Liver problems possibly linked to COVID

[SaltyMeatballs]

My recent blood test results show abnormal Bilirubin levels which could be a sign of liver damage. 

This caught me by surprise because I try my best to keep healthy and I don't drink alcohol. All my other results were mostly in the normal and optimal range.

I suspect that COVID has had an impact on my liver but I could be wrong.

I will be seeing my doctor hopefully this week.

Does anyone else here have or had liver issues lately?

Edited August 26, 2021 by SaltyMeatballs
Mistyped Bilirubin

[Michael569]

By how much was it elevated? What was the level and what was the healthy range? Bilirubin can be elevated for a variety of reasons, on its own it is not a reliable marker enough to indicate liver damage. 

Did you get some of the other enzymes taken? (GGT, AST, ALT, ALP)  What was your CRP? Anything else that was off chart? 

Were your kidney markers elevated? 

[SaltyMeatballs]

1 hour ago, Michael569 said:

By how much was it elevated? What was the level and what was the healthy range? Bilirubin can be elevated for a variety of reasons, on its own it is not a reliable marker enough to indicate liver damage. 

Did you get some of the other enzymes taken? (GGT, AST, ALT, ALP) 

See image attached

1 hour ago, Michael569 said:

 What was your CRP?

This was optimal

1 hour ago, Michael569 said:

Anything else that was off chart? 

Yep, only these two...

Omega-6:omega-3 (AA:EPA) ratio abnormal 13.3:1 

Transferrin saturation slightly high 55%

1 hour ago, Michael569 said:

Were your kidney markers elevated? 

Did not test for this

 

[undeather]

34 minutes ago, SaltyMeatballs said:

See image attached

This was optimal

Yep, only these two...

Omega-6:omega-3 (AA:EPA) ratio abnormal 13.3:1 

Transferrin saturation slightly high 55%

Did not test for this

 

Your liver is fine. ALT (Alanine Transferase) is the main one you are looking at for liver damage assessment. Bilirubin is a secondary marker. 
Your protein levels are normal as well, that means your liver does its job. 

Is this the first time your bilirubin was high? Do you have older reports with normal Bilirubin? 
Iam pretty sure your diagnosis is Gilbert's syndrome, which is super common and NOT dangerous - https://en.wikipedia.org/wiki/Gilbert's_syndrome
43 umol/L is not super high, so dont worry - A tad higher though and your skin/eyes might turn a little yellow. 

Here is what you do now:
1. We need a complete blood count report - The other thing that can cause high bilirubin is a haemolytic process and covid can do that in some very rare cases. 
2. You need an ultrasound of liver, bile ducts, pancreas & spleen
3. To verify the Gilbert's syndrome diagnosis we need direct and indirect bilirubin measurements 
4. A complete iron-status measurement would be nice, just for safety's sake

Take care

Edited August 26, 2021 by undeather

[Michael569]

1 hour ago, SaltyMeatballs said:

Omega-6:omega-3 (AA:EPA) ratio abnormal 13.3:1

It might be helpful to address this at some point. But everything else was professionally addressed in the comment above 

[Corpus]

35 minutes ago, undeather said:

Your liver is fine. ALT (Alanine Transferase) is the main one you are looking at for liver damage assessment. Bilirubin is a secondary marker. 
Your protein levels are normal as well, that means your liver does its job. 

Is this the first time your bilirubin was high? Do you have older reports with normal Bilirubin? 
Iam pretty sure your diagnosis is Gilbert's syndrome, which is super common and NOT dangerous - https://en.wikipedia.org/wiki/Gilbert's_syndrome
43 umol/L is not super high, so dont worry - A tad higher though and your skin/eyes might turn a little yellow. 

Here is what you do now:
1. We need a complete blood count report - The other thing that can cause high bilirubin is a haemolytic process and covid can do that in some very rare cases. 
2. You need an ultrasound of liver, bile ducts, pancreas & spleen
3. To verify the Gilbert's syndrome diagnosis we need direct and indirect bilirubin measurements 
4. A complete iron-status measurement would be nice, just for safety's sake

Take care

I think this is a good answer. However, a clinical exam is necessary before going on to imaging, which, if their are no signs of chronic liver disease, is not typically indicated provided that the raised bilirubin is largely indirect (unconjugated),and  the FBC/reticulocyte count are normal excluding hemolysis. A urine dipstick demonstrating no bilirubin and low levels of urobilinogen also points towards Gilberts. A serum iron level and blood ferritin are necessary to get more details of the raised Transferrin Saturation, and finding out if there is any history of hemochromatosis in the family is necessary. If the iron studies suggest iron overload then an ultrasound would not give you the resolution you would need to establish any liver damage; an MRI would be preferable.

If everything points to Gilberts then repeating the bilirubin level after a period of fasting would cause it to rise further which is effectively diagnostic of Gilberts.

Why were these tests done?    Any symptoms of any nature?

 

 

And it is good to see another medical doctor here. Remember, according to Leo, we are "the worst".  

[undeather]

Quote

And it is good to see another medical doctor here. Remember, according to Leo, we are "the worst".  

Hey friend, great input! 
I didnt realize Leo was hating on us! 

[SaltyMeatballs]

@Michael569 @Corpus @undeather 

Thank you all, I really appreciate your input.

 

On 8/26/2021 at 2:26 PM, Corpus said:

Why were these tests done?    Any symptoms of any nature?

I was feeling fatigue, low energy almost on a daily basis.

On 8/26/2021 at 1:43 PM, undeather said:

4. A complete iron-status measurement would be nice, just for safety's sake

This was in the normal range. Also TIBC, UIBC and Ferritin in the healthy range.