Some bilirubin is bound to a certain protein (albumin) in the blood. This type of bilirubin is called unconjugated, or indirect, bilirubin. In the liver, bilirubin is changed into a form that your body can get rid of. This is called conjugated bilirubin or direct bilirubin.

In one of the worst jaundice outbreaks in more than 65 years, 10 people died and thousands developed jaundice due to the supply of drinking water contaminated with Hepatitis E virus. As per reports, this happened due to contamination of a water reservoir with sewage water (4).

Known risk factors of neonatal jaundice include intrauterine retardation27, gestational diabetes28, sepsis27, intrauterine infections29, pregnancy anemia27, and congenital hypothyroidism30. It is known that exposure of pregnant women to environmental tobacco smoke is associated with the risk of neonatal jaundice31–33.

Typically, you’ll get results for direct and total bilirubin. Normal results for a total bilirubin test are 1.2 milligrams per deciliter (mg/dL) for adults and usually 1 mg/dL for those under 18. Normal results for direct bilirubin are generally 0.3 mg/dL.

Quick tips

1. Drink at least eight glasses of fluids per day.
2. Consider adding milk thistle to your routine.
3. Opt for fruits like papaya and mango, which are rich in digestive enzymes.
4. Eat at least 2 1/2 cups of veggies and 2 cups of fruit per day.
5. Look for high-fiber foods, such as oatmeal, berries, and almonds.

An elevation greater than 20 mg/dL suggests severe liver disease. In patients with hepatitis-induced acute liver failure, a serum total bilirubin level > 17.5 mg/dL (300 mmol/L) is a criterion for predicting death and the need for liver transplantation.

In most labs, a normal bilirubin level is less than 1.3 mg/dL. But some healthy people have a level up to 1.9 mg/dL. If your level is 2.0 mg/dL or greater, this is considered hyperbilirubinemia.

Other drugs can also increase bilirubin levels. These include anabolic steroids, some antibiotics, anti-malaria drugs, codeine, diuretics, morphine, oral contraceptives, rifampin and sulfonamides. Drugs that can decrease bilirubin measurements include barbiturates, caffeine and penicillin.

High total bilirubin may be caused by:

• Anemia.
• Cirrhosis.
• A reaction to a blood transfusion.
• Gilbert syndrome — a common, inherited condition in which there is a deficiency of an enzyme that helps to break down bilirubin.
• Viral hepatitis.
• A reaction to drugs.
• Alcoholic liver disease.
• Gallstones.

There are no drugs to specifically treat increased bilirubin levels, unless there is an infection, blockage or tumor. Treatment is aimed at correcting the underlying cause of increased bilirubin levels, and minimizing further damage to your liver, if damage is present.