Bilirubin

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Bilirubin

Low Bilirubin Levels

Seasonal Affective Disorder (SAD)

"People suffering from SAD have lower nighttime levels of bilirubin in their blood, writes lead author Dan A. Oren, MD, associate professor of psychiatry at Yale University School of Medicine. His study appears in the current Society of Biological Psychiatry journal"

WebMD: Hunting the Cause of Winter Depression

Increasing Bilirubin Levels

Light Box Daily Light Therapy

"During the mornings, patients had a course of 'light box daily light therapy,' a standard treatment for SAD that consists of one hour under a bright light…At the end of two weeks, the treated patients had significantly higher bilirubin levels than before treatment…The treated patients also showed fewer depressive symptoms than before."

WebMD: Hunting the Cause of Winter Depression

"Bilirubin is known to have a circadian rhythm; levels gradually increase in the blood during the night and decrease during the day."

WebMD: Hunting the Cause of Winter Depression

Elevated Bilirubin Levels

Symptoms

"When your bilirubin is increased, it usually means that there is a problem in your liver or your red blood cells are being destroyed too quickly. When bilirubin is greatly elevated, then a person may appear jaundiced (yellow) in their skin and in the whites of their eyes (sclerae)."

WebMD: Q & A

Common Causes

"High levels of bilirubin in the blood may occur because either too much bilirubin is being produced or not enough bilirubin is being eliminated.

Decreased elimination of bilirubin can be caused by some infections (such as an infected gallbladder, or cholecystitis) or by certain inherited enzyme deficiencies. Gilbert's syndrome, an inherited condition that affects how the liver processes bilirubin, is a common cause of increased blood levels of bilirubin. Although jaundice may occur in some people with Gilbert's syndrome, the condition usually is not harmful.
Decreased elimination of bilirubin may result from liver damage (caused by hepatitis, cirrhosis, or mononucleosis), digestive system problems that result in excessive reabsorption of bilirubin, or blockage of the bile ducts (such as from gallstones or pancreatic cancer).
Because their livers are immature, premature infants may not be able to eliminate bilirubin properly from the blood and are more likely to develop jaundice than full-term babies.
Elevated bilirubin levels may be caused by 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)."

WebMD: Bilirubin Test Overview

Common Causes: Gilbert's Syndrome

Note: Gilbert's syndrome is also referred to as Gilbert syndrome.

"Gilbert's Syndrome is a benign condition."

eMedicine: Gilbert Syndrome

Common Causes: Gilbert's Syndrome: Symptoms

"The syndrome is characterized by intermittent jaundice in the absence of hemolysis [increased red cell destruction] or underlying liver disease. The hyperbilirubinemia is mild and, by definition, less than 6 mg/dL. However, most patients exhibit levels of less than 3 mg/dL. Considerable daily and seasonal variations are observed, and bilirubin levels occasionally may be normal in as many as one third of patients."

eMedicine: Gilbert Syndrome

Common Causes: Gilbert's Syndrome: Causes

"Gilbert syndrome may be precipitated by dehydration, fasting, menstrual periods, or stress, such as an intercurrent illness or vigorous exercise. Patients may complain of vague abdominal discomfort and general fatigue for which no cause is found. These episodes resolve spontaneously, and no treatment is required except for supportive care."

eMedicine: Gilbert Syndrome

Effects of Bilirubin

"Bilirubin is the most abundant known circulating antioxidant and may protect neurological pathways that regulate moods, he says…His future studies will help determine whether low bilirubin causes SAD, whether it contributes to the vulnerability to depression, or if it is a marker for the disorder."

WebMD: Hunting the Cause of Winter Depression

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