Gilbert's Syndrome Needs Attention

Tired, jaundiced and nauseas? You may have Gilbert's syndrome ( a genetic liver issue) which may affect between 7% to 25% of the population depending on which part of the world you are from. Over time this condition will potentially impact your hormones and further diminish your liver's ability to detoxify. Medicine does not consider the condition serious but the symptoms experienced by some people demands an appropriate level of attention. Holistic practitioners consider the liver as key to good health.

Transcript

Daniel Baden: Maria Allerton: 0:07

Hello.

Maria Allerton: 0:09

Hi, Daniel. Thanks so much for having me.

Daniel Baden: 0:43

Maria, we're going to be talking about Gilbert's syndrome. And it's a topic that's not really discussed all that much and I guess it's not discussed all that much because in medicine, it's not considered to be a significant issue. However, you're going to tell us that there are long term problems associated with Gilbert's syndrome. And I'm just wondering what your story is.

Maria Allerton: 1:13

Yeah, so I'll start with myself. So I had jaundice as a child. I know this from my parents as a baby at birth. And as a child, I used to have a lot of digestive and immune difficulties. So lots of throwing up, particularly dairy. I was a baby and a toddler. And just yeah, really poor tolerance to many foods, sick all the time, you know, lots and lots of antibiotics all

Daniel Baden: 1:55

IBS being irritable bowel syndrome, bowel syndrome.

Maria Allerton: 1:58

And then I just sort of, you know, kept struggling with my gut. And I started work and in my 20s, lots of planning, lots of post work, drinks, and all that sort of stuff. And I realized that I was the only person out of anyone I knew who would feel really sick after like two alcoholic drinks, whereas everyone else was still chucking them down and partying on and I was like,

Daniel Baden: 2:42

So what is bilirubin?

Maria Allerton: 2:43

So bilirubin? So first of all, it's a marker on every standard blood panel that we normally get from our doctors that biochemistry panel, that's usually the longest one. He's got that long list of everything, including liver markers, and bilirubin is on there. So it's actually a byproduct of heme metabolism. So we all make him as part of our red blood cell process. And then heme

Daniel Baden: 4:17

And jaundice is a yellowing of the skin.

Maria Allerton: 4:19

Yeah, it's that yellowing of the skin and particularly the sclera of the eyes. So that seems to be quite a big symptom for a lot of people. Not everyone with Gilberts gets jaundice, but a lot of people do. And that's how they first identify that there's an issue.

Daniel Baden: 4:36

And you can also get jaundice without having Gilberts syndrome, can't you?

Maria Allerton: 4:40

Correct. So there's lots of other medical conditions that can lead to that, you know, it's a liver impairment, but it's a key symptom with Gilbert's, and usually if there's jaundice and your bilirubin is elevated, it's pretty certain that you have Gilbert's genetically.

Daniel Baden: 4:58

Are there any other symptoms that you came across like nausea or changes to your bowel habits or other.

Maria Allerton: 5:04

Yeah, lots and lots of symptoms. So personally for me, it was always about digestion and leaky gut like gut permeability as a key symptom. But you know, many, many symptoms that my clients have, and I'll read them out because there's so many these are quite common and and have been validated in research. So I've only put together a list that's actually been validated. The

Daniel Baden: 6:21

I think that anybody that listens to a podcast on natural medicine has to get used to poo.

Maria Allerton: 6:27

Yeah, lots of poor talk. Yeah, this is all poo talk, in fact, so yeah, floaty, like colored stools can have constipation or diarrhea, you know, and that IBS type irritable bowel, you know, variability between the two. Quite often people will have either their gallbladder has been removed, or they have family members whose gallbladder has been removed. So gallstones and gallbladder sludge are really common nausea,

Daniel Baden: 7:43

How does it play out through the lifecycle, like in your example, estrogen, through a woman's life cycle changes quite dramatically? Does that affect the symptoms as you get older?

Maria Allerton: 7:56

Absolutely. Yeah. So in fact, many people discover that they have Gilbert's in teenage years. And, you know, I follow and comment a lot on the social media, Gilbert's groups and Facebook and places like that. And quite often there are posts there from parents of teenagers saying things like my daughter, just just turned 14 and got her period. And she has Gilbert's and now she

Daniel Baden: 9:33

because of the increase estrogen?

Maria Allerton: 9:35

correct yeah, because it's not just so much from the increase of estrogen but the increase of the volume of estrogen that the liver has to detoxify, right. detoxification

Daniel Baden: 9:49

and what about the conversion because it with estrogen you know, there are various forms of estrogen, some more potent than others and the livers involved in some of the conversion in between the potent and not so potent forms, is Gilbert's involved in the limitations around that as well?

Maria Allerton: 10:08

Yeah, I do find, I don't know if there are studies showing this, I haven't come across any. But clinically, in my experience, I do a lot of Dutch hormone testing. So it's a functional medicine test that measures your hormone levels, but also tells you how the hormones are getting detoxified, which is really cool. So a lot of my older female Gilbert's clients have a problem detoxing

Daniel Baden: 10:55

If you've got the younger forms of estrogen, because the more potent estrogens that are associated with women who are more in their fertile state of life, and change with menopause, would you expect to see lesser symptoms of menopause in a Gilberts person?

Maria Allerton: 11:13

Haven't found that to be the case. No, there's menopause symptoms still seem to be equally as strong. It's more I think the problem happens with the gut. So because of the gut is quite impaired, in Gilberts, all those hormonal changes, you know, everything has to go through the gut. That's really what slows it down. In your case, what happened next? How will you discover to have

Daniel Baden: 12:10

What was your aha

Maria Allerton: 12:13

I think my aha moment was figuring out how to do 23 And me testing and gene testing, that's an online gene test and looking at the list of the genes that came up from that and just going, Oh, wow, okay, this explains a lot. So what did you decide to do from there? Yeah, as most people who figure out that they have Gilbert syndrome, I started taking calcium D glucurate. Which is,

Daniel Baden: 14:19

there's a lot of associated symptoms. There's a lot of associated by chemistry that you can obviously see on paper. Why does medicine not regard it as serious?

Maria Allerton: 14:33

That's a great question. Look, the more I speak to people who get that statement from their doctors, and this is all over the world. You know, I have clients from the UK, New Zealand, the US Canada, doesn't matter where they're from Europe. They go to the doctor and the doctor will say, Oh, well, that's not why you have your problems. That's a benign condition. You don't need to

Daniel Baden: 16:10

As we know that the liver is a the body's chemical factory, it produces chemicals, it breaks down chemicals, natural chemicals that we produce, but also exogenous meaning external chemicals. So if someone's had a lot of chemicals in their life through their work, or their diet, or their environment, and that's impacted the liver function, would that have an effect on the

Maria Allerton: 17:03

Absolutely. Yeah. So one of the jobs of the glucuronidation pathway, it's to clear bilirubin, but it's also to clear estrogen, whether it's real estrogen food produced endogenously inside our body, or external environmental Xeno estrogens, so things that you're referring to, like BPA plastics, and non BPA plastics, as well, all of those things, you know, environmental for each client. So it depends on their symptoms, health history, or their tests, markers put together a very personalized plan. Starting with diet and lifestyle, that's a pretty major way that we can address Gilbert's syndrome. Okay, so what sort of dietary advice would you start with? Yeah, my number one thing is for them to completely cut out or significantly reduced saturated fats from the

Daniel Baden: 19:56

Is that fermented and non fermented? story is coconut fat. So I know recently coconut oil has been promoted as this amazing health solution to all of our problems. And the more I kind of evolve as a nutritionist, the more I'm looking for what the agenda was with that and who the agenda is from, because I'm not seeing any benefits from coconut oil, generally, but particularly for Gilbert's people. So it's super, super hard to break what are cruciferous vegetables.

Maria Allerton: 21:13

So that would be things like broccoli, cauliflower, Brussels sprouts, or that whole family of veggies. So we know I mean, it's quite a well known fact that those types of vegetables improve liver function, but particularly for Gilbert, so they actually have been studies on in the Gilberts population, showing that those cruciferous vegetables improve glucuronidation. And there's

Daniel Baden: 23:07

Well, that's great and important resource, I will get the course details at the end of our chat. So people can look you up. And is the course for practitioners or for the public or both.

Maria Allerton: 23:18

It's actually written for both. Yeah, it's definitely I've made it really, really simple and complete for the general public. But if you are a practitioner, there's enough research information and enough info on pathways and detox and all that stuff that you can then take and use in your protocols in clinic that it's accessible to everyone.

Daniel Baden: 23:41

And what about other lifestyle factors like exercise? Does that have an impact?

Maria Allerton: 23:47

Yeah, definitely. So exercise is a big topic in Gilbert. So the reason why is because when we exercise, we have a higher breakdown of red blood cells through the exercise process. So therefore we have a higher level of bilirubin and that's also why men have a higher prevalence of Gilbert's syndrome because they have a higher amount of red blood cells. So the intensity of the

Daniel Baden: 24:59

Different horses for different courses.

Maria Allerton: 25:01

They're the main dietary aspects of the saturated fat, the cruciferous vegetables.

Daniel Baden: 25:06

What about supplements? You did mention calcium D Glucurate before. Do you have to take a lot of that? Is it a high dose sort of thing?

Maria Allerton: 25:16

No, not really, it's usually a starting dose is usually 500 milligrams, and then up from there. So that's a standard capsule size, and a lot of the supplements that are sold online, usually you need to take quite a bit more if the bilirubin is very high. So I found personally, you know, if I had a bilirubin rating of 25, at some stage, and normal is between five and 10, that's

Daniel Baden: 27:03

is that through changing the pH of the gut or changing the microbiome directly?

Maria Allerton: 27:08

I think it's the action of the actual compound on the border on the intestinal cells that hold the border together. So that's usually the starting point for most people is fixing their leaky gut situation and also fixing their gastric emptying. So gastric emptying speed is also impaired in Gilbert's been shown in the research so people tend to have and it's a bit of a paradox they

Daniel Baden: 28:12

Right. Okay. And I guess these things just continue to get worse with age as well. Yes. And obviously, alcohol is run out of the question.

Maria Allerton: 28:19

Yeah. So you know, just going from that initial experience that I had, my younger self, all of my Gilbert's clients will say that alcohol makes them feel so much worse. And they've either already figured that out and stopped drinking altogether, or they've significantly reduced their alcohol intake.

Daniel Baden: 28:39

When people start a program like you offer diet and lifestyle and some supplements, one of the first initial improvements that they see,

Maria Allerton: 28:50

they usually feel a lot better with their energy. So fatigue is another big, big symptom that manifests quite a lot. And I think the energy improvement comes from better gut function and better digestion. So they start digesting better, they're absorbing their nutrients better. Energy improves. And also even just simple things, you know, like removing dairy and gluten, which I

Daniel Baden: 29:34

What about other lifestyle factors which affect a lot of people in a modern world? Things like stress, or carrying a bit of extra weight? Do they have impact?

Maria Allerton: 29:45

Yeah, absolutely. Well, anything that impacts the gut and the liver is going to have an impact on Gilbert's So stress affects our hydrochloric acid production, you know, because when we're in fight or flight, we can't be in rest and digest and I say this to people all the time. And it's usually like, oh, wow, you know, it's a bit of a revelation. Like, if you are stressed, you things,

Daniel Baden: 31:51

presumably, you're following your own advice. And I'm just wondering if we all have little slip ups, I'm sure. But I'm just wondering how you're doing.

Maria Allerton: 32:04

You know, I'm doing great. Actually, I'm doing you know, I'm 46 now, and I'm doing far better at 46 than I was at 26. Let's just say that, because I've learned so much about my body and my genetics and my issues. But you know what, the liver is a really interesting organ. And having genetics in multiple pathways of the liver detox can be really, really tricky. And the other

Daniel Baden: 33:20

well. Yes. The listeners won't understand this, because they can't see you. But I can see you I can say that you surely don't look 46. So whatever you're doing, keep going.

Maria Allerton: 33:30

Oh, thanks Daniel, you get my hair color. And yeah, that will work. Yeah, well looks like in progress.

Daniel Baden: 33:39

It's so interesting. And because various studies that I've looked at, would suggest that between seven and 10% of the Australian population have potential Gilbert's syndrome. And I believe it's possibly up to 25% from some populations. I don't know who those populations are, do you?

Maria Allerton: 33:58

Yeah, that's right. In the Middle East, it's a much higher percentage, particularly amongst men. So Middle Eastern men have the highest prevalence or about 25%. A lot of Asian populations have a higher prevalence than Caucasians as well. But yeah, around 10% of Caucasians have this genetic condition. Okay.

Daniel Baden: 34:19

Yeah, look that is really high. And I'm really delighted to learn that there's something that can be done about it. And it's not just go away until something else happens. And so I'm really grateful that you had a bit of time for us today because it gives people hope. Other people get in touch with you, and tell us and how do they get in touch with your course?

Maria Allerton: 34:38

Yes, so my website is truefoodsnutrition.com.au so foods with an S. And if they go under the Education tab, or actually no, it's not under education, it's courses and programs. So truefoodsnutrition.com.au courses and programs and it's the Gilberts courses listed there. I'm also on social media. So on Instagram, I have a page called Gilbert syndrome support, which is just all

Daniel Baden: 35:47

Well, your passion certainly comes through and understanding the condition and helping people with similar symptoms. So well done. And thank you for your time.

Maria Allerton: 35:56

Thanks so much, Daniel, great to talk to you.