Elevated Total Bilirubin and Protein Levels: Next Steps

Health check: Total bilirubin and total protein levels are elevated?

Dear Dr.
Chen,
Hello! During this year's health check-up, there were two abnormalities: total bilirubin at 1.4 mg/dL and total protein at 8.1 g/dL.
I would like to know if this is very serious and what further tests I should undergo.
Thank you for your hard work!

Annie, 30~39 year old female. Ask Date: 2016/11/10

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
You only need to follow up in 3 months for comparison.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/11/10

More Info

Dear Patient,
Thank you for reaching out regarding your recent health check-up results. I understand that you have concerns about your elevated total bilirubin level of 1.4 mg/dL and total protein level of 8.1 g/dL. Let’s break down what these results mean and discuss the next steps you should consider.

Understanding Total Bilirubin
Total bilirubin is a substance produced during the normal breakdown of red blood cells. It is processed by the liver, where it is conjugated (made water-soluble) and then excreted into the bile. Normal total bilirubin levels typically range from 0.1 to 1.2 mg/dL, so your level of 1.4 mg/dL is slightly elevated.
Elevated bilirubin levels can indicate several conditions, including:
1. Liver Dysfunction: Conditions such as hepatitis, cirrhosis, or liver tumors can impair the liver's ability to process bilirubin.

2. Hemolysis: Increased breakdown of red blood cells can lead to higher bilirubin levels.

3. Bile Duct Obstruction: Conditions like gallstones or tumors can block the bile ducts, preventing bilirubin from being excreted.

Understanding Total Protein
Total protein measures the amount of protein in your blood, including albumin and globulins. Normal total protein levels typically range from 6.0 to 8.3 g/dL. Your level of 8.1 g/dL is within the normal range, but it is on the higher end. Elevated total protein levels can be due to:
1. Dehydration: This can concentrate proteins in the blood.

2. Chronic Inflammation or Infection: Conditions such as chronic inflammatory diseases or infections can lead to increased production of immunoglobulins.

3. Multiple Myeloma: A type of cancer that affects plasma cells can cause elevated protein levels, particularly if there is an increase in specific types of proteins.

Next Steps
Given your elevated total bilirubin and normal total protein levels, it is important to follow up with additional testing to determine the underlying cause of the bilirubin elevation. Here are some recommended next steps:
1. Liver Function Tests: These tests measure enzymes (such as ALT, AST, ALP) that indicate how well your liver is functioning. They can help identify liver damage or disease.

2. Complete Blood Count (CBC): This test can help assess for hemolysis by checking your red blood cell count, hemoglobin, and hematocrit levels.

3. Ultrasound of the Abdomen: An ultrasound can help visualize the liver and biliary system to check for any obstructions or abnormalities.

4. Additional Bilirubin Tests: A breakdown of direct (conjugated) and indirect (unconjugated) bilirubin can provide more insight into the cause of the elevation.

Conclusion
While your total bilirubin level is slightly elevated, it is essential to conduct further evaluations to understand the cause and determine if any treatment is necessary. I recommend scheduling an appointment with your healthcare provider to discuss these results and the next steps in detail. They will be able to provide personalized advice based on your overall health and medical history.

Thank you for your inquiry, and I wish you the best in your health journey. Please feel free to reach out if you have any further questions or concerns.

Best regards,
Doctor Q&A Teams

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