Vegas Sun: Dark Skin Hiding Faster Liver Harm?

By Franklin Everett Shaw

January 1, 2026

The yellow tinge in your eyes, the persistent fatigue – you chalk it up to the Vegas heat, the late nights, maybe one too many buffets. But what if it’s more? What if it’s your liver silently struggling, and the standard bilirubin test is failing to raise the alarm because of your skin tone? This is a reality for many Black and Hispanic residents of Las Vegas, a hidden disparity in healthcare that demands attention.

Bilirubin, a yellow pigment formed during the breakdown of red blood cells, is a key indicator of liver function. Elevated levels often signal liver damage or disease. The problem? Standard bilirubin tests can be less accurate in individuals with darker skin tones, leading to delayed diagnoses and potentially devastating consequences, especially in a city like Las Vegas where NASH (Non-Alcoholic Steatohepatitis) is on the rise.

The issue stems from the way bilirubin is measured. The test relies on spectrophotometry, which measures the amount of light absorbed by a sample. Melanin, the pigment responsible for skin color, can interfere with this process, leading to falsely lower bilirubin readings in people with darker skin. This means that a Black or Hispanic patient in Las Vegas could have significant liver damage, but their bilirubin levels might appear normal, masking the underlying problem.

Consider the case of Maria Rodriguez, a 45-year-old Hispanic woman living in East Las Vegas. She experienced persistent fatigue and abdominal discomfort for months. Her doctor initially dismissed her symptoms, citing stress and lack of sleep. A standard bilirubin test came back within the normal range. It wasn’t until she sought a second opinion from a specialist at UMC that further investigation, including a liver biopsy, revealed advanced NASH. The initial bilirubin test had failed her.

So, what can be done? How can we ensure that Las Vegas residents with darker skin tones receive accurate and timely diagnoses of liver disease? The answer lies in a multi-pronged approach that combines awareness, advanced testing, and proactive patient advocacy.

First, awareness is crucial. Doctors in Nevada need to be educated about the limitations of standard bilirubin tests in diverse populations. Medical schools and continuing education programs should emphasize the importance of considering skin tone as a factor when interpreting bilirubin results. This is especially important in a city as diverse as Las Vegas.

Second, explore alternative or adjunctive diagnostic methods. Relying solely on bilirubin is insufficient. Doctors should consider a panel of liver function tests, including ALT (Alanine Aminotransferase) and AST (Aspartate Aminotransferase), which may be less affected by skin pigmentation. Furthermore, non-invasive imaging techniques like FibroScan, which measures liver stiffness, can provide valuable information about liver health without the need for a biopsy.

FibroScan: This ultrasound-based technology is particularly useful for detecting fibrosis (scarring) in the liver, a hallmark of NASH. It’s quick, painless, and can be performed in a doctor’s office. Several clinics in Las Vegas, including those affiliated with the Cleveland Clinic Lou Ruvo Center for Brain Health (which also addresses metabolic health), offer FibroScan.
Novel Biomarkers: Research is ongoing to identify new biomarkers that are more sensitive and specific for liver damage, regardless of skin tone. These include markers of inflammation, oxidative stress, and fibrosis. While not yet widely available, these biomarkers hold promise for improving the accuracy of liver disease diagnosis in the future.

Third, advocate for yourself. If you are a Las Vegas resident with darker skin and you suspect you may have liver issues, don’t hesitate to ask your doctor about the limitations of bilirubin testing. Insist on a comprehensive evaluation, including a panel of liver function tests, imaging studies, and potentially a referral to a hepatologist (a liver specialist).

Here’s a step-by-step guide for patients in Las Vegas:

Document your symptoms: Keep a detailed record of your symptoms, including when they started, how often they occur, and what makes them better or worse. This information will be valuable for your doctor.
Research your family history: Liver disease can be hereditary. Find out if any of your family members have had liver problems.
Prepare questions for your doctor: Before your appointment, write down a list of questions you want to ask. This will help you stay organized and ensure that you get all the information you need.
Be assertive: Don’t be afraid to speak up and advocate for yourself. If you feel like your concerns are not being taken seriously, seek a second opinion.
Find a specialist: Consider consulting a hepatologist who is familiar with the nuances of diagnosing liver disease in diverse populations.

Here are a few local specialists in Las Vegas who may be helpful:

UMC (University Medical Center) Liver Clinic: Offers comprehensive liver care, including diagnosis and treatment of NASH.
Southern Nevada Health District: Can provide information about liver disease prevention and resources.
Private Hepatology Practices: Search online for hepatologists in Las Vegas and read reviews to find a doctor who is a good fit for you.

One common pitfall is assuming that a “normal” bilirubin level means everything is fine. This is a dangerous assumption, especially for individuals with darker skin. Another mistake is delaying seeking medical attention because of fear or lack of awareness. Early detection and intervention are crucial for preventing serious complications of liver disease.

The challenge is not just about improving testing methods; it’s about addressing systemic biases in healthcare. It’s about ensuring that all patients, regardless of their race or ethnicity, receive the same level of care and attention. It’s about recognizing that one-size-fits-all approaches to medicine can perpetuate health disparities.

Las Vegas, a city known for its vibrant diversity, must lead the way in addressing these disparities. By raising awareness, promoting advanced testing, and empowering patients to advocate for themselves, we can ensure that everyone has a fair chance at a healthy liver and a long life. The stakes are too high to ignore.