<s>[INST] W have had elevated biliruben my entire adult lift. I have also recently been told that the size of my re blood cells are very large. And, I once had elevated liver enzymes which were fully tested with no definitive results. I exercise, eat right and do not drink except maybe for a special occassion. All tests, including liver biopsy , ERCP , extensive blood work which were all negative. My question is, could these large macro red blood cells be responsible? Don t want to miss a possible lurking disease , but tired of all the testing. By the way I have no symptoms, except I do require 9-10 hours sleep each night. Thoughts????? [/INST] Dear Friend. Welcome to Chat Doctor. I am Chat Doctor. I understand your concern. Deranged liver functions needs to be co related. I would advise you to please share the reports with us. By saying Large RBC size I feel you mean to say raised MCV, that might be because of megaloblastic anemia. Asymptomatic Indirect Hyperbilirubinemia can be due to "Gilbert syn Chat Doctor. This is my best for you based on available details. If you have any further query, please ask me. </s>