Have You Been Gifted Gilbert's?
Before your imagination starts running in overdrive, no, I'm not talking about the type of gift you get all wrapped up with a pretty ribbon... I'm talking about the genetic gift of Gilbert's Syndrome.
My beautiful Mother has passed along more to me than any other person in my life. Advice, support, encouragement, cuddles and microbes. She’s also gifted me an interesting genetic present, which came from HER mother, called Gilbert’s Syndrome. You see, Gilbert’s is familial, meaning it’s a genetic condition passed along through family lines.
Over the past few years I've become deeply fascinated with this condition, not only because I have it, but because so many of my patients also do! It's surprisingly common! Gilbert’s affects 5-10% of those with Caucasian background, around 12% of those with Japanese ethnicity and is prevalent in up to 25% of those of Iranian ethnicity. Despite the high prevalence, astonishingly, Gilbert's Syndrome is a largely ignored clinical entity in many countries, including Australia.
Fortunately however, word is getting out about just how meaningful Gilbert's Syndrome is (which is thanks to the mentorship me and many other health professionals have received from skilled Naturopaths like Rachel Arthur). Given the prevalence of Gilbert's Syndrome, and the important role the nutrition and lifestyle medicine plays in the proper management of this condition, it's time to spread the message even further!
What IS Gilbert's Syndrome and what does it have to do with Bilirubin?
For people with Gilbert's Syndrome, there is defect there is a mutation in a gene called the UGT1A1 gene, which compromises a phase II liver detoxification pathway (called the glucuronidation pathway). This causes increased levels of unconjugated bilirubin, a yellow substance that the body creates when it replaces old dying red blood cells (and to a lesser extent myoglobin in muscles).
The more formal name is 'unconjugated hyperbilirubinemia', which basically means there is a defect in the processing of bilirubin by the liver leading to higher levels of a form of bilirubin which is not water-soluble (and therefore not easily excreted).
Gilbert's Syndrome is often discovered by accident as part of routine blood testing and is very often considered to be completely 'benign'.
If Gilbert’s syndrome is a ‘benign’ condition, why not just ignore it?
Firstly, ‘benign’ does not mean ‘insignificant’. Gilbert's Syndrome is a fascinating condition that has both upsides and downsides, and I'd argue that if you have Gilbert's Syndrome, you absolutely want to know about both! Only about 8% of people with Gilbert’s are asymptomatic, and symptoms include jaundice (if bilirubin gets too high), fatigue, mood imbalances, and digestive symptoms such as IBS-like symptoms/bloating /constipation/ food intolerances can be surprisingly common.
Why is it a gift?
Well you see, our old friend bilirubin is known to have “two faces”, and when GS is well managed, the protective aspects of bilirubin are beyond impressive. The reason being is that bilirubin has the potential to act as a powerful antioxidant, anti-inflammatory and immunomodulator. This is a big deal for not just a reduction in the risk of heart disease, but a whole range of other chronic diseases as I discuss in my course.
For good reason, bilirubin is being touted as "the gold within" and THIS is why I believe Gilbert's Syndrome can be a gift... what a seriously amazing silver lining!
Why make a course that's 100% dedicated to Gilbert's?
Firstly, because I would have LOVED to be armed with this information as a teenager or young adult. I certainly would have thought twice about skipping meals, trying extremely low-calorie diets and taking certain medications. Oh, and my “strange gut” which seemed to follow no rule book and have specialists stumped, would have also made a lot more sense!
Secondly, because there are so many ways in which this condition can play out and so many potential conversations to be had, I can NEVER fit all of this into my standard consultations (trust me, I've tried many times!).
Thirdly, to set the record straight on a few things. I've come across some fairly outlandish claims made about Gilbert's Syndrome and wanted to create a resource (first and foremost for my patients) that was evidence-based.
Finally, because there's a lot to unpack, why not create resource that my patients (and whoever else is interested) have indefinite access to so there's no pressure to remember it all or act on everything immediately. Slow and steady wins the race!
