a friend tells me he has bilirubin levels at 3 times the limit (range 1-20? his was 63 or something).  But a scan last year (when it was also high, about 50) didnt show any liver problems.  He doesnt worry much, but I was curious.  He seems very fit to me.  Could it just be high naturally?
Hello! Thank you for the query. For sure his bilirubin is not around 50 or 60. Such limit would rather cause death. He may have elevated bilirubin level due liver diseases like liver cirrhosis, fatty liver, liver viral infection; alcohol intake, medicines overuse, bile ducts obstruction, pancreas cancer, hemolysis, Gilbert disease. As you can see there are a lot of possibilities. That is why It's really hard to give precise answer not knowing much about your friend. He should have some tests to find the reason including liver tests (AST, ALT,GTP, AP), direct and indirect bilirubin, Bag, Antioch, abdominal ultrasound, urinalysis. Hope this will help. Regards.