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Gilbert syndrome

Medically reviewed by Last updated on Jul 1, 2022.


Gilbert (zheel-BAYR) syndrome is a common, harmless liver condition in which the liver doesn't properly process bilirubin. Bilirubin is produced by the breakdown of red blood cells.

Gilbert syndrome is an inherited genetic condition. You might not know you have Gilbert syndrome until it's discovered by accident, such as when a blood test shows raised bilirubin levels.

Gilbert syndrome requires no treatment.

The liver

The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen, beneath the diaphragm and above your stomach.


The most frequent sign of Gilbert syndrome is an occasional yellowish tinge of the skin and the whites of the eyes as a result of slightly higher levels of bilirubin in the blood. In people with Gilbert syndrome, bilirubin levels may increase due to:

When to see a doctor

Make an appointment with your health care provider if you have jaundice, which has many possible causes.


Gilbert syndrome is caused by a modified gene you inherit from your parents. This gene usually controls an enzyme that helps break down bilirubin in your liver. When you have an ineffective gene, your blood contains excess amounts of bilirubin because your body doesn't produce enough of the enzyme.

How the body processes bilirubin

Bilirubin is a yellowish pigment made when your body breaks down old red blood cells. Bilirubin travels through your bloodstream to the liver, where the enzyme breaks down the pigment and removes it from the bloodstream.

The bilirubin passes from the liver into the intestines with bile. It's then excreted in stool. A small amount of bilirubin remains in the blood.

How the modified gene is passed through families

The modified gene that causes Gilbert syndrome is common. Many people carry one copy of this gene. In most cases, two modified copies are needed to cause Gilbert syndrome.

Risk factors

Although it's present from birth, Gilbert syndrome usually isn't noticed until puberty or later, since bilirubin production increases during puberty. You have an increased risk of Gilbert syndrome if:


The low level of the bilirubin-processing enzyme that causes Gilbert syndrome may also increase the side effects of certain medications, since this enzyme plays a role in helping clear these medications from your body.

These medications include:

If you have Gilbert syndrome, talk to your health care provider before taking new medications. Also, having any other condition that impairs the destruction of red blood cells may increase your risk of developing gallstones.


Your health care provider may suspect Gilbert syndrome if you have unexplained jaundice or if the level of bilirubin is elevated in your blood. Other symptoms that suggest Gilbert syndrome as well as a number of other liver conditions include dark urine and abdominal pain.

To rule out more-common liver conditions, your health care provider may order a complete blood count and liver function tests.

The combination of standard blood counts and liver enzymes with an elevated bilirubin level is an indicator of Gilbert syndrome. No other testing usually is needed, although genetic testing can confirm the diagnosis.


Gilbert syndrome doesn't require treatment. The bilirubin levels in your blood may fluctuate over time. You may occasionally have jaundice, which usually resolves on its on with no ill effects.

Self care

Certain life events, such as stress, can trigger episodes of higher bilirubin levels in Gilbert syndrome, leading to jaundice. Taking steps to manage those situations can help keep bilirubin levels under control.

These steps include:

Preparing for your appointment

Before your appointment, you might want to jot down questions to ask your health care provider, including:

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