Gilbert’s Syndrome

Most doctors will tell you that Gilbert’s Syndrome is benign and having it means absolutely nothing.  The Mayo Clinic and E-Medicine sites echo the same message, although they report patient complaints of fatigue and abdominal pain.  It can take 10 years for research to be validated and made known in the clinical medical community.  In the meantime, those with a particular condition may not receive medical care appropriate to their needs or condition.

Research conducted in 2008 by the German scientists Muller and Schnakenberg found a significant increase in susceptibility to developing Environmental Illness and Chemical Sensitivity in people who have the genetic polymorphism that leads to  Gilbert’s Syndrome and other forms of  hyperbilirubinemia. Not everyone with the polymorphism develops Gilbert’s Syndrome or other forms of hyperbilirubinemia.  Those that do have Gilbert’s Syndrome will not necessarily develop chemical sensitivity.  The research simply underscores a greater susceptibility.  It is useful to know of an increased risk to developing chemical sensitivity, so you can take appropriate steps to avoid the possibility by minimizing the use of chemicals in your environment.

An innovative site, Gilbert’s Syndrome.com, was already reporting a link between Gilbert’s Syndrome and chemical sensitivity based simply upon listening to what patients at Gilbert’s Web forum have said online about their multiple challenges, and by reviewing recent research reports on the impaired detoxification capacity of people with the condition. People in the forum have reported problems with chronic fatigue, Epstein-Barr virus, hypothyroidism, candida albicans, and gastroparesis in addition to chemical sensitivity. Find out more about potential symptoms from real people with GS by visiting www.gilbertssyndrome.com

GS is considered common, occurring in about 5% or more of the population. People with GS have significantly reduced glucuronidation, a pathway responsible for de-activating many environmental toxins and endogenous substances like bilirubin.

Limit or avoid!
The Mayo Clinic and E-Medicine recommend limiting or avoiding these activities and foods, which can lead to an elevation of billirubin in people with Gilbert’s Syndrome:

  • Fasting or skipping meals
  • Unstable blood sugar (the UGT enzyme uses sugar to process toxins)
  • Dehydration
  • Overexertion
  • Infectious illnesses, like colds or the flu
  • Stress
  • Alcohol
  • Fatty foods
  • Niacin (on its own)

Gilbert’s Syndrome and Chemical Sensitivity

There are three possible mutations found in Gilbert’s Syndrome. The substances on the following lists are processed via glucuronidation, which is significantly reduced in people with Gilbert’s. Research has shown that 94% of people with GS have more than one mutation and therefore may have trouble processing the following substances if they are taken in excess. You may be able to process these substances efficiently if co-pathways are functioning well, but this is not necessarily the case for a segment of people with Gilbert’s Syndrome. Therefore, a number of toxic substances may circulate longer in your body.

On the positive side, bilirubin is an antioxidant. A mild elevation of billirubin, like that which occurs in GS, is said to be protective against cardiovascular disease.

Some individuals limit or avoid these substances if their bilirubin levels are elevated or they notice other signs of toxicity or chemical sensitivity in order to reduce competition for the same enzymes which have limited capacity.

Processed via glucuronidation

  • fluoride
  • peppermint
  • menthol
  • aspirin
  • synthetic vanilla
  • acetomiophen
  • morphine
  • diazepam (valium)
  • digitalis
  • benzoates
  • polycyclic aromatic hydrocarbons
  • some nitrosamines
  • heterocyclic amines (which form on beef, pork, fowl and fish cooked at high temperatures)
  • some fungal toxins
  • aromatic amines
  • T4 is removed through glucuronidation
  • steroid hormones (glucocorticoids, mineralocorticoids, androgens, estrogens, and progestagens.

Glucuronidation is an inactivating pathway for:

  • bilirubin
  • androgens
  • mineralcorticoids
  • glucoricords
  • fatty acid derivatives
  • retinoids
  • bile acids

These use UGT1

  • amines
  • arylamines (found in cigarette smoke, permanent hair dyes, other environmental sources)
  • alkylamines
  • sulfonamides
  • heterocyclic amines (found in meats cooked at high temperatures)
  • hydroxylated compounds

These use the UGT1A1:

  • flavinoids
  • flavanones
  • soy isoflavones (Genistein)

These lists were adapted from information on www.gilbertssyndrome.com. I encourage you to visit the site, which provides much more detailed information about GS, its symptoms, and possibly related conditions.

Aldehydes
According to Thorne Research, aldehydes are detoxified on the glucuronidation and sulfation pathways. Aldehydes are produced by candida, are a by-product of alcohol metabolism, occur in many fragrances, essential oils, and formaldehyde.

Disclaimer: I am not a doctor and nothing here should be construed as medical advice.  I am only reporting on research and anecdotal statements from other patients.

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