Empeiria

A harmless inherited cause of high bilirubin

Clinically: Gilbert syndrome · also Gilberts, Gilbert's syndrome, benign hyperbilirubinaemia

genetic ICD-10 E80.4 MONDO MONDO:0007745 unverified
This describes what this condition typically looks like. It is not a diagnosis and cannot tell you whether you have it -- patterns overlap, results vary between labs, and the same numbers mean different things in different people. Diagnosis usually rests on Bilirubin, total, interpreted alongside symptoms and history rather than read off a report.

unverified These explanations are written to be easy to read and have not yet been checked against a source. The ranges and measurement notes on this page show theirs.

definition unverified

An inherited quirk in how the liver processes bilirubin. It is harmless, needs no treatment, and shortens nobody's life.

A common, mild inherited unconjugated hyperbilirubinaemia caused by UGT1A1 variants (most often the UGT1A1*28 promoter variant) that leave about 30% of normal bilirubin-UGT glucuronidation activity; bilirubin levels fluctuate, typically rising with fasting, dehydration, illness, vigorous exercise or menstruation, and rarely reach levels that cause jaundice.

caveats unverified

Worth knowing about mainly so that a raised bilirubin does not cause alarm. The level rises when you are unwell, fasting, or dehydrated, and settles again afterwards. Every other liver test is normal, which is what separates it from anything that matters.

Worth knowing about mainly so that a raised bilirubin does not cause alarm. The level rises when you are unwell, fasting, or dehydrated, and settles again afterwards. Every other liver test is normal, which is what separates it from anything that matters.

No clinical version written yet.

How common it is

Present in roughly three to seven people in every hundred. Most never know they have it.

The typical lab pattern

What the diagnosis rests on

The results a diagnosis is actually made on.

Bilirubin, total high — Mildly raised, mostly as unconjugated bilirubin, usually below 2 mg/dL, with nothing else abnormal. It rises further on a fasting sample.
Points away from it

Results that argue against this explanation.

Alanine aminotransferase either — Normal in Gilbert syndrome. A raised ALT points away from it and towards liver injury.
Alkaline phosphatase either — Normal in Gilbert syndrome, where only bilirubin is raised. A raised ALP points to another cause.

How it usually feels

Frequencies say how often a symptom accompanies this condition — not the other way round. Most people with any of these symptoms do not have this.