Last updated on 16th Oct 2021 - By Dwayne Michaels

How Abnormal bilirubin affects heart?

Bilirubin is a yellowish substance in your blood and it acts as a natural antioxidant. High bilirubin is a sure indicator of the disease, but emerging research suggests that high levels of this compound may actually help to sustain cardiovascular health.

Blood test

In the absence of liver disease, high levels of total bilirubin confers various health benefits. Studies have also revealed that levels of serum bilirubin are inversely related to risk of certain heart diseases.

Hyperbilirubinemia is a higher-than-normal level of bilirubin in the blood. Mild rises in bilirubin may be caused by:

  • Rotor syndrome: non-itching jaundice, with rise of bilirubin in the patient's serum
  • Hemolysis or increased breakdown of red blood cells
  • Gilbert's syndrome – a genetic disorder of bilirubin metabolism that can result in mild jaundice, found in about 5% of the population
Consult a doctor

Moderate rise in bilirubin may be caused by:

  • Chemotherapy
  • Drugs such as protease inhibitors like Indinavir can also cause disorders of bilirubin metabolism by competitively inhibiting the UGT1A1 enzyme.
  • Pharmaceutical drugs (especially antipsychotic and a wide range of other drugs)
  • Sulfonamides are contraindicated in infants less than 2 months old (exception when used with pyrimethamine in treating toxoplasmosis) as they increase unconjugated bilirubin leading to kernicterus.
  • Hepatitis (levels may be moderate or high)
  • Biliary stricture (benign or malignant)

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Very high levels of bilirubin may be caused by:

  • CriglerNajjar syndrome
  • Dubin–Johnson syndrome
  • Choledocholithiasis (chronic or acute).
  • Neonatal hyperbilirubinemia, where the newborn's liver is not able to properly process the bilirubin causing jaundice
  • Unusually large bile duct obstruction, e.g. stone in common bile duct, tumour obstructing common bile duct etc.
  • Severe liver failure with cirrhosis (e.g. primary biliary cirrhosis)

Urine bilirubin may also be clinically significant. Bilirubin is not normally detectable in the urine of healthy people. If the blood level of conjugated bilirubin becomes elevated, e.g. due to liver disease, excess conjugated bilirubin is excreted in the urine, indicating a pathological process.

Bilirubin is degraded by light. Blood collection tubes containing blood or (especially) serum to be used in bilirubin assays should be protected from illumination. For adults, blood is typically collected by needle from a vein in the arm.

In newborns, blood is often collected from a heel stick, a technique that uses a small, sharp blade to cut the skin on the infant's heel and collect a few drops of blood into a small tube. Non-invasive technology is available in some health care facilities that will measure bilirubin by using an instrument placed on the skin (transcutaneous bilirubin meter)

Some at-home urinalysis kits allow you to measure several parameters, which may include testing for bilirubin in your urine. These kits typically involve collecting a urine sample in a provided cup then dipping a test strip in the cup or using a pipette to add drops of urine to the test strip.

Reference ranges may vary depending on the lab that analyzes your blood sample and sends your results. The American Board of Internal Medicine uses the following reference ranges for adults:

  • Total bilirubin: 0.3–1.0 mg/dL
  • Direct bilirubin: 0.1–0.3 mg/dL
  • Indirect bilirubin: 0.2–0.7 mg/dL

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