Gilbert’s Syndrome – The Hidden Cause of Gut-Brain Issues


About Maria from True Foods Nutrition

Maria Allerton is a fully qualified Clinical Nutritionist who runs a busy Health Clinic in Sydney. Maria uses a functional medicine approach to find the real causes of illness. She is a firm believer in the principle of ‘food as medicine’ and focuses on diet, nutrients and lifestyle when addressing the conditions of her patients.

Comments (83)

  1. Pete says:

    Hi Maria,

    I just want to say that this is a fantastic article and very comprehensive. Growing up with Gilbert’s I have been told countless times that it is a benign issue with no concerns. The comments here and in other forum posts online show that the case isn’t that clear cut.

    I find the consequens of high bilirubin -> gut permeability -> inflammation particularly insightful as it’s not obvious why issues such as anxiety or depression run along with this syndrome.

    My most prominent issues are stomach discomfort, anxiety, slow transit of food and poor coordination of weak/tight PF muscles. Stomach symptoms were at there worst last year and I have to stay on top of diet/stress to keep things okay. Even as someone who rarely drinks I definitely need to do more work to address any gut issues I may have (luckily SIBO negative).

    I wonder if you have noticed any patterns with GI stool tests from people with GS? Would be very interesting to read any research you do in this area!

    Now if only it was easy to find a FM Dr in the UK who understands GS!

    • Maria Allerton says:

      Hi Pete,
      Thanks for your kind words, glad the info is helpful! No I haven’t noticed a pattern with Gilbert’s on stool tests, except they often have raised B-glucoronidase.
      I work with clients across the globe.

  2. Ahmed says:

    Great to find this.. good stuff.. I’ve just found out I’m positive! Why do people who have Gilbert’s have slow gut (or stomach) motility? Strangely enough I have a positive ANA with a type that’s been said to cause slow gut motility 🤔 Trying to put the puzzle together!! And how does one help speed it up? B vitamins? Magnesium moves the gut but is it the solution? And what does No.6 really mean… “ A lot of gut work throughout the stomach, liver, gut lining, bowel to optimise digestion”? Thanks 🙏

    • Maria Allerton says:

      Hi Ahmed, glad you found the info useful. Every person with Gilbert’s is totally different so the gut work has to be individualised by the practitioner based on symptoms, health history and test results.

  3. kaitlyn glaze says:

    Thank you so much for spreading your knowledge about Gilbert’s Syndrome.

    I have this condition and I have been fighting SIBO, depression, hair loss and thinning, unstable weight, hormone issues, food intolerances, and other issues my whole life. I always thought it was my fault.

    I was “anorexic” and would throw up when I was a teenager. The “anorexia” was me responding to the hurt my stomach would feel because it would take so long to digest food. I said well, to hell with it and wouldn’t eat. Then I got to a point where I could only eat a few bites here and there. I was a wild child and went to raves and drank like a lot of people did and chalked up my bad memory and anxiety to side effects of partying. Which honestly is embarrassing, but I had no other reasoning. But a lot of other people did worse than I did, and were fine? I still do this day can’t drink anymore, haha.

    Sorry for the long paragraph. If I could hug you, I would. I’ve been fighting my endocrinologist thinking I had low hormones, fighting my GP with tring different mental health medications… But I hated them all and none of them worked. I can’t take birth control either. Girl, I’ve been self medicating and self diagnosing left and right. I look like I’m in my 40’s, but I’m 27. I hope it’s true that people with GS may live longer. I feel like I’m going to make it to about 60 with this stress.

    It’s such a relief to have found your page. Thank you so much.

    • Maria Allerton says:

      THIS!!! you are very welcome Kaitlyn. Hugs to you too. I hope your health continues to improve.

  4. Kiya says:

    I re-read this article again & listened to the podcast for the first time. Thank you, thank you, thank you!!

    I was diagnosed with Gilbert’s this summer, and my doctor said it was no big deal and actually discouraged me from doing my own research on it. It has been life changing to find out more about my condition. It has completely changed my understanding of my reproductive history. It has shed light on how my body processes food and all the other things it comes in contact with. It has been really hard to find information on Gilbert’s, and your website has been incredibly helpful for me in learning more.

    The podcast was given me so many actionable take-aways for my diet. I had a million light-bulb moments and a whole page of notes. Thank you!!

    • Maria Allerton says:

      That’s fantastic Kiya, thx for the feedback. Of course we all need to have a deeper understanding of our health! that’s how we can learn how to address it.

  5. says:

    Do you work with patients who are from another country?

  6. Renee Asdell says:

    I have been so excited to find your blog about Gilbert’s Syndrome. This could explain a lot in my family’s physical and mental health. I needed more info than just being told it was a harmless condition. Harmless may be true in that death or major illness will most likely not occur, but a person can be harmed on a daily basis because of what is happening in their day to day functioning. I am so grateful for your blog! Thank you/

    • Maria Allerton says:

      That’s exactly right Renee. Medical doctors seem to think that harm = death, it is all about how we feel day to day and optimal health, not just lack of disease.

  7. Jonette says:

    I have been having elevated levels of billirubin for quite some time, also non alcoholic fatty liver disease. I have many of the symptoms of pyrrole disorder, but I do not have light hair or light skin…should I test for pyrroles? Thank you,

    Jonette Olivier

    • Maria Allerton says:

      Hi Jonette, i find clinically there is a lot of cross over between pyroluria and gilbert’s, both pyrolles and bilirubin are by-products of haem metabolism. It’s worth testing yes. Not many people fit all the characteristics, they vary quite a lot.

  8. Riley says:

    I was diagnosed with Gilbert’s by my gastroenterologist but I didn’t know that my chronic constipation, reflux, and bloating could all be related to it. I’m only 20 years old! Way too young to be having problems. It really struck a chord also because my aunt has had all the same symptoms throughout her lifetime and even needed to have her gallbladder removed! I’ve definitely noticed issues with severe brain fog lately and I thought that could be related also. I was told to take miralax daily and that fixed most of my stomach reflux and constipation issues but I was wondering if there was more I could do to help treat this myself! I’ve also been suffering from dry eye syndrome I think could be related to this, but in what way, I’m not sure. I thought maybe it could be B12 deficiency as a result of it, but I never had my vitamin levels checked to know. It was a hassle that took months to even get most of this figured out and a whole endoscopy and stomach emptying scan later for the gastro to come to the conclusion that I should just take miralax all the time. I also had trouble digesting fat, but the gastroenterologist just brushed it off and said it was normal. My aunt was on miralax for a very long time as well and had her gallbladder removed. I think the same thing is eventually going to happen to me.

    This article opened my perspective a lot, but I’m wondering where I should go from here. Is there a better way to prioritize my health?

    Any help is appreciated.



    • Maria Allerton says:

      Hi Riley, If you’d like personalised help feel free to book a consult through the website. Kind regards

  9. Sharon says:

    Hi Maria,
    Many things started making sense when I learned that the last parts of a fetus to develop fully, during months 8-9, are digestive/eliminatory systems. My mother very stressed since she had a problem with late-term miscarriages (several). Thanks for your comprehensive articles.

  10. Sarah Rohrbaugh says:

    This is the first article that I have read that is spot on with what I have been experiencing. I have always had high bilirubin and in my twenties I started experiencing skin and gut issues. I have spent several years adjusting my diet, which has helped. I would like to get more information and advice if possible.

    • Maria Allerton says:

      Hi Sarah, feel free to fill in the new client application on the Book Now page to book a consult, thx

  11. Jason Sparks says:

    Hi Maria,

    I have Gilberts and have struggled with digestion for years which eventually led to autoimmunity and CFS. I have confirmed gallstones. So much of what you say rings true!

    I am now on a healing journey and have made huge progress through diet and supplements.

    Do you recommend adding bile salts/Ox bile to my diet?



    • Maria Allerton says:

      Hi Jason, thanks for you feedback. I can’t comment on any individual health issues without reviewing the whole case. Bile salts are pretty safe so you can give them a go and see if they improve your fat digestion.

  12. Trent Nicolajsen says:

    I have been trying to deal with a perianal fistula for 10 years, and I forgot that I have Gilberts syndrome. as the fistula seems to be more related to gut issues of glilberts, as crones and celiacs tested negative, yet is more of a gluten allergy that tightens my lower anal muscle, where the fistula is. I am set to do the full open surgery rather then place a string threw it again, the only time it healed over was when I was drinking a special kombucha made just from dandelions. get surgery? or check in about the Gilbert syndrome first?

  13. Petkus says:

    What I want to know is if obstructive Sleep Apnea in 16th yo boy can lead to Gilbert’s syndrome rather than or only genetics?

  14. yana says:

    Hi Maria – I have CFS and my bilirubin has been high in almost all of my blood tests for 20 years. I don’t have records going further back. Out of about 20 tests, only 2 have been normal, so I ruled out Gilberts – is it still a possibility?

    My teen daughter just had her first blood test and guess what? Bilirubin at 19. Dr didn’t even mention it but I thought ‘hmmm’! She has low energy at times amd gut/mood complaints.

    Lastly, as bacteria can cause the beta glucoronidase issues, can dysbiosis actually cause the high bilirubin and one not actually have GS after all?

  15. Logan Vickers says:

    Hi Maria

    I’ve recently been diagnosed with GS.
    I am in Perth, WA. Can you recommend a good practitioner here for me to see to discuss diet and possible pyroluria testing ?

  16. Rachelle Kenny says:

    I am a certified Nutrition Consultant myself and have a client with Seropositive RA as well as Gilbert’s Syndrome. I found your article on Gilbert’s Syndrome very informative and am wondering if you would be willing to share with me some of your strategies for working with this condition as it is new to me.

  17. Pris says:

    Wow! helpful info xx

  18. Clare says:

    Hi Maria,
    Thank you for this great information. I too am a GS sufferer. I would really like an idiots guide to a section in the article please.

    In the article it says that GS can cause:

    Impaired handling of dopamine (our motivation and reward neurotransmitter) and estrogen.

    Does this mean that dopamine and estrogen is high or low in the brain?

    Also, does high bilirubin cause high levels of serotonin and low GAMMA?

    I am trying to find out a link between anxiety, panic attacks and mild depression with GS.

    Thank you so much for any help.

  19. Santos Bollini says:

    Hi Maria great article,
    What do you know about the paleo keto diet with helping reduce bilirubin level? I read a number of articles in which looks quite interesting. I have GS myself and was wondering about your thoughts on this. Thank you

  20. Brad says:

    Hi, thanks for the article , just curious, can GS cause any permanent damage to the brain?

    • Maria says:

      Yes it can if big enough quantities and long duration. That’s why jaundiced babies are given light treatment until cleared

      • Brad says:

        Thanks, not sure what to do as I was diagnosed with this last year but show close to no symptoms, I have mild brain fog and that’s about it

  21. Miranda says:

    HI Maria — great article! I just came to it via Rachel Arthur who posted today on GS and so I did a search. I realise you can’t comment on personal situations but is it possible to have GS without high bilirubin if all the other symptoms are present? On Ancestry there are 9 UGT1A1 genes. If there are several that are heterozygous is that an indicator or is there a specific one you look at and must it be homozygous? Would a positive pyroles test and a liver functioning test, showing the glucuronidation pathway not working effectively be strong indicators? Thanks.

    • Maria says:

      Hi Miranda, thanks for your feedback. Yes, if there are no major issues billirubin can appear normal, in fact it can be normal in childhood until something ‘sets it off’. I would take several heterozygous SNPs to be strongly indicative of GS. Even though there is no proven relationship between pyrroles and GS, I do anecdotally see it in clinic together a lot. So need to look at all the pieces of the puzzle, cheers

  22. Plamen says:

    In period of 6 months I have given 3 times very high levels of bilirubin/total 1st time 49 n/mol 2nd time 52 and 3d time 59 n/mol/ and direct bilirubin levels around 17-20 n/mol
    Everything else as AST ALT and all liver biochemistry enzyms were at a normal levels, I also had no other bad results in the rest of the blood test …my gastro tels me that I have GS and have to live with it…in the first place when i went to doctor I went because I had symptoms like stomach pain in right area under the liver but after all these visit by doctor /3-4 times already/ I couldn’t understand why sudenly from nowhere I had to feel pain in my lower back and symptoms more likely to lumbago or like pinched nerve or similar and I am start to think is it related somehow with GS, because last 2 months it is almost all the time pain in lower back and now I am afraid to use NSAIDS and use Ice or Heat compression, but in hospital told me that back pain is common and not related with bilirubinemea, but why now, why after I get started feeling pain first in the abdomen right and after i noticed the high bilirubin?

    • Maria says:

      Hello, thanks for your comment. It’s very difficult to know the source of abdominal pain without further investigation. I recommend evaluating your diet and stress levels and addressing that to see if the pain will go. I now have an online program that will help with this:
      kind regards

  23. Joanna says:

    Hi Maria,
    Thank you for this article, huge help!
    I’ve been finally diagnosed with GS last year through genetic test.
    I’ve completely changed my eating habits and trying to avoid everything that may be harmful.
    I do however still experiencing quite high anxiety..
    I don’t really want to take any chemicals for that like propranolol and so on and I was wondering if you have any thought/experience with CBD oil? Help much appreciated! Best JJ

    • Maria says:

      Hi Joanna,
      thanks a lot for your comments. Sorry i don’t prescribe CBD oil so don’t have experience with it. There are plenty of natural solutions for anxiety involving nutrients and gut repair, feel free to reach out for a consult when you are ready, cheers

  24. Carlos says:

    Hello, Maria:
    Thank you very much for this information… It’ll take a while for me to digest it :-DD
    Now, seriously: I’ve been diagnosed from GS. Although the doctor says that it’s just a non-harmful condition I experiment symptoms of muscle weakness and brain confusion. I started to take Vitamins and they made a lot (A LOT) of difference. I have also fell a more energetic state and a clearer mind when I take beer yeast (after reading your article, I guess it’s for the zinc in it, although I tried it for the Chromium).
    My concern is about the fat-soluble vitamins. Do you think I can damage my liver if I take a vitamins pill per day? I have a very, very healthy diet but even so, I can only have a normal life if I take vitamins.
    Unfortunately, I live right on the opposite side of the globe and my English is far from being usable for a consultation, so I’d really appreciate if you can reply here.
    Anyhow, thanks again for your time writing this article and sharing your knowledge.

    • Maria says:

      Hi Carlos,
      thx for your message. Fat soluble vitamins cannot ‘damage’ the liver, it’s just a matter of how well they are being absorbed. I do skype consults internationally if you decide, cheers

  25. Carlos says:

    Thanks for this article. A lot of information…I’ll need some time to digest it :-DD.
    I’ve been diagnosed from Gilbert’s syndrome and what I’ve always complained about is muscle weaknesses and certain brain confussion, specially after fasting or sugar\fatty intakes.
    I’ve discovered that vitamins supplements make a great difference. When I take them I feel much (MUCH) better. Beer yeast is very helpful to me as well (I guess it’s due to Zinc). I’m worried about fat-soluble vitamins. Do you think I could damage my liver with a daily pill of vitamins?
    Thank you

  26. Mimo says:

    Hi Maria
    I v’got a question regarding Gilbert and everything in regard to high bilirubin levels.

    My levels of bilirubin are high they going from 24-34-56-67-15-34 as you can see there is a lot up and down
    My food is good but not enough to fix the problem

    In the past before having high levels of bilirubin i got infected from HPV virus from my ex partner,…and even now days i’m dealing with some of those symptoms around my body.

    When i had gallbladder out, liver had to small spots just like HPV from pictures ,..even though MRCP and ultrasound can’t detect them.
    Obviously you know what is my question,..could this HPV an detected virus compromise cells in the liver,.and making people thinking they v’got a syndrome, fact it’s something else hidden
    I seen many people profile who have Gilbert or high bilirubin levels,..and a lot of them v’got HPV spots in there face

    We know jaundice or high levels of bilirubin is underlying cause ,..if that is the case , than HPV it’s very likely to interfere with a lot of organs,..this infection could be by blood stream and by accident
    I really wanted to get un honest answer,…what do you think,..and could this fungal bacterial virus be the root of the problem and not the ghost Gilbert syndrome.

    • Maria says:

      Hi, thanks for your comment. Unfortunately it’s not possible for me to make any personal recommendations without assessing your case. Feel free to book in a consultation, thx

  27. Debbie says:

    This is very interesting. Maria do you have Gilbert’s Syndrome yourself (did you write this article). Thank you. Debbie

  28. Mireille says:

    Thank you,

    I have felt so alone in a struggle with Gilberts that is constantly ignored as ‘benign’. No Hospital, doctor or health care practitioner seems to care or be concerned and one is left confused, misunderstood, or accused of an eating disorder in my experience.

    I appreciate someone else witness to anecdotal evidence and symptoms … i still feel unsure of where to find help.

  29. Irena says:

    Hi Maria – wow, this article was a godsend!! I was diagnosed 25 years ago and, after the initial diagnosis when I was very jaundiced with very high bilirubin, I have not had significant issues. My physicals always show bilirubin on the very upper level or just above it (1.1-1.2 here in the U.S.). For the past couple of weeks, I have had sudden onset of very slow gastric emptying, it feels like food is just sitting in my upper stomach…all day long! Also migraine, some nausea and extreme anxiety/panic. Just got my blood results this morning and everything was fine except my bilirubin which is at 1.6 (it hasn’t been that high in 10 years probably). Then I happened upon your article and it explains so much!! I never knew that slow gastric emptying is common for GS. For a long time, I took both Ca-D Glucarate and Avmacol sulforaphane but ran out of both a couple of months ago and never re-ordered. Well, I’ll never make that mistake again! 🙂

    Thank you so much for this excellent overview!
    Irena 🙂

    • Maria says:

      Hi Irena,
      Thanks for your feedback, glad you are managing your condition ok. Ca D Glucarate is essential.

      • Irena says:

        Maria – what is the science behind the connection bw. GS and slow gastric emptying? I am only able to find one small study done on rats. I am very curious about this as I have felt exactly what you wrote “Slower intestinal motility… and ‘that heavy feeling in the stomach as if food sits there like a brick for hours’” for two weeks now. I feel full all the time, though forcing myself to eat, as I do not want to lose weight. As I mentioned, I got the billirubin result the other day of 1.6 (higher than it’s been in a few years). So I would really like to understand the connection. Thank you!

        • Irena says:

          Also to mention, it was an extensive bloodwork panel and everything else was completely normal, only elevated bilirubin. Also had an abdominal ultrasound which was clear.

  30. Ashish says:

    This article helps me to cheer a bit as i am diagnosed with GS for quiet a some time now and my bilirubin fluctuates between (3-6 mg/dl). Recently i have been diagnosed with gall stone of approx 9mm. Is it risky to operate on gallstone if you have gilbert syndorme? what affects could it bring if gall bladder is removed of a person with gilbert syndrome, hope one can manage. Any suggestions would be grateful.

  31. Aaron says:

    Hey Maria,

    Thank you for this article it has been very helpful! I have done a DNA test on FTDNA (for ancestry purposes) I was wondering if you knew how I could order the UGT1A1 SNP from this site? I searched and search with no luck.

    Also from time to time (once a year it seems) I become very tired and depressed it seems, I have foggy brain and when I move my head it feels like it’s moving a lot more than it actually is. Is this something that is associated with Gilbert’s? My doctor thinks it’s vertigo…

    • Maria says:

      Hi Aaron, the best way is to order gene profile and run it through the app, then you will see the UGT snp. Sorry i can’t comment on any symptoms without understanding your whole case.

    • Melissa says:

      Hi Maria, excellent article, thank you! Myself and my twin have Gilbert’s, inherited from my father and his father. Do you think Gilbert’s can appear in a baby? My 9 month olds skin can appear yellow but her eyes are white (no jaundice at birth) and I’m wondering if she has inherited this, she has a negative blood type just like me (my other children do not). We’ve had issues with her being an ‘irritable’ baby and her sleep has been terrible. I’m wondering if this is could be effecting her? Thanks so much, Melissa

      • Maria says:

        Hi Melissa, because Gilbert’s is genetically inherited that means that we are born with it, so yes your baby could have it. The only sure way to know is to do a saliva based gene test like to confirm UGT SNPs. There are numerous factors that affect babies’ sleep, it would be impossible to know if this is a factor.

        • Marina says:

          I am interested in an online consultation with Dr. Maria but I do not know English. Do you know Spanish to be able to consult me?

          • Maria says:

            Hi Marina, sorry i don’t speak Spanish, my only language other than English is Russian.

  32. Colin says:

    Hi Maria,

    Thanks for sharing your knowledge it has been very helpful.

    I have been diagnosed with Gilberts, however, i have also always had high GGT, AST, ALT liver readings. I have had every test done and ruled out all typed of problemd that cause liver damage.

    Do you think there is a correlation between these high readings and Gilberts? I have recently started taking Cal-D-Clucarate and it will be inetersting to see if all readings come down not just bilirubiun.

    • Maria says:

      Hi Colin, yes there is most likely a correlation and your liver could be trying to fight off a viral infection or deal with toxins.

  33. Laxmi Maneklal says:

    Where are you located? How does one take an appointment? What are your charges?

    Laxmi Maneklal

  34. Gaurav says:

    Mam…i have lots of problm ….in 2017 doctor told me you have gilbert syndrome after that …my life becomes hell now i have lots of problm…like appetite weakness no feeling well anytime…brain issue lot of brain fog concentration problm…feel like the brain is not with me ….you are one who can help for ..all doctor said its harmless disease bt i dnt thik so plz help me what to eat what to do …it will with me life long or what mam or it will cure ??

  35. Anna says:

    Hello there,

    I very much enjoyed this post as I have been struggling with recurrent SIBO for 3 years now. I was just diagnosed with Gilbert’s syndrome so I am trying to piece everything together. I have done 23andme before. How do I see if I have the genetic polymorphism? Thanks!

    • Maria says:

      Hi Anna, you need to upload your 23andme raw data to any of the analyser apps, such as and look for UGT snp. Feel free to reach out if you need help managing your conditions. cheers

      • Simon says:

        Hey Maria,
        my billirubin level is at 2.3 mg/dl. I suffer from nausea, vomiting in the morning and diarrhea.
        All of these symptoms come with anxiety, panic attacks and moodswings.
        Is it important to take zinc sulfate? ( i dort find and in germany) or is any kind of zinc good.
        Maybe one consultant Session could be helpful.

        • Maria says:

          Hi Simon,
          yes as per my blog zinc sulfate is a good start. More than happy to go through your case in detail, please book in a consult online on the homepage. Pls note time difference,

  36. Gaurav says:

    Mam…i have gilbert syndrome from last 2 and half year….
    My bilirubin is 2.38 now …is goes high to 4 ….mam i have problem like appetite…and a brain issue …I FEEL LIKE MY BRAIN IS NOT WITH ME when i talk to someone its feel like empty empty in the brain ..and concentration problem

    And mam gilbert can damag3 my brain or what??please help

    • Maria says:

      Hi Gaurav, yes it can, bilirubin is toxic to the brain in high amounts as it produces oxidative stress. Feel free to reach out if you need help managing this condition. cheers

      • Gaurav says:

        What to do now mam please help me…

        • Gaurav says:

          It will not cure …na mam..can i die from this?gilbert syndrome…or it can damage my brain how much is there any serious risk of it ?? Give me a solution how to maintain it please mam

  37. Joanne Garner says:

    Amazing information! I have recently had a blood test and my bilirubin level was 15 but I have had nausea and anxiety problems for weeks but been well for years since my first flare up of GS and probable diagnosis so I was so surprised my levels were within the normal marker, I have had a lot of stress lately however but could the zinc be beneficial for the anxiety,I’m sure the nausea sets off the anxiety,I take a mild getabloker for ectopic beats too

    • Maria says:

      Hi Joanne, thanks for your comment.Yes stress can elevate bilirubin levels but the key thing you need to look at is whether it is consistently elevated. 2-3 elevated readings make Gilbert’s more likely, or test for the gene. Let me know if you need more help, I do skype consults worldwide.

      • Jack says:

        Hi Maria,

        Are there any zinc supplements you can recommend? Will taking zinc cause copper deficiency?

        Thankyou for the great information!

        • Maria says:

          Hi Jack, thanks for your comment. The type and dose of supplements is highly individual and yes needs to be carefully monitored with blood and hair testing to ensure it’s appropriate.

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