Bilirubin Testing

Abnormal levels of bilirubin are usually a result of poor liver function, which is why the moment you start to experience symptoms of liver damage, you should take a bilirubin blood test and consult with your GP.

If you start to notice that your skin is turning yellow in colour as well as the whites of your eyes, you should take a bilirubin blood test and seek medical from your general practitioner as this could be a sign of liver disease.

A bilirubin blood test is also used to understand the cause of anaemia (as bilirubin is a product of the breakdown of red blood cells) and liver and bile duct conditions such as cirrhosis, hepatitis, and gallstones.

Furthermore, newborns are likely to have high bilirubin levels, and a bilirubin blood test will be necessary to determine whether treatment would be necessary depending on the amount of bilirubin present and the age of the newborn, as well as the type of bilirubin. (4-6)

A high bilirubin could be the sign of a liver disease, bile duct disease, anaemia, or in other cases another medical condition. Your bilirubin levels could be high even before reaching the liver, and in this case, it is probably not your liver which is causing high bilirubin levels.

Haemolytic anaemia is one of the causes for high bilirubin, where your red blood cells are broken down faster than usual, leading to a build up of bilirubin before reaching the liver. High bilirubin could be related to a liver dysfunction, such as cirrhosis (scarring of the liver due to chronic liver damage), hepatitis (liver inflammation), bile duct inflammation, or gallstones (when cholesterol or bilirubin block your gallbladder and harden, not allowing bilirubin to drain correctly.

Having high bilirubin levels for a long period of time can lead to the yellowing of the skin and the whites of the eyes (jaundice), and in more serious cases it can lead to brain damage. (9,10)

Given the potentially serious consequences it is important to discuss with your GP and take a liver function test to assess your bilirubin levels.

As mentioned previously, hyperbilirubinemia can be caused by a liver condition, anaemia, or other conditions that affect bilirubin drainage or production. If you have high levels of cholesterol, you might be at a higher risk of having hyperbilirubinemia, as you can have an increased risk of developing gallstones, which can prevent bilirubin from draining efficiently.

Liver dysfunction or inflammation can also raise bilirubin levels. Such liver conditions can develop due to autoimmune diseases, liver cancer, hepatitis, and drinking excessive amounts of alcohol. Excessive intake of paracetamol can also be toxic to the liver and can lead to increased bilirubin.

Haemolytic anaemia can also cause high bilirubin, and this can be either due to genetics (such as sickle cell disease or thalassemia), an enlarged spleen, certain autoimmune diseases, typhoid fever, infectious hepatitis, or other infections.

Symptoms of hyperbilirubinemia are broad and may depend on the underlying cause behind these elevated levels. The most common symptom of hyperbilirubinemia is when your skin and the whites of your eyes start to turn yellow, which is known as jaundice. Other general symptoms include abdominal pain, chest pain, fever and body aches, chills, dark urine, nausea and vomiting, fatigue and drowsiness.

Symptoms depending on why your bilirubin levels were high in the first place can vary. For example, if you have gallstones, you might experience abdominal pain or chest pain, as well as a sharp pain towards your right shoulder, as well as nausea and vomiting. If you have liver dysfunction or hepatitis, you might experience other than jaundice, itchy skin, dark urine, oedemas around your ankles, as well as unusual colour of stool (usually black), nausea and vomiting. Bile duct inflammation usually shares similar symptoms, but you might also experience weight loss. Symptoms of haemolytic anaemia include fatigue, weakness, headaches, dizziness, as well as difficulties breathing.

If you are experiencing these symptoms, even without having jaundice, it is recommended to take a bilirubin test and seek medical advice from your doctor.

If you are experiencing blood in your stool or black stool, you are vomiting blood, or have a fever above 38°C, or you are experiencing severe abdominal pain or you develop a purple to red skin rash, you should immediately seek medical advice. (13,14)

It takes approximately 6 months for your liver to recover fully from hyperbilirubinemia in adults. It depends on the cause of your hyperbilirubinemia in the first place, and if the underlying condition can be addressed as quickly as possible. It can also depend on your overall health and if you have other medical problems such as a heart condition, it can take longer for your bilirubin levels to go back to normal.  (16)

Monitoring your bilirubin levels by taking a frequent liver function test with Vitall is the best way to see if lifestyle changes and/or medical treatment is working. Your bilirubin blood levels will be displayed in a chart in your secure account dashboard, so you can easily track your progress.

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