<s>[INST] Hello doctor,I am 36 years old, male, 6'1", 265 lbs. I have a question about total bilirubin. I had it checked four weeks ago and it was at .41 mg/dl and one month later it jumped to .82 mg/dl. My alkaline phosphatase is at 1.173 ukat/l and four weeks ago was at 1.003 ukat/l. The doctor was not concerned by this but the highest I have seen it was three years ago when it was at .53 (total bilirubin).However, during the last month, I went from 282 lbs to 265. I have been extremely stressed out about it. Health problems and my anxiety are high. I barely slept the night before the tests and am possibly dehydrated. Could these factors have contributed to the increase? I am concerned about bile duct obstruction. [/INST] Hello. Since this question was posted under diabetology, I am wondering if you have any endocrine issues. The question asked here is about gastroenterology. The liver tests would be concerning for a liver process like gallstone if the enzymes were not coming back down or if you had pain in your right abdomen. Any fever? Dehydration can sometimes cause the numbers to be slightly up. It is important to have a follow up with your GP. You can also run the query through a gastroenterologist on icliniq. </s>