Gilbert’s Syndrome

Gilbert’s Syndrome, characterized by a chronically elevated serum bilirubin level (1.2 to 3.0mg/dL), is the most common of all benign unconjugated hyper-bilirubinemias. Previously considered rare, this disorder is now known to affect as much as 5% of the general population. The condition is usually asymptomatic, although some patients do complain about anorexia, malaise, and fatigue. In a small study, the most common symptom was chocolate and sweet craving followed by fatigue.

Mild unconjugated hyperbilirubinemia is the only significant laboratory abnormality, which is important clinically because it is often misdiagnosed as chronic hepatitis. Research indicates that Gilbert’s syndrome is due to a slow down in the liver’s Phase II detoxification system. A 31% slower rate of glucuronidation has been reported in the typical person with Gilbert’s syndrome.

 


Signs, symptoms & indicators of Gilbert's Syndrome

Lab Values - Chemistries  

High indirect bilirubin level



 

High total bilirubin



Symptoms - Food - General  

Weak appetite



Symptoms - General  

Fatigue on light exertion




Conditions that suggest Gilbert's Syndrome

Allergy  

Environmental Illness / MCS

People who have Gilbert’s syndrome are more susceptible to toxic reactions to chemicals and drugs. Drugs that are poorly metabolized by those with Gilbert’s syndrome include acetaminophen, menthol, clofibrate and tolbutamide.



Diet  


 


Musculo-Skeletal  


Symptoms - Metabolic  

Gilbert's syndrome



Counter Indicators
Symptoms - Metabolic  

Absence of Gilbert's syndrome




Risk factors for Gilbert's Syndrome

Symptoms - Metabolic  

History of Gilbert's syndrome




Recommendations for Gilbert's Syndrome

Diet  

Vegetarian/Vegan Diet

Chemicals that tax Phase II liver detoxification pathways tend to be found in higher concentrations in animal products than in fruits, vegetables, whole grains and legumes.



 

Therapeutic Fasting

Those with Gilbert’s syndrome are poor candidates for water fasting, a process that stresses the liver’s detoxification systems and can lead to the development of significant jaundice.



Habits  

Fluoride Reduction/Avoidance

It has been suggested that Gilbert’s syndrome is due to a partial deficiency of the hepatic enzyme glucuronyl transferase. Fluoride, being an enzyme inhibitor, reduces the enzyme’s activity even further.

John Lee, MD a physician in private practice has stated that elevated bilirubin levels can be reduced in Gilbert’s syndrome by avoiding fluoridated water and other sources of fluoride. This physician has seen bilirubin levels rise again when fluoride has been reintroduced. Gilbert’s syndrome may be due to a partial deficiency of the hepatic enzyme glucuronyl transferase. Fluoride, being an enzyme inhibitor, reduces the enzymes’ activity even further. [“Fluoride Linked to Gilbert’s Syndrome”, Lee, John R., M.D., Cortlandt Forum, September 1990;101: pp.31-33]

In some cases, complete elimination of fluroide can reverse the jaundice of Gilbert’s syndrome.



Nutrient  

TMG (Tri-methyl-glycine) / SAMe

Methionine, administered as SAM, resulted in a significant decreases in serum bilirubin in patients with Gilbert’s syndrome in a clinical study. SAM has been used with favorable results in a variety of other chronic liver diseases. TMG converts to SAMe while being considerably less expensive. TMG can be helpful in treating Gilbert’s syndrome because it activates several Phase II pathways.



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences

Glossary

Serum

The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Milligram

(mg): 1/1,000 of a gram by weight.

Benign

Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.

Asymptomatic

Not showing symptoms.

Anorexia Nervosa

An eating disorder characterized by excess control - a morbid fear of obesity leads the sufferer to try and limit or reduce their weight by excessive dieting, exercising, vomiting, purging and use of diuretics. Sufferers are typically more than 15% below the average weight for their height/sex/age and typically have amenorrhea (if female) or low libido (if male). 1-2% of female teenagers are anorexic.

Malaise

A vague feeling of bodily discomfort, as at the beginning of an illness. A general sense of depression or unease.

Chronic

Usually Chronic illness: Illness extending over a long period of time.

Hepatitis

Inflammation of the liver usually resulting in jaundice (yellowing of the skin), loss of appetite, stomach discomfort, abnormal liver function, clay-colored stools, and dark urine. May be caused by a bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins or transfusion of incompatible blood. Can be life-threatening. Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.

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