati