Gilbert's Syndrome

Gilbert's Syndrome is a common inherited condition where your liver processes bilirubin more slowly than normal. Bilirubin is a yellow pigment created when your body breaks down old red blood cells. In most people, the liver quickly converts bilirubin and removes it from the blood. People with Gilbert's Syndrome have lower levels of an enzyme that helps process bilirubin.

This condition affects about 3 to 7 percent of people in the United States. It is considered harmless and does not cause liver damage or serious health problems. Most people with Gilbert's Syndrome live normal, healthy lives without needing treatment. The condition is usually discovered during routine blood tests that show mildly elevated bilirubin levels.

Gilbert's Syndrome is genetic and typically runs in families. You inherit it when you receive a specific gene variation from both parents. The condition is more common in men than women. Many people have Gilbert's Syndrome without ever knowing it because symptoms are often mild or absent.

• Mild yellowing of the skin and whites of the eyes, especially during stress or illness
• Fatigue or feeling unusually tired
• Weakness or low energy
• Mild abdominal discomfort
• Nausea or digestive issues
• Dark urine during episodes of elevated bilirubin
• Brain fog or difficulty concentrating

Many people with Gilbert's Syndrome experience no symptoms at all. Symptoms tend to appear or worsen during periods of stress, fasting, dehydration, illness, or intense exercise. Between these episodes, most people feel completely normal.

Gilbert's Syndrome is caused by an inherited gene mutation that affects how your liver processes bilirubin. This mutation reduces the activity of an enzyme called UGT1A1, which normally helps break down and clear bilirubin from your blood. You need to inherit the altered gene from both parents to develop the condition. The syndrome is present from birth but often goes unnoticed until adolescence or early adulthood.

Certain triggers can cause bilirubin levels to rise temporarily in people with Gilbert's Syndrome. Common triggers include fasting or skipping meals, dehydration, illness or infection, stress, intense physical activity, menstruation in women, and lack of sleep. Some medications can also interfere with bilirubin processing. These triggers do not cause the condition but can make it more noticeable.

Gilbert's Syndrome is usually diagnosed through blood tests that measure bilirubin levels. A blood test will show elevated total bilirubin, specifically the indirect bilirubin portion, while direct bilirubin remains normal. Liver function tests will appear normal because the liver itself is healthy. Your doctor may order testing after noticing mild jaundice or during routine health screenings.

Rite Aid offers bilirubin testing that can help detect elevated levels associated with Gilbert's Syndrome. Our testing includes total bilirubin, direct bilirubin, and indirect bilirubin measurements. Additional tests may be needed to rule out other liver conditions. Genetic testing can confirm the diagnosis but is rarely necessary.

• No treatment is usually required since the condition is harmless
• Eat regular meals and avoid prolonged fasting to prevent bilirubin spikes
• Stay well hydrated, especially during illness or exercise
• Manage stress through relaxation techniques, adequate sleep, and exercise
• Avoid excessive alcohol consumption, which can stress the liver
• Be cautious with certain medications that may interact with bilirubin processing
• Inform your doctor and pharmacist about your diagnosis before starting new medications
• Monitor for unusual symptoms or signs of other liver conditions