I Have Low Bilirubin: What Does This Mean?
Medically reviewed by Steffini Stalos, DO
In most cases, low bilirubin levels are not a reason for concern. The problem does not cause symptoms. In fact, how low your bilirubin count is may remain unknown until it appears on a blood test for another reason.
Bilirubin is a yellow byproduct of the breakdown of aged red blood cells. It is a major part of bile, a fluid produced in your liver. After it breaks down, bilirubin travels through your bloodstream until it is excreted.
While having high bilirubin can be a sign of liver disease and other health problems, low levels rarely pose an urgent danger. There may be gains to raising levels to normal ranges. Research shows that having normal levels may provide some benefits against the risks of certain diseases.
This article defines low bilirubin levels, causes, symptoms, and ways to raise levels to normal ranges.
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Causes of Low Bilirubin on Blood Tests
While low bilirubin is not caused by specific medical conditions, it has been identified as a risk factor for some diseases. In some cases, a test result indicating low bilirubin can result from the temporary effects of the following:
Barbiturates
High-dose salicylates
To avoid these effects, you are typically advised to fast for at least four hours before taking a bilirubin blood test.
Low bilirubin levels have also been linked to the following autoimmune and inflammatory conditions:
Studies also indicate a relationship between low bilirubin levels and the following:
Diabetic retinopathy in people with type 2 diabetes
Deep white matter lesions, which indicate a high risk of future impaired cognitive function, in people with low bilirubin
Function of Bilirubin and Normal Levels
Bilirubin is temporarily stored in your gallbladder, where it contributes to food digestion. A healthy liver breaks down bilirubin so it can be removed via urine and stool.
Research on bilirubin indicates that bilirubin functions as a metabolic hormone and an antioxidant before it leaves your body. While low bilirubin levels are often disregarded as a cause of concern, research shows that low bilirubin levels may be relevant to the development of the following diseases:
Fatty liver disease (damage that happens from too much fat in your liver)
Bilirubin levels are measured with a bilirubin blood test. Your healthcare provider can help you interpret your results.
Normal range values can vary based on your age, gender, health history, and other health factors. In addition, different laboratories use slightly different normal value ranges.
Indirect
Indirect (unconjugated) bilirubin is developed during the breakdown of red blood cells. It is water-insoluble and very toxic to your body. Indirect bilirubin must be converted into direct bilirubin so it can be removed from your body in urine or stool.
An average adult range for indirect bilirubin is 0.2 to 0.8 milligrams per deciliter (mg/dL).
Direct
Direct (conjugated) bilirubin is formed when unconjugated bilirubin conjugates (attaches) to glucuronic acid in your liver. Direct bilirubin is water soluble and can be filtered by your kidneys for excretion.
An average adult value for direct bilirubin is 0.0 to 0.3 mg/dL.
Total
Total bilirubin represents a combination of all the bilirubin in your bloodstream. It is a combination of indirect and direct bilirubin levels. An average adult value for total bilirubin normal range is 0.3 to 1.0 mg/dL.
Read Next: Understanding Common Blood Tests and What They Mean
After Low Bilirubin Blood Test: Steps to Treatment
Your healthcare provider can advise you on the best way for you to deal with a low bilirubin blood test based on your condition. Taking the following steps may help increase bilirubin to normal levels and lower your risk of problems like cardiovascular disease, diabetes, stroke, fatty liver disease, and obesity:
Consume more flavonoid-rich fruits and vegetables: Flavonoids provide antioxidant, anticancer, and anti-inflammatory health benefits including an increase in bilirubin levels. Flavonoid-rich foods that help reduce the risk factors of life-shortening diseases include all plant-origin foods, especially the following:
Leafy green vegetables
Onions
Apples
Berries
Cherries
Tea
Grains
Nuts
Wine
Establish and maintain a healthy weight: If you weigh more than average for your height or are experiencing obesity, weight loss has proven to increase serum bilirubin levels. In addition to weight loss, changes in body fat percentage are linked with higher bilirubin in obese people.
Participate in regular exercise: Research indicates that any type of exercise, whether habitual or irregular, can increase total bilirubin levels. However, the intensity of the exercise done can make a difference. There is evidence that training at an intensity of 50% of aerobic capacity raises serum bilirubin levels, while lower training loads have no impact.
Treat low bilirubin with medication: Certain medications can be effective in regulating serum bilirubin levels. These drugs include NSAIDs like aspirin (acetylsalicylic acid) and COX (cyclooxygenase) inhibitors. Drugs for hyperlipidemia like statins, fibrates, and niacin can also impact bilirubin levels.
Learn More: Confused About Your Health? The Answer May Be in Your Blood
Summary
Having low bilirubin levels may not pose a health risk for most people. The problem typically does not cause symptoms or health problems. In some cases, low levels result from the impact of certain drugs on your blood test results.
However, if you are at risk of problems like heart disease or diabetes, you may benefit from raising your low bilirubin levels. This may be done without formal treatment. Making changes to your diet and exercise plans can help increase levels to normal ranges.
Consult with a healthcare provider regarding choosing the best way to deal with low bilirubin levels. Based on factors like your age, gender, and other health issues, they can help you decide how to proceed.
Read the original article on Verywell Health.
