Gilbert's syndrome is a common genetic disorder that can cause jaundice, a condition in which the high amount of bilirubin in the bloodstream makes the eyes and skin have a yellowish color. The jaundice will not usually lead to any problems. It will come and go; no treatment is available or even necessary. Certain situations can trigger it, however.
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Gilbert's syndrome is a hereditary disorder that affects approximately 8 percent of the population, men more than women, according to Dr. Allan Wolkoff, chief of the division of hepatology at Albert Einstein College of Medicine, in “Harrison’s Principles of Internal Medicine.” This disorder develops if you have a mutation in an enzyme called glucuronyl transferase, also referred to as UDP-glucuronosyltransferase. Enzymes are used by the cells to make a reaction go faster, and the cells in the liver use this enzyme to attach bilirubin to a substance called glucuronic acid.
The normal lifespan of a red blood cell is 120 days. After that time, the red blood cell breaks down, and the hemoglobin, which the cell used to carry oxygen, is changed to bilirubin; the bilirubin is attached to an albumin protein and sent through the bloodstream to the liver. Once inside the liver, the albumin protein leaves the bilirubin, and glucuronyl transferase helps attach the bilirubin to glucuronic acid, as explained in “Ganong’s Review of Medical Physiology” by Kim Barrett, a professor in the Department of Medicine at the University of California. The bilirubin is now water-soluble; that is, it can now dissolve in water.
In Gilbert's syndrome, with the mutated glucuronyl transferase enzyme, some of the bilirubin does not attach to the glucuronic acid to become water-soluble, so an increased amount of bilirubin builds up in the bloodstream. The normal range of bilirubin in the blood is 0.1 to 1.2 mg/dL, says Dr. Diana Nicoll, associate dean of the University of California in the “Pocket Guide to Diagnostic Tests.” If you have Gilbert's, the bilirubin can be as high as 3 mg/dL, but it fluctuates and can rise to 5 mg/dL as a result of fatigue, illness, stress, drinking alcohol and not eating enough calories. Therefore, the only “food” to avoid is alcohol.
The Mayo Clinic does not list any foods that should be avoided with Gilbert's syndrome. Instead, they recommend eating healthy and making sure you consume plenty of vegetables and fruits. They also advise that you do not skip any meals, but routinely eat during the day on a schedule, being careful to have enough calories each day and not to fast. Other than their recommendations about food, because stress can trigger increased bilirubin levels, they advise learning how to handle stress with quiet times that you spend alone and/or with exercises.
REFERENCES & RESOURCES
- “Ganong’s Review of Medical Physiology”; Kim Barrett et al.; 2010
- “Harrison’s Principles of Internal Medicine”; Dr. Anthony Fauci et al.; 2008
- “Pocket Guide to Diagnostic Tests”; Dr. Diana Nicoll et al.; 2007
- National Institutes of Health: UGT1A1
- “University of Maryland Medical Center”; Gilbert's Disease; David Dugdale, III, M.D.; 2009