High Bilirubin Levels: Symptoms, Causes and Treatment

Bilirubin is a yellowish pigment and a byproduct when old red blood cells break down. Red blood cells break down when they complete their lifecycles (120 days) in your body and pass through your bloodstream to the liver. The liver sorts bilirubin with other waste products into a fluid called bile that exits your body through the intestines.

Have you ever wondered why your skin and eyes appear yellowish? This is due to high levels of bilirubin in the body, which causes a condition known as hyperbilirubinemia, commonly referred to as jaundice. 

High bilirubin level is a silent warning from your body, which often points to liver problems, bile duct blockages, pancreatitis, or other hidden health issues. 

What Level of Bilirubin is Concerning?

The typical range of bilirubin in the bloodstream is between 0.2-1.3 mg/dl. High bilirubin levels are generally classified when it is above 1.3 mg/dl.

For children between the ages of 15 days to 18 years, it should be less than 1.0 mg/dl. 

• Mild Elevation (1.3-2.0 mg/dl)– It may cause mild jaundice, but often due to benign conditions such as dehydration and Gilbert’s syndrome
• Moderate Elevation (2-5 mg/dl)– Noticeable jaundice, which may indicate liver disease and bile flow obstruction
• High Elevation (Above 5 mg/dl)– Severe liver problem, bile duct blockage, or hemolysis
• Severe Elevation (Above 10-15 mg/dl)– A very serious condition associated with advanced liver disease that requires urgent medical attention

Symptoms

Common signs and symptoms of high bilirubin are:

• Abdominal pain and swelling
• Fatigue
• Dark urine
• Nausea & vomiting
• Pale stools
• High fevers or chills
• Chest pain
• Yellowing of the skin

What are the Causes of High Bilirubin?

High bilirubin can be a sign of several health conditions, such as:

• Liver Diseases: Conditions such as cirrhosis, autoimmune hepatitis, liver cancer, and failure can affect the liver’s function and cause it to lose its ability to remove bilirubin from your bloodstream.
• Gallstones: These develop when cholesterol or bilirubin harden in the gallbladder and prevent the excretion of bilirubin from the body.
• Blockage in the Bile Ducts: Bile ducts connect your liver to the gallbladder, which helps to move bile, which contains bilirubin, from your liver and gallbladder into your intestines. If these ducts become inflamed or blocked, bile can not be drained and leading to increased levels of bilirubin.
• Hepatitis: Your liver becomes inflamed due to viral infection and can not easily process bilirubin, which causes its buildup in the blood.
• Hemolysis: When blood cells break down too quickly and release excessive bilirubin into the bloodstream.
• Genetic Condition: Diseases like Gilbert’s syndrome cause your liver not to process bilirubin properly and causing its buildup. 

How to Diagnose High Bilirubin?

Various tests are performed to determine the cause of high bilirubin levels:

• Blood Tests: Measure total, direct, and indirect bilirubin levels in the blood sample. A blood sample will be collected via a needle from the vein in the arm and observed in the lab
• Physical Exam: The doctor will check the abdominal area to see swelling or tenderness in the liver
• Liver Function Test: To check the overall liver function and test for hepatitis
• Imaging Tests: Such as ultrasound, CT scans, MRI, computerized X-rays to evaluate the bile ducts and liver
• Liver Biopsy: It is performed by taking a small sample of the liver tissue to asses any liver disease

Sometimes, the doctor will also request a urine sample to check the bilirubin levels. No bilirubin is present in the urine, so if it is found in the urine sample, it indicates an underlying condition.

Treatment Options

High bilirubin treatment depends on its underlying cause. Common treatment options include:

 Home Management

• Maintain hydration
• Avoid alcohol
• Maintain a low-fat, high-fiber diet
• Limit medications that can strain the liver
• Exercise regularly
• Maintain a healthy weight
• Schedule regular health checkups

Strategies for Prevention

Not all cases of high bilirubin can be prevented, but people can reduce the risk by taking proper measures:

• Practice safe sex and hygiene
• Take vaccinations for Hepatitis A and B
• Maintain a balanced diet
• Avoid toxins and excessive alcohol
• To maintain a healthy weight, exercise regularly

By following these tips, one can maintain healthy bilirubin levels and prevent liver complications.

Is High Bilirubin a Sign of Cancer?

High bilirubin is not always a sign of cancer, but it can be when associated with certain malignancies, especially those affecting the pancreas, liver, or bile ducts, such as:

• Pancreatic cancer
• Liver cancer
• Cholangiocarcinoma

In these cases, patients often have:

• Persistent jaundice
• Weight loss
• Itchy skin
• Pale stool and dark urine
• Upper abdominal discomfort

Cancer is a possibility if bilirubin levels are very high and accompanied by other warning signs. It is vital to consult a medical professional promptly for a thorough evaluation. 

Takeaway

High bilirubin level is a warning signal from your body that something is wrong. No matter if it’s a liver issue or a bile duct problem, proper monitoring is vital. Understanding the symptoms and seeking timely intervention is critical for early diagnosis and effective treatment. 

With the right medical care and lifestyle adjustments, high bilirubin levels can be managed effectively. If the condition becomes severe, consulting a healthcare professional is beneficial to preserve overall health and quality of life.