Gilbert's Syndrome and Alcohol Consumption

Gilbert’s syndrome is a relatively common condition that can lead to yellowing of the skin and eyes. It affects up to 13% of the population in the United States, but most people will rarely show physical symptoms of its effects. Although it is a lifelong disorder, it is relatively easy to manage.
Evidence Based
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What is Gilbert's Syndrome?

Gilbert’s syndrome is a mild genetic disorder that occurs when the liver is unable to properly process bilirubin. Bilirubin is a toxic substance that is produced when red blood cells are broken down. The buildup of this substance is called hyperbilirubinemia, and it is usually mild, even though bilirubin is toxic. 

Bilirubin is usually removed from the body after undergoing a chemical reaction with liver enzymes, where the body can process bilirubin. However, people with Gilbert’s syndrome cannot complete this reaction. 

In some cases, higher bilirubin levels caused by Gilbert’s syndrome can lead to mild jaundice, a yellowing of the skin and eyes. There is a strong link between Gilbert’s syndrome symptoms and alcohol consumption. These symptoms can worsen from drinking alcohol much like side effects from taking medications. 

Causes of Gilbert Syndrome

Gilbert’s syndrome affects about 3 to 7 percent of the population. It is an inherited disorder caused by an abnormal UGT1A1 gene. This gene is responsible for orchestrating the breakdown of bilirubin in the liver. Without a properly functioning UGT1A1 gene, the bloodstream will contain excess amounts of bilirubin as it cannot eliminate it. 

While alcohol does not cause this genetic condition, it can cause symptoms to appear, as bilirubin levels tend to elevate after consuming alcohol. 

Symptoms of Gilbert Syndrome 

Symptoms of Gilbert syndrome are typically mild and may include:

  • Fatigue
  • Yellowing of the eyes and skin (familial nonhemolytic jaundice)
  • Loss of appetite
  • Dizziness
  • Upset stomach or abdominal pain
  • Concentration issues

Can You Drink Alcohol with Gilbert's Syndrome?

It is possible to drink with Gilbert’s Syndrome, but many people with this condition find that alcohol worsens their symptoms. For some, even one alcoholic drink can lead to a painful digestive tract or pronounced dizziness. 

Since both bilirubin and alcohol are broken down in the liver, those with Gilbert’s syndrome may find it difficult to process even small amounts of alcohol. The effects of alcohol may also last for an extended period. Many individuals with Gilbert’s syndrome experience hangover symptoms for several days after consuming as little as one or two drinks. 

Risk Factors: Is Gilbert’s Syndrome Dangerous?

Gilbert’s syndrome is typically a mild condition, even though the buildup of a toxic substance causes it. It can cause uncomfortable symptoms, especially after alcohol consumption, but it does not pose a significant health threat. 

Gilbert’s syndrome does not lead to impaired liver function, liver damage, or an increased risk of developing liver disease. One of the determining factors in diagnosing Gilbert’s syndrome is if a patient’s liver function tests are normal. However, the bilirubin levels will not be normal. Doctors may repeat the blood tests to ensure the readings are accurate. 

It is currently unknown how people with Gilbert’s syndrome react to covid-19 caused by the novel coronavirus. 

Treatment for Gilbert’s Syndrome

Gilbert’s syndrome is often diagnosed at the onset of puberty, but it can also present later in life. Routine blood test results that reveal high levels of bilirubin may prompt further genetic tests to rule out this condition. In most cases, Gilbert’s syndrome does not require treatment, but there are several things to do to lessen unwanted symptoms, including:

  • Sleeping more
  • Minimizing long, intense workouts
  • Proper hydration
  • Meditation or breathing exercises
  • Eating right
  • Avoiding alcohol consumption

How to Manage Gilbert Syndrome

While Gilbert’s syndrome is a lifelong disorder, it does not pose a significant health threat and can usually be managed well. Acute episodes of jaundice and other uncomfortable symptoms usually pass quickly and without treatment. Changing your diet and exercise routine will not cure the condition, but it will help manage it and reduce the onset of certain symptoms. Avoiding alcohol is also beneficial in managing Gilbert’s syndrome, though some people are more affected by alcohol than others. 

It is essential to seek medical advice before attempting to manage the symptoms of Gilbert’s Syndrome on your own. 

Gilbert Syndrome: Questions and Answers

What medications should be avoided with Gilbert's syndrome?

Some drugs you should avoid taking if you have Gilbert's syndrome include HIV medications (atazanavir and indinavir), cholesterol medications (gemfibrozil and statins), bowel cancer medicine (irinotecan), and blood cancer medicine (nilotinib). Speak with your doctor for a complete up-to-date list of all medications that interact with Gilbert's syndrome.

Does Gilbert's syndrome make you tired?

Fatigue, dizziness, and tiredness are common symptoms of Gilbert's syndrome. However, jaundice (yellowing of the skin) is the most common symptom.

Can Gilbert's cause liver damage?

No, Gilbert's syndrome does not increase your risk of liver damage or liver disease. The condition is lifelong but does not pose any major threats to your health.

Can Gilbert's syndrome cause anxiety?

It can. People with Gilbert's syndrome may experience symptoms of anxiety and insomnia.

Does Gilbert's syndrome go away?

Gilbert's syndrome does not go away; it is a minor, lifelong condition that doesn't require treatment.

Resources

O'Malley, Stephanie S et al. “Acute alcohol consumption elevates serum bilirubin: an endogenous antioxidant.” Drug and alcohol dependence vol. 149 (2015): 87-92. doi:10.1016/j.drugalcdep.2015.01.023 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540054/

National Institute of Health. “Gilbert Syndrome.” NIH https://ghr.nlm.nih.gov/condition/gilbert-syndrome#genes

Genetic and Rare Diseases Information Center. “Gilbert Syndrome.” GARD https://rarediseases.info.nih.gov/diseases/6507/gilbert-syndrome#:~:text=Most%20people%20with%20Gilbert%20syndrome,weakness%2C%20nausea%2C%20or%20diarrhea.

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Updated on: November 4, 2020
Author
Jordan Flagel
About
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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