Q: I am a 46 years old male. Recently, I underwent a health check up in which all values were normal except total bilirubin. Then my doctor told to go for liver function test and the results were direct bilirubin 6.4 mg/dl, indirect 4.38mg/dl, SGOT 39 u/l and SGPT 32 u/l. I did have this problem 25 years ago when doctors did all tests and scanned my liver and could not detect anything. I weigh 66 kg and lead normal healthy life. I have no fatigue or tiredness. My doctor told me that I am suffering from Gilbert's syndrome. He told me that it is harmless and more than 5% of the population is suffering from this problem and there is nothing to worry.

A:Gilbert's syndrome is a common disorder of benign nature, which has no clinical implications for the individual other than a raised level of bilirubin. People diagnosed with it lead a normal lifestyle with no restriction on diet or activity. Liver from individuals having Gilbert syndrome has even been used for liver transplant purposes. The level of jaundice is mild (bilirubin usually < 6.0 mg/dl) with a mild elevation in alkaline phosphatase enzyme level in the absence of any liver disease or hemolytic anaemia (a condition associated with increased breakdown of red blood cells that causes jaundice). There may be daily variations in the level of bilirubin in a given individual and the jaundice may become pronounced in case of dehydration, fasting, vigorous exercise or other illness but this resolves spontaneously. Bilirubin is normally produced from hemoglobin in the liver by the breakdown of aged red blood cells. Being water insoluble (unconjugated form), and hence toxic), the liver converts it into a water soluble form called conjugated bilirubin, to facilitate its excretion from the body (via liver and kidneys). In Gilbert syndrome, an enzyme involved in this conversion of unconjugated bilirubin to its conjugated form is present in lower than normal amounts, allowing it to build up in body resulting in raised levels of bilirubin.