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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
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Experience:  MD
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My bilirubin count is 1.5, my SGPT 22 and SGOT 25. I got the

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My bilirubin count is 1.5, my SGPT 22 and SGOT 25. I got the test taken as part of a regular check up, but also because while there is no pain, as a runner, I have noted that I get I often get a stitch like feeling where my liver is and often feel during the day, that I need to lean back almost to stretch out or make more room in that area. Should I be concerned?

Dr. D.J. :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Dr. D.J. :

Hi there,


This is Dr. D.J., experienced Internal Medicine Specialist.


I am here to address your concerns and provide great service.

Dr. D.J. :

Your SGOT and Pt levels are normal.

Dr. D.J. :

Bilirubin level is mildly elevated.

Dr. D.J. :

If the majority is the unconjugated bilirubin, then this is seen in fasting blood test in some individuals.

Dr. D.J. :

This is due to the certain enzyme deficiency in the liver.

Dr. D.J. :

This does not cause any serious problem.

Dr. D.J. :

The pain or discomfort you are experiencing is likely muscle related problem.

Dr. D.J. :

Liver related problem is unlikely.

Customer:

But is the enzyme deficiency a problem? What causes it? It said on the test results "high"

Dr. D.J. :

Not a problem.

Dr. D.J. :

the enzyme responsible is known as uridine diphosphoglucuronate-glucuronosyltransferase 1A1 (UGT1A1), which is responsible for the conjugation of bilirubin with glucuronic acid.

Customer:

But what causes the deficiency? Can it be alcohol use?

Dr. D.J. :

That is genetic related.

Dr. D.J. :

Genetic defect.

Customer:

But it has never been high in the past, if genetic, would it not always have been high?

Dr. D.J. :

now in your test, does it indicate the direct bilirubin level?

Customer:

.36 is direct

Dr. D.J. :

Ok so your indirect bilirubin is 1.24

Dr. D.J. :

Longer you fast the more probability, this will show up.

Dr. D.J. :

This is also known as Gilbert's syndrome.

Dr. D.J. :

A benign condition

Customer:

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?

Dr. D.J. :

how long did you fast this time?

Customer:

10-12 hours

Dr. D.J. :

ok and what about before?

Customer:

I am not sure what you mean before? You mean my tests in earlier years? I can look those up.

Dr. D.J. :

yes I mean how long fasted before prior tests 10-12 hours?

Dr. D.J. :

Also how old are you?

Dr. D.J. :

Gilbert's is diagnosed only during adult ages like after 18 or so.

Dr. D.J. :

The bilirubin production increases in the body with age making detection more likely.

Customer:

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.

Customer:

I also was put on folate, a high dose of krill oil by a naturopath over the last two months.

Dr. D.J. :

Ok

Dr. D.J. :

Since your other liver enzymes SGOT and SGPT are normal, just rise in bilirubin does not sound concerning.

Dr. D.J. :

However, this test should be repeated as sometimes wrong blood draw can cause falsely elevated bilirubin.

Dr. D.J. :

A liver ultrasound also can be considered to rule out any liver problem.

Dr. D.J. :

This is better than a blood test/

Customer:

Thanks! Would you recommend a liver ultrasound or a repeat of the test first?

Dr. D.J. :

I will recommend a liver ultrasound since this is inexpensive, non invasive and better test.

Customer:

Thank you. My last question, I promise. Do I just ask my internist to order the ultrasound?

Dr. D.J. :

yes correct your internist can order the ultrasound.

Customer:

Thank you.

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