Gilbert syndrome: common, but unknown

What is Gilbert syndrome? What symptoms does it present? Could it constitute a protective category against other diseases? We tell you about it in this article.

In 1901, gastroenterologist Agustín Nicolás Gilbert first described Gilbert syndrome. He observed that certain patients had elevated levels of indirect bilirubin and, therefore, a yellowing of the skin and ocular sclera, called jaundice.

These patients did not have any viral alterations such as hepatitis or obstructions of the bile ducts due to tumors, or anything like that. What happened is that, Due to a genetic mutation, people with Gilbert syndrome were missing a liver enzyme known as glucuronosyltransferase.

Since this enzyme was not present, it was impossible for bilirubin – a yellow pigment found in bile and formed by the degradation of hemoglobin – to be metabolized normally, as occurs in the rest of the population. For this matter, serum levels have increased.

Although Gilbert syndrome does not have serious implications for a person’s life, it is convenient to know that although it is often downplayed, it presents a series of symptoms that are extremely uncomfortable. A significant association with emotional problems such as anxiety, depression and obsessions has also been noted.

On the other hand, although not much is known, it is estimated that It affects 5% of the population and is more common in men than women.. Some people who suffer from it don’t know they have it until they have routine blood tests. It is diagnosed between 15 and 30 years of age.

In addition to these symptoms, which we will now explain in more depth, it is curious to observe that on the other hand Bilirubin is protective against other pathologies.

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It has been proven that bilirubin levels slightly higher than normal result in an antioxidant that can prevent relevant pathologies, such as cancer. It has also been found that Patients with Gilbert syndrome are more protected against cardiac problems and that its tension is especially low.

What symptoms does Gilbert syndrome present?

Although in medical consultations it is common to hear that Gilbert’s syndrome “has no symptoms”, the reality is that A significant percentage of patients feel misunderstood because this statement does not correspond to their daily reality..

Although it is true that not 100% of affected people present these symptoms, many do and feel frustrated when they see that There is no treatment that helps them lead a more normal life..

Symptoms usually appear in flares, when bilirubin rises. This usually increases in situations in which the liver is forced to work harder. For example: when fasting, when we do physical exercise, if we suffer from stress or if we are sick from a virus.

Among the most typical symptoms verbalized by the patients themselves are:

Jaundice. It is the main symptom and the most objective since it can be seen with the naked eye. It appears when the total bilirubin reaches approximately 2.5 mg (it is normal to have it at 1 mg). The skin turns yellow, as well as the eyes. It is not bothersome on a physical level, but obviously, it is not very flattering and can lead to self-esteem problems if the person does not accept it.Fatigue. It is another of the classic symptoms of Gilbert syndrome. sometimes the tiredness is so extreme that the person needs to sit up immediately or lie down. This, of course, leads to work or social problems. People around the patient do not understand this fatigue if no effort has been made and many times patients are treated as “lazy” when in reality they are exhausted for no apparent reason.Digestive problems and weight loss. The liver is part of the digestive system and therefore, it is relatively common for these patients to present digestive problems such as nausea, frequent diarrhea or pain in the liver area. As a result, when bilirubin rises in a crisis, they often lose their appetite and lose weight.Depression and anxiety. It is also typical for these affected people to present with depression and anxiety throughout their lives. It is as if the bilirubin somehow disturbs your emotional well-being. Therefore, their quality of life is diminished since it may be more difficult for them to get out of this state.Migraines. Migraine headaches consist of an intense headache. It is normally located unilaterally and may or may not be accompanied by auras. Auras are neurological symptoms that can consist of visions of flashes or geometric shapes, paresthesias and even difficulty speaking.

Conclusions about Gilbert syndrome

Based on recent epidemiological studies, it appears that Gilbert’s syndrome is not just a “cosmetic” condition as far as jaundice is concerned. There is enough documentation to affirm a inverse correlation between cardiovascular and oncological riskespecially colorectal cancer and total blood bilirubin levels.

These findings have been replicated in various ethnic groups. The reason is that Bilirubin exerts a protective antioxidant and anti-inflammatory effect. Bilirubin has a greater capacity to reduce lipid oxidation than glutathione and vitamin E. Higher levels of total bilirubin are associated with a lower risk of nonalcoholic steatohepatitis, diabetic nephropathy, and coronary stent restenosis.

Would it be very far-fetched then to propose artificial bilirubin induction to prevent these diseases? Is Gilbert Syndrome, paradoxically, a therapeutic disease?

Like other diseases, such as irritable bowel syndrome or fibromyalgia, even Gilbert’s Syndrome remains “orphaned” in terms of consideration and research. The conclusions that we can reach in this article are that perhaps Such research could open many doors.

On the one hand, the design of some type of treatment that would alleviate the adverse symptoms of this condition as much as possible. For another, analyze in greater depth the properties of bilirubin in blood and check its possible benefits in different diseases that are currently life-threatening.