Bilirubin is high but other liver functions are normal. Should I worry?

Q. Bilirubin is high but other liver functions are normal. Should I worry?

Answered by
Dr. Singh Smrita
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jan 27, 2018 and last reviewed on: Jul 31, 2023

Hello doctor,

I did blood tests and attached are the reports. Are they alright, or do I need to investigate further?



Welcome to

I have reviewed your test results (attachment removed to protect patient identity), and the only abnormality is high direct bilirubin. Higher than normal levels of direct bilirubin in your blood may indicate your liver is not clearing bilirubin properly. The most common causes are cirrhosis, gallbladder disease, Gilbert's syndrome, bile duct cancer or stenosis due to other causes, hepatitis, liver cancer, sickle cell disease, and following chemotherapy. You will need further tests, including imaging tests, to evaluate your bile duct and the liver to come to a diagnosis.

Hello doctor,

Thank you for the answer. I was told by the doctor here that because my other liver functions are normal, it is nothing to be worried about. It could be Gilbert's syndrome. Is that correct?



Welcome back to

Yes, that is possible since your indirect bilirubin is much higher than the direct bilirubin levels and your other liver function tests. Your complete blood count and reticulocyte count are absolutely normal, and you do not have any other disease process. The normal hematology results rule out the possibility of sickle cell disease or other hemolytic anemia, which can cause high indirect bilirubin levels. Thank you.

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