Spoiler alert! Avoid your eyes if you haven’t seen Kung Fu Panda before. Return to the dark cave from whence you came.
Just as Oogway becomes dust, red blood cells die and puff out bilirubin. This is shunted to the liver, which does the necessary cleaning job, removing the unwanted bilirubin from the bloodstream through glucuronidation. This forms conjugated bilirubin. After Liver Kondo has done its thing, the product is pumped out to the intestines, then away it goes.
Gilbert Syndrome is an autosomal recessive condition where the UGT1A1 gene is most commonly affected. This gene makes an important enzyme for the bilirubin detoxifying process, so the result is raised bilirubin. Specifically, it would be unconjugated hyperbilirubinaemia and possibly jaundice, often not requiring treatment except in stress-affected situations.
References
- Mayo Clinic (2025). Gilbert syndrome. [online] Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/gilberts-syndrome/symptoms-causes/syc-20372811.
- Grant LM, Faust TW, Thoguluva Chandrasekar V, et al. Gilbert Syndrome. [Updated 2024 Oct 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470200/.
- Hamoud AR, Weaver L, Stec DE, Hinds TD Jr. Bilirubin in the Liver-Gut Signaling Axis. Trends Endocrinol Metab. 2018 Mar;29(3):140-150. doi: 10.1016/j.tem.2018.01.002. Epub 2018 Feb 3. PMID: 29409713; PMCID: PMC5831340. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5831340/.
- MedlinePlus (n.d.). UGT1A1 gene: MedlinePlus Genetics. [online] medlineplus.gov. Available at: https://medlineplus.gov/genetics/gene/ugt1a1/.