In my blog last week I went over how bilirubin pays a pivotal role in your antioxidant defense system. While glutathione was crowned champion of the antioxidants, bilirubin sat there completely alone and destitute. Current research is flipping this notion on its head.
If you didn’t catch the last blog, take a peep here. For a quick rundown:
- Glutathione is produced at high concentration in cells and plays a role in repairing oxidative damage to proteins. It isn’t effective at repairing damage to lipids.
- Bilirubin is produced during the breakdown of heme, a component of red blood cells. It’s sent to the liver and released in to the digestive tract with bile. It’s good at repairing oxidative damage to lipids such as those found in the plasma membrane.
It’s probably not that obvious to you, but the fact that bilirubin gets dumped in to the digestive tract with bile is pretty important. The intestinal barrier is composed of:
- The plasma membrane of enterocytes
- Tight junction proteins that hold them together
- A mucus layer to protect the enterocytes from bacteria and damage from enzymes
The primary function of the intestinal barrier is to let some things in to the bloodstream and keep others out. The plasma membrane of cells that make up the barrier form the last line of defense.
Now, the point of this blog isn’t to sell you on the importance of bilirubin to the microbiome, that was the last one. In this blog I’ll give you 3 free and simple ways to get the benefits of mildly elevated bilirubin.

1)Earthing/grounding
Earthing or grounding is the process of touching bare feet to the Earth. Such a simple process seem like it wouldn’t have any effect on your physiology. Turns out that’s wrong.
While there are only been small studies looking at the subject, the results are consistent. Earthing has been shown to:
- Improve glucose utilization and red blood cell metabolism during exercise(1)
- Reduces cortisol during sleep and re-synchronizes diurnal cortisol output(2)
- Improves wound healing and decreases inflammation(3)
- Increases bilirubin(1, 3)
In fact, here is a graph of the data on bilirubin in grounded vs non-grounded(Control) subjects:

In this study, subjects performed an exercise routine and followed for a week. The placebo group did nothing and the grounded group performed grounding with pads on their feet during the day. At night, they slept on a pad that was grounded. As you can see, the results heavily favored the grounding group.
When you look at what grounding does, the mechanism makes sense. The surface of the Earth holds a small negative charge due to the presence of electrons at the surface. When your bare feet are in contact with this surface, you may “absorb” some of these electrons. Shoes block this process.
In this particularly study, exercise served as a means of causing oxidative damage to muscles. This damage gets repaired by antioxidants lending electrons to the damaged cells. Bilirubin serves this purpose.
The hypothesis is that the grounded group had access to an unlimited supply of electrons from the Earth. This means they didn’t use up bilirubin to do the job. In the control group, bilirubin served as a surrogate to donate electrons. This caused a drop in serum bilirubin.
I think the data on grounding is pretty solid, but not solid enough to spend a fortune on the various products that have popped up. Flat out, the best way to ground is to have bare feet exposed on grass, dirt, untreated cement, and sand.
There are mats that some people place on their bed when they sleep. There are also mats to put under your feet when you sit at the computer. Finally, there are sandals with technology that allows you to get the benefits from grounding while still protecting your feet. All these seem to work, but I’m more for doing things au natural and free.

2)Eating grass-fed beef, especially liver
In my last blog I went over how bilirubin gets produced in the breakdown of heme, a component of red blood cells that give them their color. Heme is a protein involved in the transport of oxygen and its use in energy production.
In addition to hemoglobin, heme is found in other hemoproteins. One of these hemoproteins is myoglobin. Myoglobin is found predominantly in slow twitch muscle fibers and lends a red color to them. The red in red meat is due to higher myoglobin content than white meat such as chicken.
Within the cow, the liver is a pretty concentrated source of bilirubin. For the most part, when you see iron content in an animal product it’s attached to hemoproteins.
This form of iron is much easier to absorb than the plant form. To liberate the iron and absorb it, the heme must get broken down and bilirubin released.
On this end I recommend eating liver at least once a week and grass-fed beef another time. You definitely don’t want to overdo the liver because it’s high in retinol. Regular high doses of retinol can be toxic as it bioaccumultaes. I personally eat grass-fed cow’s liver every 5 days.

3)Cardiovascular exercise
Of the things you can do to get the benefits of bilirubin, cardiovascular exercise is king. Over time, cardiovascular exercise raises the number of red blood cells you make. This is an adaptation to the increased demand for oxygen transport to tissues.
An additional adaptation to cardiovascular exercise is more frequent destruction of blood cells(cite). This is due, in part, to an increased oxidative load on the red blood cells. Also, the pounding associated with running can cause mechanical damage to red blood cells and cause them to rupture. Either way, this releases heme and increases the production of bilirubin.
Changes in muscle fibers also increase systemic bilirubin. One of the primary adaptations over time to cardiovascular exercise is an increase in myoglobin content.
All these factors converge to increase serum bilirubin in people who perform cardiovascular exercise. Especially in people with metabolic syndrome or obesity(cite).
You can get this effect following the standard recommendation of 150 minutes per week or more of moderate to vigorous activity. A mild effect is seen with lower outputs as well(cite).
Conclusion
There are some pretty easy ways to get the benefits from mildly elevated bilirubin. Pharmaceutical approaches are likely to be disastrous given the toxic nature of bilirubin at high doses and people’s penchant for mistakingly taking too much of their medication.
It’s telling that these 3 methods of increasing bilirubin fall in line with our evolutionary heritage. Our early hominid ancestors regularly participated in all 3 of these processes. Not because they wanted to, but because it was necessary.
The positive effects of these interventions may lie deeply ingrained in our genome. While early research pointed to bilirubin as a toxic waste product, that seems wrong. Our current knowledge points to bilirubin as a powerful antioxidant central to our physiology.
Why else would the body waste energy on a process that takes something that’s easy to remove(biliverdin) and turns it in to something toxic that’s more difficult to removed(bilirubin)? Given bilirubins role in repairing cell membrane lipids, we may have our answer.
Hello Dave,
What’s your take on people who have Gilbert’s Syndrome?
Just like me, thanks Clood
What do you mean? You have a reduced risk for cardiovascular disease but I don’t think I understand your question.