17661 Gilberts Syndrome

Overview

Gilbert's syndrome is a common and harmless condition that affects the way your liver processes a yellow substance called bilirubin. Bilirubin is made when your body breaks down old red blood cells. In people with Gilbert's syndrome, bilirubin levels can occasionally become a little bit high, which may cause mild yellowing of the skin or eyes (jaundice). It is not a disease, does not damage the liver, and does not require treatment.

Yes, Gilbert's syndrome is quite common. Around 5 to 10 in every 100 people have it, making it one of the most common genetic liver traits.

Gilbert's syndrome affects both men and women, but it is more often noticed in men. It is present from birth, but it may not be discovered until puberty or later, often by chance during a blood test for something else.

Symptoms

Common symptoms

• Mild yellowing of the skin and the whites of the eyes (jaundice)
• Occasional tiredness or fatigue
• Feeling generally unwell during episodes of jaundice
• No symptoms at all in many cases

Symptoms in children

• Children with Gilbert's syndrome rarely have noticeable symptoms. Sometimes a mild yellowish tint to the skin or eyes can appear during an illness, after fasting, or when the child is very tired. It usually goes away on its own and causes no harm.

Symptoms in older adults

• Older adults with Gilbert's syndrome may notice the same mild jaundice, but it is not due to aging. If new jaundice appears in an older adult, it is important to see a doctor to rule out other causes, as it may not be Gilbert's syndrome.

Causes

Main causes

• Gilbert's syndrome is caused by a change in a gene that helps the liver process bilirubin. This genetic change means the liver becomes slightly less efficient at removing bilirubin from the blood.
• The condition is inherited – it runs in families. You may have Gilbert's syndrome if one of your parents passes the affected gene to you.

Risk factors

• Having a family history of Gilbert's syndrome.
• Being male – the condition is more often noticed in men, though the genetic trait affects both sexes.
• Being under physical or emotional stress, not eating for a long time, or being unwell can trigger a temporary rise in bilirubin levels.

When to see a doctor

See a doctor urgently if:

• Go to urgent care or see a doctor the same day if you have jaundice with dark urine, pale stools, or pain in the upper right side of your belly.
• If you have jaundice plus a fever, chills, or feel very unwell, get urgent medical advice.

Book a routine appointment if:

• Make a routine appointment if you notice a yellow tint to your skin or eyes that does not go away after a few days.
• If you have not been diagnosed with Gilbert's syndrome but have a blood test showing high bilirubin, discuss it with your doctor.
• If you have Gilbert's syndrome and your symptoms change or become more frequent, check in with your doctor for reassurance.

Diagnosis

Gilbert's syndrome is usually found by accident when a blood test shows slightly high bilirubin levels. Your doctor will ask about your symptoms and medical history and may repeat the test to confirm the level is stable. If other liver tests are normal and you are otherwise well, the diagnosis can be made confidently without further tests.

Tests that may be done

• Blood test to measure bilirubin and other liver enzymes.
• A repeat blood test after fasting or exercise to see if bilirubin goes up temporarily.
• In rare cases, a liver ultrasound to rule out other liver conditions.

What to expect at your appointment

The diagnosis is straightforward and non-invasive. You may need to fast for several hours before a blood test. Your doctor will explain that your bilirubin level can fluctuate and that this is normal for Gilbert's syndrome. In many cases, no follow-up appointments are needed.

Treatment

Gilbert's syndrome does not require any treatment. It is seen as a harmless variation, not a medical condition. The most important part of care is knowing that the symptoms are not dangerous. Your doctor may simply reassure you that you do not need any medicines or special care.

Self-care at home

• Eat regular meals and avoid skipping meals for long periods.
• Stay well hydrated by drinking plenty of water.
• Get enough rest and manage stress with relaxation techniques or gentle exercise.
• Avoid drinking too much alcohol, as alcohol can raise bilirubin levels temporarily.

Medical treatments

There are no specific medications needed for Gilbert's syndrome. Doctors do not prescribe any drug to lower bilirubin because high bilirubin in this condition is harmless. If you have other symptoms that affect your daily life, talk to your doctor – they can suggest general ways to feel better, but never take any medicine for Gilbert's syndrome unless your doctor advises it.

When is surgery considered?

No surgery is ever needed for Gilbert's syndrome.

Living with this condition

For most people, Gilbert's syndrome has no impact on daily life. You can work, study, exercise, and live exactly as before. If you notice mild jaundice now and then, it usually fades on its own. It may help to keep a simple routine of regular eating and sleeping to avoid triggering higher bilirubin levels.

Lifestyle tips

• Maintain a balanced daily routine with regular meals.
• Get enough sleep and try to reduce unnecessary stress.
• Limit alcohol – sticking to the recommended low-risk guidelines is sensible.
• Stay active but rest when you feel tired.

Diet and exercise

No special diet is needed for Gilbert's syndrome. Eat a normal, healthy diet with plenty of fruits, vegetables, whole grains, and lean protein. Regular moderate exercise is good for your overall health. Avoid crash dieting or very long periods without food, as this can cause bilirubin to rise temporarily.

Mental health and emotional wellbeing

Being told you have a 'condition' can sometimes cause worry, even when it is harmless. Some people feel anxious about jaundice episodes or fear liver damage. It is important to know that Gilbert's syndrome is not dangerous. If you feel anxious or stressed about it, talk to your doctor or a trusted friend. Counselling can help if you need extra support.

Prevention

Gilbert's syndrome cannot be prevented because it is a genetic trait present from birth. It is not caused by something you did or did not do. You cannot 'avoid' it, and you do not need to try. The only thing you can do is manage your lifestyle to reduce temporary rises in bilirubin levels.

Vaccines

There is no vaccine for Gilbert's syndrome, and none is needed. However, it is important to stay up to date with all routinely recommended vaccines to protect your liver from infections, such as hepatitis A and B, which can affect liver health.

Screening programmes

No routine screening is needed for Gilbert's syndrome. If you have no symptoms, there is no reason to test for it. The condition is mild and harmless, so screening would not change anything.

Complications

If left untreated

• Gilbert's syndrome has no complications, even if it is not treated. It does not cause liver damage, cirrhosis, or liver failure.
• People with Gilbert's syndrome have a normal lifespan and normal quality of life.
• The only possible issue is temporary jaundice, which is cosmetically noticeable but not harmful.

Long-term outlook

The outlook is excellent. Gilbert's syndrome is a benign trait, meaning it will not harm your health. You can live a completely normal, healthy life without any fear of liver problems. Knowing your bilirubin level may be slightly higher than average is simply part of your normal body make-up.

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