Gilbert's syndrome

Read NHS information about Gilbert’s syndrome, which is a common and harmless condition where people experience occasional episodes of jaundice (yellowing of the skin and whites of the eyes).

Key Information

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What should I do?

If you think you have this condition you should see a doctor within 2 weeks.

How is it diagnosed?

Your doctor will be able to diagnose Gilbert’s syndrome based on your symptoms, a physical examination and a blood test checking your liver function. A small sample (biopsy) from your liver might be required in some cases to rule out other conditions.

What is the treatment?

No treatment is required for this condition; the yellowing of the skin should resolve on its own, although you may find that it comes and goes.

When to worry?

You should see your doctor within 48 hours if you have the following:

  • vomiting
  • fatigue
  • ‘flu-like symptoms.

Gilbert’s syndrome is a common and harmless condition where people experience occasional episodes of jaundice (yellowing of the skin and whites of the eyes).

Gilbert’s syndrome is caused by a build-up of a yellow pigment, called bilirubin, in the blood. Bilirubin is found naturally in the blood and is formed when red blood cells break down. The body usually removes bilirubin, but in Gilbert’s syndrome this process does not work properly.

If you have Gilbert’s syndrome, during an episode of jaundice you may have symptoms such as:

  • stomach cramps
  • feeling very tired (fatigue)
  • problems concentrating and thinking clearly (brain fog)
  • a general sense of feeling unwell

However, around one in three people with Gilbert’s syndrome experience no noticeable symptoms and the condition is only detected during testing for other, unrelated conditions.

People with Gilbert’s syndrome often find that there are certain ‘triggers’ that can bring on jaundice, such as:

  • being dehydrated
  • going without food for long periods of time (fasting)
  • being ill with an unrelated infection
  • stress
  • in women, having their monthly period

The jaundice and any associated symptoms will pass without the need for treatment.

People with Gilbert’s syndrome are often concerned about having jaundice because jaundice can often be a sign of an underlying liver problem, such as cirrhosis (scarring of the liver) or hepatitis C.

However, it is important to stress that Gilbert’s syndrome is harmless and has nothing to do with liver problems. People with Gilbert’s syndrome are no more likely to develop liver disease than the population at large.

What causes Gilbert’s syndrome?

Gilbert's syndrome is a genetic condition. People with Gilbert’s syndrome have a faulty gene that means their body has problems breaking down a substance in the blood called bilirubin.

Normally, when red blood cells reach the end of their life (after about 120 days), haemoglobin, the red pigment that carries oxygen in the blood, breaks down into bilirubin.

The liver converts bilirubin into a water-soluble form, which then passes into bile and is eventually removed from the body in urine or stools. Bilirubin gives urine its light yellow colour and stools their dark brown colour.

In Gilbert’s syndrome, the faulty gene means that bilirubin is not converted at the normal rate. It builds up in the bloodstream and can cause the skin and eyes to take on a yellowish tinge.

Other than inheriting the abnormal gene, there are no known risk factors for developing Gilbert's syndrome. It is not related to any lifestyle habits or caused by environment factors.

Diagnosing Gilbert's syndrome

Gilbert’s syndrome can be diagnosed using a blood test to measure the levels of bilirubin in your blood.

It is likely that you will also have another type of blood test called a liver function test. When the liver is damaged, it releases enzymes into the blood. At the same time, levels of proteins that the liver produces to keep the body healthy begin to drop.

By measuring the levels of these enzymes and proteins, it is possible to build up a reasonably accurate picture of how well the liver is functioning.

If the tests show that you have high levels of bilirubin in your blood but your liver is working normally, a diagnosis of Gilbert’s syndrome can usually be made with confidence.

Who is affected by Gilbert's syndrome?

Gilbert’s syndrome is a common condition. It is more common in men than women.

The symptoms of Gilbert’s syndrome usually first become apparent around puberty, possibly as a result of the hormonal changes that occur during this time.

Living with Gilbert's syndrome

Gilbert’s syndrome does not require treatment because the condition does not pose a threat to health and is not associated with any complications.

You may find it useful to avoid known triggers for the condition, such as dehydration and fasting.

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