Gilbert's (zheel-BAYRS) 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.

If you have Gilbert's syndrome — also known as constitutional hepatic dysfunction

and familial nonhemolytic jaundice — you're born with the condition as a result of an
inherited gene mutation. You might not know you have Gilbert's syndrome until it's
discovered by accident, such as when a blood test shows elevated bilirubin levels.

Gilbert's syndrome requires no treatment.

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Symptoms

The most frequent sign of Gilbert's syndrome is an occasional yellowish tinge of the
skin and the whites of the eyes as a result of the slightly elevated levels of bilirubin in
the blood. In people with Gilbert's syndrome, bilirubin levels may increase and
jaundice may become apparent because of:

 Illness, such as a cold or the flu

 Fasting or eating a very low-calorie diet

 Dehydration

 Menstruation

 Stress

 Strenuous exercise

 Lack of sleep

When to see a doctor

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

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Causes

An abnormal gene you inherit from your parents causes Gilbert's syndrome. The gene
normally 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 normally 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 abnormal gene is passed through families

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

Risk factors

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

 Both your parents carry the abnormal gene that causes the disorder

 You're male

Complications

The low level of the bilirubin-processing enzyme that causes Gilbert's 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:

 Irinotecan (Camptosar), a cancer chemotherapy drug

 Some protease inhibitors used to treat HIV