What is bilirubin and what happens in Gilberts syndrome?
Bilirubin is constantly being made. It is a breakdown product of haemoglobin. Haemoglobin is a chemical that is in red blood cells and carries oxygen to the tissues. Many red blood cells and haemoglobin break down each day, and bilirubin is one of the waste products. Bilirubin is carried in the bloodstream to the liver where it is taken in by liver cells. The liver cells process the bilirubin which is then passed out from the liver into the gut with the bile. An enzyme (chemical) in liver cells called uridine-diphosphate glucuronosyltransferase (UGT) helps the liver cells to process the bilirubin. People with Gilbert’s syndrome have a reduced level of this enzyme and so a backlog of bilirubin can build up in the bloodstream. A high level of bilirubin causes jaundice (a yellowing of the skin and whites of the eyes). In people with Gilbert’s syndrome, the blood level of bilirubin can go up and down. Often the level is within the normal range. At other times it is higher than normal, but
