Gilbert's syndrome

What is Gilbert’s Syndrome?

Gilbert’s syndrome is a common chronic but benign condition which can lead to yellowing of the eyes (or jaundice). It relates to a form of intermittent unconjugated hyperbilirubinemia (elevated bilirubin levels). Unconjugated (or indirect) bilirubin is bilirubin which is bound to protein in the blood and carried to the liver, where ordinarily it is changed to the conjugated (or direct) form of bilirubin. In Gilbert’s Syndrome the liver has difficulty removing this unconjugated bilirubin from the bloodstream, causing it to build up. Gilbert’s Syndrome should not be considered a disease but is a common condition affecting up to 5% of the population in Ireland.

How did I acquire Gilbert’s Syndrome?

Gilbert’s Syndrome is an inherited genetic condition caused by a faulty gene. This means that it runs in families. It is not related to lifestyle factors in any way.

How does Gilbert’s Syndrome present itself?

Gilbert’s Syndrome is most often diagnosed by chance, on routine blood testing with your GP which shows a serum bilirubin level slightly above the normal range. Usually patients with Gilbert’s Syndrome have no symptoms or signs of the condition, but it can cause a mild short lived jaundice (only noticeable as yellow discolouration of the whites of the eyes – scleral icterus) under conditions such as illness, fasting, or conditions of stress, typically when a younger patient is preparing for school exams. Patients may sometimes see dark (coca cola or tea coloured) urine during these episodes.

How is Gilbert’s Syndrome diagnosed?

Gilbert’s Syndrome is termed a ‘diagnosis of exclusion’ – meaning that it is a benign condition diagnosed only after other more serious disorders are excluded first. Gilbert’s Syndrome is described in an otherwise well patient who has unconjugated hyperbilirubinemia, normal liver enzyme values (meaning no liver inflammation), and a normal haemoglobin concentration (meaning no evidence of red blood cells being broken down).

How do I live well with Gilbert’s Syndrome?

Gilbert’s Syndrome is lifelong and there is no treatment, because it is a very mild condition. There are no dietary or lifestyle modifications specifically for Gilbert’s Syndrome however you may find it useful to identify which factors trigger your episodes of jaundice ( e.g. stress, excess alcohol, or lack of sleep) and avoid or minimise these if possible.