Q: I have corticated cysts in the bone marrow. I have symptoms of skull, brain fogging and rib pain for the last 1 year. I have confirmed Gilbert syndrome and have a raised Hb level of 15.4 which for an average female is too high. Confirmed corticated cysts in left femur hence they lie in bone marrow. Bone marrow is in skull and ribs. What research do we have on Gilbert and crossing the blood brain barrier to the brain and the long term affects of this? Can this cause brain damage? Concerns as local doctors do not know enough about bilirubin levels getting to brain. Need to know specialists about advice on Gilbert and the long term effects of this condition on blood vessels in the brain. Greatly appreciate any advice and help.

A:The first thing to say is that Gilbert syndrome is not a serious condition. It is quite common and people only get jaundiced if they have an infection or fever. The level of the bilirubin is never so high as to cause a brain problem such as fogging or even coma. The levels would have to be in the 100s and Gilbert never does this. Most people live with Gilbert without any problems at all and it is probably one end of the normal spectrum. Having said this , the cause of your fogging must be due to something else. With the bone lesions you should have the Bence Jones protein measured and your doctors should look for another cause.