Gilbert’s Syndrome: Why Mild Jaundice Isn’t Always a Sign of Liver Disease

November 6, 2025

Gilbert’s Syndrome: Why Mild Jaundice Isn’t Always a Sign of Liver Disease

Verified By
KIMS-SUNSHINE
Specialist,
06 November, 2025

Having yellow coloured skin, nails or the iris of the eyes has long been associated with jaundice and can be a cause for great alarm in most people. But, for some individuals, high bilirubin levels can be a normal occurrence, which means they will look mildly jaundiced often. This mild jaundice is called Gilbert’s Syndrome, by doctors. It is a genetic condition and while it is harmless, it still seems to affect over 20% of the Indian population. The incidence is higher in India, when compared to other countries in the world. This can be attributed to the presence of a specific genetic mutation of the UGT1A1 gene.

What is Gilbert’s Syndrome?

Gilbert’s syndrome is a medical condition that affects how the liver functions and processes the breakdown of old red blood cells. RBC breakdown is what forms bilirubin – which is a waste product that needs to be removed. But, if too much is retained by the blood, jaundice can be observed. This retention occurs because the amounts of a specific enzyme needed for the process is produced in lower than usual quantities. The liver is a super important organ that takes care of a lot of metabolic functions in the body. While jaundice is normally associated with abnormal functioning of the liver, in this particular instance, it is not a worrisome symptom.

Causes Of Mild Jaundice

Gilbert’s syndrome is a genetic condition that is caused by a genetic mutation of the UGT1A1 gene. This causes the liver to make less amounts of the enzyme needed to break down old RBCs. The bilirubin thus obtained is sent into the intestines, along with bile (giving bile its characteristic yellowish green tinge) and gets excreted in stool. Some bilirubin will however be present in your blood always

Gilbert’s Syndrome Symptoms

Apart from mild jaundice, some people may also show other symptoms like

Dark urine or clay coloured stool
Not being able to concentrate or focus on tasks for long.
Having GI issues like diarrhoea, nausea or abdominal pain.
Flu like symptoms
Not having much of an appetite.

Symptoms can get worse if someone is on their period, or are very dehydrated. It can also be due to some form of stress, skipped meals or too much physical activity.

Diagnosing Gilbert’s Syndrome (Blood Test, Bilirubin Levels)

Liver function tests and blood tests are commonly used to diagnose this condition. Genetic tests may also be done to check for mutations which cause the condition.

Difference Between Jaundice And Liver Disease

Gilbert’s syndrome is a benign condition that does not cause any long term problems. But, liver disease is a chronic condition that can get worse, if not diagnosed and treated in time. The presence of scar tissue or fibrosis can also cause abnormal liver function.

Conclusion

Lifestyle management for Gilbert’s Syndrome can include making sensible changes to your diet and lifestyle. Skipping meals or getting dehydrated can exacerbate symptoms, so being mindful of these 2 factors by staying hydrated and eating on time can help. Workouts need to be moderately paced and consistent and you should never overdo it on a particular day. Getting enough sleep can greatly help with stress management too, in the long term. Try not to drink too much and continue taking any medications that you have been prescribed. Following these simple and basic rules can help you stay healthy for a long time. Talk to your doctor or a hepatologist, for a more specialised overview, for effective management of your symptoms.

Frequently Asked Questions

What is Gilbert’s syndrome?

Gilbert’s syndrome is a common, harmless inherited liver condition in which the liver does not properly process bilirubin, a yellow pigment produced from the breakdown of red blood cells. This occurs due to reduced activity of the enzyme that helps remove bilirubin from the blood. Many people have it without knowing.

Why does Gilbert’s syndrome cause mild jaundice?

In Gilbert’s syndrome, the liver enzyme that processes bilirubin—called UDP-glucuronosyltransferase—is less active than normal. This means bilirubin builds up slightly in the blood, giving the skin and eyes a yellowish tint known as jaundice. Jaundice often appears during times of stress, fasting, illness, dehydration, or lack of sleep, when bilirubin levels temporarily rise. It usually resolves on its own without treatment.

How is Gilbert’s syndrome diagnosed?

Gilbert’s syndrome is diagnosed through blood tests showing mild, persistent elevation of unconjugated bilirubin, with otherwise normal liver function. Other causes of jaundice, such as hepatitis or haemolysis, are ruled out first. Genetic testing can confirm the diagnosis but is rarely needed.

Can Gilbert’s syndrome cause any serious health problems?

Gilbert’s syndrome does not cause liver damage, long-term complications, or serious illness. However, some people may experience mild fatigue or abdominal discomfort. Rarely, certain medications may build up in the body because the enzyme that processes bilirubin also helps metabolise some drugs.

Can people with Gilbert’s syndrome live a normal, healthy life?

Yes, people with Gilbert’s syndrome can live completely normal and healthy lives. The condition does not affect life expectancy, fertility, or general wellbeing. Mild jaundice may appear occasionally, but it is temporary and harmless. Maintaining a balanced diet, staying hydrated, managing stress and avoiding prolonged fasting can help prevent flare-ups.