What is Gilbert’s Syndrome?

What’s wrong with my liver?! What is this Gilbert’s Syndrome?!

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A French Dr Gilbert discovered Gilbert’s Syndrome in the early 1900’s and so it was named after him. There’s a technical name for it too : ‘Unconjugated hyperbilirubinaemia’, but that just describes how it works in medical words.

You have Gilbert’s Syndrome because you have a gene that is different from most people’s (mutated). The gene is called: uridine-diphosphate  – glucuronosyltransferase, which which means you’ve got less of the enzyme (called UGT for short) that is linked to it.  An enzyme is a chemical substance in your body that causes a chemical reaction to happen. Because you have less of this UGT stuff your body works slightly differently from most people’s. Ta da ! Gilbert’s Syndrome symptoms! Here are some of the Gilbert’s Syndrome symptoms you might recognise:

Gilbert’s Syndrome and Jaundice –
Red blood cells release ‘bilirubin’ into the bloodstream, which the liver should pick up and convert to bile, and then flush from the body. In Gilbert’s Syndrome, without the enzyme needed to do this properly, the bilirubin builds up and and can make you look yellow.  It’s also key in diagnosing Gilbert’s Syndrome, through blood tests which identify fluctuating levels of bilirubin in the blood. Gilbert’s Syndrome is also known by this symptom as Unconjugated hyperbilirubinaemia.

Gilbert’s Syndrome and toxins  –
Parts of the liver, called the ‘Phase II’ pathways, process certain toxins, for example: pollution; chemical fumes; and chemicals in some drugs.  This process, called glucuronidation, has been reported to be 31% slower in the typical person with Gilbert’s Syndrome.  Numerous studies have shown various drugs are processed less well by people with Gilbert’s Syndrome.

Many of the resulting symptoms of our liver’s reduced ability to do the cleaning it’s designed to – jaundice, nausea, fatigue, shakiness, bowel complaints, vomiting, ‘brain-fog’ or difficulty concentrating, are experienced in varying degrees by those with Gilbert’s Syndrome.

Doing some particular things may make these symptoms worse, by placing extra stress on your liver.  Missing meals, lack of sleep, vigorous exercise, illness and stress can all bring on the symptoms.

Most important in keeping your liver working as well as possible is keeping your blood sugar level stable.  This is because the enzyme we don’t have much of uses sugar to help get rid of the toxins it is supposed to deal with.  We can also fool the liver into making more of the enzyme by eating certain foods and diet and Gilbert’s Syndrome is important in managing your symptoms.


31% reduced glucuronidation https://www.sciencedirect.com/science/article/abs/pii/0016508592901069#:~:text=Gilbert%27s%20syndrome%20occurs%20in%205,in%20its%20accumulation%20and%20jaundice.

explanation of glucuronidation and use of glucose in enzyme process https://gilbertssyndrome.org.uk/wp-content/uploads/2022/10/Glucuronidation-process.pdf

40 Replies to “What is Gilbert’s Syndrome?”

  1. I am the opposite I have GS and have been very skinny all my life, I cant gain any weight even if I eat alot due the nature of my liver.

    1. Hi Norman, yes, body shape can be impacted by many different things. I have found a whole food plant based diet that is low in fat works best to keep me fit and healthy and full of energy, it also means I am slim as it’s very difficult to add weight when mostly eating plants! Many who avoid fat, alcohol and sugar to help with their Gilbert’s Syndrome will find they have a lower than average weight too. Everyone’s health and metabolism and genetics are different though, and other factors such as thyroid issues, food control issues and inability to exercise due to fatigue can make it harder to stay a healthy weight. Thanks for sharing!

  2. Hi, I’m 28 and suspected by GP to have GS due to >20 bilirubin. I’ve had no symptoms other than occasional yellow eyes, but recently I woke up one morning feeling drunk without having drunk anything, have felt like this continuously for 2 months now, eye tests have shown my vision is fine. Can’t find any similar symptoms anywhere when researching GS… my ALT is slightly high and platelets low but not sure if this could be down to GS?


    1. Hi Dec, thanks for sharing your symptoms. Just to note – I’m not medically qualified and this website plus any comments are no substitute for medical advice. Without knowing a great deal more about your symptoms or your medical history I will restrict my thoughts to general observations which may or may not help! The yellow eyes and bilirubin count – with not other clinical reason, sounds like GS as your GP notes. I’m not sure what you mean about feeling drunk – but it’s common for people with Gilbert’s syndrome to feel nauseous, have brain fog, fatigue, and generally unwell (a bit like you’ve got a hangover). I also feel dizzy and like I have vertigo when I’m overtired. Are these the sorts of symptoms that you mean? I have found that with rest, which includes sleep, relaxation and reduced physical exertion, plus regular meals (not fatty or sugary, but with good fibre and protein content), that symptoms usually go after a few days. If I have recently had a virus then these symptoms can be more acute and it might take longer. If you continue to feel unwell then I would definitely consult your Doctor. Previously I have thought I have felt unwell due to Gilbert’s Syndrome, to find that I have a vitamin or mineral deficiency instead! Regarding your platelet levels – there is a study that shows low platelet levels may be associated with Gilbert’s Syndrome and you can find more here: https://pubmed.ncbi.nlm.nih.gov/23348429/ I hope that is of some use, take care and hope you feel better soon.

  3. Hi there , for months now my boyfriend has been ill , his eyes have had for quite some time and yellow tone to then . Often had a upset stomach then recently for the past month or so a family member has been ill and passed away and now he has been vomiting most morning’s, hes lost weight etc seems to be typical symptoms . Gps have done some tests and think it may be gs. All feeling very overwhelmed because there is no cure. It says handle ur stress but how does one even do that! Any tips for the vomiting and constantly feeling unwell and good things for it would be appreciated
    Thank you

  4. I was just diagnosed with Gilbert’s. I wanted blood work done because there were times I just felt exhausted and could not function. After months of test they finally told me this. They also said its nothing to worry about and there is nothing that can be done for it.

  5. I lowered my total bilirubin from 2.6 to 1.7 in a little over a month by adding broccoli extract powder and Green Superfood powder to my daily fruit smoothie. Google “cruciferous bilirubin” for some articles on the connection between broccoli and other cruciferous vegetables and bilirubin processing.

  6. Try calcium d-glucarate in small amounts say 250mg. Get your bilirubin levels checked after a month or so. If they haven’t gone down raise the amount. It made my levels normal after a lifetime of being high. And yes like all of you it has caused lots of havoc. Autoimmune disorder issues, sensitivities, exhaustion, but worse it keeps estrogen levels too high leading to fibroids, thickened uterus lining etc. the key I’m finding is optimize your liver. This kingpin is d glucarate but also indole3carbinole milk thistle turmeric. And of course a healthy diet with lots of water and not too much fat (fat can be good for you but I believe Gilbert’s makes it harder to process). Also cut back on simple carbs and processed food. Hang in there. This can be improved.

  7. Well I agree with most things said here am 37 was told last year I had gs after plenty of trips to the doctors, feeling tired dizziness fell like going to pass out it’s the feeling u get when you getup to fast but a lost worse and could be sat down and feel it, alcohol well a couple and it’s a no go as gos straight to my head now, the doctors just seem not to be both no more now they have labeled me and say nothing they can do so it’s good to find this sight and read that am not the only one and it’s not in my head and must be because of gs as I have most of the things said, think it’s about time the doctors took gs seriously and not just dismiss you and make you feel yr wasting there time as sometimes u feel really unwell

  8. I was diagnosed with Gilberts aged 30 yrs when pregnant with my fourth child. Before then I had had episodes of jaundice and nausea, fatigue and aching which was put down to various things such as glandular fever. I was given a diagnosis of CFS aged 40, which was then found (after more detailed testing) to actually be a specific neurological disease, neuromyotonia (symptoms include cramps, fasciculations, sweating, intense fatigue, sharp muscle/nerve pains, etc). This was diagnosed at the same time that blood tests showed up macrocytosis (enlarged red blood cells) and low serum B12. The neurologists prescribed B12 intramuscular injections every second day for life to prevent further peripheral neuropathy. This helps with many of the symptoms of neuromyotonia, and also seems to have helped the Gilbert’s symptoms. I still get the symptoms when I have got too tired, stressed or if I m not eating enough. Dieting is difficult although I need to as I am overweight. It definitely helps to get enough sleep but medical problems of other members of the family mean that I often have only 4 or 5 hours of broken sleep, symptoms are much worse after nights like that.


    1. Tanya, I lost alot of weight too. I often feel sick and not like eating. Abdominal pains and IBS are also common in people with Gilbert’s Syndrome. I drag myself around from day to day in a tired haze, and getting enough sleep is absolutely vital. A good eight hours is really important for you. Look after your diet, there are lots of tips on this website, drink lots of water, get lots of sleep, and try milk thistle and other liver friendly herbs. Hopefully that will perk you up.

  10. Dear,

    My nam is Mario, I have 36 years old and have diagnostic Gillbert syndron.
    I have one simple question, can this syndrom be a couse off ”fat liver” diagnostic with ultrasund. My ALT, AST, GGT, Cholesterol are normal, but ultrasound of my liver is very very ”fat liver”. I am not fat, i have 75 kg, and 175cm of high.

    Thanks to all.

    1. Hi there, actually usually Gilbert’s Syndrome would protect you against fatty liver as you wouldn’t do the things which cause it. Fatty liver is a different thing, and isn’t related to being fat. I’d suggest researching fatty liver more as a separate condition. Hope that helps

  11. I have GS and suffer from fatigue and brain fog. The British Liver Trust publish a leaflet on GS which was written by a consultant in Southampton. Has anyone seen him ?

  12. This is an interesting site. I was diagnosed with ME/CFS years ago and also GS. The Dr’s always said that GS doesn’t cause any symptoms but after reading other people’s experiences with GS I sometimes wonder whether all my symptoms are down to GS.

    1. Hi, there is certainly speculation that the two could be one and the same, and that they certainly impact each other. I’ll be publishing a story about that in due course, from someone else who suffers both. Stay posted, best Adina

    2. PS, I came across this statistic, but don’t have a record of from where: Studies show that people with GS are four times more likely to have Chronic Fatigue Syndrome (CFS), and also that 75% of those with CFS have allergies. In fact, some suggest that CFS is the effect of chronic allergies.

      1. Hi, I got diagnosed aged 24 after a lifetime of fatigue, tummy pains, aches. I have been seriously unwell for 4 years to the point of wanting to top myself but had to fight on for my kids. My gp suspected fibro,cfs after a million test they dx fibro. I never mentioned I had gilberts as I was told at the time it was harmless but would causf fatigue etc. When I say ive had 1 good day in 7 for the last 4 yrs im not lying. Symptoms. Hot and cold sweats flashes, aches, stiffness, migraines, poor eyesight, foggy head, head pressure, cognitive problems, adverse reactions to meds, hangovers for days, jumpiness,insomnia, bruised feeling of the skin, feeling fluey. After plenty of research into gs ive started milk thistle before a meal and tumeric afterwards and after a week ive seen a 50 % reduction in my symptoms especially the disabling fatigue that has left me in bed and dragging my self about. I hope. To improve furthes ive had 4 yrs of my life taken by gs im not convinced by fibro. Doctors need to stop passing this off as harmless I almost ended my life or would of had I have to liue another 30 yrs as ill as I was. Anyone who is suffering milk thistle and tumeric help I swear by it so far, im booking in with my gp to discuss my improvement and to tell her about my gilbert7 as itl be way bk in my record and I never mentioned it as was told it was harmless yeah right we cant shift toxins well with gs that is not harmless, I really think alot of cfs/fibro patients could be undiagnosed gilberts x

        1. Im now 39 and got dx with gs when I was 24 , cant believe I failed to mention it to my gp as I change docs a few times. I had jaundice aged 6 too, gs needs more research and studys into the toxic effects we suffer x

    3. Thanks for your research. Yeah I believe they are related in some measure, I don’t know if medical science will come up with something. They seem to be very slow on things like this.

    4. I too have suffered with ME for many years and was told when I was formally diagnosed that I had GS, but it was nothing to worry about, there was no treatment or cure, just to be aware I had it in case it came up in further tests. My brother also has it and had jaundice as a baby. He was also ill with hepatitis as a young adult. Other than that he doesn’t appear to have symptoms, although the whites of his eyes go yellow if he is unwell.

      I have been undergoing treatment that clears the hypothalamus of toxins via lymphatic drainage, called the Perrin Technique. It has been life transforming. But migraines have set me back and medication causes tiredness. I have been thinking about GS again and its interesting to read about other people with it and how they are affected. But most especially someone else who has the same combination as me.

  13. Hi, it is so good to find a website which recognises the fact that people with GS can in fact feel extremely unwell. I was diagnosed many years ago during a particularly long spell of GS. Neither of my parents was ever diagnosed or had any suspicions that they may have GS.
    Last year, after several weeks of feeling unwell, my son aged 15 was diagnosed as having it too. Our main problem seems to be knowing how best to handle it so that the symptoms reduce quicker – a lot of trial and error has gone on. As described by others on the website, doctors either don’t know much about it or dismiss it as not much of a problem. They haven’t been able to give us very much useful information apart from referral to websites.

    1. Hi there May, you are exactly right – trial and error is how I have managed to control my symptoms, but even then life circumstances are not exactly within control all the time. That’s why I wanted to offer people the benefit of all the hard work I do to try and live ‘well’ so that those with symptoms are not alone and can find a short cut to trying what might work for them. If you’d like to send more information about what you find works for you and your son please do email help@gilbertssyndrome.org.uk. I am hoping to write a self-help book to compile the information for other people to access. thanks again, Adina

    2. I was first told I had high bilirubin at age 13 but nothing more was said about it and I wasn’t aware it was a problem until much later in life even though I always seemed to have something wrong with me – sinus, headaches, aches and pains, constant nausea etc.
      When I was pregnant at age 31 I had a severe attack of vomiting and diarrheoa, I thought I was having a miscarriage. Stomach bug was diagnosed and I went on to have these attacks about once or twice a year for the next 10 yrs.
      A GP told me in my early forties that these attacks were oesophageal reflux and it was quite common for women of my age. He also told me I had GS but it didn’t mean anything and would cause me no problems. However as I entered my late 40’s and early 50’s (I’m 52) my period became irregular due to normal hormonal changes but the episodes and severity of the attacks have increased.

      I have also lost weight, have lots of aches and pains, vertigo, shakiness, nausea, the smell of perfumes makes me feel ill or gives me a massive headache and I can’t tolerate alcohol. After lots of different tests and hundreds of dollars spent having acupuncture, physio, massage and naturopathic consultations I don’t feel any better. My bilirubin level was 73 in 2008 when I had a particularly bad attack. I have had more episodes since but recently had to go to hospital in an ambulance as I was so ill. I am waiting to find out my bilirubin level (it’s normally about 40) but my GP still doesn’t think it has anything to do with the attacks!! or that it is causing any of my problems.
      Are these symptoms familiar to anyone else?

      1. Hi Donna, I’m sure these symptoms will be familiar to many, including myself! I take medication for acid stomach, and have had stomach problems for 20 years, I lost alot of weight after first getting Gilbert’s Syndrome symptoms, and often suffer nausea, vertigo, shakiness and chemical smells make me feel very unwell. Many of these symptoms could be put down to the liver struggling. When I am hungry I become jaundiced and very shaky. When I’m over tired I can get jaundice, abdominal pains and vertigo. Diet helps, as does regulation of excercise, stress and life in general! Plus getting lots of sleep helps (unfortunately I’m not very good at getting sleep). I don’t get attacks of vomiting and diarrheoa any more, possibly thanks to taking as many precautions as is reasonable, as mentioned, but also I took a series of high dose probiotics to try and get back the balance in my gut, which had clearly suffered from a number of years of diarrhoea. Very best of luck in trying to manage your symptoms. regards Adina

        1. Please have a look at this site – http://www.msgtruth.org/why.htm – and also here – http://unblindmymind.org/ . The last link is the site which led me to find out the information that’s answered nearly all the questions of what’s ailed me all my life. Biochemistry of food is still poorly understood by many Doctors. We are putting Chemicals into our food that are unfortunately, making us ill to varying degrees, Gilberts Syndrome will make this worse. Trying to avoid MSG is difficult but may transform your life.

          1. I react very badly to MSG and also aspartame . Sometimes my body craves sugar. I also had a bout of ulcerative colitis 6 years ago which I think had a connection.

      2. When I read your comments, it was like reading about myself, incredibly spooky. At this moment in time I am sat in hospital, it is the middle of the night, the wind is battering the windows and I am here undergoing tests because I keep getting ill over the last few years, always the same thing, only getting progressively worse and this attack is the worst so far.

        I never knew that GS did this, I was just told I cannot metabolise alcohol, as I am not a drinker I didn’t see this as an issue. Now, I am beginning to realise that it far from the dismissive thing that the doctor made out.

        I am 47 and going through the change, I am assuming this is why it is getting worse. I have never come across anyone else with the same symptoms as me before. It makes me want to cry and I am not a crier!

        There must be something that can be done to change this.

    1. Hi there, you can find advice on good foods for people with Gilbert’s Syndrome in the diet category on this website. Hope that helps.

  14. I have a question with regards to having recently been told about having Gilberts Syndrome. It was discovered (by fluke) after I was struggling to balance thyroid medication in order to feel better. After having 2 daughters in 2 years I developed Hashimoto’s Disease. I am trying at this time to read up about as much as possible of anything that can affect me (for good and bad) and wondered if there are any links discovered. Also, will GS affect the way my meds work at all? I do think my brother has this too (GS I mean) as he had an operation a while ago and they thought he was given an overdose of pain medication as he turned all yellow (but perhaps it was not an overdose as such after all?!). Any comments would be much appreciated as I am faced with dealing things mostly alone as my GP and endocrinologist are far too relaxed about things for my liking.

  15. You say that “diet plays an important part in managing GS” but I cannot find any further reference to diet on your web site.

    Which foods should I avoid and which foods should I be encouraged to consume ?


    1. Hi there, please do check back as the site progresses and more information is updated and added. Diet is a large section which will be covered.
      very best

        1. I dont understand what happened to me my biliuribin levels are always high both unconjugated and conjugated. And also my gastroentrologist suggested me it is gs. i have these high levels for past 3 years.
          I am confused.

          1. Hi Verma, yes, both levels may be high in Gilbert’s Syndrome. I hope some of the information on the website helps you.

    2. I have Gilbert’s and found it improved my symptoms if I divided my meals up throughout the day, to have more frequent small meals. This probably keeps your albumen levels more constant. Avoid foods that are hard on the liver, such as alcohol or high-fat foods. If I am feeling poorly, I put myself on a lower fat diet for a few weeks, and try to eat foods with less than 5% fat content. This seems to help me. You just have to find out what works for you, by trial and error. Good luck.

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