Answers
Bilirubin slightly high but I feel fine: is it Gilbert's syndrome?
Short answer
Gilbert's syndrome is a common, harmless inherited condition in which the liver processes bilirubin a little slowly. Bilirubin, mostly the indirect type, is mildly raised while all other liver tests are normal. The eyes may look slightly yellow during fasting, illness, stress or poor sleep. It needs no treatment and does not damage the liver.
Signs
It is often first noticed in teenagers and young adults, more often in men, and sometimes during a Navratri or Ramzan fast.
- Mildly raised bilirubin, usually under 3 to 4 mg/dL, found on a routine test
- Indirect (unconjugated) bilirubin makes up most of it
- Normal SGPT, SGOT, alkaline phosphatase, albumin and blood counts
- Slightly yellow eyes after fasting, a fever, hard exercise, stress or late nights
How it is confirmed
Your doctor checks that the raised bilirubin is mainly indirect, that liver enzymes and blood counts are normal, and that there is no breakdown of red blood cells (haemolysis). Repeating the test after a few weeks usually shows the same mild pattern. A genetic test is rarely needed.
What it means for you
- It is not a liver disease and does not lead to cirrhosis
- No diet, medicine or 'jaundice treatment' is needed
- Eat regular meals and avoid long fasts if the yellow colour bothers you
- Tell doctors you have it, as a few medicines, including some cancer and HIV medicines, are handled differently
When it is not Gilbert's
See a doctor if bilirubin is high along with raised liver enzymes, dark urine, pale stools, itching, anaemia, weight loss or belly pain. These suggest another cause that needs tests.
Food and Gilbert's syndrome
Eat more
- Regular meals at fixed times
- Enough water through the day
- A normal, balanced diet; nothing special is needed
Cut down
- Long fasts or skipped meals, which make the eyes look more yellow
- Crash diets
- 'Jaundice diets' and herbal remedies, which are not needed
Good to know
- The yellow tint is harmless and fades once you eat normally again.
- Sleep, hydration and managing stress help as much as food.
Common questions
Can I fast during Navratri or Ramzan?
Yes. Your eyes may look slightly yellow during the fast, which is harmless. It settles once normal eating resumes.
Will it turn into hepatitis or cirrhosis?
No. Gilbert's syndrome does not damage the liver. Other liver problems are no more likely because of it.
Do I need to repeat tests every year?
No, once the diagnosis is clear. Repeat tests only if you develop new symptoms or other liver tests become abnormal.