Total Bilirubin Levels and Gilbert's Syndrome

Total Bilirubin Levels and Gilbert's Syndrome

I received my health check-up results in December 2022.

In the liver function test, I found that my total bilirubin levels were higher than normal.

 

‘Normal range of total bilirubin: 0.2~1.2 mg/dl, my result: 2.3’

Every year during my health check-up, this value always comes out high. An increase in bilirubin is often associated with liver disease, hemolytic diseases, or obstructive jaundice.

 

What is bilirubin?

Bilirubin is a component of bile and is produced from the breakdown of hemoglobin.

 

In our blood, red blood cells circulate for about three weeks, supplying oxygen. After that, they are broken down, and during this process, hemoglobin is metabolized into bilirubin. Hemoglobin is first broken down into unconjugated (indirect) bilirubin, which then goes to the liver where it is converted into conjugated (direct) bilirubin. Conjugated bilirubin is secreted by the liver into bile, and it is then broken down in the intestines and excreted through the stool.

 

Total bilirubin refers to the overall bilirubin levels in the blood, including both direct and indirect bilirubin. When bilirubin levels rise, jaundice may occur. Total bilirubin can be elevated in conditions like liver disease, obstructive jaundice, hemolytic anemia, or Gilbert’s Syndrome.

 

My previous experience with high bilirubin levels

A few years ago, while working abroad, I wasn’t feeling well and underwent a blood test. The results showed similar high bilirubin levels.

 

At the time, the doctor explained that all my other values, including hemoglobin, were within normal ranges, but only bilirubin was elevated. He diagnosed me with Gilbert’s Syndrome. This was the first time I had heard of Gilbert’s Syndrome, and I realized why my bilirubin levels had been consistently high during my liver function tests every year—it was due to a genetic factor.

Gilbert’s Syndrome

This condition is named after the French gastroenterologist Augustin Nicolas Gilbert, who discovered it. It’s a common disorder, affecting about 8% of the population. It is more common in men and is primarily caused by genetic factors, with a 50% chance of being passed on to offspring. Gilbert’s Syndrome is a harmless liver condition.

 

Most of the time, people with this syndrome live without any issues, but during periods of excessive fatigue or stress, jaundice may appear, along with symptoms like fatigue, decreased concentration, loss of appetite, abdominal pain, and weight loss. These symptoms tend to disappear when the person’s condition improves.

 

Gilbert’s Syndrome is caused by elevated bilirubin levels in the blood, but interestingly, bilirubin acts as an antioxidant, which might help prevent coronary artery disease or other vascular conditions.

 

No special treatment is necessary

However, it is recommended to avoid excessive fasting, strenuous physical activity, stress, or extreme dieting, as these factors can increase bilirubin levels.