Should I wait or seek immediate medical attention for hyperbilirubinemia and hematuria while taking Wegovy (semaglutide), Vitamin D (10,000 IU, five days a week) + K2, prenatal pills, B1, Omega-3, B12 (twice weekly), Estrodot (estradiol) (50), and progesterone (100 micronized) daily?

Urgent Medical Attention Needed for Elevated Bilirubin and Hematuria

You should seek immediate medical attention at a walk-in clinic rather than waiting another week due to your significantly elevated bilirubin level of 27 mg/dL, which requires prompt evaluation and management. 1

Understanding Your Lab Results

Your laboratory findings show concerning abnormalities:

• Bilirubin level of 27 mg/dL (severely elevated)
• Microscopic hematuria (blood in urine: 80)
• Low creatinine

Bilirubin Elevation Concerns

Bilirubin at 27 mg/dL represents significant hyperbilirubinemia that requires urgent assessment. According to guidelines, this level of elevation indicates:

• Potential liver dysfunction or biliary obstruction 1
• Risk of complications if left untreated
• Need for identification of underlying cause

In adults, bilirubin elevations of this magnitude are not normal and should never be ignored, unlike mild elevations that might be seen in conditions like Gilbert's syndrome 2.

Medication Considerations

Several medications you're taking could potentially impact your liver function:

• Wegovy (semaglutide): While not commonly associated with severe liver injury, any medication can potentially affect liver function
• High-dose Vitamin D (10,000 IU): Excessive vitamin D can cause hypercalcemia which may affect kidney function
• Hormone therapy (Estrodot and progesterone): Can occasionally impact liver function tests

Recommended Action Plan

1. Visit a walk-in clinic within 24 hours for immediate evaluation

   • Do not wait another week as your bilirubin level is significantly elevated
   • Bring a complete list of your medications and supplements

2. At the clinic, expect the following assessments:

   • Additional blood tests to determine if the bilirubin is predominantly conjugated or unconjugated 1
   • Liver function tests (AST, ALT, ALP, GGT)
   • Complete blood count to check for hemolysis
   • Abdominal ultrasound to evaluate liver and biliary tract

3. Medication review:

   • The clinician should evaluate all your current medications and supplements for potential hepatotoxicity
   • Temporary discontinuation of non-essential supplements may be recommended

Warning Signs Requiring Emergency Care

Seek emergency care immediately if you develop:

• Yellow discoloration of the skin or eyes (jaundice)
• Abdominal pain, especially in the right upper quadrant
• Nausea or vomiting
• Confusion or mental status changes
• Dark urine or clay-colored stools
• Fever

Why This Is Urgent

Hyperbilirubinemia at this level (27 mg/dL) can indicate serious underlying conditions including:

• Hepatocellular injury
• Biliary obstruction
• Hemolytic processes
• Drug-induced liver injury

The combination with hematuria (blood in urine) and low creatinine suggests potential multi-system involvement that requires prompt medical assessment 1.

While some cases of isolated hyperbilirubinemia may be benign 2, your combination of symptoms and test results warrants immediate evaluation rather than waiting for your regular doctor to return from vacation.