Gilbert’s Syndrome: My Story & A Deeper Look Into This Overlooked Condition
My story with Gilbert’s Syndrome began at birth. I was born jaundiced - my skin a wash of yellow. Thankfully, I’ve never again experienced jaundice to that degree, though I’ve always noticed subtle yellow undertones in my skin and a faint tint in the whites of my eyes. It’s something most people wouldn’t notice, but it has been part of me for as long as I can remember.
From early childhood, I also struggled with mild food sensitivities that worsened during my teenage years. Digestive discomfort, nausea after rich meals, and bouts of constipation were regular companions. I tolerated alcohol far less than my peers and discovered quickly that I was highly sensitive to medications, particularly opioids and the oral contraceptive pill.
If you’ve recently had bloodwork showing elevated bilirubin, you may have stumbled across the term Gilbert’s Syndrome (pronounced “zhil-bairs”). Often described as benign or harmless, it’s usually dismissed by conventional medicine. But as I’ve learned, both personally and professionally, there’s more to the story. Gilbert’s Syndrome is far more than a lab quirk. It can shape your digestive health, energy, hormone balance and even your mental wellbeing.
What Exactly is Gilbert’s Syndrome?
Gilbert’s Syndrome (aka familial hyperbilirubinemia) is a genetic condition involving the UGT1A1 gene. This gene affects the liver’s ability to process bilirubin - a yellow pigment created when red blood cells are broken down. In Gilbert’s, the liver doesn’t “conjugate” bilirubin efficiently, so unconjugated bilirubin builds up in the bloodstream.
This process isn’t just about bilirubin, it’s about the glucuronidation pathway, one of the liver’s key detoxification routes. Glucuronidation helps clear:
Estrogen and testosterone
Neurotransmitters like dopamine and serotonin
Fatty acids and bile acids
Environmental toxins and pollutants
Medications such as paracetamol, NSAIDs, benzodiazepines and opioids
When this pathway runs at partial capacity, wide-reaching effects can show up in hormone balance, mood regulation, digestion and detoxification.
Common Symptoms of Gilbert’s Syndrome
Many people never notice obvious symptoms, while others experience subtle but chronic complaints. Triggers often include illness/virus, stress, fasting or hormonal changes.
Possible signs include:
Mild jaundice (yellowing of skin or eyes)
Fatigue without clear cause
Nausea after fatty meals or poor fat tolerance
Constipation, diarrhoea, or mustard-coloured stools
Digestive discomfort, bloating or reflux
Low alcohol tolerance
Sensitivity to medications
Hormonal symptoms such as PMS, heavy or painful periods or low libido
Mood swings, anxiety or disrupted sleep
Hormones & Gilbert’s Syndrome
Estrogen metabolism is particularly affected in Gilbert’s Syndrome due to reduced glucuronidation capacity. This can contribute to “estrogen dominance” symptoms such as:
Heavy or painful periods
PMS with anxiety, fatigue, bloating or headaches
Breast tenderness
Fibroids or endometriosis
Weight changes and low libido
Men are not exempt, many experience low testosterone-related symptoms such as fatigue, mood shifts, reduced muscle mass, or erectile concerns.
Histamine intolerance is another downstream issue connected with sluggish estrogen clearance, something I’d like to cover more deeply in a separate post.
Gut Health Connections
The gut-liver axis plays a central role in Gilbert’s Syndrome. Elevated bilirubin and sluggish detoxification can disrupt gut function in several ways:
Leaky gut: loosened intestinal junctions contribute to food sensitivities and autoimmunity risk.
Delayed gastric emptying: food lingers in the stomach, causing bloating, burping and discomfort.
SIBO risk: slower motility creates an environment for bacterial overgrowth, leading to bloating, pain, carbohydrate intolerance and nutrient deficiencies.
Gallbladder stress: because bilirubin is excreted via bile, the gallbladder carries a heavier burden, raising the risk of sludge or gallstones.
The Mental Health Link
Gilbert’s doesn’t only affect the liver and gut, it also influences brain chemistry. Impaired bilirubin clearance disrupts dopamine and glutamate balance, often resulting in anxiety, sleep issues or mood disorders.
A compromised gut barrier can also weaken the blood-brain barrier, allowing inflammatory compounds like LPS (bacterial toxins) to impact the brain. This gut-brain connection helps explain the overlap of Gilbert’s Syndrome with depression, fatigue and brain fog.
Testing for Gilbert’s Syndrome
The most reliable marker is consistently elevated Total Bilirubin - specifically the unconjugated fraction - usually above 15 µmol/L. Liver enzymes and other markers typically remain normal.
Additional tools:
Direct bilirubin (conjugated) stays normal in Gilbert’s.
Fasting vs. non-fasting bilirubin: fasting levels are often 50% higher.
Genetic testing: confirms UGT1A1 variants, though often unnecessary if symptoms and labs align.
Supporting Your Health Naturally
The good news is that with the right lifestyle and naturopathic support, many people find their symptoms can improve significantly!
Step 1: Reduce Triggers
Try to limit or avoid:
Alcohol
Fasting or skipping breakfast
Very high-fat or very low-fat diets
Medications like NSAIDs, paracetamol, oral contraceptives and opioids (speak to your doctor before changing any prescriptions)
Chronic stress or over-exercising
Step 2: Strengthen Detox Pathways
Nutrients and herbs that support the liver and glucuronidation pathway include:
Broccoli sprouts (sulforaphane)
Calcium-D-glucarate
B vitamins, magnesium and zinc
Herbal allies such as dandelion root to support bile flow
Step 3: Repair the Gut
Nutrients like glutamine, vitamin D, zinc carnosine and omega-3s help heal the gut lining.
Support healthy motility and microbiome balance to reduce bloating and sensitivities.
👉🏼 Always consult with a qualified practitioner before starting supplements as each case is unique.
The Silver Lining
Here’s the exciting part: Gilbert’s isn’t all bad news! In fact, research shows people with Gilbert’s often enjoy certain health advantages. Elevated bilirubin is a powerful antioxidant, linked with:
Lower risk of heart disease
Better blood sugar control
Reduced risk of some cancers
Protective effects on aging and DNA health
So while Gilbert’s can bring challenges, it also offers benefits. By learning how to support your liver and gut, you can reduce uncomfortable symptoms and lean into those protective effects.
Final Thoughts…
Gilbert’s Syndrome is far from “nothing.” It’s a sign that your body processes certain compounds differently, and that your liver, gut and hormones need a little extra support.
If you’ve been diagnosed with Gilbert’s or suspect you may have it, know that you’re not alone. With naturopathic support, there are practical, empowering ways to help your body thrive. 🌿
Understanding your biology is the first step to transforming your wellbeing - for deeper support you can book a naturopathic appointment here.
