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Gilbert Syndrome

Liver | August 29, 2018 | Author: Naturopath

liver

Gilbert Syndrome

If you have been diagnosed with gilbert syndrome no need to panic. Though it sounds bad gilbert syndrome is considered a harmless condition where the liver is unable to breakdown bilirubin, the pigment in bile that gives it its colour. A yellow residue can sometimes appear in the eyes or give the skin a yellow hue.

What is Bilirubin

Bilirubin is a pigment produce from the breakdown of old red blood cells by the spleen. These blood cells are transported to the liver where they are processed and made water soluble then transported in bile to be removed from the body.

Bile is produced by the liver and stored in the gall bladder. Its role is to break down the fats from digestion and store toxins, processed by the liver, to be removed through the bowel system. Bilirubin in bile is further digested by bacteria in the intestine and is what gives faeces its colour.

In Gilberts Syndrome

There is an enzyme in the liver responsible for the breakdown of bilirubin. In Gilberts syndrome, this enzyme is deficient resulting in a deficit in the processing of the dead red blood cells, and leading to elevation of bilirubin in the blood stream. This does not mean you have a liver disease, in Gilbert syndrome, the liver is not affected.

Signs and Symptoms

Gilbert syndromeThe main sign is from blood test, but elevated bilirubin can sometimes result in a yellow hue of the skin or eyes. This residue of colour is considered harmless, but it is important to rule out other liver diseases that could be the cause. The levels of bilirubin can fluctuate in the body. Generally, there are no symptoms of Gilberts disease, but gastrointestinal discomfort and fatigue have been noted in sufferers. Whether these symptoms are part of the syndrome or separated has not been confirmed.

Diagnosis

A diagnosis of Gilbert syndrome usually made when bilirubin levels are found to be elevated and is usually only discovered when testing is being done for other conditions.  Diagnostic test will check for liver function – which is normal in Gilbert syndrome, and the absence of bilirubin in the urine.

Diagnostic tests include:

  • medical history
  • physical examination
  • blood tests
  • urine tests

Medical History

People diagnosed with Gilbert syndrome often discover they have other family members with the disorder and maybe considered genetically inherited disorder, although it is not necessary to be tested to confirm.  

Blood Test

Gilbert syndromeA normal Liver function test will include a test for total bilirubin.  The normal range is considered to be between 3 and 20 micromoles/litre total bilirubin. If the blood test has a reading of 20 or more it will be marked as high. Jaundice (yellowing of the skin or eyes) may occur when the blood total bilirubin reaches a level roughly between 35 and 50 micromoles/litre. Stress, fasting and fevers have been implicated in elevated bilirubin levels.

Urine Test

Bilirubin can also be measured from a urine test and a doctor may do this test to help diagnose why bilirubin is high on blood tests results. Only soluble (known as conjugated) bilirubin is found in the urine in Gilbert syndrome.  If unconjugated bilirubin is found in the urine, this may indicate a sign for liver disease.

Other conditions associated with elevated bilirubin levels include:

Liver diseases

Liver disease can cause bilirubin levels to be high and can be an indicator of liver damage. This is why a full liver function tests are performed.

Blocked bile ducts

The bile ducts carry bile from the liver and gallbladder to the pancreas and duodenum.  Sometimes blockages can occur such as from gallstones which can cause an elevation of bilirubin levels. The blocked ducts cause a build up of bile in the liver which then elevates in the blood stream.

Red blood CellsGilbert syndrome

Haemolysis is the process of normal breakdown of a percentage of red blood cells. If too many break down at the same time, more bilirubin is released.

Any condition that causes excessive red blood cell breakdown can cause bilirubin to increase in the blood stream.

Alcohol consumption

Long term excessive alcohol consumption can cause liver damage resulting in an inability to process bilirubin.

Note: Yellow skin colour with normal bilirubin may be due to carotenaemia.

Treatment

Gilberts syndrome is considered a harmless disorder and no treatment is necessary.

What you can do to prevent elevation of bilirubin

  • Eat a regular healthy balanced diet – avoiding long periods of fasting
  • Drink plenty of water – dehydration is implicated in elevated bilirubin levels
  • Manage your stress
  • Reduce or eliminate alcohol

Even though there is no harm in having elevated levels following the above recommendations will help avoid yellowing of the skin.

Support normal liver function by consuming a healthy diet of organic fresh foods – fruit, vegetables, meat, chicken and fish. Include wholegrains, seeds and nuts and limit intake of processed and fatty foods.

Enjoy at least 30 minutes of exercise everyday to keep your body in good functioning order.Gilbert syndrome

Cautions

Gilberts syndrome may interfere with how some medications work. This is due to the medicines needing the same enzyme that is deficient in gilbert syndrome (known as UGT) to be processed. 

Always let your health care provider know if you have been diagnosed with this disorder, especially when being prescribed medications. These may include some cholesterol lowering medication, anti-HIV medicines and chemotherapy medication.

Summing up

Gilberts syndrome is a harmless disorder caused by deficient breakdown of old blood cells, leading to a pigment in bile, called bilirubin, being elevated in the blood stream.

It is important to rule our other more serious diseases of the liver

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References

https://www.merckmanuals.com/professional/SearchResults?query=gilbert+syndrome

https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/gilberts-syndrome

https://www.rcpa.edu.au/Library/Practising-Pathology/RCPA-Manual/Items/Pathology-Tests/B/Bilirubin

https://ghr.nlm.nih.gov/condition/gilbert-syndrome

http://www.mydr.com.au/gastrointestinal-health/gilbert-syndrome

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