Bilirubin (T-bil) in the Blood and Jaundice

March 22, 2021

Bilirubin (T-bil) in the Blood and Jaundice

Total bilirubin (T-bil) is one of the blood test items in health checkups and physical examinations. In this article, we talk about this bilirubin.

 

What is bilirubin?

Bilirubin is a yellow pigment that forms when the hemoglobin in red blood cells breaks down. Hemoglobin carries oxygen and carbon dioxide, and old hemoglobin is broken down. What is produced in this process is indirect bilirubin.

In addition to indirect bilirubin, there are two other types of bilirubin: direct bilirubin and indirect bilirubin. Indirect bilirubin is carried with the blood to the liver, where it is further processed to become direct bilirubin, which then enters the bile.


The role of the gall bladder

Bile produced by the liver is stored in the gall bladder, a sac-like organ located under the liver. Here, the bile absorbs excess water and becomes more concentrated. When you eat, the gallbladder catches the information and secretes bile, which flows from the bile duct through the common bile duct into the duodenum to help digest the food.

The reason why the color of your stool is brown no matter what color food you eat is because this digestive process mixes with the bile that contains this yellow pigment, direct bilirubin.


What happens when bilirubin levels are high?

Going back to the blood test here, the bilirubin level is an indication of how much of these bilirubins are in the blood. If this number is high, it means that the bile is not being drained out of the body properly due to inflammation of the gall bladder or gallstones.

In addition, if the liver is not functioning properly, it may not be able to process indirect bilirubin in time, resulting in a high bilirubin level, which may indicate liver dysfunction or cirrhosis. The same thing can also happen if cancer develops around the liver or gall bladder.


This is a little bit of a departure from the blood test, but when the bilirubin level is high, the color of the yellow pigment, bilirubin, appears on the face. In other words, your face becomes yellowish. This is a symptom called jaundice. Jaundice is a symptom of high levels of bilirubin in the blood, and is different from the yellowing of the face caused by eating too many oranges.

For Japanese people who are Asian, jaundice is often difficult to recognize. Therefore, jaundice is judged by looking at the yellowing of the whites of the eyes rather than by looking at the color of the skin. Therefore, in the early stages of jaundice, the yellowing of the eyes is often pointed out by others.

You may also experience symptoms such as yellowish white paper, itchiness, and lethargy. In such cases, it is recommended to visit a medical institution and have an examination. Because jaundice may mean that there is some kind of disease in the area of the liver or gall bladder.


Finally.

The bilirubin level can be high even when the liver is not sick but just tired. This should not be dismissed as mere fatigue. The liver is a very important organ that plays a variety of roles, such as storing energy necessary for life, detoxifying toxic substances that enter the body, storing blood, and producing bile.


The liver is an organ that is susceptible to oxidative stress because it plays a role in detoxifying and decomposing acetaldehyde, a toxic oxidative stress substance that occurs when people drink alcohol.

It is said that by the time subjective symptoms appear, it is too late for the liver. In addition, there is a method of transplantation when the liver is damaged, but it is difficult due to the lack of donors.

Although it is inevitable that you may get sick without knowing it, it is important to take care of your liver on a daily basis to prevent illness. For this reason, please try to have a lifestyle that reduces oxidative stress on a daily basis.