What is bilirubin?

Bilirubin is a byproduct of broken-down old red blood cells. When red blood cells finish their life cycles in our body, they break down and pass through our bloodstream to our liver for processing. Our liver sorts of bilirubin with other waste products into a fluid called bile. Bile exits our body through our intestines. Bilirubin is the pigment that gives bile its distinctive yellow color. It also colors our stool.

High or low bilirubin levels might indicate that some part of the process of breaking down and clearing old red blood cells isn’t working correctly.

What do bilirubin levels in your blood indicate?

Doctors often advise bilirubin tests to check on the health of patient’s liver. The bilirubin test is one of a comprehensive panel of liver function tests that measure different liver products in patient’s blood. If these values are high or low, they might indicate that patient’s liver is struggling in some way. But abnormal bilirubin levels don’t always indicate a problem in the liver. Sometimes it is pancreas said Dr Qaisar Ahmed.

What causes high bilirubin levels (hyperbilirubinemia)?

Bilirubin might build up in someone’s blood if:

• Patient’s body breaks down too many red blood cells too fast. You might be overproducing bilirubin if you have a blood disorder, such as hemolytic anemia, that destroys red blood cells.
• Liver is struggling to process its normal load of bilirubin. Patient’s liver might struggle with occasional toxic overload, or it might have a chronic liver disease that affects its functioning.
• Biliary system isn’t clearing bile efficiently. There might be a blockage in the bile ducts or patient’s gallbladder that’s causing bile to back up and leak into the bloodstream.

What causes low bilirubin levels (hypobilirubinemia)?

Certain medications can lower your bilirubin levels, including antibiotics, birth control pills, sleeping pills and seizure medications. Low levels aren’t generally a cause for concern.

What does bilirubin do in your body?

Bilirubin is a waste product of expired red blood cells. Normally, our body expels it through our intestines. On its way out, it provides some benefits, current studies suggest it acts as an antioxidant that helps protect against cardiovascular disease. However, too much can be toxic. If it builds up in our blood, it can make us feel ill. It can also irritate nerves under the skin, making it itch.

What are symptoms of high bilirubin?

High bilirubin leads to jaundice, a yellow cast to your skin and the whites of your eyes. Jaundice is often the first symptom that would prompt a healthcare provider to check your bilirubin levels. High bilirubin in your blood can also leak out in your pee, making it darker. If bilirubin isn’t coming out in your poop as it should, your poop might be lighter or clay colored. Very high bilirubin can make pruritus (itchy skin).

Ask your patient not to eat or drink for a few hours before test. They’ll insert a hollow needle and draw out a small sample into a vial. A nurse will usually take a blood sample from a vein in patient’s arm and send the sample to a lab for testing.

If your newborn has jaundice, check their bilirubin levels to make sure they aren’t too high, very high bilirubin levels in newborns can be toxic. A doctor or nurse usually take a blood sample from a newborn by pricking their heel with a sterile lancet (a common way of screening newborns for diseases).

The test results will show measurement values for the bilirubin in patient’s bloodstream.

There are two different types of bilirubin in bloodstream: the bilirubin that goes to our liver for processing, and the bilirubin that comes out of our liver.

Test will show these values separately, as well as patient’s total bilirubin as milligrams of bilirubin per deciliter of blood (mg/dL).

Direct (conjugated) and indirect (unconjugated) bilirubin

The bilirubin that goes to our liver for processing is “unconjugated,” which means it’s not water-soluble. It’s bound to a protein in our blood called albumin that helps carry it to our liver. When our liver processes the bilirubin, it unbinds it from the albumin and binds it to a sugar molecule, making it water-soluble. This allows it to mix with bile and pass through our intestines.

“Conjugated” or direct bilirubin is the bilirubin our liver processed. It’s called “direct” bilirubin on our test results because this type can be measured directly.

Unconjugated bilirubin can’t be measured directly. It’s measured by subtracting the value of conjugated bilirubin from the value of total bilirubin in our blood. Unconjugated bilirubin may be called “indirect” bilirubin on our test results.

At what level is bilirubin a concern?

Different areas may have slightly different ranges for what we consider normal bilirubin levels. On average, total bilirubin levels between 0.2 and 1.3 mg/dL are considered normal for children and adults.

Some allopathic doctors thinks that high bilirubin itself won’t usually need treatment, but I (Dr Qaisar Ahmed) think that any abnormality should be treated as soon as possible to avoid serious illnesses.

Bilirubin levels for newborns

Normal levels for newborns can range anywhere between 1.0 and 12.0 mg/dL. Most of the time, hyperbilirubinemia in newborns is predictable and self-limited. But a doctor should continue to monitor these cases to make sure bilirubin levels don’t rise too far or too fast. This could indicate a more serious condition, and it could also be toxic to the newborn.

What level is dangerous?

Doctors recommend treatment for newborns when bilirubin levels rise above 15 mg/dL in the first 48 hours or 20 mg/dL after 72 hours. At these levels, unconjugated bilirubin exceeds the amount of available albumin to bind it. The unconjugated bilirubin can cross the blood-brain barrier in newborns and harm their developing brains. It can cause varying degrees of brain damage, called kernicterus.

Brain damage isn’t the same for children and adults. Adult brains aren’t as vulnerable, and adults aren’t as likely to have such high levels of unconjugated bilirubin. Newborns produce bilirubin faster than adults do, and they conjugate it much slower. There are many more causes of conjugated hyperbilirubinemia in adults. For adults, hyperbilirubinemia itself isn’t dangerous but is a signal about dangerous condition.

What does it mean when bilirubin is high?

Higher levels of unconjugated (indirect) bilirubin if a person’s body is breaking down red blood cells faster than his/her liver can keep up with, this might indicate:

• Hemolytic disease.
• Sickle cell disease.
• Adverse reaction to a blood transfusion.

Common causes of unconjugated bilirubinemia in newborns include:

• Premature birth.
• Mismatched blood type between the baby and birthing parent.
• Reactions to substances in breast milk.

You might have higher levels of conjugated bilirubin (direct) if your body is having trouble clearing it. This might indicate a biliary disease or gallstone disease, such as:

• Gallstones or Cholecystitis.
• Cholangitis.

Conditions that affect liver’s ability to process bilirubin will cause high levels of both types to build up in the blood.

A person might have a higher total bilirubin count if something is temporarily stressing his/her liver, such as a new medicine or a high dose of alcohol. It could also indicate an acute or chronic liver disease. Some causes include:

• Infections such as viral hepatitis and mononucleosis.
• Genetic conditions that affect bilirubin metabolism, such as Gilbert’s syndrome, Wilson disease and Crigler-Najjar syndrome.
• Toxic hepatitis (alcohol-induced or drug-induced).
• Cirrhosis and chronic liver failure.

What if test results will abnormal?

A good doctor will review patient’s symptoms and health history to try and identify likely causes. Different causes will have different treatment options, that’s why may be further blood tests or imaging tests could help diagnose patient’s condition. If bilirubin rises too high in newborn, recommend treatment to reduce it.

Allopathic treatment for high bilirubin in newborns

Phototherapy is the standard treatment to reduce bilirubin levels in newborns. A nurse places the infant under a lamp that emits fluorescent white or blue-spectrum light. The light helps break down the bilirubin into a water-soluble form so that the body can excrete it without conjugating it in the liver. This prevents unconjugated bilirubin from depositing in newborn’s brain tissue.

Allopathic treatment for an adult’s bilirubin levels

Patient’s bilirubin levels will go down if doctor can effectively treat or manage the condition that’s causing them to rise. Depends on the condition, a doctor will discuss the options for either curing or reducing its effects.

In general, a patient can reduce overall stress on his/her liver by eliminating alcohol and allopathic drugs/medicines of all type — including over the counter (OTC) allopathic medications, if possible — and maintaining a healthy diet.

Homeopathic treatment for high bilirubin in newborns

Natural phototherapy – that is morning sun bath, is the standard Homeopathic treatment to reduce bilirubin levels in newborns. A parent places the infant under the early morning (sunrise/sunshine) sunlight for fifteen to twenty minutes daily for three to seven days. The morning sunlight helps break down the bilirubin into a water-soluble form so that the body can excrete it without conjugating it in the liver. This prevents unconjugated bilirubin from depositing in newborn’s brain tissue.

Homeopathic treatment for an adult’s bilirubin levels

Patient’s bilirubin levels will go down if a Homeopathic doctor can effectively treat or manage the condition that’s the root cause of rising bilirubin levels in the blood. Depends on the condition, a Homeopathic doctor will advise the treatment for liver, spleen, and/or for the gallbladder.

Patient has to reduce overall stress on his/her liver by eliminating alcohol, quitting smoking and sniffing tobacco, quit coffee and all coffee/chocolate products, quit white sugar, fast food, caned and processed foods and allopathic drugs/medicines of all type — including supplements and over the counter (OTC) allopathic medications to maintain a healthy lifestyle maintaining a healthy diet.