Gilbert’s Syndrome: The Harmless Liver Disorder?

Gilbert’s Syndrome is a harmless liver disorder in which a slightly elevated level of bilirubin, a liver enzyme – necessary in the disposal of blood waste matter – is present.

Not a disease at all, Gilbert’s syndrome is not pathologic. In fact, it is a genetic condition present in 3-7% of Americans.

Genetics 101: The Cause of Gilbert’s Syndrome

Gilbert’s syndrome is caused by mildly elevated levels of a liver enzyme called bilirubin. A natural pigment, bilirubin is formed from the body’s normal breakdown of hemoglobin from red blood cells.

The liver enzyme abnormality associated with Gilbert’s syndrome most often occurs after starvation or dehydration or in the setting of stressors like infection.

While both sexes are affected, Gilbert’s syndrome occurs 25% more often in men than in women.

Gilbert’s syndrome is passed on genetically, which is why it’s more commonly found among family members. More than 50% of the general population carries one copy of the inherited, abnormal gene that controls the enzyme that assists in the breakdown of bilirubin.

If parents who each possess the abnormal gene have a child, the genetic defect that causes Gilbert’s syndrome may be passed along, but not in all cases.

And not everyone who has two copies of the abnormal gene develops Gilbert’s syndrome, so it’s possible to have the condition without a family history of the disorder.

Gilbert’s Syndrome Signs, Symptoms, and Risk Factors

Opinions regarding the symptoms associated with this disorder vary somewhat.

While some experts say there are Gilbert’s syndrome patients who don’t develop any symptoms, jaundice is possible and dependent upon how high the bilirubin level becomes.

In general, Gilbert’s syndrome is documented as a chronic disorder that – in the absence of any specific symptoms – presents with fluctuating jaundice.

Other Possible Symptoms:

  • Abdominal pain
  • Anxiety
  • Fatigue
  • Nausea
  • Weakness

Factors that Sometimes Increase Symptoms:

  • Alcohol
  • Dehydration
  • Fasting
  • Illness, including infections such as a cold or the flu
  • Menstruation
  • Overexertion

Gilbert’s Syndrome Complications

Other than jaundice – which normally comes and goes, disappearing on its own – there are no other known complications for Gilbert’s syndrome, and the disorder doesn’t damage the liver. The condition does not require any treatment.

When a person with Gilbert’s syndrome is ill with, say, the flu, sometimes the bilirubin level may further increase. Often, this is when jaundice occurs, and the condition actually gets diagnosed.

There may be increased side effects with certain medications. Irinotecan (Camptosar) – a colon cancer treatment – for example, can reach toxic levels if the patient has Gilbert’s syndrome, resulting in severe diarrhea.  

Diagnosing Gilbert’s Syndrome

Cases of Gilbert’s syndrome are often discovered by chance when routine testing of liver function tests indicates an elevated level of bilirubin in an asymptomatic person. Typically, test results will be normal except for a slightly elevated level of unconjugated bilirubin.

While Gilbert’s syndrome is not serious at all, it’s important – especially if you’re experiencing jaundice – to rule out more problematic liver conditions.

You want to rule out an excessive breakdown of red blood cells, hepatitis, or an obstructed bile duct, so further testing to rule out more worrisome causes of an elevated bilirubin may be required.

Managing Gilbert’s syndrome

Try to avoid alcohol, dehydration, prolonged fasting, infectious illnesses such as colds or the flu, and overexertion.

Eat regular, nutritious meals, and consider a multivitamin to ensure adequate vitamin, mineral, and nutrient intake, and to promote overall health. And be sure to manage your stress level each day.

Since Gilbert’s syndrome is an inherited genetic disorder, it’s not possible to prevent the disorder or make it go away. However, by avoiding and being aware of factors that trigger bilirubin levels to rise, it’s possible to reduce the number of episodes of jaundice you experience.

Read more about other conditions tied to the liver:

Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.