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Hello. 31 year old male here, looking for some feedback. I have pretty severe anxiety, (namely, health anxiety) so I'm kinda freaking out.
I took a blood test 4 1/2 years ago that showed bilirubin levels of 2.0 when the normal range was up to 1.2. All other tests came back normal. I ended up getting an ultrasound which showed nothing abnormal, and my doctor at the time said my "levels are just naturally high", and she didn't seem overly concerned . I was 26 then.
A few weeks ago I went to a new doctor for something unrelated and we did a routine blood test. Everything was completely normal except my total bilirubin again, this time at 2.5 although their normal range now is anything under 2.0. This time, he suggested another blood test to differentiate indirect vs direct bilirubin. He wasn't even concerned about it until I messaged him later asking if there is anything I should be concerned about and he offered to order that test. We had talked about it in his office previously and he wasn't really concerned at all. That was Friday and I just received the results.
Direct bilirubin is 0.7 - normal is 0.5 or less.
Total bilirubin dropped to 2.1 - normal is 2.0 or less.
So at this point in freaking out because he had mentioned Gilbert's and we already kinda figured that's what was causing this, but then I saw the increased direct levels.
Not long after, my doctor messaged me saying that since my bilirubin is mostly unconjugated, it's most likely Gilbert's like he had suggested. He said the next step would be a liver biopsy to figure out exactly what it is, but because all my other liver tests were normal, he's not concerned and doesn't think that's necessary if I'm asymptomatic.
Now I'm confused. From what I've read, Gilbert's would raise indirect bilirubin, not direct bilirubin. My doctor doesn't seem to be concerned with the slightly elevated levels, but if my direct levels were normal, I'd be well within the normal range for total bilirubin to begin with.
I found several of those "ask a doctor websites" with people asking similar questions, even with very similar test results, and none of the doctors seem concerned if the other tests are normal. This is leading me to believe a slightly elevated level isn't really indicative of anything. From what I've read, they're looking for like 50% or more of your total bilirubin to be direct if there was a problem. Mine is 33%. Also, if I just took the normal total bilirubin test today, it would hardly be considered abnormal.
Like I said, I have severe health anxiety so I'm trying to stay calm. My rational brain is telling me it's been elevated for over 4 1/2 years, if it was something serious I'd probably know by know, haha. I'm hoping others can reassure me. Has anyone here had slightly elevated direct bilirubin before?
Thanks for taking the time to read this.
EDIT: After looking into it more, it seems like a slightly elevated direct bilirubin isn't too concerning. I guess they're looking for like 2.0 levels of direct bilirubin is what would be concerning.
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