Gilbert Syndrome
What is Gilbert Syndrome?
Gilbert Syndrome is a common inherited liver condition that affects how your body processes bilirubin. Bilirubin is a yellow pigment created when your red blood cells break down naturally. Your liver normally converts this bilirubin into a form your body can eliminate. People with Gilbert Syndrome have slightly less of the enzyme needed for this process.
This condition affects about 3 to 7 percent of people in the United States. It causes mild increases in unconjugated bilirubin, the form that has not been processed by the liver yet. Most people with Gilbert Syndrome never experience any symptoms. When symptoms do appear, they usually show up during teenage years or early adulthood.
Gilbert Syndrome is not dangerous and does not require treatment in most cases. It is not a form of liver disease and does not cause liver damage. Many people discover they have this condition only when blood tests show elevated bilirubin for another reason. The condition runs in families and follows a genetic pattern.
Symptoms
- Mild yellowing of the skin and whites of the eyes, called jaundice
- Fatigue or feeling tired without clear reason
- Weakness or low energy levels
- Abdominal discomfort or mild pain
- Loss of appetite during episodes
- Nausea or feeling unwell
- Difficulty concentrating or mental fog
Most people with Gilbert Syndrome have no symptoms at all. Episodes of jaundice may come and go, often triggered by stress, illness, fasting, or dehydration. Between episodes, bilirubin levels may be normal or only slightly elevated. Many people live their entire lives without knowing they have this condition.
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Causes and risk factors
Gilbert Syndrome is caused by a change in the UGT1A1 gene. This gene provides instructions for making an enzyme that processes bilirubin in your liver. People with Gilbert Syndrome have about 30 percent of normal enzyme activity. The condition is inherited in an autosomal recessive pattern, meaning you need to inherit the gene change from both parents. If you inherit it from only one parent, you become a carrier but usually will not have symptoms.
Certain triggers can cause bilirubin levels to rise temporarily in people with Gilbert Syndrome. These include fasting or skipping meals, dehydration, illness or infection, stress, intense exercise, and lack of sleep. Menstrual periods can trigger episodes in some women. Some medications may also raise bilirubin levels. The condition is more common in men than women and typically becomes noticeable during the teenage years.
How it's diagnosed
Gilbert Syndrome is diagnosed through blood tests that measure bilirubin levels. Your doctor will check both total bilirubin and the breakdown between conjugated and unconjugated forms. People with Gilbert Syndrome have elevated unconjugated bilirubin while conjugated bilirubin remains normal. A key diagnostic feature is that urine bilirubin remains negative, unlike other liver conditions. This helps distinguish Gilbert Syndrome from liver disease or bile duct problems.
Rite Aid offers testing that includes urine bilirubin as part of our flagship panel. Your doctor may order additional tests to rule out other conditions that cause elevated bilirubin. Genetic testing can confirm the diagnosis but is rarely needed. A fasting test, where bilirubin is measured after not eating for several hours, may show a characteristic rise in levels. Most people discover they have Gilbert Syndrome incidentally during routine blood work.
Treatment options
- No specific treatment is usually needed for Gilbert Syndrome
- Eat regular meals and avoid prolonged fasting or very low calorie diets
- Stay well hydrated by drinking plenty of water throughout the day
- Manage stress through relaxation techniques, exercise, or meditation
- Get adequate sleep of 7 to 9 hours per night
- Avoid excessive alcohol consumption
- Tell your doctor and pharmacist about your condition before starting new medications
- Some medications may need dose adjustments or alternatives
Concerned about Gilbert Syndrome? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Gilbert Syndrome is not dangerous and does not cause liver damage. It is a benign condition that does not shorten life expectancy. Most people with Gilbert Syndrome live normal, healthy lives without any treatment. The condition does not progress to serious liver disease.
Jaundice from Gilbert Syndrome typically comes and goes in episodes. Most people appear completely normal between episodes. When jaundice does occur, it is usually mild and resolves on its own. Permanent or severe jaundice is not a feature of this condition.
Common triggers include fasting, skipping meals, dehydration, illness, stress, and lack of sleep. Intense physical exercise can also trigger episodes in some people. Menstrual periods may cause episodes in women. Avoiding these triggers can help reduce how often symptoms appear.
Gilbert Syndrome is a genetic enzyme deficiency, not actual liver disease. The liver itself is healthy and functions normally in other ways. Urine bilirubin stays negative in Gilbert Syndrome, while it becomes positive in true liver disease. Liver enzyme tests like ALT and AST remain normal.
No special diet is required for Gilbert Syndrome. The most important dietary advice is to eat regular meals and avoid fasting. Staying hydrated is also important. A balanced diet with adequate calories supports stable bilirubin levels and overall health.
Some medications are processed by the same enzyme that is reduced in Gilbert Syndrome. These drugs may build up to higher levels in your blood. Tell your doctor and pharmacist about your condition before starting new medications. Certain chemotherapy drugs and HIV medications may need dose adjustments.
Gilbert Syndrome does not affect fertility in men or women. It does not cause complications during pregnancy. However, the condition can be passed to your children if your partner also carries the gene change. Genetic counseling is available if you have concerns about inheritance.
Most people with Gilbert Syndrome do not need regular monitoring once diagnosed. Your doctor may check bilirubin levels if you have symptoms or start new medications. Regular testing is generally not necessary if you feel well. Focus on managing triggers and maintaining healthy lifestyle habits.
You are born with Gilbert Syndrome because it is genetic. However, it often goes unnoticed until teenage years or early adulthood when symptoms first appear. Some people are diagnosed much later in life during routine blood work. The condition was always present but may not have caused noticeable effects earlier.
Alcohol can stress the liver and may worsen symptoms in some people with Gilbert Syndrome. Excessive drinking can trigger episodes of jaundice. Moderate alcohol consumption may be acceptable for some people, but it is best to discuss this with your doctor. Staying hydrated is especially important if you do drink alcohol.