Bilirubin....

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With all this said, I bet it is your liver processing the venom and the meds you

had in the hospital

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Bilirubin

Test Overview

A bilirubin test measures the amount of bilirubin in a blood sample. Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool (feces) and gives stool its normal brown color.

Bilirubin circulates in the bloodstream in two forms:

Indirect (or unconjugated) bilirubin. This form of bilirubin does not dissolve in water (it is insoluble). Indirect bilirubin travels through the bloodstream to the liver, where it is changed into a soluble form (direct or conjugated).

Direct (or conjugated) bilirubin. Direct bilirubin dissolves in water (it is soluble) and is made by the liver from indirect bilirubin. Total bilirubin and direct bilirubin levels are measured directly in the blood, whereas indirect bilirubin levels are derived from the total and direct bilirubin measurements.

When bilirubin levels are high, the skin and whites of the eyes may appear yellow (jaundice). Jaundice may be caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the tubes (bile ducts) that allow bile to pass from the liver to the small intestine.

Too much bilirubin (hyperbilirubinemia) in a newborn baby can cause brain damage (kernicterus), hearing loss, problems with the muscles that move the eye, physical abnormalities, and even death. Therefore, some babies who develop jaundice may be treated with special lights (phototherapy ) or a blood transfusion to lower their bilirubin levels.

In a newborn baby, the blood sample is usually taken from the heel (heel stick).

Why It Is Done

The bilirubin test is used to:

Check liver function and watch for signs of liver disease, such as hepatitis or cirrhosis, or the effects of medicines that can damage the liver. Find out if something is blocking the bile ducts. This may occur if gallstones, tumors of the pancreas, or other conditions are present. Diagnose conditions that cause increased destruction of red blood cells, such as hemolytic anemia or hemolytic disease of the newborn. Help make decisions about whether newborn babies with neonatal jaundice need treatment. These babies may need treatment with special lights, called phototherapy. In rare cases, blood transfusions may be needed.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful (except in newborns) include: Caffeine, which can lower bilirubin levels.

Not eating for a long period (fasting), which normally increases indirect bilirubin levels.

What To Think About

A common cause of aundice in newborns is a condition called physiologic jaundice. It occurs in healthy babies when they are 1 to 3 days old for several reasons, including the increased breakdown of red blood cells right after birth. It usually disappears on its own within a week without causing problems. However,

in some cases, a baby with physiologic jaundice may need treatment with special lights (phototherapy) to prevent serious problems. Bilirubin can be measured in amniotic fluid if your doctor thinks that your unborn baby may have a condition that destroys red blood cells (erythroblastosis fetalis). For more information, see the medical test Amniocentesis. Bilirubin may also be measured in the urine. Normally urine does not contain any bilirubin. If bilirubin is detected in urine, additional testing may be needed to determine the cause. High amounts of bilirubin in urine may indicate that the bilirubin is not being removed from the body by the liver. Using a transcutaneous bilirubin test, doctors can screen all newborns for jaundice. They place a device gently against the skin to check bilirubin levels before a baby goes home from the hospital.

Results

A bilirubin test measures the amount of bilirubin in a blood sample. The results are usually available in 1 to 2 hours. Normal adult values Normal values may vary from lab to lab.

Bilirubin levels in adults

Bilirubin type Bilirubin level

Total bilirubin 0.3–1.0 mg/dL or 5.1–17.0 mmol/L

Direct bilirubin 0.1–0.3 mg/dL or 1.7–5.1 mmol/L

Indirect bilirubin (total bilirubin level minus direct bilirubin level) 0.2–0.8 mg/dL or 3.4–12.0 mmol/L

High values

High levels of bilirubin in the blood may be caused by:

Some infections, such as an infected gallbladder, or cholecystitis.

Some inherited diseases, such as Gilbert's syndrome, a condition that affects how the liver processes bilirubin. Although jaundice may occur in some people with Gilbert's syndrome, the condition is not harmful.

Diseases that cause liver damage, such as hepatitis, cirrhosis, or mononucleosis.

Diseases that cause blockage of the bile ducts, such as gallstones or cancer of the pancreas. Rapid destruction of red blood cells in the blood, such as from sickle cell disease or an allergic reaction to blood received during a transfusion (called a transfusion reaction).

Medicines that may increase bilirubin levels. This includes many antibiotics, some types of birth control pills, indomethacin (Indocin), phenytoin (Dilantin), diazepam (Valium), and flurazepam (Dalmane).

Low values Low levels of bilirubin in the blood may be caused by:

Medicines that may decrease bilirubin levels. This includes vitamin C (ascorbic acid), phenobarbital, and theophylline (Elixophyllin). Normal values in newborns Normal values in newborns depend on the age of the baby in hours and whether the baby was premature or full term. Normal values may vary from lab to lab. Total bilirubin levels in newborns less than 7 days old

Age Premature baby Full-term baby

Less than 24 hours Less than 8.0 mg/dL or less than 137 mmol/L Less than 6.0 mg/dL or less than 103mmol/L

Less than 48 hours Less than 12.0 mg/dL or less than 205 mmol/L Less than 10.0 mg/dL or less than 170 mmol/L 3 to 5 days Less than 15.0 mg/dL or less than 256 mmol/L Less than 12.0 mg/dL or less than 205 mmol/L 7 days or older Less than 15.0 mg/dL or less than 256 mmol/L Less than 10.0 mg/dL or less than 170mmol/L

Bilirubin levels that may require treatment in a full-term, healthy baby Baby's age Bilirubin level

24 hours or younger: More than 10mg/dL or more than 170 mmol/L 25 to 48 hours: More than 15 mg/dL or more than 255 mmol/L 49 to 72 hours: More than 18 mg/dL or more than 305 mmol/L Older than 72 hours: More than 20 mg/dL or more than 340 mmol/L

Note: A premature or sick baby with bilirubin levels lower than those listed above may need treatment. A premature baby's liver is immature and may not be able to break down bilirubin properly in the blood. This is one of the reasons premature babies are more likely than full-term babies to develop jaundice.

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