What Causes Increased Bilirubin?

Increased bilirubin levels in the blood, a condition known as hyperbilirubinemia, can be caused by various factors. Bilirubin is a yellow pigment produced during the breakdown of hemoglobin from red blood cells. It is normally processed by the liver and excreted in the bile. Elevated bilirubin levels may indicate an issue with the liver’s ability to process or excrete bilirubin or an increased breakdown of red blood cells. Common causes of increased bilirubin include:

  • Hemolysis: Hemolysis is the breakdown of red blood cells, which can occur due to various conditions, including hereditary disorders like sickle cell anemia, autoimmune diseases, or infections. Increased bilirubin levels are a result of the excess breakdown of hemoglobin.
  • Liver diseases: Liver diseases, such as hepatitis, cirrhosis, and alcoholic liver disease, can impair the liver’s ability to process bilirubin effectively, leading to elevated levels.
  • Gilbert’s syndrome: Gilbert’s syndrome is a benign genetic condition in which the liver has a reduced ability to process bilirubin. It often leads to mild, intermittent increases in bilirubin levels without any other symptoms.
  • Dubin-Johnson syndrome and Rotor syndrome: These are rare inherited conditions that affect bilirubin metabolism and transport within the liver, leading to increased bilirubin levels.
  • Biliary obstruction: Blockages or obstructions in the bile ducts, which can be caused by gallstones, tumors, or strictures, can prevent bilirubin from being properly excreted, leading to elevated levels.
  • Medications: Certain medications, such as some antibiotics, antimalarials, and nonsteroidal anti-inflammatory drugs (NSAIDs), can interfere with bilirubin metabolism, resulting in increased bilirubin levels.
  • Newborn jaundice: Many newborns experience elevated bilirubin levels in the first few days of life due to the normal breakdown of fetal red blood cells. This is typically harmless and referred to as physiologic jaundice. In some cases, however, it may require treatment.
  • Hemolytic anemia: Hemolytic anemias are a group of conditions characterized by the premature destruction of red blood cells, leading to an increase in bilirubin levels. Examples include thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Crigler-Najjar syndrome: This is a rare genetic disorder that impairs the liver’s ability to process bilirubin, leading to extremely high levels of unconjugated bilirubin, which can be toxic.
  • Physiologic jaundice: This is common in newborns due to an immature liver. It usually resolves on its own but may require treatment in severe cases.

The underlying cause of elevated bilirubin levels will determine the appropriate treatment and management. If you have concerns about your bilirubin levels or experience symptoms such as jaundice (yellowing of the skin and eyes), it’s essential to consult with a healthcare professional for a proper evaluation and diagnosis.