Bilirubin - An Internal Protector

Two scientific premises have recently come together: “lowering uric acid decreases death and aging” and “elevation of bile” (bilirubin) does the same. An inexpensive drug, Probenecid can improve both of these. In the Journal of the American Medical Association, researchers reviewed the literature showing that elevation of uric acid (hyperuricemia) is not only a predictor of gout but is commonly present in new onset high blood pressure. Other previously documented research supports elevation of uric acid causes cardiovascular disease to include stroke, heart attack, and peripheral vascular problems.

In 1998, Louis J. Ignarro won the Nobel Prize for his discovery of Nitric Oxide's role in cardiovascular health. Uric acid was subsequently shown to reduce nitric oxide levels in the lining of arteries, causing them to be more easily damaged. A well controlled double-blind study in lowering of uric acid artificially with the drug Allopurinol resulted in a significant reduction in Blood Pressure. As noted in the past, hypertension is a significant risk factor in cardiovascular disease because of its role in atherosclerosis, stress to the heart, and acceleration of the inflammatory processes of the body.

Bile (bilirverdin/bilirubin) was long considered a merely metabolic waste product from the breakdown of red blood cells and was discarded in the liver. Bile in the intestinal tract functions to markedly improve our fat digestion. For the last twenty years, this pigment has been shown to decrease experimental hardening of the arteries, prevent blood clotting, and reduce the risk of damage to the brain after a Stroke. It has been recognized to have an anti-inflammatory, antioxidant, and cyto-protective properties.

The NHANES (National Health and Nutrition Examination Survey), conducted every decade for the last fifty years, represents a cross-section of our population and surveys over 13,000 patients. The survey shows that people who had higher bilirubin had a significantly reduced incidence of neurological damage due to Stroke, plus a decreased incidence of Heart Attacks and peripheral vascular disease. The study was carefully controlled for other risk factors to include hypertension, diabetes, lipids, homocysteine, C-reactive protein, and body weight. Those that had significant liver disease, a very common cause of very high bilirubin, were not included. It has been long noted that people with high bilirubin, for whatever reason, have far less hardening of the arteries. A rare, benign, inherited elevation of Bilirubin, called Gilbert’s disease, has also been shown to increase longevity. These findings are suggestive that elevation of Bilirubin is an important defense mechanism against atherosclerosis and protective for neurologic injury in the setting of stroke. The well tolerated Probenecid, as noted above, not only lowers Uric Acid but raises bilirubin.

A strategy for a decrease of vascular disease and all accrued benefits is to have your doctor prescribe Probenecid 500 mg a day. It is still used to treat High Uric Acid. This will raise the bilirubin slightly and significantly give anti-inflammatory and cyto-protective effects to increase longevity. Normal bilirubins are from 0.1 to 1.3 and if the bilirubin is between 1.1 and 2.0, you are much better off. People do not become jaundiced unless their bilirubin is over 3.0. Another ploy without using the doctor is to consume a fair amount of ox bile, also this drug would lower the Uric Acid to the ideal which is less than 5. This would not only improve your lipids and your bowels, but will raise the bilirubin to protective levels. Although a double-blind study has yet to be done, it is almost a no-brainer to consider this healthy strategy.