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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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My bilirubin level checked at 1.64 and my ast level was 45

Customer Question

My bilirubin level checked at 1.64 and my ast level was 45 and my alt level was 66 should I be concerned and what can be done?
JA: OK. The Doctor will need to help you with this. Please give me a bit more information, so the Doctor can help you best.
Customer: This is the first time my bilirubin tested this high I still have my gall bladder and I take 10mg of lisinopril daily and I am slightly over weight I need to lose 25 ponds
JA: Is there anything else the Doctor should be aware of?
Customer: I used to take Tylenol for sinus headaches I have not taken anything in about a month
JA: Our top Doctor is ready to take your case. Just pay the $5 fully refundable deposit and I'll fill the Doctor in on everything we've discussed. You can go back and forth with the Doctor until you're 100% satisfied. We guarantee it.
Submitted: 7 months ago.
Category: Medical
Expert:  Dr Uzair replied 7 months ago.

Hi and welcome,

Your bilirubin, AST and ALT are high so i would suggest to get an ultrasound abdomen to look at liver and gallbladder and get viral serology for hepatitis B and C. It is better to get gastroenterologist consultation for thorough examination.

Expert:  Dr Uzair replied 7 months ago.

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Best wishes.

Expert:  Dr. Thomas, MD replied 7 months ago.


In the US you are going to need to see your primary care doctor.

You generally can not have your insurance pay without a referal to a GI doctor.

Your AST is normal range. Your alt is slightly high.

To interpret the bilirubin, which is also not so high, a direct bilirubin would be good to know. If this is high, this is likely to be gallstones or gallbladder disease.

If not, it is something else.

The liver work up includes

All hepatitis screens.


Iron and ferritin to rule out hemachromatosis.

I am a double board certified US doctor.

Find me by request anytime.

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