Elevated Direct Bilirubin. What are potential causes and testing to consider?

Patient

Q: I am a 23 year-old male with a family history of diabetes, high blood pressure, and hypothyroidism. My mother had a benign liver tumor in her late-twenties which required surgical removal of part of her liver. I am moderately active I do about 2.5 hours of cardio a week and about an hour of light to moderate weights.

I have had two liver panels over the last three years. One three years ago and one about a month ago. Both showed high direct bilirubin.

The test results from ONE WEEK AGO showed:

Bilirubin total 0.99 (Normal) (range 0.0 - 1.0)
Direct bilirubin 0.44 (H) (range 0.0 - 0.3)
Lipase 20 (Normal) (range 16 - 63)
Total protein 7.3
ALT (SGPT) 30
ALK PHOS 52
AST (SGOT) 26
ALBUMIN 4.9

I also had a metabolic panel, thyroid panel, and CBC. Exceptional results were very high niacin levels and very high thyroid antibodies. I am now about 5lbs overweight and moerately active.

I was not fasting for this blood test.

The blood work from THREE YEARS AGO showed:

Bilirubin total 2.1 (H) (range 0.0 - 1.0)
Direct bilirubin 0.4 (H) (range 0.0 - 0.3)
Lipase 15 (L) (range 16 - 63)
Total protein 7.6
ALT (SGPT) 19
ALK PHOS 56
AST (SGOT) 22
ALBUMIN 5.2

I also had a metabolic panel, ultrasensitive TSH test, and CBC which were both pretty much normal (except for slightly low neutrophils and slightly high lymphocytes). At the time I was 20 years old, sedentary, and about 10lbs overweight.

I was not fasting for this blood test.

The question is what potential problems could these results and what should me next course of action be? Thank you!

Doctor

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