Gilbert's Syndrome

Gilbert's Syndrome: Overview

Gilbert's Syndrome, characterized by a chronically elevated serum bilirubin level (1.2 to 3.0mg/dL), is the most common of all benign unconjugated hyper-bilirubinemias.  Previously considered rare, this disorder is now known to affect as much as 5% of the general population.

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Signs and Symptoms

The condition is usually asymptomatic, although some patients do complain about anorexia, malaise, and fatigue.  In a small study, the most common symptom was chocolate and sweet craving followed by fatigue.

Diagnosis and Tests

Mild unconjugated hyperbilirubinemia is the only significant laboratory abnormality, which is important clinically because it is often misdiagnosed as chronic hepatitis.

Signs, symptoms & indicators of Gilbert's Syndrome:

Symptoms - Food - Preferences

Symptoms - General

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Conditions that suggest Gilbert's Syndrome:

Lab Values

Elevated Bilirubin Levels

One common – and harmless – cause of elevated bilirubin is Gilbert's syndrome, a deficiency in an enzyme that helps break down bilirubin.

Recommendations for Gilbert's Syndrome:


Fluoride Reduction/Avoidance

John Lee, MD, a physician in private practice has stated that elevated bilirubin levels can be reduced in Gilbert's syndrome by avoiding fluoridated water and other sources of fluoride.  This physician has seen bilirubin levels rise again when fluoride has been reintroduced.  Gilbert's syndrome may be due to a partial deficiency of the hepatic enzyme glucuronyl transferase.  Fluoride, being an enzyme inhibitor, reduces the enzymes' activity even further. ["Fluoride Linked to Gilbert's Syndrome", Lee, John R., M.D., Cortlandt Forum, September 1990;101: pp.31-33]


TMG (Trimethylglycine)

Methionine, administered as SAM, resulted in a significant decreases in serum bilirubin in patients with Gilbert's syndrome in a recent clinical study.  SAM has been used with favorable results in a variety of other chronic liver diseases.  TMG also converts to SAMe while being considerably less expensive.

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