Gilbert Syndrome
Overview
- What is Gilbert Syndrome?
Gilbert Syndrome is a genetic liver disease with low levels of the enzymes that handle bilirubin. Bilirubin is made when blood cells break down.
- How common is Gilbert Syndrome?
Gilbert Syndrome is more common in men than women and shows up in the teen years.
United States: 3-7% of people
Worldwide: 2-10% of Caucasians, 2% of Japanese and Eastern Asians, 20% of Indian, Southern Asian and Middle Eastern peoples
- What is the outlook for people with Gilbert’s Syndrome?
Excellent. Gilbert’s Syndrome does not change the liver’s health or change a patient’s lifespan.
Symptoms
- What are the signs and symptoms of Gilbert’s Syndrome?
Mildly increased levels of one type of bilirubin in the blood. This is called hyperbilirubinemia.
Most people have no symptoms. Sometimes when the body is stressed, the bilirubin gets even higher. This can lead to yellow skin and eyes (jaundice). Body stress can happen with illness, menstruation, dehydration, fasting (skipping meals), too much exercise and with certain medications.
- When should I see a doctor about Gilbert’s Syndrome?
To make the diagnosis and to rule out other liver diseases when bilirubin levels are high.
Causes/Risk Factors
- What causes Gilbert’s Syndrome?
Low amounts of the liver enzymes that break down bilirubin.
- What are the risk factors for Gilbert’s syndrome?
Family history because this is a genetic condition.
Diagnosis
- Who should be evaluated for Gilbert’s Syndrome?
Patients with high levels of bilirubin.
- How is Gilbert’s Syndrome diagnosed?
Blood tests that show high bilirubin without other causes of liver disease. A liver biopsy is rarely needed. If done it shows normal cells. Unnecessary testing should not be done.
Treatment
- What are the treatments for Gilbert’s Syndrome?
Observation. Because there are no symptoms or damage to the liver there is no other treatment needed.
- Am I at risk for developing other conditions?
Yes- including pigmented gallstones, jaundice as a newborn. There is a risk of having toxic drug levels when taking medications that alter bilirubin break down. Some of those medications include: atazanavir, indinavir, acetaminophen, tyrosine kinase inhibitors, nonsteroidal anti-inflammatory drugs, statins, ezetimibe, oxazepam, lorazepam, lamotrigine, cyclosporin A, rifampin, ethinylestradiol, buprenorphine, menthol, and tocilizumab.
Author(s) and Publication Date(s)
Victoria Howard, PA, University of Rochester, Rochester, NY – Updated December 2025.