Gilberts Syndrome – Symptoms and Causes

Overview

The liver is the largest internal organ in the human body. Comparable to the size of a football, it sits mainly in the upper right section of the abdomen. This important organ rests below the diaphragm and above the stomach.

The liver performs many critical functions, including processing bilirubin, which comes from the breakdown of red blood cells.

Gilbert syndrome affects how the liver processes bilirubin. This genetic condition is inherited and generally harmless. Many people don’t realize they have this condition until blood tests reveal higher bilirubin levels. Fortunately, Gilbert syndrome doesn’t require treatment.

Signs and Symptoms

The most common symptom of Gilbert syndrome is a yellowish color in the skin and eyes caused by higher bilirubin levels in the blood.

Several factors can trigger increases in bilirubin:

• Common illnesses like colds or flu
• Not eating enough or skipping meals
• Not drinking enough water
• Monthly periods in women
• Heavy physical activity
• Emotional or mental pressure

These triggers are temporary, and symptoms usually disappear once the triggering factor resolves.

When to see a doctor

If you notice yellowing of your skin or eyes (jaundice), contact your healthcare provider right away. Jaundice can be a sign of several different health issues. A doctor can determine the cause and recommend proper treatment.

Why It Happens

Bilirubin is a yellow substance created when old red blood cells break down. This normal process happens constantly in your body. When functioning properly, this process works like this:

1. Red blood cells break down after their lifespan ends
2. Yellow bilirubin enters the bloodstream
3. Blood carries bilirubin to the liver
4. Special enzymes in the liver process the bilirubin
5. Processed bilirubin moves into bile and then intestines
6. Most bilirubin leaves the body in stool

In healthy individuals, a small amount of bilirubin stays in the blood. People with Gilbert syndrome have higher blood bilirubin levels because their liver can’t process it efficiently.

Genetic Inheritance Pattern

Gilbert syndrome runs in families through a specific inheritance pattern. The condition develops when a person inherits two copies of the modified gene—one from each parent. This gene controls production of the enzyme that processes bilirubin.

Many people carry just one copy of this modified gene without developing symptoms. The modified gene is actually quite common in the general population. When both parents carry the gene, their children have:

• 25% chance of getting two normal genes
• 50% chance of carrying one modified gene (typically no symptoms)
• 25% chance of getting two modified genes (Gilbert syndrome)

Risk Factors

Gilbert syndrome exists from birth but typically becomes noticeable during or after puberty when the body produces more bilirubin.

Your chances of having this condition increase if:

• Both parents carry the genetic mutation that causes Gilbert syndrome
• You are male

These factors can help predict who might develop symptoms of elevated bilirubin levels over time.

Complications

People with Gilbert syndrome may face increased side effects from certain medications due to their lower levels of the bilirubin-processing enzyme. This enzyme helps clear medications from the body. When it’s reduced, issues can arise.

Medications that may cause problems include:

• Irinotecan – a drug used in cancer chemotherapy.
• Some protease inhibitors – used in HIV treatment.

If you have Gilbert syndrome, always consult with your healthcare provider before starting any new medication.

Also, other conditions that affect red blood cell breakdown may increase your risk of developing gallstones.