Gilbert's syndrome

Gilbert’s Syndrome Care in Grand Rapids, Michigan

Gilbert’s syndrome is a common, mild liver condition seen in many otherwise healthy people in Grand Rapids and across Michigan. It affects how the liver processes a natural pigment in the blood called bilirubin, sometimes causing mild jaundice (yellowing of the skin or eyes).

This condition is usually harmless, does not damage the liver, and typically does not require treatment. Understanding Gilbert’s syndrome can help you know when to seek care from a Grand Rapids healthcare provider and when simple monitoring is enough.

How the Liver and Bilirubin Work

Your liver has many important jobs, including:

Filtering impurities and toxins from the blood
Processing proteins, carbohydrates, and fats
Producing bile to help digest fats

Bilirubin is a yellowish‑brown pigment formed when old red blood cells are broken down, mainly in the spleen. This bilirubin then travels to the liver, where it is processed and added to bile. Bile is stored in the gallbladder and released into the intestines to help digest fats.

In a healthy liver, bilirubin is:

Taken up by liver cells
Processed (conjugated) by a specific liver enzyme
Excreted into bile and removed from the body through the stool

What Is Gilbert’s Syndrome?

In Gilbert’s syndrome, the liver enzyme that processes bilirubin works less efficiently than normal. As a result:

Bilirubin is not processed as quickly
Levels of unconjugated bilirubin in the blood can rise
The skin and the whites of the eyes may appear yellow (jaundice), especially during certain triggers

Despite this, overall liver function is normal. In Grand Rapids patients, routine liver tests are usually normal except for a mildly elevated bilirubin.

How Common Is It?

Gilbert’s syndrome is:

A common inherited condition worldwide and in the Grand Rapids / West Michigan population
Thought to be inherited in about half of all cases
More frequently diagnosed in men than women
Most often noticed between the late teens and early 30s

Many people in Grand Rapids live their whole lives with Gilbert’s syndrome and never know they have it until a routine blood test reveals a slightly high bilirubin level.

Symptoms of Gilbert’s Syndrome

Most people with Gilbert’s syndrome in Grand Rapids have no symptoms other than occasional mild jaundice.

Most Common Symptom

Yellowing of the skin or eyes (jaundice)
- May come and go
- Often mild
- May be more noticeable in bright winter light reflecting off snow in West Michigan, or in good bathroom/clinic lighting

Some people report:

Mild abdominal discomfort
Gastrointestinal complaints (such as mild nausea or changes in bowel habits)
Fatigue or tiredness
A sense of weakness or low energy

However, research has not clearly proven that these symptoms are directly caused by the higher bilirubin levels. In a city like Grand Rapids, where winter months can already contribute to fatigue and low mood, it’s important to talk with your healthcare provider so other causes (such as anemia, thyroid problems, or seasonal affective disorder) are not missed.

Gilbert’s Syndrome vs Hepatitis and Other Liver Diseases

Because both conditions can cause jaundice, people sometimes worry that Gilbert’s syndrome means serious liver disease. In reality, Gilbert’s syndrome is not related to viral hepatitis.

Key Differences

Gilbert’s Syndrome:

Mild, fluctuating jaundice
Normal‑colored (straw‑colored) urine
No liver damage on blood tests
Usually no fever or severe illness
Normal liver function tests (other than bilirubin)

Viral Hepatitis or Other Serious Liver Disease:

Jaundice often more intense
Dark urine (tea- or cola-colored)
Possible fever, nausea, vomiting, and significant fatigue
Abnormal liver enzyme tests (ALT, AST, etc.)
May cause abdominal pain or swelling

If you live in Grand Rapids and notice jaundice with dark urine, fever, or feeling very unwell, you should contact your doctor, an urgent care clinic, or visit a local emergency department such as:

Corewell Health (formerly Spectrum Health) Butterworth Hospital
Trinity Health Grand Rapids Hospital
University of Michigan Health–West (Metro Health)
Mercy Health facilities in the greater Grand Rapids area

What Causes Gilbert’s Syndrome?

Gilbert’s syndrome is caused by a genetic change that reduces the activity of a specific liver enzyme (usually the UGT1A1 enzyme). This enzyme is responsible for processing (conjugating) bilirubin.

Because of this:

The liver is less efficient at processing bilirubin
Unconjugated bilirubin can build up in the blood
Bilirubin levels may fluctuate, sometimes being normal and sometimes mildly elevated
Jaundice may appear during certain times and then fade

Common Triggers That May Increase Jaundice

People with Gilbert’s syndrome in West Michigan may notice more yellowing when they experience:

Fasting or skipping meals
Illness, such as a cold or flu (common in our colder Michigan winters)
Dehydration, which can occur in both hot summer weather and dry heated indoor air in winter
Stress (physical or emotional)
Lack of sleep
Intense exercise

How Gilbert’s Syndrome Is Diagnosed in Grand Rapids

Gilbert’s syndrome is often discovered by accident during routine blood work or evaluation for another condition.

Typical Evaluation

A Grand Rapids healthcare provider may use:

Medical history
- Ask about episodes of jaundice
- Family history of Gilbert’s syndrome or unexplained jaundice
- Medication use and alcohol intake
Physical examination
- Check for yellowing of the skin or eyes
- Look for signs of liver disease (usually absent in Gilbert’s syndrome)
Blood tests
- Total and direct bilirubin (often shows mildly elevated unconjugated bilirubin)
- Liver function tests (ALT, AST, ALP, GGT), usually normal
- Sometimes additional tests to rule out other liver or blood disorders
Urine tests
- To check for dark urine or other signs of liver disease or infection

Genetic Testing

A genetic test exists that can detect the gene variant associated with Gilbert’s syndrome. However:

It is not usually necessary for diagnosis
It may not be widely ordered in routine care
Most Grand Rapids providers diagnose Gilbert’s syndrome based on blood tests, history, and ruling out other causes

If needed, a specialist such as a gastroenterologist or hepatologist at local centers (for example, Corewell Health, Trinity Health Grand Rapids, or Metro Health) may be involved.

Treatment of Gilbert’s Syndrome

For most people in Grand Rapids, no treatment is needed.

Gilbert’s syndrome is considered harmless
It does not progress to cirrhosis, liver failure, or liver cancer
People with Gilbert’s syndrome can lead normal, healthy lives

Managing Triggers

While you cannot change the genetic cause, you can often reduce episodes of jaundice by:

Eating regular, balanced meals and avoiding prolonged fasting
Staying well hydrated, especially during dry Michigan winters and humid summers
Getting enough sleep
Managing stress with relaxation techniques, exercise, or counseling
Avoiding excessive alcohol use
Talking with your doctor before starting any new medications or supplements

Medications and Gilbert’s Syndrome

In most cases, Gilbert’s syndrome does not affect how people handle common medications. However, for a few specific drugs, reduced enzyme activity can lead to higher drug levels and potential side effects.

Medications That May Be Affected

Some drugs that may have increased toxicity in people with Gilbert’s syndrome include:

Irinotecan – a chemotherapy drug used to treat certain cancers
Indinavir – a medication used in the treatment of HIV/AIDS

If you have Gilbert’s syndrome and are being treated at a Grand Rapids cancer center or infectious disease clinic, your specialist will typically review this and adjust treatment if needed.

General Medication Safety

For most everyday medicines (like common antibiotics, pain relievers, or blood pressure medications), there is no evidence that Gilbert’s syndrome causes problems. Still, it is wise to:

Inform your primary care provider that you have Gilbert’s syndrome
Remind any specialist (oncologist, infectious disease doctor, surgeon) about your diagnosis
Ask your doctor or pharmacist if you are unsure whether a new medication is safe for you

Children and Gilbert’s Syndrome in Grand Rapids

Gilbert’s syndrome can also be diagnosed in children and teens. Pediatric specialists in the area, including those at Helen DeVos Children’s Hospital in Grand Rapids, are experienced in evaluating:

Unexplained jaundice in older children and teens
Differentiating Gilbert’s syndrome from more serious liver conditions
Providing reassurance and guidance for families

If your child has intermittent yellowing of the eyes or skin but is otherwise healthy, your pediatrician may consider Gilbert’s syndrome and order simple blood tests.

Living with Gilbert’s Syndrome in West Michigan

Because Gilbert’s syndrome is mild and non‑progressive, most people in Grand Rapids can:

Work or attend school normally
Exercise and participate in sports
Enjoy outdoor activities year‑round, from Lake Michigan beaches in summer to winter sports

You may notice jaundice more often:

During winter illnesses (like flu, COVID‑19, or other viral infections)
When appetite is low and you’re not eating regularly
During periods of stress, such as exams, job changes, or major life events

In these situations, it is usually enough to rest, hydrate, and maintain a regular eating schedule. If symptoms seem worse than usual or you feel unwell, contact your healthcare provider.

When to See a Doctor in Grand Rapids

Contact a local healthcare provider if you:

Notice new or worsening jaundice
Develop dark urine, pale stools, or intense itching
Have fever, significant abdominal pain, or vomiting
Feel extremely fatigued or weak
Are starting new medications, especially chemotherapy or HIV treatment
Are unsure whether your symptoms are due to Gilbert’s syndrome or something more serious

You can seek care from:

Your primary care doctor or family physician
A gastroenterologist or hepatologist at Corewell Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health
Pediatric specialists at Helen DeVos Children’s Hospital for children and teens

The Kent County Health Department and Grand Rapids Public Health can also provide information about local healthcare resources and help you connect with primary care services if you do not have a regular doctor.

Key Points About Gilbert’s Syndrome in Grand Rapids

Gilbert’s syndrome causes mild, fluctuating elevations of bilirubin, which can lead to yellowing of the skin and eyes (jaundice).
It is a common, inherited, and mild condition; about half of cases have a clear family history.
Men are at higher risk than women and tend to develop noticeable signs in their late teens to early 30s.
Liver function is otherwise normal, and the condition is considered harmless and typically does not require treatment.
Most people have no symptoms other than occasional mild jaundice and live normal, healthy lives in Grand Rapids and beyond.
A small number of medications (such as irinotecan and indinavir) may be affected, so always discuss new drugs with your healthcare provider.

If you live in the Grand Rapids, MI area and have questions about bilirubin levels, jaundice, or Gilbert’s syndrome, schedule an appointment with your local primary care provider or a gastroenterologist for evaluation and reassurance.