Gilberts Syndrome

Overview

Gilbert's syndrome is a common, harmless inherited condition that affects how your liver processes bilirubin — a yellow substance made when old red blood cells are broken down. People with Gilbert's syndrome have slightly higher levels of bilirubin in the blood, which can sometimes cause the skin or eyes to look slightly yellow. It is not a disease and does not damage the liver.

Yes, it's quite common. Depending on the country, about 5 to 10 people in every 100 have Gilbert's syndrome.

It affects slightly more men than women. It is present from birth, but it is often not noticed until the late teens or early 20s, sometimes only when a blood test is done for another reason.

Symptoms

Common symptoms

• No symptoms at all for most people
• Mild yellowing of the skin or the whites of the eyes (jaundice) that comes and goes
• Feeling tired or fatigued at times — though this is not proven to be directly caused by Gilbert's syndrome
• Mild tummy discomfort or a feeling of being unwell, especially during illness, stress, or fasting

Symptoms in children

• Gilbert's syndrome rarely causes symptoms in children.
• Mild jaundice may appear during a childhood infection or after fasting, but it settles on its own.
• Children usually grow and develop normally.

Symptoms in older adults

• Symptoms are the same as in younger adults — usually very mild.
• Jaundice may be more noticeable if there are other health conditions or medicines involved.
• Any new jaundice in an older adult should always be checked by a doctor to rule out more common causes.

Causes

Main causes

• Gilbert's syndrome is caused by a change in a gene called UGT1A1.
• This gene makes an enzyme that helps the liver remove bilirubin from the blood.
• When the enzyme doesn't work as efficiently as usual, bilirubin builds up slightly.
• The condition is inherited, meaning it is passed down from parents to children.

Risk factors

• Having a parent who has Gilbert's syndrome or carries the gene change
• Being male, since it is more commonly diagnosed in men
• Fasting, dehydration, stress, lack of sleep, or intense exercise can temporarily raise bilirubin levels and make jaundice more noticeable

When to see a doctor

See a doctor urgently if:

• Seek same-day medical advice if you have jaundice that appears suddenly or is getting worse.
• See a doctor the same day if you have jaundice with dark urine or pale stools.
• If jaundice is accompanied by fever, abdominal pain, or vomiting, contact your local health service promptly.

Book a routine appointment if:

• Make a routine appointment if you notice a yellow tint to your eyes or skin, even if it comes and goes.
• Talk to your doctor if you are worried about tiredness or other vague symptoms.
• If you have a family history of Gilbert's syndrome and want to be checked, mention it at your next appointment.

Diagnosis

Gilbert's syndrome is usually diagnosed after a blood test shows slightly raised bilirubin while other liver test results are normal. Your doctor will rule out more serious causes of jaundice, such as liver disease, hepatitis, or problems with red blood cells. Often the diagnosis is clear, and further tests are not needed.

Tests that may be done

• A blood test to measure bilirubin and check liver enzymes
• A full blood count (FBC) to look for signs of red blood cell breakdown
• Liver function tests (LFTs) to make sure the liver is working normally
• Sometimes a genetic test for UGT1A1, but this is not usually required for diagnosis

What to expect at your appointment

Your doctor will go through your symptoms, examine you, and review your blood tests. If the pattern fits Gilbert's syndrome and other conditions are ruled out, they can give you a confident diagnosis. In rare cases where findings are unclear, you may be referred to a liver specialist for extra checks, such as an ultrasound scan.

Treatment

There is no specific treatment for Gilbert's syndrome, and most people don't need any. It is a lifelong feature, but it is not a medical problem. The occasional yellow finish can be a nuisance, but it is not harmful and will usually fade by itself.

Self-care at home

• Drink plenty of fluids to stay well hydrated.
• Eat regular meals and avoid long periods without food.
• Get enough sleep and avoid going too long without rest.
• Find ways to manage stress, such as gentle exercise or relaxation.
• Limit alcohol intake, as it can affect the liver.
• If you exercise hard, make sure you have eaten something light beforehand.

Medical treatments

No medicine is needed to treat Gilbert's syndrome. However, some medicines are processed by the liver, so your doctor and pharmacist should always know about your diagnosis before starting a new prescription. They will check that any medicine is safe and adjust the dose if necessary.

When is surgery considered?

If you are going to have surgery, tell your surgeon and the anaesthetist that you have Gilbert's syndrome. It is generally safe for surgery, but being aware of the condition helps the healthcare team choose medicines and fluids that will keep your bilirubin levels from rising.

Living with this condition

Living with Gilbert's syndrome is completely manageable. You can work, study, exercise, and enjoy life just like anyone else. Some days you might notice a slight yellow tint to your eyes, especially when you are tired, stressed, or fighting off a bug. This is not dangerous and will usually pass without treatment.

Lifestyle tips

• Keep a regular eating schedule and don't skip meals.
• Stay hydrated throughout the day.
• Make time for enough rest and sleep.
• Try to reduce stress with activities like walking, reading, or mindfulness.
• Drink alcohol only in moderation — excessive drinking is harmful for anyone's liver.
• If you feel a jaundice episode coming on, take it easy for a day or two.

Diet and exercise

There is no special diet for Gilbert's syndrome. Eat a balanced diet with fruits, vegetables, whole grains, and lean protein. Avoid crash diets or very low-calorie fasting, as these can raise bilirubin levels. Regular, moderate exercise is fine, but avoid extremely strenuous workouts on an empty stomach.

Mental health and emotional wellbeing

Finding out you have a genetic condition can be a relief — or a worry. It may help to know that Gilbert's syndrome is harmless and does not affect your long-term health. If you feel anxious, down, or overly concerned about your symptoms, talk to your GP. Support from family, friends, or a counsellor can also make a difference.

Prevention

Gilbert's syndrome is inherited, so it cannot be prevented. But you can reduce the frequency of jaundice episodes by keeping yourself well: eat regularly, stay hydrated, get enough rest, and manage stress.

Vaccines

There is no vaccine for Gilbert's syndrome, but keeping up to date with recommended vaccines, such as those that protect the liver, is a good idea for everyone.

Screening programmes

No routine screening is needed for Gilbert's syndrome. If you have a family history, it is not something that needs to be checked unless you have symptoms or concerns. Your doctor can advise you if testing would be useful.

Complications

If left untreated

• There are no known complications from leaving Gilbert's syndrome untreated.
• It does not cause liver cirrhosis, liver failure, or liver cancer.
• It does not reduce life expectancy.
• In very rare cases, Gilbert's syndrome can increase sensitivity to certain medicines, which is why telling your healthcare team is important.

Long-term outlook

The outlook is excellent. People with Gilbert's syndrome live normal, healthy lives. Jaundice may come and go, but it is not a sign of serious illness and does not require treatment. With a few simple self-care steps, you can keep symptoms at bay and not let it hold you back.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.