Bilirubin 16 5. Reasons for increased bilirubin in the blood and signs. Why is total bilirubin elevated in a blood test?

It is a yellow-green pigment formed after the breakdown of hemoglobin. Bilirubin is found in both bile and blood serum. An organ such as the liver plays a significant role in the metabolic processes of bilirubin. When the bilirubin pigment in the blood increases, jaundice may begin, accompanied by yellowing of the sclera of the eyes and skin of the body, as well as mucous membranes. Liver diseases, in particular hepatitis, as well as various types of anemia, can also be triggered by an increase in the level of bilirubin.

How does bilirubin form?

Red blood cells, called erythrocytes, contain hemoglobin, which carries oxygen directly to the tissues from the lungs. Damaged red blood cells, just like old ones, decompose in the liver and spleen cells intended for this purpose, as well as in the bone marrow. In the process of destruction of the erythrocyte substance, hemoglobin is released, which, after some time and a stage of chemical reactions, turns into the substance bilirubin. The bilirubin that was just formed from hemoglobin (indirect bilirubin) is extremely harmful to the body, in particular to the central nervous system. Therefore, right in the liver, some substances seem to bind bilirubin, thereby neutralizing it. This bilirubin is called direct bilirubin. It is secreted into bile by the liver and leaves the human body along with feces through the intestines. If the stool is dark, then we can say that it contains bilirubin (altered). There are diseases with the biliary tract and liver, when the process of releasing bilirubin directly into the intestines is hampered, disrupted, and feces become colorless, like clay.

Characteristics of direct (connected) and indirect bilirubin

As mentioned above, direct and indirect bilirubin are the two main fractions of this substance. It all depends on how the laboratory reaction with the diazo reagent goes.

Indirect bilirubin is poisonous and toxic bilirubin that has recently formed from hemoglobin and has failed to reach the liver.

Direct or bound bilirubin is a substance that has been neutralized in the liver. Here, bilirubin is prepared for removal from the body, therefore there is no toxicity in it.

What indicators are considered normal?

A bilirubin test is taken in the morning on an empty stomach.

Bilirubin levels are determined through blood tests. In this case, it is necessary to undergo a biochemical analysis. In order for its results to be reliable, the analysis must be carried out only in the morning, and, of course, on an empty stomach. It is very important not to eat anything for about eight hours before the test itself. Biochemical analysis is carried out from a vein.

So, the norm for bilirubin (both direct and indirect) is its level in the blood serum from 8.5 to 20.5 µmol per liter. Thus, the norm for bilirubin in the indirect fraction is 17.1 micromol per liter, while for direct bilirubin, up to 4.3 micromol per liter is considered normal.

Signs of increased bilirubin in the blood

Considering the fact that the liver plays the main role in bilirubin levels, it becomes clear that the main symptom of an increase in the level will be jaundice. This symptom occurs both when there is a violation of the binding of excess substances, and when there are difficulties with the excretion of bile.

Important: the severity of jaundice may be less in people who are overweight and have edema.

Jaundice has its own characteristics. First of all, changes in the sclera are noted. Further, yellowness appears on the oral mucosa and on the skin of the palms. Only then, in the absence of treatment, does jaundice spread to the entire body. Concomitant symptoms will depend on the root cause of the change in bilirubin levels, that is, on the underlying disease.

What diseases cause bilirubin levels to increase?

A presumptive diagnosis can be determined by which bilirubin is elevated. Thus, direct bilirubin increases more often in the following diseases:

Hepatitis of viral and bacterial nature, including chronic.
Food poisoning (usually mushrooms).
Intoxication due to improper use of medications (hormonal contraceptives, NSAIDs, antitumor drugs).
Tumors of liver tissue.
Cirrhosis.
Hereditary pathologies - Rotor, Dabin-Jackson syndrome.

Indirect bilirubin is more often observed in pathologies such as:

Congenital hemolytic anemia.
Hemolytic anemia caused by SLE, lymphocytic leukemia, lymphogranulomatosis.
Sepsis, .
Long course of cephalosporins, penicillins, insulin and NSAIDs.
Toxic anemia due to poisoning with metals, arsenic, salts, as well as after snake bites.
Gilbert's syndrome, Lucy-Driscoll.

What can cause an increase

Here we can highlight three main reasons that can provoke an increase in bilirubin levels.

Accelerated rate of destruction of red blood cells
Disturbances in the process of processing bilirubin directly in the liver
Disturbances in bile flow

If there is an increased rate of erythrocyte destruction, then, accordingly, hemoglobin and bilirubin increase sharply. The main reason for such accelerated destruction of red blood cells is hemolytic anemia, which is the destruction of blood. Hemolytic anemias can be either congenital or acquired. If anemia is congenital, it can develop due to certain defects in the erythrocyte structure or hemoglobin disorders. This may be hereditary microspherocytosis and thalassemia, as well as sickle cell anemia. Acquired anemia results from autoimmune processes. Here the immune system begins to fight its own red blood cells. Acquired anemia can also be caused by malaria and the use of certain medications.

In general, indirect bilirubin may increase in the presence of hemolytic anemia. With such anemia, discomfort may be felt under the left rib caused by an enlarged spleen. With hemolytic anemia, body temperature rises and the urine darkens. Thus, shades of urine can range up to dark brown and black, which will indicate that red blood cells are being destroyed inside the vessels. Such destruction of red blood cells can be found with a defect in cell membranes in the blood - Marchiafava-Miceli disease. Thus, the membranes become unstable and lead to the destruction of red blood cells.

During such anemia, a person may feel severe fatigue and frequent heart pain.

As mentioned, the liver plays an important role in the metabolic processes of the substance bilirubin. Thus, in case of liver diseases, indirect bilirubin cannot be neutralized in liver cells. Diseases may occur: viral hepatitis A, B, C, D and E types, drug-induced hepatitis and alcoholic hepatitis. Liver cirrhosis develops, and subsequently liver cancer. So, you can observe sharp jumps in the level of bilirubin, which can manifest itself in jaundice and other symptoms. Such symptoms include “bitter” belching and nausea; discomfort may occur after eating food, in particular fatty foods. Performance decreases, as does appetite, which is accompanied by a sharp increase in overall body temperature.

There are other causes of increased bilirubin. So, it may be heredity, when the body lacks a liver enzyme. This process is called glucuronyl transferase. The missing enzyme is involved in the metabolic processes of bilirubin. This syndrome is called Gilbert's syndrome. Here an increased, and significantly, level of bilirubin appears. This can manifest itself in yellowing of the skin and eye sclera, as well as mucous membranes of the body.

Increased bilirubin can be detected if bile outflows from the liver or from the gallbladder are disrupted. This can occur with cholelithiasis and pancreatic or gallbladder cancer. If bile flow is impaired, then direct bilirubin may be elevated in the blood. What could such an increase lead to? First of all, this is the development of an acute form of jaundice. However, other symptoms may also occur, such as hepatic colic, which usually precedes the development of jaundice in gallstone disease. Hepatic colic is accompanied by an attack of acute pain under the right rib.

Bilirubin irritates the nerve endings of the skin and can cause itching of the skin, which can be quite pronounced.

Bloating or constipation and frequent diarrhea may occur.

Disturbances also occur in the stool - it takes on a white clay shade, almost discolored. This indicates disturbances in the bile outflows.

Urine can change its consistency and shades, including dark, brown and black.

Increased bilirubin is normal for a newborn

An increase in bilirubin levels in newborns requires special attention. In general, elevated bilirubin is normal for infants. The fact is that immediately after birth, the child begins to rapidly destroy red blood cells. During the development of the baby inside the womb, he has fetal hemoglobin in his red blood cells, which, of course, differs from ordinary hemoglobin. Red blood cells, which contain such hemoglobin, are easily destroyed.

Accordingly, the rapid destruction of most red blood cells can lead to a jump in bilirubin upward, after which the newborn may develop normal jaundice. For a newborn, the norm of bilirubin four days after birth is 256 µmol per liter in children who are considered full-term. If the baby is premature, the figure for him will be 171 micromol per liter.

With a strong increase in the level of hemoglobin in a child, pathological jaundice may begin to develop, indicating a hemolytic disease of the newborn.

Diagnostics

First of all, it is determined by how much the indicator has changed. For this purpose, Harrison's test is prescribed. The technique is based on the ability of bilirubin to be oxidized under the influence of reagents to biliverdin. Additional tests are performed based on the preliminary diagnosis. More often a biochemical blood test is prescribed.

Features in women and men

It should be noted right away that normal indicators for men and women do not differ. The same applies to the reasons for the increase in the indicator - they will be similar. But there is one difference. According to statistics, men are 10 times more likely to experience Gilbert's syndrome.

Separately, the increase in bilirubin during pregnancy should be considered. In addition to the above reasons for changes in the level of the indicator, when carrying a child, the following conditions can provoke the symptom:

Acute fatty liver degeneration.
Formation of gallstones.
Severe toxicosis of the early period.
Intrahepatic cholestasis of pregnancy.
Eclampsia and preeclampsia.

In addition to the above, the indicator may change during pregnancy if the woman is a carrier of the Epstein-Barr virus, cytomegalovirus, or there is an exacerbation of chronic liver pathologies.

Important: a slight increase in bilirubin against the background of normal general health may be the result of stress in the expectant mother.

A growing fetus can also cause an increase in bilirubin. This is explained by the fact that it displaces and compresses organs, in particular the gallbladder ducts, which causes stagnation of bile.

How can you reduce bilirubin?

Before treating elevated bilirubin levels in the blood, you need to make sure that the reasons for its increase are correctly established. Initially, you need to determine the cause of the destruction of red blood cells and build on it.

If increased bilirubin is caused by liver diseases, then the phenomenon of increased bilirubin here is only a symptom. It may disappear immediately after the patient recovers. If the reason is stagnation of bile, then it is important to remove all obstacles that interfere with the quality outflow of bile. So, bilirubin will decrease.

To reduce bilirubin in a newborn, you need to use special activators - inducer drugs for liver enzymes.

Any increase in bilirubin requires nutritional correction. This will help reduce the load on the liver. First of all, you should reduce your salt intake as much as possible. It's better to cook without it. The daily norm will be 10 g. Naturally, marinades, pickles, smoked meats and canned food are excluded. Baked goods, especially those containing soda, are also prohibited. Mushrooms, fatty broths, sour fruits and berries, spices, seafood and alcohol are unacceptable.

Water-based porridge should definitely be on your menu if bilirubin levels are high.

The menu is compiled using the following products:

Porridge cooked in water.
Lean meat.
Low fat dairy products.
Vegetable oils.
Juices, just not sour ones.
Honey and sugar.

All products must undergo heat treatment, preferably boiled or baked. It is especially important to maintain a drinking regime that involves drinking two or more liters of water. Herbal decoctions, compotes, and still mineral waters are acceptable.

The complex of biochemical blood analysis includes the determination of pigment metabolism in the human body. It is assessed by bilirubin, but most people do not know what this substance is, what it is responsible for and why its increased concentration is dangerous. When its amount becomes very high, this indicates certain diseases and disorders in the body.

Types of bilirubin

Bilirubin is called a product of material metabolism. The substance is formed from hemoglobin, which is broken down inside the liver and excreted in urine, feces and bile. There are three types of bilirubin:

direct - it is water soluble and is also called conjugated. Formed in the liver as a result of connection with glucuronic acid;
indirect does not dissolve in water. It is toxic and is a breakdown product of heme substances;
total is the total amount of both forms of the substance in human blood plasma.

During a diagnostic examination of patients, doctors determine diseases of internal organs, including liver pathologies and even infertility, by the amount of different types of bilirubin.

In its indirect form, the substance is toxic, and to neutralize it, the liver converts it into a soluble form. An increased content of total bilirubin is accompanied by yellowness of the skin, toxicosis and itching of the skin.

What level means that bilirubin is not elevated?

We figured out what the different types of bilirubin are, but what indicators are considered normal? When its concentration is elevated, this may indicate various diseases. So, the norms according to modern medical tables are as follows:

in indirect form - no more than 16.2 µmol/l;
in a straight line - no higher than 5.1 µmol/l;
the amount of total bilirubin varies from 0.5 to 20.5 µmol/l.

Even figures of 21-21.7 units are considered overestimated, but this is not a reason for concern. The predominance of a certain form of a substance may be due to various reasons. When the concentration of the substance reaches 35-36 units, the patient may experience the first symptoms of jaundice, and read more about them below.

Symptoms of elevated bilirubin

When the analysis reveals high levels of bilirubin, a person’s skin may turn slightly yellow, and the urine will take on a dark tint (on average, with a reading of more than 34 units).

As a result of increased concentration, a person may experience a number of symptoms after physical activity:

temperature increase;
discomfort in the left hypochondrium;
lethargy;
general weakness.

The doctor determines what is causing the disorder and prescribes appropriate treatment. When the bilirubin level is increased significantly (60, 71.3, 96, 120 units), some disease is definitely developing in the body, requiring qualified treatment.

In rare cases, the concentration of the substance reaches critical levels of 220-300 µmol/l, and this is very dangerous. This is rare in adults, but occurs in children and adolescents under 15 years of age.

Why does the amount of bilirubin increase and what are the consequences of such a violation we will now understand.

What are the dangers of increasing indicators?

As mentioned, bilirubin is toxic, therefore it contributes to intoxication of the body and disruption of organ function. The brain tissue is the most sensitive, while the liver, kidneys and heart have higher resistance. In any case, everything depends on the exact concentration determined from the test results.

If the norm is slightly exceeded, when the concentration of the substance reaches 29-30 or higher values of 46-80 units, this is not dangerous to the patient’s health. This is not yet severe intoxication and the organs do not suffer toxic damage, and some people live with such indicators, although this is not normal.

With a pronounced increase in bilirubin, when it reaches 150-180 units, everything is quite dangerous, but still not critical. Long-term preservation of this state is accompanied by intoxication, which must be dealt with as quickly as possible.

In severe forms, when the substance content reaches 300 µmol/l, doctors talk about a threat to the patient’s life. In this situation, severe intoxication and dysfunction of many organs occur. For adolescents, this concentration of bilirubin is more dangerous than for adults.

There is also an extremely severe form, when bilirubin exceeds 300 units. Such indicators in the case of adult patients are incompatible with life. If treatment is not started within a few days and the concentration in the blood is not reduced, the consequences will be the most dire - death is possible.

Sometimes women are interested in whether it is possible to do IVF with elevated bilirubin, since this occurs quite often. Also on forums there are often questions related to the concentration of this substance and infertility. In fact, experienced doctors refute the connection between bilirubin levels and infertility, but whether to refer for IVF if its numbers are inflated or not depends on the indicators and other individual factors.

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Why does bilirubin rise?

Doctors know various causes of increased bilirubin, including:

high-intensity hemolysis of erythrocytes;
liver damage;
problems with the outflow of bile;
disturbances in the production of enzymes.

In liver diseases, the secretion of direct bilirubin into bile may be impaired and the intensity of hemolysis may increase. When the content of the substance in the blood reaches high levels, and the skin acquires a yellow tint, and the urine darkens, and weakness and fatigue occur, the cause may be anemia, gallbladder pathologies, helminthic infestation or acute deficiency of vitamin B12.

Congenital or acquired anemia can contribute to a noticeable acceleration of the destruction of red blood cells in human blood, and this will lead to a slight or noticeable increase in bilirubin. Other body functions may be working normally, but the test will show only high indirect bilirubin.

Various types of cancer, cirrhosis and hepatitis can lead to high concentrations of the substance and unpleasant consequences. All of them interfere with the formation of direct bilirubin. Among the provoking factors are hereditary diseases and Gilbert's syndrome (deviations in the secretion of enzymes). In some situations, even taking medications can cause an increase in the content of the substance by approximately twofold - it’s all about side effects that affect the functioning of the gallbladder. In this case, only bilirubin can be increased, and other indicators will remain normal.

How to lower high bilirubin?

We found out what kind of disease can be caused by increased bilirubin in the blood, and now we just need to figure out how to reduce it. First, any attending physician makes a diagnosis and determines what is causing the increase in the concentration of the substance. After this, the optimal therapy complex is selected.

Often, the basis of treatment for adolescents and adults over 30 years of age with high bilirubin is infusion therapy. The patient is given intravenous injections of special drugs and glucose, due to which the substance and its breakdown products are more intensively removed from the body. Typically, doctors use this technique in critical situations, and when bilirubin is 39-46 units or so, other methods are used. Also, infusion therapy may be resorted to when a slight excess of the norm does not decrease for a long time.

Another method is phototherapy - irradiation with special lamps. The toxic indirect form of the substance is destroyed under their rays and turns into a simple direct form, after which it is freely expelled. The technique is in demand when you need to quickly reduce bilirubin levels, and it is especially effective for children and adolescents.

When the cause of the deviation is associated with impaired bile excretion, doctors prescribe pharmaceutical drugs to patients to normalize this physiological process. Among choleretic drugs, Karsil, Allohol, Chofitol and Cholenzym are especially in demand. In addition, a suitable daily diet is required. In addition to complex cleansing preparations, regular activated carbon and various gels for removing toxins help. It is important to reduce the load on the liver by removing spicy, sweet and fried fatty foods from your diet.

Sometimes, with increased bilirubin, the liver hurts, and doctors diagnose hepatitis. In such a situation, it is necessary to take medications to protect this internal organ and fight the underlying disease, as a result of which the concentration of the substance will gradually begin to decrease. Medicines for liver restoration include Essentiale, Ursosan and Hepatrin.

Bilirubin is a special substance in human blood that is formed during the processing of hemoglobin and dead red blood cells. It is this indicator that allows you to determine the correct functioning of the liver, but, in addition, this indicator can be used to judge the condition of the spleen, as well as the metabolic rate.

Preparing for the test

In order for the test results to be reliable, a number of simple rules must be followed and some preparation must be done. As with a regular biochemical blood test, when checking bilirubin, you must come to the treatment room early in the morning, on an empty stomach. 1 - 2 days before the planned blood draw, you should avoid eating fried and fatty foods so that the liver is not overloaded.

2–3 days before the test, you should refrain from playing sports, since intense exercise and stress affect the functioning of the liver. The use of medications should also be limited (about 1 to 2 weeks in advance), since the components they contain can also change indicators, complicating diagnosis.

In some cases, the doctor may prescribe a repeat test with mandatory adherence to a diet for several days, while the nutritional value of the foods consumed should not exceed 500 kcal.

Blood is drawn from a vein. The patient's arm above the elbow is clamped with a tourniquet, after which a vein is pierced with a syringe and the required amount of blood is drawn.

Types of bilirubin

When determining the amount of yellow pigment, the concentration of total bilirubin is initially determined, after which the direct component is determined, and the difference between these indicators is considered the level of the indirect component.

Total bilirubin is usually understood as the entire available volume of this substance in the blood plasma. The indirect type of bilirubin consists of unconjugated and water-insoluble elements. The direct type is a substance that is conjugated and soluble in water.

Each type of bilirubin (direct and indirect) has its own special significance, since it is through the determination of this substance that doctors are able to identify many pathologies in the functioning of not only the liver, but also other systems and organs.

The indirect form of bilirubin is a toxic element, and the liver’s task is to neutralize it, convert it into a direct form, that is, into substances soluble in ordinary water, with which bilirubin is excreted from the body. If the level of this substance in the patient’s blood is elevated, he develops characteristic “icteric” signs: yellowing of the skin, dryness and itching, toxicosis.

The norm of total bilirubin in the blood of women by age

The average normal pigment indicator is considered to be a number from 3.5 to 20.5 µmol/l. Of course, reference data is of decisive importance, so doctors mainly focus on them.

Features of deviations from the norms

With age, most women tend to decrease the level of this blood element, which is largely due to the gradual appearance of various ailments that affect the level of pigment formed.

As a rule, women who have given birth by this age have a weakening of the liver, which is caused by the increased load on the organ during the period of gestation. This also cannot but affect bilirubin levels and is not an abnormal deviation. Let us consider in more detail the features of deviations from the norm of total bilirubin in the blood in women after 40, 50, 50 years.

Features of decreased bilirubin levels in adult women:

In women over 40 years of age, the norm is considered to be from 3.9 to 17.6 µmol/l, which is associated with various liver diseases, as well as disturbances in the digestive system as a whole. Also, deviations considered normal occur during ovulation, during menstruation. The amount of pigment can also be influenced by external factors, for example, climate change, excessively high temperature outside or, conversely, hypothermia.

The normal level of bilirubin in the blood of women over 50 years of age ranges from 3.7 to 17.4 µmol/l, but sometimes the result may be somewhat underestimated. At this age, women already enter menopause, which causes not only hormonal instability, but also the appearance of many diseases on this basis. All this cannot but affect the level of bilirubin, but, as a rule, deviations are not negative.
After 60 years, the level of bilirubin in the blood of women, however, like men, may decrease slightly, since most people of this age develop diseases of the cardiac system. As a result of the lower content of red blood cells in the blood and the decrease in hemoglobin due to these diseases, the level of bilirubin, formed from the destruction of dead red blood cells, also drops.

Bilirubin in pregnant women

During the period of gestation, it is very important to constantly monitor the level of bilirubin, which should be in the range from 8.4 to 20.5 µmol/l. It is very important not to exceed the maximum value, since in this case the woman may experience jaundice, since the level of this substance is always related to the functioning of the liver and bile.

In most cases, during pregnancy, the level of bilirubin in women is normal, but sometimes there may be fluctuations in one direction, both minor and very noticeable. If, when deciphering the analysis, it is clear that the amount of pigment does not meet the established standards, the woman must undergo a full examination.

It is important to remember that high bilirubin levels can have a very negative impact on the health of a developing baby, which may indicate a possible illness.

Some diseases, such as hemolytic anemia, can have very serious consequences, including leading to premature birth and sometimes stillbirth. Therefore, it is important to detect and treat any diseases on time.

Increased bilirubin

Reasons for the high rate

Bilirubin levels may increase due to:

The presence of severe gallstone disease, especially in chronic or acute form.
The presence of serious diseases of the gallbladder or liver, for example, cirrhosis or hepatitis.
The presence of bad habits, such as smoking or alcoholism, especially with frequent abuse.
The appearance of various forms of acute respiratory infections and acute respiratory viral infections, as well as influenza and other infectious diseases.
Abuse of many drugs, especially analgesics, aspirin, various groups of antibiotics, hormonal drugs.
Hereditary factor.
The presence of prolonged and very frequent bleeding.
The presence of malignant neoplasms in the body.
Diseases of the pancreas that are inflammatory in nature.

Increased bilirubin in the blood for a long time poses many dangers to the female body, for example, this condition threatens serious toxic damage to the muscles, which can spread to the brain. This will require urgent qualified medical care.

Treatment

In order to quickly and effectively reduce bilirubin, it is important to determine the exact cause that caused this disorder. And since the causes of the disorder are very diverse, only an experienced doctor can prescribe adequate therapy in each specific case, based on the available indications.

The main method of treating elevated bilirubin is infusion therapy, which involves intravenous infusions of glucose and detoxification drugs, as well as special solutions that accelerate the removal from the body of not only this substance, but also all its breakdown products.

But doctors resort to the above method of infusion therapy only in particularly severe cases.

An easier way to treat high levels of bilirubin in the blood is phototherapy., in which the patient is irradiated with special lamps that do not cause him harm. With this effect, indirect bilirubin, which is toxic, is destroyed. In this case, the indirect pigment is transformed into its direct form, after which it is easily processed by the body and removed from it.

The phototherapy method is completely safe, so it is often used even in cases where the amount of bilirubin urgently needs to be reduced in infants up to one year old.

Causes of low bilirubin levels

may occur due to the following factors:

Abuse of drinks containing a lot of caffeine, such as energy drinks, black coffee, tea.
Diseases of the heart and blood vessels, especially in chronic form, for example, cardiosclerosis, heart failure of various types, coronary heart disease.
The presence of bad habits, alcoholism or smoking, and their abuse.
Excessive use of certain medications.

Doctors recommend that women undergo a routine medical examination at least once a year and be sure to take all tests, including determining the level of bilirubin, because this indicator is a very important criterion for assessing their health status.

Blood contains many different substances. Each of them has its own content standards. Exceeding the established indicators indicates the presence of certain pathologies or disorders. One of these substances is. It performs an important function and if its level in the blood is exceeded, therapeutic measures are required.

bin and its meaning

It contains hemoglobin, which carries oxygen from the lungs to all tissues of the body. But when the blood cells can no longer perform their functions, they are destroyed in the liver, spleen and bone marrow. Hemoglobin is released and converted into bilirubin.

But the resulting cells are dangerous for the body and have a negative effect on the nervous system. That is why it enters the liver, where it is neutralized by various substances. In this way, an indirect type of substance is obtained, which is subsequently excreted along with bile, and then excreted from the body along with urine.

The transformation of a substance is a complex chemical process that continuously occurs in the body.

Disruption at various stages of the conversion of hemoglobin into indirect bilirubin causes changes in its level. Indicators are considered quite important in diagnosing various diseases.

In medicine, substances are usually divided into two types:

Indirect. It dissolves only in fats and is formed by breakdown. It is considered dangerous to the body, as it easily penetrates cells, disrupting the functioning of certain organs.
Straight. Synthesized in the liver. It is soluble in water and is not considered hazardous to the body. It is excreted naturally along with bile.

Direct bilirubin is completely safe for the body, as it is previously neutralized by liver enzymes. The substance does not have a negative effect on the functioning of various systems and organs and is easily eliminated from the body. During diagnosis, the level of both direct and indirect bilirubin is determined.

Diagnostics and norms

Bilirubin is found in human blood. That is why blood is drawn to establish its level. In order for the indicators to be reliable, the patient must follow a number of rules.

First of all, you need to stop eating at least 12 hours before the procedure. You also need to exclude stressful situations and physical activity. It is not recommended to smoke two hours before taking blood for analysis.

The analysis results reflect three indicators:

General indicator. It should not be lower than 5.1 mmol/l, but not higher than 17 mmol/l.
Indirect. The norm is considered to be from 3.4 to 12 mmol/l.
Straight. The indicator can vary from 1.7 to 5.1 mmol/l.

The indicators of the substance according to gender practically do not differ and do not change between the ages of 18 and 60 years.

Causes of elevated bilirubin levels

When studying the results of the study, the specialist pays attention not only to the level of total bilirubin, but also direct and indirect.

An increase in the amount of direct bilirubin occurs due to a change in the outflow of bile, as a result of which it does not enter the stomach, but into the vessels and is transported along with the blood.

The causes of this disorder are the following diseases:

Acute form of viral hepatitis, for example, hepatitis A, B or infectious mononucleosis.
Hepatitis is of a bacterial origin.
Drug-induced hepatitis that occurs due to long-term use of drugs of various groups (for tumors, tuberculosis or inflammation).
Autoimmune hepatitis.
Hepatitis caused by poisoning with toxic substances or poisonous mushrooms.
Cholelithiasis.
Cancerous tumors in the liver, pancreas or gall bladder.
Dubin-Johnson or Rotor syndrome.

During diagnosis, an increase in the amount of indirect bilirubin may also be observed. This condition can be caused by the following diseases:

Infectious lesion. The most commonly diagnosed diseases are sepsis, typhoid fever and malaria.
Congenital hemolytic anemia. Similar diseases include Marchiafava-Michele disease, non-spherocytic disease, thalassemia and others.
Lucy-Driscoll, Crigler-Najjar, Gilbert syndromes.
Toxic anemia, caused by the bites of poisonous snakes, poisoning by toxins and various poisons, heavy metals, lead, arsenic.
Drug-induced anemia that occurs due to prolonged use of NSAIDs, insulin or aspirin.

The reason for the increase in the level of indirect bilirubin in the blood can be provoked by acquired autoimmune hemolytic anemia, which occurs against the background of rheumatoid and other diseases.

Associated symptoms

Increased bilirubin has its own distinctive signs, by which one can suspect the presence of a disorder without conducting a laboratory blood test. The analysis only serves as evidence of an increase in the normal content of the substance in the blood.

With a significant level of bilirubin, the main symptoms are:

Dyspeptic disorders, which manifest themselves as an unpleasant taste in the mouth and nausea.
Headache.
The appearance of a gray or white coating on the tongue. Has a viscous consistency
Dizziness.
Skin itching.
Fast fatiguability.
Yellowness of the mucous membranes of the mouth and skin.
Colorless feces.
Dark shade of urine.

There is also discomfort in the area, which is caused by the increased size of the liver. After eating fatty and heavy foods, heartburn and belching occur. Stool upset may occur.In cases where the cause of excess bilirubin is viral hepatitis, a significant increase in body temperature is also noted.

What are the dangers of high bilirubin?

Thanks to modern methods of therapy, it is possible to normalize elevated bilirubin levels without consequences for the body. But in the absence of medical care, this condition can lead to serious consequences, including:

Disruption of all systems and organs.
Encephalopathy.
Chronic form.
Formation of gallstones.
Viral form of hepatitis.

Against the background of significantly higher than normal bilirubin, the development of pathological processes that are irreversible is observed. This condition can also lead to coma.

How to normalize bilirubin levels?

To restore the normal amount of bilirubin in the blood, it is first necessary to establish the cause of the change in indicators.Infusion therapy is often used, which involves intravenous administration of glucose and saline solutions. This helps relieve signs of intoxication and remove metabolic products from the body.

In certain cases, phototherapy is also used. The technique involves irradiation with special lamps. Under the influence of rays, the transformation of indirect bilirubin into direct bilirubin is observed, which is then excreted from the body.

Medicines are prescribed to normalize the process of bile excretion, along with which bilirubin is also excreted. Means are also used to relieve symptoms of intoxication. Often patients are prescribed activated charcoal.

In cases where excess bilirubin in the blood is caused by hepatitis, therapy is prescribed aimed at eliminating the virus.

The use of drugs aimed at protecting the liver from harmful effects and preventing the occurrence of cirrhosis is indicated.When diagnosing Gilbert's syndrome and other disorders, treatment should be prescribed only by a specialist in accordance with the patient's condition, type, form and degree of development of the disease.

Hepatoprotectors are used for infectious liver damage. Immunomodulatory, antibacterial and antiviral agents are also prescribed.It is strictly prohibited to use traditional medicine recipes to normalize the level of bilirubin in the blood. This is due to the fact that there can be many reasons for the occurrence of this condition and improper treatment will lead to the development of serious consequences.

A high level of bilirubin in the blood requires adjustment of the diet. The diet helps reduce the load on the liver. Patients should first reduce the amount of salt they consume. It is recommended to prepare dishes without it. It is allowed to use no more than 10 grams per day.

You should also completely eliminate the use of pickles, marinades, smoked meats, as well as canned meat and fish. Patients are prohibited from consuming fatty broths, mushrooms, alcoholic beverages, sour berries and fruits. Spices should not be used when preparing dishes.

If bilirubin is elevated, you should include in your diet:

Fermented milk products with low fat content.
Sweet juices.
Sugar and honey.
Lean meat.
Porridge on the water.
Vegetable oil.

It is important to maintain a drinking regime and heat treat all foods.An increased level of bilirubin in the blood is characterized by pronounced symptoms, which allows for timely detection of the disorder. It is important to establish the cause of this condition and carry out treatment.

More information about bilirubin can be found in the video:

Patients should not only take prescribed medications, but also follow a diet. Lack of therapy or improper treatment can lead to serious consequences. This is why you should not put off going to the doctor.

During diabetes, the patient faces many health problems. And if treatment is not started in time to normalize blood sugar and the symptoms of the disease are not eliminated, diabetics may develop diseases of the cardiovascular system, kidneys or liver. One of the problems that diabetes can cause is high bilirubin levels.

Increased bilirubin in the blood is formed as a result of the breakdown of red blood cells. First, indirect bilirubin is formed in the body - a toxic substance that cannot dissolve in water.

This means that it is not excreted from the body, as a result of which it enters the liver along with the blood and is converted into bilirubin.

The formed substance, in turn, can easily dissolve in liquid and is excreted from the human body through urine and feces, giving them a brown tint.

To detect total bilirubin in an adult, you need to do a special blood test. The normal level of the substance is 3.4 µmol/liter for direct and 17.1 µmol/liter for indirect bilirubin.

Elevated total bilirubin is diagnosed in adults at levels greater than 4.6 and 15.4 µmol/liter, respectively.

Symptoms of increased bilirubin

If the level of total bilirubin in the blood increases significantly, the patient experiences a yellow tint to the skin and dark urine. This suggests that increased amounts of bilirubin have leaked into human tissue, turning them gray-yellow.

Also, as a result of the fact that the level of bilirubin increases, a person may experience discomfort in the left hypochondrium after exercise, as a result of which the patient may experience weakness, lethargy and increased body temperature.

If a person exhibits similar symptoms, this means that it is necessary to treat the internal organs. You should immediately consult a doctor who will conduct a blood test to determine total bilirubin and prescribe treatment. If the total level of the substance is very high, this indicates that there are some reasons for the development of the disease that need to be treated.

In some cases, the critical level of bilirubin can increase to 300 units, which is dangerous to health and requires immediate treatment. Typically, levels of 300 µmol/liter can be observed in infants; doctors call this phenomenon infantile jaundice, which goes away after a few days.

Based on the symptoms, the doctor will order a blood test to determine the level of bilirubin. An analysis for total elevated bilirubin is usually done in the morning on an empty stomach.

Before taking the test, you should not drink for four hours. If you follow all the rules, accurate research results will be obtained.

Reasons for increased bilirubin

The reason for the increase in bilirubin in the blood can be caused by diseases of the liver and circulatory system. There are several options for why the concentration of a substance in the body is disrupted.

As a result of congenital or acquired anemia, the process of destruction of red blood cells in the blood accelerates in the human body, which leads to an increase in bilirubin levels. The disorder develops due to increased accumulation of this substance. At the same time, as a result of anemia, indirect bilirubin increases.
Another reason is associated with impaired production of direct bilirubin in the liver. This can be caused by such well-known diseases as hepatitis, cirrhosis, cancer and other types of diseases. The reasons for increased bilirubin levels may also be hereditary. For example, the disease Gilbert's syndrome leads to disruption of the production of liver enzymes.
The third reason may lie in problems with the gallbladder. Due to a violation of the outflow of bile from the choleretic bladder, the level of bilirubin in the body often increases.
The reasons may also be related to taking any medications. This means that before starting treatment, you must be sure to familiarize yourself with the contraindications that are prescribed in the instructions.
Often the cause of increased bilirubin is infection of the body with helminths. When helminthiasis is detected, the first thing you must do is undergo the necessary treatment, then take a blood test and re-check your bilirubin levels.
With a deficiency of vitamin B12, bilirubin levels may also increase. This means that before treating with medications, you need to replenish the body with missing nutrients.

Decreased bilirubin levels in the blood

Before starting treatment, it is necessary to find out the cause of the disease. The techniques available in modern medicine make it possible to treat the disorder based on the prescribed indications. For this reason, only a doctor can prescribe lowering bilirubin levels.

With the help of infusion therapy, glucose and detoxification medications are infused intravenously.

This treatment allows you to cleanse the body of increased amounts of bilirubin. This method is used if the patient has a serious condition.

Phototherapy is used to reduce bilirubin levels not only in adults, but also in infants. The method involves irradiating the patient using special lamps, under the influence of which indirect bilirubin is converted into a direct form, after which it can easily leave the body.

If the reason for the increase in bilirubin lies in a violation of the excretion of bile from the body, the doctor prescribes appropriate treatment with special medications. First of all this.

A therapeutic diet is also great for lowering the concentration of bilirubin in the blood. Additionally, treatment is accompanied by the use of activated carbon, cleansing medications and detoxifying gels. Fatty, fried, spicy foods and carbonated drinks are also excluded from the patient’s diet.

If a patient is diagnosed with hepatitis, the first thing the patient is prescribed is treatment for this disease, which in turn reduces bilirubin. The doctor also prescribes medications to protect the liver.

For Gilbert's syndrome and some liver diseases, Phenobarbital is prescribed.

To avoid complications, treatment and medications should be prescribed by a doctor after examination and testing.

Diseases with high bilirubin levels

Direct bilirubin increases due to the following reasons:

Increased bilirubin in the blood;
Acute hepatitis A, B, hepatitis with infectious mononucleosis;
Chronic hepatitis C, autoimmune hepatitis;
Brucellosis and leptospirosis bacterial hepatitis;
Poisoning with toxic substances or mushrooms;
Use of hormonal contraceptives, NSAIDs, drugs against tuberculosis and tumors;
Jaundice during pregnancy;
Liver tumor;
Biliary cirrhosis;
Hereditary jaundice - Rotor, Dabin-Johnson syndrome.

Indirect bilirubin increases in the blood due to the following factors:

Congenital hemolytic anemia, including spherocytic, non-spherocytic, sickle cell disease, thalassemia, Marchiafava-Michele disease;
Acquired hemolytic anemia, which develops against the background of systemic lupus erythematosus, rheumatoid arthritis, lymphocytic leukemia, lymphogranulomatosis.
Sepsis, typhoid fever, malaria and other infectious diseases;
Drug-induced hemolytic anemia caused by taking insulin, cephalosporins, aspirin, NSAIDs, chloramphenicol, penicillin, levofloxacin;
Toxic hemolytic anemia caused by poisoning with a toxic substance, mushrooms, arsenic, copper sulfate, and poisonous insect bites.
Gilbert, Crigler-Najjar, Lucy-Driscoll syndromes.

Age	Norm of total pigment in µmol/l
From 18 to 19 years old	From 3.5 to 17
From 20 to 29 years old	From 4 to 18
From 30 to 39 years old	From 3.8 to 17.8
From 40 to 49 years old	From 3.9 to 17.6
From 50 to 59 years old	From 3.7 to 17.4
From 60 to 69 years old	From 3.4 to 17.1
Over 70 years old	From 3.1 to 16.9