Gilbert's Syndrome
What is 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.
Symptoms
- 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.
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Causes and risk factors
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.
How it's diagnosed
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.
Treatment options
- 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
Need testing for Gilbert's Syndrome? Add it to your panel.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
No, Gilbert's Syndrome is not dangerous and does not cause liver damage or serious health problems. It is a benign inherited condition that most people live with their entire lives without complications. The condition does not shorten life expectancy or require medical treatment in most cases.
Bilirubin levels rise when your liver cannot process it fast enough due to reduced enzyme activity. This happens more during stress, fasting, dehydration, illness, or intense exercise. These triggers temporarily overwhelm the liver's already reduced capacity to clear bilirubin from your blood.
Jaundice is a symptom, not a condition, that describes yellowing of the skin and eyes. Gilbert's Syndrome is one of many possible causes of jaundice. Unlike serious causes of jaundice such as hepatitis or bile duct blockage, Gilbert's Syndrome is harmless and does not damage the liver.
There is no cure for Gilbert's Syndrome because it is a genetic condition you are born with. However, no cure is needed because the condition is harmless and does not progress or worsen over time. Most people manage it simply by avoiding known triggers and maintaining healthy lifestyle habits.
Blood tests measuring total bilirubin, direct bilirubin, and indirect bilirubin can detect Gilbert's Syndrome. People with this condition typically have elevated total and indirect bilirubin while direct bilirubin remains normal. Liver function tests will show normal results because the liver tissue itself is healthy.
Some medications are processed by the same liver enzyme affected by Gilbert's Syndrome and may need dose adjustments. These include certain cancer drugs, HIV medications, and some pain relievers. Always inform your doctor and pharmacist about your Gilbert's Syndrome diagnosis before starting new medications.
Yes, eating regular meals helps prevent fasting-induced bilirubin spikes. Staying hydrated and limiting alcohol also support liver function. Some people find that avoiding processed foods and eating a diet rich in vegetables and lean protein helps them feel better overall.
Gilbert's Syndrome does not typically affect pregnancy or fetal development. Some women experience slightly elevated bilirubin during pregnancy, but this is usually harmless. Inform your obstetrician about your diagnosis so they can monitor your liver function appropriately during prenatal care.
Most people with Gilbert's Syndrome do not need frequent testing once diagnosed. Your doctor may recommend periodic liver function tests to ensure no other conditions develop. If you experience new or worsening symptoms, additional testing may be needed to rule out other liver problems.
Yes, stress is a common trigger that can temporarily raise bilirubin levels in people with Gilbert's Syndrome. Physical stress from illness or intense exercise and emotional stress can both contribute to elevated levels. Managing stress through adequate sleep, regular exercise, and relaxation techniques can help minimize symptoms.