Difference between Conjugated and Unconjugated Bilirubin

High unconjugated bilirubin levels in the plasma refer to unconjugated hyperbilirubinemia. Unconjugated hyperbilirubinemia can also cause jaundice in neonates. Various factors might be responsible for unconjugated hyperbilirubinemia. These include:

1. An increase in the production of bilirubin or increased haemoglobin degradation.
2. Impaired hepatic bilirubin uptake.
3. Reduced or impaired conjugation of bilirubin.
4. Having inherited disorders like hemolytic anaemia and Gilbert's syndrome.

Conjugated bilirubin is otherwise also known as direct bilirubin. 

1. Conjugated bilirubin is water soluble and is not toxic to the body.
2. An adult's normal value of conjugated bilirubin should be between 0.0 to 0.3 mg/dL. 
3. Since conjugated bilirubin is water soluble, it can be filtered by the kidney.
4. Conjugate bilirubin is formed when unconjugated bilirubin is conjugated by adding glucuronic acid. 
5. Normally, conjugated bilirubin is not present in the urine. However, in certain conditions or diseases, it may be seen in the urine. The presence of conjugated bilirubin in the urine will give it a dark cola or tea-like colour (brown). 

Elevating the conjugated bilirubin level leads to conjugated hyperbilirubinemia. Various causes lead to an increase in the level of conjugated bilirubin. Some of these causes of conjugated hyperbilirubinemia include:

1. Cholelithiasis
2. Viral hepatitis  
3. Liver cirrhosis 
4. Certain medications and toxins
5. Sepsis 
6. Alcohol 
7. Autoimmune disorders 
8. Certain metabolic diseases like Gaucher disease, Niemann-Pick disease, etc.

1. An impairment in bilirubin conjugation can be caused due to hereditary conditions like Gilbert's syndrome and the Crigler-Najjar syndrome type I and II.
2. Many newborns develop Neonatal hyperbilirubinemia due to breastfeeding. This is because breastfeeding increases the level of unconjugated bilirubin in the baby. This condition is otherwise also called breast milk jaundice or breastfeeding jaundice.

To summarise the differences between conjugated and unconjugated bilirubin:

1. Bilirubin is a yellow-coloured substance and a metabolite of heme. There are two types of bilirubin, conjugated and unconjugated bilirubin. An increase in the level of bilirubin in the body and its buildup in the tissues may indicate liver condition or damage. 
2. Building up of bilirubin leads to jaundice. Hence, symptoms like yellowing skin, sclera or a dark urine colour must not be ignored. 

You must immediately consult a doctor if you notice any such symptoms related to high levels of conjugated and unconjugated bilirubin. Our experts will help manage your condition at the right time! So visit HexaHealth to get the best treatment for your conditions!

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