High Bilirubin (Jaundice): Causes, Symptoms, and Treatment

Our body produces bilirubin naturally. This pigment fulfills important functions but if it is concentrated in excess in the blood it can cause jaundice and other symptoms.

In this article we will analyze what are the causes and symptoms of high bilirubin and what treatments are recommended for this disorder.

What is bilirubin?

Bilirubin is a yellow pigment that is produced as a result of the degeneration of hemoglobin., a protein found in red blood cells that carries oxygen between the lungs and other tissues.

Bilirubin acts mainly as a cellular antioxidant; This reduction in oxidation processes causes cells to wear out less. However, the excessive presence of antioxidants can damage cells.

This pigment is the cause of the color of the bruises and of the feces, when it is eliminated through the bile. It also explains the peculiar skin tone of people with jaundice.

Various beneficial properties are attributed to moderately high bilirubin levels in addition to protection of cells, among which the reduction in the risk of atherosclerosis and other cardiovascular diseases stands out.

types of bilirubin

We can distinguish between two types of bilirubin: direct or conjugated and indirect or unconjugated. The sum of the values ​​of both types is called “total bilirubin”.

Indirect bilirubin is that which has not yet reached the liver, where it will become soluble in water, which will allow us to eliminate it through excretions.

For its part, direct bilirubin is produced in the liver from the indirect. It accumulates in the gallbladder and binds to the bile, through which it will be subsequently eliminated.

normal and high levels

In healthy adults, normal values ​​for total bilirubin are below 1.2 mg/dl. (milligrams per deciliter of blood), approximately.

Indirect bilirubin is concentrated in the blood at about 0.1 to 0.5 mg/dL, while healthy direct bilirubin levels are between 0 and 0.3 mg/dL.

Different diseases can cause a direct or indirect increase in bilirubin levels in our body., causing various symptoms.

Symptoms of hyperbilirubinemia

Bilirubin concentrations greater than 2 or 2.5 mg/dl of blood can cause jaundice, a term that designates yellowish pigmentation of the mucosa, eyes, and skin.

For jaundice to be visible on the skin it is usually necessary for total bilirubin levels to exceed 3 mg/dl, while the white part of the eyes can turn yellowish from 2 mg/dl. Other frequent symptoms are the darkening of the tone of the urine and, conversely, the acquisition of a pale coloration by the feces.

We distinguish between conjugated or direct hyperbilirubinemia and unconjugated or indirect hyperbilirubinemia depending on whether the disease that causes it increases one or the other type of bilirubin.

Causes of high bilirubin

Hyperbilirubinemia is usually caused by diseases of different types, but there are also other causes that may be enough for it to develop, such as chemotherapy and the use of antipsychotic drugs, among others.

Direct hyperbilirubinemia

The most frequent causes of increased levels of conjugated bilirubin are related to liver problems.

• Hepatitis: Damage to liver cells from inflammation can increase direct bilirubin levels.
• Hepatic cirrhosis: diseases such as alcoholism or some viruses can cause liver cells to be replaced by scar tissue; severe cirrhosis causes jaundice.
• Gallstones and tumors in the pancreas they can obstruct the gallbladder, making it difficult to remove bilirubin.
• Dubin Johnson and Rotor syndromes: benign hereditary diseases that have jaundice as the main symptom.

indirect hyperbilirubinemia

Some of the most common causes of unconjugated hyperbilirubinemia are:

• Hemolytic anemia: a disorder that causes red blood cells to break down prematurely, increasing levels of bilirubin and "bad cholesterol."
• Gilbert's syndrome: benign hereditary disease that can cause mild jaundice in periods of stress or if there is general poor health.
• Crigler-Najjar syndrome: A form of inherited jaundice that can cause brain damage in babies born with it.

Treatment

The treatment of jaundice depends on the disease that causes the increase in bilirubin. In general, jaundice is cured by strengthening the liver, since many of its causes are determined by liver disorders.

In cases of obstruction of the gallbladder, a surgical operation is usually required.. The treatment of the rest of the diseases that cause hyperbilirubinemia is normally carried out by means of medicines.

Beyond these assumptions, mild jaundice does not usually require treatment in adults. If it is itchy, it can be reduced by using cholestyramine, a medicine that helps eliminate bilirubin.

In newborn babies, in which high levels of bilirubin are common and these may be somewhat more worrisome, jaundice is treated with exchange transfusion and therapy light

In addition, drink plenty of water, eat fruits and vegetables, and limit your intake of saturated fats and refined sugars are natural methods to reduce the symptoms of high bilirubin.