Reviewed By: Pramod Kerkar, MD, FFARCSI

Gilbert Syndrome is a harmless genetic condition that causes elevated levels of bilirubin in the blood. Bilirubin is a byproduct of red blood cells breakdown. Gilbert Syndrome, mostly, does not present with any symptoms except yellowing of the eyes and skin. In addition, some individuals complain of fatigue and vague illness. However, these symptoms are not specific to Gilbert Syndrome.

Bilirubin and Gilbert Syndrome

As we know, Gilbert Syndrome is caused due to inability of liver to properly remove bilirubin from blood. The average life span of red blood cells is 120 days and after that, hemoglobin is broken down into heme and globin. Heme part is a waste product, whereas globin protein can be recycled in the body. Heme is broken down to bilirubin that is a fat-soluble yellow-orange pigment. Bilirubin is taken to the liver where it binds to specific proteins to make it water-soluble. This reaction is controlled by uridine diphosphate glucuronyl transferase (UGT) enzyme. The soluble bilirubin is carried to small intestine via bile to be excreted through feces. However, in Gilbert Syndrome, UGT enzyme is defective, so the capacity of liver to convert insoluble bilirubin to water-soluble bilirubin is decreased to about 60 to 70%. This free bilirubin builds up and its concentration rises in blood causing symptoms of yellowing of eyes and skin.

Jaundice and Gilbert Syndrome

The serum bilirubin levels in individuals suffering from Gilbert Syndrome are usually within normal limit or slightly above normal, they are usually less than 6 mg/dl. The skin and eyes of people suffering from Gilbert Syndrome become slightly yellow due to elevated levels of serum bilirubin and jaundice may be triggered particularly in people suffering from Gilbert Syndrome.

Various studies have also shown people with Gilbert Syndrome are prone to other symptoms such as extreme fatigue, dizziness, nausea, headache and abdominal discomfort. Various factors can trigger jaundice including stress, fatigue, insomnia, repeated vomiting, and infections such as virus, heavy menstruation, dehydration, fasting, starvation or surgery.

What Are The Complications Of Gilbert Syndrome?

Mild elevation in bilirubin in Gilbert Syndrome does not harm the liver nor has other repercussions, so no treatment is required for it. A person does not have to follow any diet or any other restrictions, but can surely improve lifestyle in order to meet desired results, so that jaundice can be kept at bay and liver can be kept healthy by eating liver friendly foods. Since it is a lifelong disorder, one needs to eat foods that are healthy and take measures that do not trigger episodes of jaundice.

There are no severe complications of Gilbert Syndrome, but there are certain things that one should avoid in order to live a better and healthy life. A person suffering from Gilbert Syndrome should not fast or starve for long and eat regularly, staying rehydrated and stress free as far as possible.

Since a person with Gilbert Syndrome is deficient in UGT enzyme responsible for processing bilirubin, there may be complications after ingesting certain medications that are processed in the same pathway as bilirubin or medications that inhibit UGT enzyme. The medications that should be avoided by Gilbert Syndrome individuals include certain antivirals such as atazanavir (Reyataz) and indinavir (Crixivan) that are used to treat HIV infection. They should also avoid irinotecan (Camptosar), a drug used in the treatment of advanced bowel cancer along with gemfibrozil (Lopid) that is a drug used in hypercholesterolemia. Statins and paracetamol are partly metabolized by UGT enzyme, so one should consult his/her doctor before taking these medications if they have Gilbert Syndrome, as they may suffer greater side effects when taking these medications. Individuals with Gilbert Syndrome should absolutely avoid alcohol as they may be intolerant to alcohol and may suffer from severe hangovers after consuming it with severe episodes of vomiting.

Thus, individuals with Gilbert Syndrome should always consult their physicians before starting a medication, so that they do not suffer from any side effects of medications.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 31, 2018

This article does not provide medical advice. See disclaimer

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