Medical Questions? Ask a Doctor Online!
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This is Dr. D.J., experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.
Your SGOT and Pt levels are normal.
Bilirubin level is mildly elevated.
If the majority is the unconjugated bilirubin, then this is seen in fasting blood test in some individuals.
This is due to the certain enzyme deficiency in the liver.
This does not cause any serious problem.
The pain or discomfort you are experiencing is likely muscle related problem.
Liver related problem is unlikely.
But is the enzyme deficiency a problem? What causes it? It said on the test results "high"
Not a problem.
the enzyme responsible is known as uridine diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1), which is responsible for the conjugation of bilirubin with glucuronic acid.
But what causes the deficiency? Can it be alcohol use?
That is genetic related.
But it has never been high in the past, if genetic, would it not always have been high?
now in your test, does it indicate the direct bilirubin level?
.36 is direct
Ok so your indirect bilirubin is 1.24
Longer you fast the more probability, this will show up.
This is also known as Gilbert's syndrome.
A benign condition
Total is 1.5 and indirect is 0.36 If Gilbert's would this not have shown up earlier or does it show up with age?
how long did you fast this time?
ok and what about before?
I am not sure what you mean before? You mean my tests in earlier years? I can look those up.
yes I mean how long fasted before prior tests 10-12 hours?
Also how old are you?
Gilbert's is diagnosed only during adult ages like after 18 or so.
The bilirubin production increases in the body with age making detection more likely.
I am 52. My bilirubin total in 2/2013 was 0.5, I did not see anything on those test results that say indirect. Now total says 1.5 -- seems like a big leap, though indirect was .36 (not sure what the difference is between total and indirect) Was just concerned is test has always been normal, and now a few months later, I get a total of 1.5 and a high.
I also was put on folate, a high dose of krill oil by a naturopath over the last two months.
Since your other liver enzymes SGOT and SGPT are normal, just rise in bilirubin does not sound concerning.
However, this test should be repeated as sometimes wrong blood draw can cause falsely elevated bilirubin.
A liver ultrasound also can be considered to rule out any liver problem.
This is better than a blood test/
Thanks! Would you recommend a liver ultrasound or a repeat of the test first?
I will recommend a liver ultrasound since this is inexpensive, non invasive and better test.
Thank you. My last question, I promise. Do I just ask my internist to order the ultrasound?
yes correct your internist can order the ultrasound.