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Elevated bilirubin and contradictory diagnosis. Worried.

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Peter72
New Member
Joined : Feb 2018
Posts : 3
Posted 2/3/2018 3:37 AM (GMT -6)
Hello!

I am 45 years old male. I had been a intense social drinker (mainly weekend) many year but in last 3 year I increased my alcohol consumption. I drank 4 days in week often a lot.

One month and half ago, after severals days that i drank a lot, I felt a mild abdominal pain in right side. This pain decreased during a week, but after christmas days, when I ate a lot (But I did not drink too much alcohol), this pain pain appeared again and was moderate or strong accompanied by weakness. I think that my urine was darker during some days. I have not gone back to drinking alcohol since then. This more intense pain disappeared in one to two days, but a discomfort or mild pain remained.

I visited a doctor after the more intense pain and did me a blood test. This test was done about 3 weeks after inicial mild pain and 10 days after the more intense pain. The blood test showed that my liver enzymes was at normal, good leves, as well as other indicators. But total bilirubin level was high, 1.8 (1.1 unconjugated and 0.7 conjugated). Normal is under 1.2 (0.8 Un/0.3 Con). He did me another blood test three days later an enzyme remained at normal leves and total bilirubin were 1.4. And urine test said that it was normal (no bilirubin). My doctor says me that probably I expelled a small gallstone and my liver is fine. An ultrasound was done and did not show more stones.

The doctor sent me to a specialist for security and then this specialist told me that he did not think that I expelled a gallstone!!!. He thinks that I have Gilbert's syndrome and also that my liver is fine, no hepatitis, fatty liver, cirrhosis or other disease. But i read that in Gilbert's syndrome only unconjugated bilirubin is elevated, not both. One doctor says gallstone, other Gilbert's syndrome!!!

I do not know what to think and I'm very worried. I have read that only a advanced liver disease or cirrhosis, can raise direct and indirect bilirubin without elevating enzyme levels. Could I have such an illness if my liver enzymes and other indicators are fine?. I have no more symptoms and the discomfort has almost disappeared, but I do not know what to do, i think that with my drinking history, I can have a liver disease and nobody is diagnosing it.

Post Edited (Peter72) : 2/3/2018 2:52:26 AM (GMT-7)

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ppm guy
Veteran Member
Joined : Apr 2010
Posts : 1261
Posted 2/3/2018 1:29 PM (GMT -6)
Hi Peter72 and welcome,
The gallstone is not likely, since your ultrasound was normal, and your bilirubin remained elevated..

Gilberts is more likely,since your liver function is normal, except for your bilirubin..The high unconjugated bilirubin is the result of your liver having trouble making an enzyme (glucoronyl transferase).. this enzyme makes your bilirubin water soluble, so you can pass it thru your urine..

Gilberts can also cause some of your symptoms you described. I have not heard of Gilberts being a serious problem.

let me know how things work out
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Peter72
New Member
Joined : Feb 2018
Posts : 3
Posted 2/3/2018 2:36 PM (GMT -6)

ppm guy said...
Hi Peter72 and welcome,
The gallstone is not likely, since your ultrasound was normal, and your bilirubin remained elevated..

Gilberts is more likely,since your liver function is normal, except for your bilirubin..The high unconjugated bilirubin is the result of your liver having trouble making an enzyme (glucoronyl transferase).. this enzyme makes your bilirubin water soluble, so you can pass it thru your urine..

Gilberts can also cause some of your symptoms you described. I have not heard of Gilberts being a serious problem.

let me know how things work out

Thanks for the reply. Gilberts is not a serious problem but I have read that in Gilberts only indirect bilirubin is elevated. And I have both elevated, but conjugated is comparatively higher, unconjugated is only a little high. This is very strange and I am very worried.
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ppm guy
Veteran Member
Joined : Apr 2010
Posts : 1261
Posted 2/3/2018 5:20 PM (GMT -6)
Your dr wasn’t concerned, and I looked at a website that said: it says if your conjugated billirubin is normal and your unconjugated is elevated, it is a sign of excessive hemolysis.

I found that by googling high conjugated billirubin, and opening the site:
Medicalhealthtests.com

Hope that helps
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cured4real?
Veteran Member
Joined : Dec 2005
Posts : 1952
Posted 2/26/2018 11:11 PM (GMT -6)
Maybe not drinking would be a good idea. I did that and have never regretted it. Perhaps with the Gilberts drinking is just too much. You can get a really good feeling from being really healthy. On a side note, when I got the worst liver damage and was the sickest my ALT was zero. My liver could not repair ir make enzymes. So low can also be bad. If you are really worried seek a second ooinion from a liver specialist if you can or a good gi. It could be your gi tract that caused the pain.
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Sisleya
New Member
Joined : Oct 2019
Posts : 3
Posted 10/1/2019 4:13 PM (GMT -6)
Hi, after reading your post...cured4real...I was wondering if u have any info about the Liver
Being enlarged 21cm...and all my enzymes are off ALK PHOS 158...AST 115.....ALT 106
THE GFR IS 100...those were results of a blood test in August of this year...I had a liver
scan...and now they want one done with contrast...that's this week..then I go see the
Gastroenterologist...I have quit drinking any alcohol the past 2 weeks..I have very high
Blood Triglycerides like 363..total choLesterol..223...PLUS I had been taking way too
Much Tylenol 500 rapid release, for at least a year...now I've completely stopped any
Tyleno!....I Live in CHRONIC PAIN since 2007..had spinal fusion.C456+7..titanium plate
Put in.2007...Carpal tunnel surgery both hands a few yrs apart...bad hip pain for yrs.
Then 2016 R total hip replacement..4 dislocation s....hernia surgery 2017....Left total hip
replacement 2018(went well) BUT can not lay on the left side for even a second...extreme
Pain....So thru out all these surgeries..recoveries...I have been on A LOT of pain meds
Last year a pain clinic FINALLY listened (after 6 months) and gave me Oxycodone 15 IR 4X A
Day...no Tylenol...the clinic I now go to has me on NUCYNTA ER 150MG 2X A DAY..10mg Oxycodone IR 3x a day...no Tylenol...So my tired Liver has been abused from Meds, Tylenol
And Alcohol....the scan does say fatty liver...and some other medical terms i don't understand
Even after looking them up...I am worried sick..my GP said...no alcohol..no tylenol..low fat
Strict diet...I've been working at it really seriously a little over 2,3 weeks (couldn't stop everything at once). Unfortunately, Altho I cut way back on the booze...it's just 2 wks
Completely no alcohol..Is it possible to repair the liver and the damage?? ANY INFO
from anyone who has been thru something like this....I would be so thankful to hear from
Bad news..good news..suggestions?? Thanks...
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