The Analyst™

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  Gilbert's Syndrome  
Search treatments and conditions
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Recommendations


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.


  Sugar Craving
  Chocolate Craving


  General Weakness

Symptoms - Metabolic

  Gilbert's syndrome

  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.

Not recommended:
  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.


  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.


  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.

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