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Bilirubin is created through the breakdown of hemoglobin. Though toxic, bilirubin can be neutralized through processing by the liver. Its presence in the blood is often an indicator of liver health. (source)
Low blood bilirubin levels can stem from physiological factors linked to liver health and red blood cell turnover, as the liver is responsible for processing bilirubin from the breakdown of old red blood cells. Nutritionally, insufficient intake of foods rich in antioxidants and certain vitamins, like vitamin C and folic acid, may impact bilirubin production. (source, source, source)
Prioritize flavonoid-rich foods: Eating flavonoid-rich foods has been associated with higher bilirubin levels. (source) Flavonoids can increase bilirubin levels by inhibiting the liver enzymes that remove bilirubin from the system. (source, source) Recommendation: Consume at least one serving of flavonoid-rich foods daily.
One serving examples: Dark Chocolate (1 oz), Blackberries (¾ cup), Kale (1 cup), Green Tea (1 cup), Apple (with skin) (1 medium apple)
Train regularly: Engaging in physical activity has been shown to promote healthy bilirubin levels. (source) Exercise promotes heme-oxygenase-1 activity, supporting a primary bilirubin production pathway. (source) Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
Supplement with milk thistle: Supplementation with milk thistle has been shown to positively affect serum bilirubin levels. Milk thistle is a great source of flavonoids, which have been shown to increase bilirubin levels by inhibiting the liver enzymes that remove bilirubin from the system (source, source) Recommendation: Supplement with at least 420 mg of milk thistle daily.
High blood bilirubin levels can often stem from physiological factors affecting liver function, as the liver plays a key role in processing and eliminating bilirubin from the body. Nutritionally, factors like excessive intake of certain foods, alcohol, or medications, as well as dehydration may also contribute to elevated bilirubin levels. (source, source, source)
Prioritize vitamin C-rich foods: Consumption of vitamin C has been shown to positively affect bilirubin concentrations. (source) Vitamin C's antioxidative properties support liver health by reducing liver stress and resulting in a decrease in bilirubin levels. (source) Recommendation: Consume at least one serving of foods high in vitamin C daily.
One serving examples: Red Bell Peppers (chopped) (1 cup), Strawberries (8 medium strawberries), Orange (1 medium orange), Grapefruit (½ large grapefruit), Citrus Juice (100%) (½ cup)
Avoid alcohol: Alcohol consumption has been shown to raise bilirubin levels. (source) Alcohol is disruptive to multiple liver functions, including bilirubin conjugation and removal. (source) Recommendation: Monitor alcohol intake. Try to limit consumption to one or two drinks daily, with the goal of less than three per week.
Supplement with N-Acetylcysteine (NAC): NAC supplementation has been shown to reduce serum bilirubin levels. (source) NAC is a powerful antioxidant and has been shown to successfully reduce reactive oxygen species in the body, helping to reduce liver stress and bilirubin concentrations. (source) Recommendation: Supplement with at least 600 mg of NAC daily.
