Gilbert's Syndrome

What is Gilbert's syndrome?

Consequences

Symptoms - common

Symptoms - less frequent

Triggers

Prevention / remedies / treatment for Gilbert's syndrome

References

What is Gilbert's syndrome?

Gilbert's syndrome (Unconjugated hyperbilirubinaemia or Gilbert-Meulengracht syndrome) is a hereditary disease causing increased bilirubin in the blood. Bilirubin is a yellow-coloured by-product remaining after old red blood cells are broken down. Normally, most of the bilirubin should be excreted into the bile, where it assists with digestion and other processes. A person suffering GS has higher levels in the blood, giving them a jaundiced (yellow-coloured) skin and eyes. A blood test can measure the level of bilirubin.

In Europe and America 5-10% of people suffer from Gilbert's syndrome. In India and Africa it is 10-25%, and in South East Asia less than 5%.

Most doctors and their desk references refer to it as a harmless syndrome. Ideally, with management through lifestyle and diet Gilbert's Syndrome has little consequence. Those with GS need only follow a healthy diet and avoid liver toxins such as excessive alcohol and liver-toxic drugs. However, under an adverse diet and conditions GS can cause a wide array of problems.

GS causes a reduced level of activity of UGT enzymes such as glucuronyltransferase, which conjugates bilirubin and some other lipophilic molecules. The enzymes make bilirubin water-soluble, after which it is excreted in bile into the duodenum.

Some researchers have found that as bilirubin is an antioxidant, and increased levels may reduce the risk of cardiovascular disease and other oxidative and inflammatory diseases.

Consequences

Jaundice. Mild jaundice may appear under conditions of exertion, stress, fasting, and infections.

Reduced detox ability. The lack of the enzyme glucuronyltransferase may reduce the liver's ability to detoxify various forms of pollution, chemical fumes, some drugs and hormones. The drug Irinotecan becomes toxic to those with GS.

Neutropenia (a low neutrophils count). Neutrophils are the most important type of white blood cell, comprising 50-70% of circulating white blood cells. They are the primary defence against infections, destroying bacteria and fungi in the blood.

Symptoms - common

• Jaundice (yellow-coloured skin).
• Fatigue.
• Brain fog, poor concentration.
• Nausea.
• Feeling antisocial, anxiety, poor memory, irritability.
• Difficulty digesting fatty foods, pale stools that float.
• Loose stools / diarrhoea.

Symptoms - less frequent

• Insomnia.
• Headaches, dizziness.
• Depression, mood swings, panic attacks.
• Dry skin, Itching.
• Breathlessness or laboured breathing.
• Heart palpitations, chest pain.
• Aching muscles, body ache, joint pain, muscle twitches.
• Numbness, tingling, tremors, weakness.
• Chemical sensitivity, intolerance to drugs.
• Alcohol intolerance - strong hangovers.
• Acid reflux.
• Lump in the throat, sore or dry throat.
• Loss of appetite.
• Intolerance to carbohydrates, especially wheat.
• Food intolerances, environmental allergies.
• Irritable bowel syndrome (IBS).
• Abdominal pain, stomach pain & cramping, bloating or swelling, indigestion, liver pain, gallbladder pain.
• Excessive thirst.
• Swollen lymph nodes.
• Bitter or metallic taste in the mouth.
• Low body temperature, feeling cold, cold hands and feet.

Triggers

• Missing meals, low blood sugar.
• Lack of sleep.
• Excessive vigorous exercise.
• Illness.
• Chronic stress.
• Alcohol.
• Fatty foods (notice which types of fats - always polyunsaturated. See below.)
• Sugary foods and refined carbohydrates - they upset your blood glucose level, your energy level, and your liver's ability to detoxify.
• Fluorides.
• Peppermint.
• Vanilla.
• Niacin/vitamin B3/nicotinic acid supplements. B3 is OK if you get it naturally in your food.
• Artificial sweeteners.

Prevention / remedies / treatment for Gilbert's syndrome

Please report how you go with these remedies. Thousands of people read this page and will value your experience, both positive and negative.

• Gilbert's Syndrome needs a liver-friendly diet high in protein, sulphur, glutathione, glycine, glutamic acid, cysteine and taurine. Eggs, fish (particularly oily fish), seafood, poultry and dairy are all good sources.
• Try to eat some protein with each meal.
• Minimise the toxic load on your liver. Avoid alcohol, pharmaceutical drugs, environmental toxins, chemical additives in foods and personal products that your liver has to process and remove from your body. Buy organic, free range products where possible. Try to avoid products from intensively-farmed animals.
  
  Activated charcoal is a traditional medicine used as a natural liver cleanser.
• Avoid fructose, which is liver-toxic in excess. Fructose (fruit sugar, HFCS high fructose corn syrup) is very hard on your liver as this particular sugar can only be metabolised by your liver, and so places a heavy load on it. Avoid processed foods, which nearly all have added sugar. Reduce the amount of fruit you eat, especially sweet fruits. Avoid fruit juices.
• Avoid all other sugars and refined carbohydrates (flour) and everything made from them. Even better, avoid all grains and everything made from them.
• Avoid polyunsaturated fats. These are the golden vegetable oils lined up in your supermarket. They include canola, corn, cottonseed, flax seed, grape, mustard, nut oils, peanut, safflower, sesame, (all seed oils), soy and sunflower oils. Polyunsaturated fats are very hard on your liver and are associated with various liver diseases (1) including cancer, and many other modern degenerative diseases.
• Sufficient saturated fats. Butter, ghee, cream, tallow, lard, palm oil, goose and other poultry fats are all liver-friendly and may be used to heal a variety of liver diseases. (2, 3, 4, 5) Saturated fats help the liver produce sufficient bile, which helps properly digest fats, in a beneficial circle. If larger quantities of fats give you diarrhoea or make any GS symptoms worse, simply reduce their level until you get back into balance.
• Light. Neonatal jaundice occurs when bilirubin builds up in newborns and particularly in premature babies. About half of all newborns have it to some extent, but in normally corrects in a few days. Full body exposure to sunlight is an effective treatment, and if sunlight is not available then blue or ultraviolet light are the more effective wavelengths. Sunlight is a traditional cure going back millennia, and the ability of sunlight to break down bilirubin has been confirmed in studies. (6, 7) As with other natural remedies here at Grow Youthful, sunlight is unlikely to do you any harm, and at the very least will benefit you in other ways. If you use sunlight to treat Gilbert's syndrome, please leave a comment with your experience, for others to benefit from.
• Dairy. Enjoy raw or fermented dairy products (kefir, raw yogurt, mild raw cheese). Use butter and cream.
• Grow Youthful explains why this diet is so effective, and gives you more details. The entire lifestyle in my ebook is the perfect remedy for Gilbert's syndrome.
• Other liver-friendly foods include avocado, green beans, beetroot, broccoli, blueberries, cabbage, carrots, cauliflower, garlic, gelatine, onion, seaweeds, turnips, turmeric and just a couple of walnuts.
• Exercise - Sudden over-exertion can cause fatigue. However, gently increasing fitness level over time results in an improvement in ongoing energy and wellbeing. Slowly build up your strength with regular daily exercise.
• Sleep - try to get at least 8 hours per day while recovering from the symptoms of GS. Lack of sleep stresses the liver and worsens GS symptoms. A nap after lunch is helpful, especially if you have an active evening planned.
• Anxiety, irritability, being antisocial and depression. There is anecdotal evidence that people who have GS suffer these mental symptoms. However GS is not usually a serious disease, so it may be that these psychological problems are stressing the liver and actually causing the GS. Mental and physical health are inextricably linked. People who have GS need to look at ways to manage their anxiety, stress and unhappiness. It may mean changes to priorities and goals, and healthy changes to lifestyle to regain balance. Meditation, exercise, social connection and volunteering are worth trying. Perhaps you can create more time for resting and a social life with a part-time job. If your job is all you can do during the day, and there is no energy for socialising in the evening, perhaps you could have lunch with friends, and see them during the day at weekends instead.

References

1. Rivera CA et al. Toll-like receptor-2 deficiency enhances non-alcoholic steatohepatitis. BMC Gasttoenterol. 2010 May 28; 10(1):52.

2. Romestaing C et al. Long term highly saturated fat diet does not induce NASH in Wistar rats. Nutr Metab (Lond). 2007 Feb 21; 4:4.

3. Nanji AA et al. Dietary saturated fatty acids: a novel treatment for alcoholic liver disease. Gastroenterology. 1995, August; 109(2):547-554.

4. You M et al. Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice. Hepatology. 2005 Sept; 42(3):568-77.

5. Ronis MJ et al. Dietary saturated fat reduces alcohol hepatoxicity in rats by altering fatty acid metabolism and membrane composition. J Nutr. 2004 April; 134(4):904-12.

6. Dobbs RH, Cremer RJ. Phototherapy. Archives of disease in childhood, 50, no. 11 (1975):833-36.

7. Cremer RJ, et al. Influence of light on the hyperbilirubinaemia. Lancet 1, no. 7030 (1958): 1094-97.