All About Jaundice

Jaundice is when the whites of your eyes (sclerae) and possibly your skin develop a yellowish color. Jaundice is a symptom caused by a larger problem of too much bilirubin in your blood, called "hyperbilirubinemia." When you notice parts of your body turning yellow, it's time to go see a doctor, because something may be wrong. Several things are known to cause yellow skin, and liver disease is one of the most common and important.


What Causes Jaundice?

Jaundice is caused by too much bilirubin in the blood. Bilirubin is a yellow pigment (a chemical in the body that has a color) that your body makes from old red blood cells in the spleen, an organ next to your stomach. The bilirubin then goes to the liver, where it's combined with other molecules to make bile. This is a normal process that happens every day. It's your body's way of recycling unused things, such as old red blood cells, and forming them into necessary products, such as bile. You use bile every time you need to digest fats after a meal, such as from a big steak dinner. Bile is a fluid that's essential in nutrition, because it helps break down the fats into a form the body can use.

This is an important system, but it can be disrupted. If the liver becomes damaged, such as from hepatitis, it may not be able to make bile. The body, though, is constantly breaking down old red blood cells and using the salvaged iron to make bilirubin. If the liver can't use the bilirubin to make bile, the bilirubin starts concentrating in the blood and may even leak in to surrounding tissues, such as the sclerae and skin. When the tissues become overly saturated with bilirubin, it becomes noticeable as jaundice. Jaundice is a symptom of liver disease, but there are other reasons your body may develop hyperbilirubinemia. Two of these reasons are overproduction of red blood cells and some obstruction of the liver's ducts, such as a tumor. Doctors will search for these, and other, possibilities when evaluating you for jaundice.



Do I Have Jaundice?

The easiest way to verify jaundice is by physical examination. Though jaundice can turn the skin a yellow tint, it's easiest to see jaundice by looking at the whites of the eyes, because bilirubin is especially attracted to the sclerae. It's often difficult to see jaundice in the sclerae, however, under fluorescent lighting. In these instances, you may be able to better see jaundice in the tissue under your tongue. Another indicator of jaundice is a darkening of your urine.

Before you can see jaundice on your skin, you need to have a certain amount of bilirubin in your blood and tissues. Normally, adults have anywhere from 0.3 to 1 mg/dL (which stands for milligrams per deciliter) of bilirubin in their blood, which is a very small amount. For comparison, a large grain of sand weighs around 11 milligrams and one deciliter is about 7 tablespoons! To actually see jaundice in your skin, you'll need at least 3 mg/dL of bilirubin in your blood.