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Apr 2023

All you need to know about high bilirubin levels

Posted By Suborna Fermi Posted on Apr 19, 2023

Nearly everyone knows what jaundice is, but not all of us know about high bilirubin levels. In fact, low bilirubin levels are considered as typical. However, high bilirubin levels may indicate several underlying health conditions, and can lead to jaundice if not treated.

So, what is bilirubin? Bilirubin is basically a brownish-yellow substance in the blood. Red blood cells have an average life expectancy of 120 days, and when they decompose, bilirubin is produced.

As bilirubin can be harmful, this is why our body releases it in small amounts through urine and stool. Bilirubin is also eliminated through bile. Bilirubin may leak into your blood, if your liver is injured and is unable to release bilirubin through bile. This can result in excessive bilirubin in blood, which can lead to jaundice.

High bilirubin levels

The condition of high bilirubin levels is medically known as hyperbilirubinemia. High levels of bilirubin usually indicates an underlying health condition, such as cirrhosis and hepatitis.

High bilirubin level may occur in newborns also, which is called neonatal hyperbilirubinemia. if they fail to eliminate bilirubin during their first few days in life. However, hyperbilirubinemia in newborns is not permanent.

High bilirubin levels in newborns can be harmful to the nervous system. Hyperbilirubinemia in newborns can lead to kernicterus, a disorder that can cause seizure, brain damage and even death.

long-term jaundice is very common in infants who are breastfeeding. Although this type of jaundice is not harmful for infants, it may need close observation.

What are the symptoms of high bilirubin level?

High levels of bilirubin in blood can lead to jaundice, which may cause symptoms including:

  • Yellowing of skin
  • Yellowing in the white of the eyes
  • Itchy skin
  • Pale stool
  • Dark urine

Apart from that, hyperbilirubinemia may also occur due to underlying diseases, such as liver diseases and anemia. These condition may cause symptoms such as:

  • Fever
  • Chills
  • Fatigue
  • Nausea
  • Vomiting
  • Weakness
  • Chest pain
  • Headache
  • Low appetite
  • Unintentional weight loss
  • Stomach ache
  • Bloating

What are the symptoms of high bilirubin levels in babies?

Elevated bilirubin levels in babies may cause symptoms such as:

  • Fussy mood
  • Very low appetite
  • Not waking up easily
  • Not sleeping well
  • Not peeing enough (At least 4 to 6 wet diapers in 24 hours)

As high bilirubin may cause jaundice, with jaundice your baby’s skin and the whites of eyes may look yellowish.

What causes high bilirubin levels?

There are several conditions and reasons that can raise bilirubin levels. The most common causes are discussed below.

Hemolytic anemia:

As we know, bilirubin is produced when the red blood cells break down. With hemolytic anemia, the red blood cells degrade more rapidly. This rapid breakdown of red blood cells can cause high bilirubin levels.

Hemolytic anemia may occur due heredity as well as an autoimmune disorder. The common symptoms of hemolytic anemia may include:

  • Headache
  • Lightheadedness
  • Stomach pain
  • Chest pain
  • Breathing problem
  • Jaundice


Hepatitis is the inflammation of our liver, which is usually caused by a virus. As the liver is inflamed with hepatitis, it cannot properly release bilirubin. Therefore the bilirubin may get up and down due to this liver condition.

Usually hepatitis does not show any symptoms. However, hepatitis with high bilirubin levels may cause fever, weakness, low appetite, stomach ache, nausea, and vomiting.


Prolonged high bilirubin levels may lead to severe liver disease such as Cirrhosis. Cirrhosis is the condition in which liver tissue is scarred due to certain long-term liver diseases, including hepatitis.

Gilbert's Syndrome:

Gilbert’s syndrome is a hereditary liver condition that affects your liver’s ability to process bilirubin. This condition can cause bilirubin buildup in the blood. Gilbert syndrome typically does not show many symptoms, but you may experience minor abdominal pain, nausea, vomiting, diarrhea and jaundice.


Gallstones are a solid mass of bilirubin and cholesterol that may form in the gallbladder. It can develop if your liver is producing too much cholesterol and bilirubin due to a liver disorder. Gallstones can block the gallbladder, which may lead to bilirubin buildup in the blood. Symptoms of gallstones may include fever, abdomen pain, shoulder pain, nausea and vomiting.

Intrahepatic cholestasis:

Intrahepatic cholestasis is a short-term condition that may occur in the third trimester of pregnancy. It slows down or completely stops the bile drainage. This leads to bilirubin buildup in blood.

Intrahepatic cholestasis in pregnancy may cause symptoms, such as jaundice, shoulder pain, nausea, vomiting, itchy hands and feet without any rash.

Bile duct inflammation:

If the bile duct gets blocked or inflamed, bile cannot be completely removed, which can result in bilirubin buildup in blood.

Bile duct inflammation may cause you symptoms, such as fever, nausea, vomiting, weight loss, itchy skin, jaundice, pale stool and dark urine.

What tests are used to detect high bilirubin?

Absolutely no condition can be diagnosed only through symptoms, diagnostic tests are extremely important to diagnose any health concerns.

The doctors usually prefer going for a bilirubin test in order to detect hyperbilirubinemia. However, as liver inflammation may cause high bilirubin levels, your doctor may also recommend a liver function test. A bilirubin test price is very reasonable.

Conjugated bilirubin and unconjugated bilirubin are the two types of bilirubin that will be measured for the test. The measurement of both of these bilirubin levels will help to understand the underlying cause.

For newborn babies, the blood is commonly taken from the heels. However, in some cases, healthcare providers might also collect the blood sample from the umbilical cord.

Besides, for the adults, the blood samples are usually collected from the hands. Remember, the tests for hyperbilirubinemia may require fasting before the test.

In some rare cases, the doctors may also run a urine test. There should not be any bilirubin present in urine. The presence of any bilirubin in urine indicates underlying health conditions.

When should you go to the doctors?

In some cases, high bilirubin levels do not require immediate medical attention. However, if you experience the under mentioned signs then immediately fetch medical help:

  • A fever of 38.3°C 101°F or higher
  • Red-ish or purple-ish skin rash
  • Vomiting blood
  • Intense abdominal ache
  • Black stool
  • Blood in stool
  • Disorientation

High bilirubin level is basically a sign that you may have an underlying health condition. And in most cases, those underlying conditions are not very serious. But, it is important to take care of the condition before it gets worse.