Gilbert's Syndrome Treatment Boston MA

Should you worry about your GS? In Gilbert’s syndrome (GS), your liver loses some of its ability to eliminate bilirubin—a yellow pigment that results from the breakdown of red blood cells.

Frederick W Heiss, MD
(718) 744-8743
41 Mall Rd
Burlington, MA
Business
Lahey Burlington Gastroenterology
Specialties
Gastroenterology

Data Provided by:
Moises Gelrud, MD
(617) 636-3244
750 Washington St # 233
Boston, MA
Specialties
Internal Medicine, Gastroenterology
Gender
Male
Education
Medical School: Univ Central De Venezuela, Esc De Med L
Graduation Year: 1965

Data Provided by:
Ramnik Joseph Xavier
(617) 724-6007
55 Fruit St
Boston, MA
Specialty
Gastroenterology, Internal Medicine

Data Provided by:
Marshall Kaplan
(617) 636-5000
750 Washington St
Boston, MA
Specialty
Gastroenterology

Data Provided by:
Irwin Harold Rosenberg, MD
711 Washington St
Boston, MA
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Harvard Med Sch, Boston Ma 02115
Graduation Year: 1959

Data Provided by:
Charles M Bliss
(617) 638-7440
720 Harrison Ave
Boston, MA
Specialty
Gastroenterology

Data Provided by:
Andrew George Plaut, MD
(617) 636-5882
750 Washington St # 006
Boston, MA
Specialties
Gastroenterology
Gender
Male
Education
Medical School: Tufts Univ Sch Of Med, Boston Ma 02111
Graduation Year: 1962

Data Provided by:
Brian Cory Jacobson, MD
(617) 638-6563
85 E Concord St Rm 7721
Boston, MA
Specialties
Gastroenterology
Gender
Male
Education
Medical School: A Einstein Coll Of Med Of Yeshiva Univ, Bronx Ny 10461
Graduation Year: 1995

Data Provided by:
Leonard S Gottlieb, MD, MPH
(617) 534-5309
784 Massachusetts Ave
Boston, MA
Specialties
Gastroenterology
Gender
Male
Education
Graduation Year: 2007

Data Provided by:
Dr.Jaime Oviedo
(508) 620-9200
720 Harrison Ave #701
Boston, MA
Gender
M
Education
Medical School: Pontificia Univ Javeriana, Fac De Med, Bogota
Year of Graduation: 1991
Speciality
Gastroenterologist
General Information
Accepting New Patients: Yes
RateMD Rating
4.9, out of 5 based on 4, reviews.

Data Provided by:
Data Provided by:

Ask the Doctor—Living with Gilbert's Syndrome

Provided by: 

By Robert Rountree, MD

Q After finding elevated bilirubin on a routine blood test, my doctor told me I had Gilbert’s syndrome, but it was nothing to worry about. Is that really true?

In Gilbert’s syndrome (GS), your liver loses some of its ability to eliminate bilirubin—a yellow pigment that results from the breakdown of red blood cells. A relatively common genetic condition, GS may affect as much as 10 to 20 percent of the population. Under normal conditions, the liver detoxifies bilirubin by combining it with a type of sugar called glucuronic acid in a process known as conjugation. The liver then releases the “conjugated” bilirubin into the bile ducts from whence it subsequently gets eliminated in the stool. For people with GS, the UGT1A1 enzyme that conjugates bilirubin works at only 20 to 70 percent of normal.

In a person with GS, situations that either increase the breakdown of red blood cells or overload the detoxifying ability of the liver can cause blood levels of “unconjugated” bilirubin to rise so high that the whites of her eyes will turn yellow—a condition called jaundice. This can occur with fasting, prolonged strenuous exercise, fatigue, surgery, infections, excessive alcohol intake, or menstruation.

Up until a few years ago, experts considered GS an innocuous condition, the only significant feature of which was abnormally high levels of unconjugated bilirubin on routine fasting blood tests. As it turns out, GS is not so benign: A significant percentage of people with this genetic abnormality also have an impaired ability to metabolize and excrete certain medications, including the pain-relieving drug acetaminophen (Tylenol) and a cancer chemotherapy agent called irinotecan. That makes them more susceptible to side effects, such as liver toxicity from acetaminophen or a severe drop in white blood cells from irinotecan. More recently, a groundbreaking study at the University of Washington in Seattle has shown that having a sluggish UGT1A1 enzyme can make it more difficult for people with the most severe form of GS to eliminate cancer-causing environmental toxins found in smoke, automotive exhaust, and charbroiled meat.

The study also reports another significant discovery, however: Eating a diet rich in cruciferous vegetables like broccoli, Brussels sprouts, cabbage and watercress can increase the activity of the UGT1A1 enyzme. (Onions, citrus fruits, and legumes also increase activity of the UGT1A1 enzyme, but not quite at the level as crucifers.) This implies that people with GS are particularly susceptible to the beneficial, cancer-preventive properties of broccoli and its edible relatives. Based on this research, I would recommend that you minimize the use of acetaminophen and avoid grilled meats, cigarette smoke, and exhaust fumes from petrochemical fuels as much as possible. In addition, eat at least one full serving of cruciferous vegetables every day. Or, if you aren’t particularly fond of this vegetable family, tr...

Author: Robert Rountree, MD

Copyright 1999-2009 Natural Solutions: Vibrant Health, Balanced Living/Alternative Medicine/InnoVisi...