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):
  • Sickle Cell Disease
  • Pancreatic Cancer
  • Chemotherapy Side-Effects
  • Gallbladder Disease
  • Drug Side-Effects
  • Hepatitis
  • Liver Cancer
  • Gilbert's Syndrome

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:
significant abdominal distension
regularly feeling unusually cold
pale fingernails
frequent unexplained nausea
weak appetite
frequent rotten egg burps
dark urine color
mild right lumbar discomfort
processed meat consumption
severe fatigue after slight exertion
moderate recent weight loss
occasional unexplained nausea
... and more than 70 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
Gilbert's Syndrome 92% Confirm
Liver Cancer 26% Unlikely
Hepatitis 26% Unlikely
Sickle Cell Disease 0% Ruled out
Drug Side-Effects 0% Ruled out
Gallbladder Disease 0% Ruled out
Chemotherapy Side-Effects 0% Ruled out
Pancreatic Cancer 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.

Gallbladder Disease

Certain health conditions, such as gallstones or an infected gallbladder, can block the bile ducts and lead to an accumulation of bile in the body.

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.

Hemolytic Anemia

Certain conditions, such as hemolytic anemia, can cause increased destruction of red blood cells and therefore increased bilirubin production.

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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