Jaundice: Causes, symptoms, and treatments
What Causes High Bilirubin Levels?
The body produces bilirubin when it breaks down red blood cells, and the liver helps excrete it. High bilirubin levels in adults can result from liver disease, pancreatitis, some cancers, and other health problems.
Elevated bilirubin can lead to jaundice, which causes yellowing of the skin and eyes. High bilirubin levels can occur in adults and newborns.
In adults, jaundice is usually caused by a medical condition. This is called pathologic jaundice and is more severe. In 75% of jaundice cases in newborns, the cause is physiologic or non-pathologic.
The skin normally becomes yellow once levels reach over 3 mg/dL. Any person who experiences yellowing of the skin or eyes should see a doctor. It may be a sign of a serious condition.
This article defines bilirubin and examines the causes of elevated bilirubin levels in adults and newborns. It also looks at the symptoms and treatment options for high bilirubin levels.
The breakdown of red blood cells (RBCs) in the body produces bilirubin.
The RBCs have a lifespan of around 120 days, and they renew continually. RBCs contain hemoglobin, which helps transport oxygen around the body.
The process of removing iron from each cell's hemoglobin helps the cells break down into bilirubin and other substances.
Bilirubin is transported to the liver by albumin, a simple protein. Liver cells absorb bilirubin, which then undergoes several chemical processes.
Once in the liver, bilirubin becomes "conjugated." This means it is water-soluble, and the body can excrete it. The body ultimately expels bilirubin through stool. Bilirubin is brown and yellow, and it is this pigment that makes feces brown.
Unconjugated bilirubin is toxic. Conjugated bilirubin is usually not because it can come out of the body as long as nothing interferes with its removal.
High levels of bilirubin in the blood is known as hyperbilirubinemia. Elevated bilirubin levels can cause jaundice. Jaundice makes the skin and the whites of the eyes appear yellow, due to the brown and yellow bilirubin in the blood.
A doctor can usually detect a person's bilirubin levels through a blood test. In adults, the approximate normal range of bilirubin in the blood is less than 1.0 milligram per deciliter (mg/dL).
Several conditions can cause high bilirubin levels before reaching the liver, after leaving the liver, or within the liver itself.
Before reaching the liverSome conditions cause elevated bilirubin levels before it reaches the liver.
This is the pre-hepatic or the "pre-liver" phase. The cause is hemolytic anemia and the reabsorption of internal pools of blood by the body.
Hemolytic anemia occurs when too many red blood cells break down before their natural life cycle ends.
In the liverIf the liver is not working as it should, it may be unable to make bilirubin water-soluble. This may result in too much bilirubin building up in the liver.
Causes for this include:
After leaving the liverOnce bilirubin has left the liver, in the "post-hepatic phase," its levels may be elevated because it is unable to leave the body.
This may result from a blockage in one of the other organs that assist excretion, such as from gallstones in the gallbladder.
Other causes may include inflammation or cancer of the gallbladder, which produces bile, or pancreatitis.
Gilbert's syndromeGilbert's syndrome is a mild form of high bilirubin. The levels go up and down because Gilbert's syndrome slows down the process of removing it from the body.
The fluctuation is rarely enough to cause the skin to yellow, but some people may experience symptoms such as stomach pain or fatigue.
Doctors estimate that about 1 in 3 people with Gilbert's syndrome do not experience any symptoms at all. In fact, doctors often discover the condition with a blood test performed for some other reason.
There is a gene linked to Gilbert's syndrome that shows family patterns of heredity. This gene codes for an enzyme that enables the liver to convert bilirubin to its conjugated form. The absence of this gene in Gilbert's syndrome means that this enzyme does not work.
Newborns with elevated levels of bilirubin have a condition that doctors call neonatal hyperbilirubinemia or jaundice in neonates.
A doctor generally considers anything above these values to be elevated:
According to a 2023 overview of research, approximately 50% of full-term infants and 80% of preterm infants have visible jaundice in the first 2–4 days after birth if their serum bilirubin levels are at or above 5 mg/dL.
In adults, bacteria in the gut break down the conjugated bilirubin to create a by-product called urobilinogen, some of which is excreted by the kidneys as urobilin. The urobilin is also what gives urine its yellow color.
In neonates, the liver takes several days to start adequately processing bilirubin. Neonatal jaundice occurs when the liver is not quite ready to process the bilirubin, and the accumulation in the blood causes certain tissues to look yellow.
Are elevated bilirubin levels in newborns a cause for concern?The seriousness and medical significance of elevated bilirubin will depend on the cause. The infant's age, as well as whether they were born premature, is also a factor.
Doctors need to distinguish whether the cause is pathologic or non-pathologic. Doctors consider jaundice in newborns to be pathologic if:
For premature infants, the earlier the delivery occurs in the gestation period, the lower the threshold at which health professionals consider bilirubin levels to be excessive.
High bilirubin levels can be toxic to the nervous system and cause brain damage. However, most jaundice in infants is not severe, and the symptoms resolve naturally.
Prolonged jaundice is more common in infants who are breastfeeding or chestfeeding or breastfeeding. This type of jaundice is usually not harmful but requires close monitoring. The neonatal doctor might recommend seeing a lactation consultant, among other treatments if they diagnose jaundice.
Some infants receive phototherapy, where a physician exposes the baby to a special kind of blue-green light. This is a standard treatment in which the light converts the bilirubin to a different form that the liver and kidneys can remove.
High levels of bilirubin in the blood can cause jaundice, which may cause symptoms such as:
Because an underlying condition, such as liver disease or hemolytic anemia, may cause high bilirubin levels, a person may also experience other symptoms, including:
Blood tests can measure bilirubin levels.
In adults, a healthcare professional will collect a blood sample via a needle from a vein in the arm.
A healthcare professional will collect a blood sample in newborns via a heel-prick. In some cases, they may instead place a device called a transcutaneous bilirubin meter on the skin. However, this may still need to be followed up with a blood test.
A doctor will often request a bilirubin blood test alongside other laboratory tests to assess the function of the liver.
Other tests may include:
Treatment depends on the underlying cause of the high bilirubin. If the cause is known, a person might remove bilirubin through treatment or lifestyle changes, such as avoiding alcohol.
Infants may need phototherapy, which helps the liver break down bilirubin using a special type of blue-green light, to treat their high bilirubin levels.
An exchange transfusion may also be necessary to remove the blood through a thin plastic tube and replace it with blood from a suitable donor.
Here are some common questions about high bilirubin levels.
Is high bilirubin life threatening?High levels of bilirubin are often a symptom of another underlying health condition, which can range in terms of severity and prognosis.
In infants, high levels of bilirubin in the blood can lead to serious complications if left untreated, including kernicterus, a condition that can lead to brain damage, intellectual disabilities, and issues with hearing or vision.
Who is at a higher risk for elevated bilirubin levels?According to a 2023 review, newborns and older adults are at a higher risk for developing jaundice caused by elevated bilirubin levels. However, the prevalence of specific causes of elevated bilirubin can also vary depending on several factors, including age and sex.
What does it mean to have elevated bilirubin with normal liver enzymes?If a person has normal levels of liver enzymes, it may mean that there is another condition contributing to the elevated bilirubin levels besides liver disease.
However, keep in mind that a person can still have liver damage with normal liver enzyme levels, so it is best to talk with a medical professional to determine the cause and best course of treatment.
When the RBCs break down, they produce bilirubin. Usually, the body removes excess levels of bilirubin via stool and urine. However, elevated bilirubin levels can occur when it is unable to leave the body.
This can happen due to a variety of medical conditions, such as liver disease, pancreatitis, and other health problems.
Doctors usually request blood tests to test for elevated bilirubin levels, and the treatment a person requires will depend on the underlying cause.
Experts Reveal 20 Baby Names Soaring In Popularity To Watch Out For In 2024
Naming a child is one of the first important decisions parents have to make, and to help them along, a baby name expert has shared some of the monikers soaring in popularity this year and beyond
Naming your baby is one of the first hard decision you have to make as a parent (stock image) (Image: Getty Images)
If your baby is due in 2024 and you still haven't thought of a name, fear not, because an expert has shared some of the monikers currently soaring in popularity.
Naming your child is one of the hardest decisions you have to make when you're expecting. It not only has to be a name you and your partner agree on, but it should be one that the baby will like when they are older. You might want it to be something sentimental, and might even want to take into consideration the opinion of your family.
According to a study from JoJo Maman Bébé, as many as half (51%) of British parents have had a hard time choosing a name for their child. So if you're one of those struggling to think of a fitting moniker, it might be helpful to look at some of the baby names that have been soaring in popularity in 2023, and will no doubt be ones to look out for in the coming year.
Baby name consultant Colleen Slagen has looked at some of the names rising in popularity this year. For boys, parents have increasingly used the names Rhodes, Cal (Callan, Callum, Calvin and Cal), Lucien, Dutton, Casey, August, Wells, Sonny, Arlo and Alden. For girls, the names Collins, Maeve, Margot, Phoebe, Poppy, Goldie, Sunday, Esti, Indie and Frankie have surged in popularly.
In addition to these, parents can't go wrong with a vintage baby name, as they often come back in the trends - such as Betty. Colleen explained: "These older names appeal to parents who are searching for timeless charm. They also feel both unique and familiar, which is something a lot of parents are seeking in a name. They want their child's name to both standout and fit in. They want a name that feels sweet but ages well and older names check all these boxes."
Colleen also explained that she is seeing a "variety of trends which reflect the name diversity of the newest generations". She added: "Trends that are only getting hotter include nature names such as Willow and River or nicknames as given names such as Archie or Sam. Names with traditional and modern elements, for example, surnames such as Finley and Addison are having a huge moment."
The baby name expert added that "virtue names" or "grace names" is another trend that parents are favouring. Colleen explained that these are "names which express cultural values such as Faith, Chastity or Grace". She continued: "The recent trend of cottage-core which romanticises rural life has impacted name trends, with cottage-core names such as Autumn and Cedar on the rise."
In particular, two names she think will be really popular in 2024 are August and Margot. Colleen also thinks gender-neutral names such as Tatum will be ones to watch in 2024. She explained: "Both ultra-feminine names and masculine names for girls are rising with the emergence of bold feminism. Many parents want to pick a versatile name that will fit their child's persona no matter who they turn out to be, whether that's a name that is considered gender-neutral (Tatum) or a name with a nickname that has a very different vibe than the given name, like Frances to Frankie for a girl."
Many parents look to TV shows to draw inspiration when it comes to naming their babies, and it seems like 2023 is no different. Colleen explained: "TV shows often impact naming trends as it's a great place to find name inspiration through a beloved character, and often a place to discover fresh/unique names. Hearing the unique name of a TV character adds an element of familiarity that helps the name feel wearable and accessible to the average person. We are seeing this with the show Yellowstone having a huge influence on cowboy names like Dutton and Kayce."
Do you have a story to share? You can email ariane.Sohrabishiraz@reachplc.Co.Uk
The 20 Most Adorable Greek Baby Names
From delicious salad to epic mythology, we owe a lot to Greece. And don't even get us started on gyros…but instead of naming our child tzatziki (although, it does kinda have a nice flavor—er—ring to it), we discovered 20 Greek baby names that are worthy of your future offspring. Here, the cutest ones to add to your list.
100 Uncommon Baby Names to Help Your Child Stand Out from the Crowd
1. AthenaTwenty20
Athena is the Goddess of Wisdom in Greek mythology. Give this one to your baby girl and she's sure to be a child prodigy.
2. KostasTwenty20
Fans of Sisterhood of the Traveling Pants will recognize this name from the movie. (Hint: He was a total heartthrob.) That said, Kostas dates way back as a Greek given name with a meaning of "steadfast."
3. CalistaTwenty20
This melodic feminine name of Greek and Latin origin has ties to a mythological Arcadian with the power to transform into a she-bear. It means "the most beautiful."
4. AchillesTwenty20
A mythological Trojan war hero from Homer's Iliad whose name means "pain." (And let's just say, stay off his heel.)
5. ThaliaTwenty20
In Greek mythology, Thalia is one of the Three Graces and the muse of comedy. Give this one to a little girl and there will never be a dull moment.
6. NikosTwenty20
Originally a nickname derived from the Greek given name Nikolaos, Nikos has evolved to be a standalone masculine moniker. It has a vibe that's both traditional and unique, plus a fierce meaning of "victory of the people."
7. HeraTwenty20
In Greek mythology, Hera is the Goddess of marriage, protector of women in childbirth and queen of the Olympian gods. Yep, the future is most definitely female.
8. TheodoraTwenty20
This melodic feminine moniker can be traced back to ancient Mycenaean Greek. It means "God's gift."
9. KristosTwenty20
A decidedly fresher and more unique version of the Greek name Christopher with the same meaning: "bearer of Christ."
10. ClioTwenty20
This gender-neutral name is well-suited to a future academic or musician, given that it is the name of the muse of history and lyre playing in Greek mythology.
11. AriadneTwenty20
A Cretan princess in Greek mythology whose name boasts a lofty meaning of "most holy" and a super cute nickname of Ari to boot.
12. IsidoreTwenty20
This masculine moniker is derived from a Greek given name that means "gift of Isis," which is a badass reference to the Ancient Egyptian Goddess of Healing. Plus, how cute is the nickname Izzy?
13. ParisTwenty20
Here, a gender-neutral place name with a classy feel, ties to a prince from Greek mythology and a meaning of "the lover."
14. DimitriosTwenty20
"Earth-lover" is the meaning of this sturdy sounding masculine name, which also implies being a "follower of Demeter" (i.E., the Greek goddess of agriculture). We see a green thumb in your boy's future.
15. HerculesYifei Fang/Getty Images
Probably the best known figure from Greek mythology, Hercules is a famed demi-god and fearless warrior who went from zero to hero, just like that. (It's all in the Disney movie, friends.)
16. Penelopeeverste/Getty Images
Or Penny for short—this classic feminine name meaning "weaver" comes from Homer's epic poem The Odyssey. (It's also seriously fun to say.)
17. Rheati-ja/Getty Images
This gentle feminine name of Greek origin means "flowing river" and boasts powerful associations with motherhood and family.
18. Daphnerecep-bg/Getty Images
Daphne is a perky feminine moniker with Greek origins, ties to a mythological nymph and a lovely botanical meaning of "laurel tree."
19. Ajaxevgenyatamanenko/Getty Images
The fierce sound of this masculine moniker meaning "eagle" matches its Greek history as the name of a famous Trojan war hero from Homer's Iliad. We're getting too-cool-for-school vibes here.
20. OrionPekic/Getty Images
A given name of Greek origins and a famous constellation, this masculine moniker means "rising in the sky." (Makes sense, right?)
105 Irish Baby Names That We're Totally Going to Steal
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