Can complete bed rest and having plenty of fluid help in correcting bilirubin levels?

Q. My 56-year-old mother has a mildly increased bilirubin level. Kindly help.

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Aug 08, 2021

Hi doctor,

I got LFT test done for my mother who is 56-year-old.

Her results show:

1) Bilirubin total is 1.18 mg/dL, range: 0-1 mg/dL.

2) Bilirubin direct is 0.48 mg/dL, range: 0.00-0.25 mg/dL.

3) Lactate dehydrogenase is 500 U/L, range: 230-460 U/L.

Can you please let me know how serious is this and what the remedy is?



Welcome to

I can understand your concern. According to your statement, your mother recently has undergone liver function tests, and some results of liver function have become slightly raised.

Bilirubin (total) level is 1.18 mg/dL where as normal range is 0-1mg/dL, bilirubin (direct) is 0.48 mg/dL and normal range is 0-0.25 mg/dL and LDH (lactate dehydrogenase) is 500 U/L where as normal range is 230-460 U/L. So, all three markers of liver function test are slightly raised.

They are not raised as much that will indicate some serious liver diseases. As your mother is now 55 years, so such type of mildly raised values can be found in investigations reports due to aging. Again, one investigation report does not confirm anything. Investigation reports may vary from laboratory to laboratory and for many other factors.

Your mother can take complete bed rest and plenty of fluids. Do repeat her liver function tests one month later.

I hope this was helpful. Please get back if you have further doubts.

Hi doctor,

Thank you.

She is a pure vegetarian. Can you please suggest what food she should take, more or less? Does the result convey any sort of vitamin deficiency? Should she take any supplements? What can help bring down her levels to normal?

She feels very tired and dizzy most of the time. Do you suggest any other test?

Kindly give your opinion.



Welcome back to

She will avoid spicy, oily, and fatty foods. As she is vegetarian, so she can carry on her food habits. Take complete bed rest and plenty of fluids, and these will help to bring down her levels of liver function tests. Vitamin deficiencies like B complex and iron deficiency may cause raised LDH levels, but without doing the investigations, it cannot be confirmed. She can take Iron and Vitamin B complex enriched foods or supplements daily. As she feels tired and dizzy, so monitor her blood sugar level, blood pressure, oxygen saturation level, etc. Some investigations like CBC (complete blood count), RBS (random blood sugar), thyroid function tests, etc., can be done initially to find out the underlying etiology and then treat them accordingly. I hope this was helpful.

Thank you doctor,

She has done CBC. I am attaching her report here. Her absolute lymphocyte count is high and other levels are borderline. She has itching in her palms and legs with red rashes. Can you please take a look?



Welcome back to

Thank you for joining again. According to her blood reports, her absolute lymphocytes count are 3.42 thou/microliter. The normal range is 1 to 3 thou/microliter which is above the normal range. A count significantly higher than 3000 lymphocytes in a microliter of blood is generally considered to be lymphocytosis in adults. High absolute lymphocyte count or lymphocytosis generally indicates that the body is dealing with an infection like bacterial, viral or fungal, allergies, or other inflammatory conditions. Usually, a temporary increase in absolute lymphocyte count is considered to be a normal effect on the body's immune system.

Lymphocytes help to fight off diseases. So it is quite normal to notice a temporary increase after an Infection. But, occasionally absolute lymphocyte count remains elevated due to serious underlying health conditions like leukemia, lymphoma, carcinoma, or any other type of chronic condition. High lymphocyte count or absolute lymphocytosis may also result from allergies, bacterial infections like tuberculosis, syphilis, or whooping cough, viral infections like hepatitis A, B, or C, infectious mononucleosis, CMV (cytomegalovirus), HIV (human immunodeficiency virus), fungal Infections, hypothyroidism, protozoal infections or parasitic infestations, leukemia, lymphoma, carcinoma and many more.

High lymphocyte count or absolute lymphocytosis can also be caused by any type of allergic reaction in our body like atopy, asthma, allergic rhinitis, worms infestations. According to your statement, your mother has been suffering from itchy rashes in her palms and legs. Lymphocytes play important role in allergic reactions. Mast cells and basophils release a variety of chemical mediators and cytokines which cause allergic reactions. So, your mother's present allergic reactions like itchy rashes may cause high lymphocyte count or absolute lymphocytosis. Your mother can take antihistamines like Fexofenadine or Cetirizine orally and apply mild corticosteroid creams like Hydrocortisone cream on her itchy rashes in the palms and legs. If needed, then oral corticosteroids can also be taken. Take care. In case of any other query ask me.

Thank you doctor,

Thank you for explaining in detail. I could not get Hydrocortisone cream. Can please suggest an alternative? How many times to be applied? She has hypothyroidism and takes 100 mg Thyronorm daily. Her thyroid levels are also normal. I am attaching the report here. Can you please suggest whether she needs any other tests to be done to confirm whether elevated levels of absolute lymphocytes are a serious issue or not? When can we do the next blood test? What should she eat or do to bring down the levels?



Welcome back to

Thank you for joining again. Hydrocortisone cream is available as Efficort Hydrocortisone ointment, Cutisoft cream, Lycor cream, Tendrone lotion, and Hydrocortisone ointment. Use Hydrocortisone topical cream twice daily on her itchy rashes area. According to her thyroid function test reports, all parameters are within the normal range. So, she can continue taking Thyronorm 100 mg. As I have already mentioned, lymphocytosis is temporary and not serious. It may result from allergies or any type of bacterial, viral, or fungal Infections.

Complete bed rest, daily taking of balanced diet, plenty of fluids intake, and taking green leafy vegetables daily help to bring back her lymphocytes count to a normal level. If her itchy rashes persist for a long time, then she needs to do some investigations. At present, she does not need to undergo any investigations. If she wants, then hepatobiliary system ultrasound or MRI (magnetic resonance imaging), skin prick test, and RAST test (radioallergosorbent) can be done. Repeat her CBC (complete blood count) after a month. Take care. In case of any other query ask me.

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