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Dr Chip (M.D.)
Dr Chip (M.D.), Doctor
Category: Medical
Satisfied Customers: 31654
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Just got lab results back that showed Total Bilirubin at 3.3

Resolved Question:

Just got lab results back that showed Total Bilirubin at 3.3 mg/dL. I have always had "high" levels - but the annual reads were consistently around 2.5 for past few years. Is an increase from 2.5 to 3.3 significant or could it be normal variation? My physician for years has attributed the elevated readings to Gilbert's syndrome. All of my other readings/blood work were in normal levels, other than a slightly elevated iron level. I have changed my diet materially in the past six months, losing 25 pounds (was at 250) and eating significant amounts of fish and vegetables, not sure if that led to elevated iron.
Submitted: 5 years ago.
Category: Medical
Expert:  Dr Chip (M.D.) replied 5 years ago.
your liver enzyme levels were normal? Are you getting jaundiced?
Customer: replied 5 years ago.
No sign of jaundice, I do not think liver enzyme were part of the normal panel of labs that were run
Expert:  Dr Chip (M.D.) replied 5 years ago.
Do you know if the bilirubin was fractionated into direct and indirect levels?
Customer: replied 5 years ago.

did not have an indirect number, but the direct was listed as 0.43 with a reference range of 0-0.40

Not sure if a liver enzyme is included in the list below, I am not familiar with all the terms:

BUN/Creatinine Ratio 14 9-20
Sodium, Serum 140 mmol/L 135-145
Potassium, Serum 4.1 mmol/L 3.5-5.2
Chloride, Serum 100 mmol/L 97-108
Calcium, Serum 9.8 mg/dL 8.7-10.2
Phosphorus, Serum 3.5 mg/dL 2.5-4.5
Protein, Total, Serum 7.1 g/dL 6.0-8.5
Albumin, Serum 4.5 g/dL 3.5-5.5
Globulin, Total 2.6 g/dL 1.5-4.5
A/G Ratio 1.7 1.1-2.5
Bilirubin, Total 3.3 H mg/dL 0.0-1.2
Bilirubin, Direct 0.43 H mg/dL 0.00-0.40
Alkaline Phosphatase, S 57 IU/L 25-150
LDH 133 IU/L 0-225
AST (SGOT) 18 IU/L 0-40
ALT (SGPT) 20 IU/L 0-55
GGT 31 IU/L 0-65
Iron, Serum 165 H ug/dL 40-155
Cholesterol, Total 194 mg/dL 100-199
Triglycerides 97 mg/dL 0-149
HDL Cholesterol 59 mg/dL >39

According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.

VLDL Cholesterol Cal 19 mg/dL 5-40
LDL Cholesterol Calc 116 H mg/dL 0-99
T. Chol/HDL Ratio 3.3 ratio units 0.0-5.0
WBC 6.2 x10E3/uL 4.0-10.5
RBC 5.03 x10E6/uL 4.10-5.60
Hemoglobin 15.8 g/dL 12.5-17.0
Hematocrit 47.1 % 36.0-50.0
MCV 94 fL 80-98
MCH 31.4 pg 27.0-34.0
MCHC 33.5 g/dL 32.0-36.0
RDW 13.6 % 11.7-15.0
Platelets 260 x10E3/uL 140-415
TSH 1.250 uIU/mL 0.450-4.500

Expert:  Dr Chip (M.D.) replied 5 years ago.
OK--just one more question--you're feeling well and no abdominal pain?
Customer: replied 5 years ago.
Correct - no abdominal pain. I have had some back pain (not sharp, just nuisance) for the past couple of months, but I have attributed that to increased exercise and workouts - coincided with when I really started working harder on getting fit
Expert:  Dr Chip (M.D.) replied 5 years ago.
OK. Gilbert's can cause a total bili of up to around 6.0 so in itself, your values are still consistent with the diagnosis. A rise in in bilirubin without the same in the liver enzymes could indicate a hemolytic disorder or an obstruction of the common bile duct, but your labs and your feeling well don't support that. The next time it's checked, your bili could well be back under 3.0.
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