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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18533
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My bilirubin came in at 1.3. --Albumin. globulin and total

Resolved Question:

my bilirubin came in at 1.3. --Albumin. globulin and total protein are all normal. I understand that 1.3 is out of the normal range, but is it considered high? My testosterone is high at 40. 46 year old male.
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. D. Love replied 7 years ago.

Are you having any symptoms?

Was the direct and indirect bilirubin checked?

Were the liver enzymes and a CBC also checked?

Do you have any chronic medical problems?

Are you on any chronic medicines?

Customer: replied 7 years ago.
no symptoms--the test just says bilirubin total and the normal range is listed as .1-1.2
I'm not sure about the enzymes, but there are things like SGOT,SGPT,and GGT listed and they are all normal. I have no health problems and take no medicines. This test was done for life insurance and I'm just curious about the only thing on the test that was out of the normal range and if it's cause for concern.
Expert:  Dr. D. Love replied 7 years ago.

Thank you for the additional information. The SGOT, SGPT, and GGT are liver enzymes, and the fact that they are normal is reassuring. There are several perspectives regarding this blood test.

First, a result that is very close to the limit of the normal range is frequently normal. The reason for this is how the normal range is defined. Whenever any test is measured in a large population of "normal" people, the results will vary, generally in the shape of a bell shaped curve. The normal range is calculated based upon the average value and the standard deviation, a measure of the variability. The normal range encompasses 95% of this normal population. Therefore, by definition, one of every normal twenty people will have a result that is just beyond the limit of the normal range. Since there are no symptoms and no other lab abnormalities, this is the most likely explanation of this bilirubin level.

Another common cause of a mild increase in bilirubin is called Gilbert's syndrome, which is a genetic condition that affects the metabolism of bilirubin in the liver, resulting in the mild elevation of bilirubin. The bilirubin will frequently range up to 3.0, and may be transiently higher. This is a very common condition, occurring in ~5% of the general population. It causes no problems, so is not considered a disease process, but rather a variant of normal.

Bilirubin is a breakdown product of red blood cells that is metabolized by the liver. Any disease that increases the breakdown of red blood cells or affects liver metabolism may affect the bilirubin. Therefore, the evaluation of an elevated bilirubin would usually include a blood count and liver function tests. If a CBC was not done as part of the insurance evaluation, it would be appropriate to have it done, and a normal CBC would reassure that there is no significant problem.

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