Bilirubin levels went down and are now up

[v47]

I had jaundice in May this year due to hepatitis A and I healed pretty quickly as I went down to a very strict schedule of not drinking , not smoking and a zero fat diet. I even started going to the gym.

My levels for bilirubin and SGPT kept going down after that and on 31st July 2012 were down to:
Total - 1.1 mg/dl
Direct - 0.4 mg/dl
Indirect -0.7 mg/dl
SGPT - 34 IU/L

I am still not drinking and not smoking although I have introduced fat in my diet starting from August.
I got a sonography done yesterday and I was diagnosed with Grade-1 Fatty Liver.
I have had no discomfort related to it though.
Just to be sure , I got some blood tests done. My cholesterol, haemoglobin (is at 16) etc is perfectly within range.
So is my blood sugar.
However my bilirubin levels are now so:

Total - 1.7 mgdl
Direct - 0.5 mg/dl
Indirect - 1.2 mg/dl
SGPT - 9 IU/L

Need advice related to this. Are these levels due to me introducing fat in my diet again?
Does it mean that I have to still be careful related to my jaundice as my liver cant still take the hit of heavy food?
Or is it something else that I need to be worried about?

[Thomas D Schiano, MD]

if you continue all of this, i think your liver will be fine

[v47]

Thanks doc !
Really appreciate the response.

I guess I am just going to limit my fat intake and keep my diet restrictions as they were until July as I understand my liver is still not able to take the load.
Also, I have stopped drinks entirely since May and I plan to continue that stoppage. Not smoking either.
And yes, I shall keep doing my cardio at the gym to keep my weight issues at bay (I am 6'1" and 92 kgs, 26 years, so I am going to try to bring that down).

I guess after all this, it shouldn't be a problem as I mentioned that all my other reports are way in the normal range.
I guess that should do it, right?

[Thomas D Schiano, MD]

i think that you still need to be careful with your lifestyle changes.  the slightly elevated bilirubin is almost all indirect, which is consistent with gilbert's disease--thus this may remain slightly elevated. i think that you will be fine.