What to Eat — and Avoid — if You Have Gilbert’s Syndrome

Being told you have Gilbert's syndrome — which causes bouts of jaundice — can leave you with lots of questions about what foods to eat or avoid. The good news? There's nothing complicated about a diet that will keep symptoms in check: avoid fasting, eat healthy and stay hydrated.

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According to the Mayo Clinic, Gilbert's (pronounced zheel-BAYRS) syndrome is a harmless condition in which the liver doesn't properly process and excrete bilirubin, the pigment produced by the breakdown of red blood cells.

Gilbert's syndrome occurs due to an inherited gene mutation and for the most part doesn't cause day-to-day symptoms. However, people with Gilbert's syndrome can easily become jaundiced, which shows up as yellowing in the skin and whites of the eyes.

Feeling under the weather is a common trigger for jaundice in those with Gilbert's syndrome, says Talal Adhami, MD, an American Liver Foundation spokesperson and gastroenterologist at the Cleveland Clinic. "If there's any febrile illness, maybe an upper respiratory infection, this can increase the production of the bilirubin, which accumulates in the blood [of people with Gilbert's syndrome]," Dr. Adhami says.

People with the syndrome may be more susceptible to jaundice when they are having a menstrual period, Dr. Adhami says, while fatigue and overexertion — running a marathon, for example — are other triggers.

If you were worried that you'll need a complicated diet to manage Gilbert's Syndrome symptoms, relax.

"There are no specific foods to avoid with Gilbert's syndrome and you should just aim for a normal caloric intake and balanced diet," Dr. Adhami says. The condition doesn't have any impact on your weight, but fasting can trigger symptoms, he adds.

"When you don't eat for maybe 12 to 24 hours, this increases the bilirubin mobilization from the fat tissue, which can go into the blood, and [in people with Gilbert's syndrome] trigger an episode of jaundice," Dr. Adhami explains. "Similarly a diet that is very low-fat, or low in caloric intake, can also stimulate jaundice symptoms," he says.

Some people with Gilbert's syndrome choose to eat a higher-fat paleo or keto-style diet. A report in the April 2015 issue of ​American Journal of Medical Case Reports​ claimed success with this type of diet, but it only reported on one patient's experience, and wider recommendations can't be made.

Watching fluid levels is also very important for people with Gilbert's syndrome. "Dehydration can trigger levels of bilirubin to rise," Dr. Adhami says. People more prone to dehydration are those with diabetes, older folks and people who take medication with a diuretic action (such as some blood pressure tablets).

The caffeine in your cup of joe can also act as a diuretic, Dr. Adhami says, so people with Gilbert's syndrome might need to watch how much coffee and other caffeinated beverages they drink, particularly if they also take diuretic medications.

A good reminder of how much to drink is to take a look at the color of your urine, according to the Cleveland Clinic. If it's clear, pale or straw-colored, you're set. If it's darker, you may be dehydrated and should drink some more fluids — plain water being preferable.

"Gilbert's syndrome isn't a disease and isn't life-limiting or altering, but it can complicate other conditions," Dr. Adhami says. Specifically, people with the syndrome who also have another condition that increases bilirubin levels, such as sickle cell anemia, run a higher risk of getting gallstones.

According to the Mayo Clinic, having Gilbert's syndrome may mean you may also not clear some medications, including the cancer chemotherapy drug irinotecan (Camptosar), so quickly from the body. If you have Gilbert's syndrome, always discuss this with your doctor when you are being prescribed a new drug.

On the plus side, people with Gilbert's syndrome who have higher levels of bilirubin have a reduced risk of cardiovascular disease, according to a review in the March 2015 issue of ​Atherosclerosis​​.​

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