Symptoms of Gilbert’s Syndrome
The symptoms of Gilbert’s syndrome are typically mild, intermittent, and often go unnoticed. In fact, many people with Gilbert’s syndrome are unaware they have the condition until it is discovered incidentally during blood tests for unrelated issues. Despite its effect on bilirubin processing, the condition does not damage the liver or other organs, and symptoms—when they do occur—are usually harmless.
The hallmark of Gilbert’s syndrome is elevated levels of unconjugated bilirubin in the blood, which can lead to occasional jaundice. However, the condition may also be associated with other non-specific symptoms that can vary in severity and frequency between individuals.
Jaundice: The Primary Symptom
The most recognised and visible sign of Gilbert’s syndrome is jaundice—a yellowing of the skin and whites of the eyes (sclera). In most cases:
The jaundice is mild and transient
It occurs when bilirubin levels temporarily rise
It may resolve spontaneously without any intervention
The yellowing is usually most noticeable in the eyes and may not affect the skin at all in lighter-skinned individuals. In darker skin tones, jaundice may be more difficult to detect.
Jaundice episodes are often triggered by:
Fasting or skipping meals
Dehydration
Stress, both emotional and physical
Viral illnesses, such as colds or flu
Menstruation in some women
Overexertion or intense physical activity
These episodes may last for a few hours to several days, depending on the trigger and the individual’s metabolic state.
Fatigue and Low Energy
Many individuals with Gilbert’s syndrome report episodes of fatigue or low energy, especially during or following an episode of jaundice. While studies have not definitively linked fatigue to elevated bilirubin levels, it remains one of the most frequently mentioned symptoms among those diagnosed with the condition.
Fatigue in Gilbert’s syndrome is often described as:
A generalised sense of tiredness without clear cause
Difficulty concentrating or mental sluggishness
Feeling drained after normal daily activities
It is important to note that fatigue may also be related to poor sleep, stress, or coexisting conditions, so a thorough assessment is often required.
Gastrointestinal Discomfort
Although Gilbert’s syndrome does not directly affect the gastrointestinal tract, some people report:
Mild nausea
Abdominal bloating or discomfort
Loss of appetite
Occasional indigestion
These symptoms are generally not severe and do not require medical treatment. However, they may coincide with periods of fasting, illness, or bilirubin spikes.
There is no evidence to suggest that Gilbert’s syndrome causes chronic digestive diseases, but heightened sensitivity to changes in metabolism might make the digestive tract more reactive.
Dizziness and Brain Fog
Some individuals with Gilbert’s syndrome mention experiencing:
Light-headedness or feeling faint
Brain fog, described as unclear thinking or mental sluggishness
Difficulty with mental focus, especially during stressful situations or illness
While these symptoms are not universally experienced, they may result from the body’s temporary adaptation to increased bilirubin or stress-related metabolic shifts.
Again, these symptoms are not dangerous and often resolve quickly.
Sensitivity to Medications
People with Gilbert’s syndrome may be more sensitive to certain medications, especially those processed by the UGT1A1 enzyme, which is impaired in this condition. While this is not a symptom in the traditional sense, it can lead to:
Nausea or adverse reactions after normal drug dosages
Delayed clearance of certain medications from the body
Affected drugs may include:
Irinotecan (a chemotherapy drug)
Atazanavir and indinavir (used for HIV)
Certain anaesthetics or sedatives
Though rare, patients should discuss heightened drug sensitivity with healthcare providers to avoid unexpected side effects.
Anxiety or Emotional Effects
The appearance of jaundice or the diagnosis itself can sometimes lead to:
Health anxiety can increase when people mistake jaundice for liver disease
Emotional stress during public events or work situations where visible symptoms are present
Feelings of embarrassment or withdrawal, particularly among young adults
Clear communication about the benign nature of Gilbert’s syndrome can alleviate these concerns and help patients feel more in control.
Symptom Summary
| Symptom | Frequency / Severity |
| Mild jaundice | Common, especially under stress |
| Fatigue or low energy | Reported by many, varies in intensity |
| Digestive discomfort | Occasional, mild and non-specific |
| Brain fog / poor focus | Sometimes reported |
| Sensitivity to medications | Rare but clinically relevant |
| Emotional effects | Common if undiagnosed or misunderstood |
Do Symptoms Change Over Time?
For most individuals, symptoms of Gilbert’s syndrome are intermittent and manageable. The frequency and intensity may vary throughout life, often influenced by lifestyle factors such as diet, stress, and sleep patterns.
In many cases, symptoms diminish with age, and people learn to recognise their own triggers and adjust their routines accordingly.
When to Seek Medical Attention
Gilbert’s syndrome itself does not require regular medical follow-up. However, a medical review is advised if:
Jaundice becomes persistent or more severe
New or unexplained symptoms develop
Fatigue or digestive issues interfere with daily life
Doctors prescribe a new medication, especially if it is processed by the liver
Doctors do this to ensure they do not overlook any unrelated liver conditions.
Symptoms of Gilbert’s Syndrome
Understanding the symptoms of Gilbert’s syndrome helps individuals manage their health confidently, avoid unnecessary worry, and prevent misdiagnosis of more serious conditions.
