Your Bilirubin Level

What Causes Elevated Bilirubin Levels?

Elevated bilirubin levels can have various causes, ranging in severity from 'worrying' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose elevated bilirubin levels, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "elevated bilirubin levels" as a symptom.  Here are eight of many possibilities (more below):
  • Hemochromatosis
  • Hepatitis
  • Bile Duct Cancer
  • Chemotherapy Side-Effects
  • Pancreatic Cancer
  • Gallbladder Disease
  • Drug Side-Effects
  • Sickle Cell Disease

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
dark urine color
no blood in nipple discharge
hepatitis A
constant fatigue
red palms/fingertips
recent onset diarrhea
meal-induced pain for 1-4 weeks
history of bile duct cancer
reasonably controlled diabetes
having a moderate fever
having elevated melatonin levels
low lymphocyte count
... and more than 80 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of elevated bilirubin levels:
Cause Probability Status
Pancreatic Cancer 95% Confirm
Chemotherapy Side-Effects 19% Unlikely
Hepatitis 14% Unlikely
Gallbladder Disease 1% Ruled out
Hemochromatosis 1% Ruled out
Drug Side-Effects 1% Ruled out
Bile Duct Cancer 1% Ruled out
Sickle Cell Disease 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate having had recent lab tests, The Analyst™ will ask further questions including this one:
Bilirubin, total. Unit: mg/dL [umol/L]
Possible responses:
→ Don't know
→ 0.0 to 1.3 [0-22] (normal)
→ Recently elevated
→ Chronically elevated
Based on your response to this question, which may indicate either normal bilirubin or high total bilirubin, The Analyst™ will consider possibilities such as:
(Prescription) Drug Side-Effects

Certain medicines can damage the liver.  Examples include many antibiotics, some types of birth control pill (sex hormones), antipsychotic drugs, and many others.

Cirrhosis of the Liver

Diseases that cause liver damage can lead to increased bilirubin levels.  Cirrhosis may cause normal, moderately high or high levels of bilirubin, depending on the type of cirrhosis.

Gilbert's Syndrome

One common – and harmless – cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin.

Hepatitis

Diseases that cause liver damage can lead to increased bilirubin levels.  To further investigate the cause of jaundice or increased bilirubin levels, liver function tests or other evidence of infective hepatitis (hepatitis A, B, C, delta, E, etc.) are commonly used.

Pancreatic Cancer

Certain diseases, such as pancreatic cancer, can block the bile ducts and lead to an accumulation of bile in the body.

Sickle Cell Trait / Disease

Sickle cell disease causes rapid destruction of red blood cells in the blood, leading to increased bilirubin levels.

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