Gilbert's Syndrome and Alcohol Tolerance

It’s a new spring day! You feel a little groggy after the time change, but you’re excited to spend some time in the sunshine. You bounce out of bed and barrel into the bathroom.

As you brush your teeth, you catch a glimpse of your face in the mirror. Something’s… off.

There’s a sickly, yellowish tint to your skin! You lean closer and see that it’s even creeping into the whites of your eyes. Why is this happening?! Is this jaundice? Isn’t that something that happens only to babies?

You’re not the only one to have this experience. Every day, people well into their late teens, twenties, and thirties realize they have Gilbert’s syndrome. Let’s break down this common genetic condition, how we can avoid jaundice flare-ups, and which lifestyle choices we’ll need to make.

What Is Gilbert’s Syndrome?

Gilbert’s syndrome is a disorder that disrupts our body’s ability to process bilirubin — an orange-yellow byproduct of broken-down blood cells. It’s also known as constitutional liver dysfunction, Meulengracht syndrome, Gilbert-Lereboullet syndrome, and familial nonhemolytic jaundice (whew!).

To understand this genetic disorder, we can think of our liver as a janitorial service full of workers (enzymes). As red blood cells age and die, producing bilirubin, the staff should be serving as a cleanup crew, making the waste water-soluble and getting rid of it.

Most people’s livers are fully staffed. However, in those of us with Gilbert’s syndrome, most of our employees are standing around instead of working through their bilirubin to-dos. We operate at about 30% capacity.

This difference can be attributed to changes in the UGT1A1 gene, which is supposed to signal each of those enzymes to take part in bilirubin breakdown. Its malfunction means that our bodies may have a buildup of this substance, putting us at risk of hyperbilirubinemia — elevated blood levels of bilirubin. You’ll probably know that condition by its common name: jaundice.

While most genetic disorders are rare, Gilbert’s syndrome is actually pretty common. It affects between 4% and 16% of people. However, thanks to its lack of obvious symptoms, many cases of Gilbert’s syndrome go undetected.

Symptoms of Gilbert’s Syndrome

In most of us, Gilbert’s syndrome is so mild that we may not even realize we have it. Around 30% of people exhibit no outward signs at all, making this an asymptomatic condition.

Those of us who do present with symptoms may only notice one — a very slight yellowing of our skin, eye whites, and mucus membranes. That’s jaundice — it doesn’t only occur in babies! For those of us with darker skin tones, it may primarily manifest as a yellowing in the whites of our eyes. In folks with bilirubinemia, episodes of jaundice may be triggered by environmental changes. We’ll dive into those in a bit.

Some people with Gilbert’s syndrome have described symptoms such as weakness, fatigue, and gastrointestinal issues like nausea and diarrhea. Researchers believe that these experiences may be better associated with anxiety about the condition than excess bilirubin levels.

Living With Gilbert’s Syndrome

The first step to living with Gilbert’s syndrome is to get a diagnosis. This can be challenging in part because of the disorder’s characteristic fluctuations — how can a doctor observe elevated bilirubin levels if they’re always changing? Healthcare professionals may use multiple blood tests, ultrasounds, and even genetic testing to determine whether we have this condition.

Once we know what we’re dealing with, we can make a plan to manage our symptoms. We’ll want to give our body all the nutrients it needs to successfully compensate for wonky bilirubin levels. That means prioritizing hydration, a balanced diet, and regular exercise.

Our doctor will also tell us about stressors that can trigger a rise in unconjugated bilirubin, which may manifest as jaundice. There are quite a few: 

• Fasting. Long periods without food can make our body break down its own tissue instead, causing bilirubin to build up in our system.
• Illness. Any illness that affects the liver, including cirrhosis and hepatitis, can further impact our ability to process bilirubin.
• Menstruation. Hormonal changes associated with menstruation may trigger jaundice.
• Overexertion. Intense physical activity triggers hemolysis, the breakdown of red blood cells — that’s the process that creates bilirubin.
• Dehydration. When we don’t drink enough water, the amount of bilirubin in the blood becomes more concentrated, leading to jaundice.
• Drinking. Excessive alcohol use can impact liver function, increasing our risk of bilirubin buildup. When we have Gilbert’s syndrome, alcohol may cause unwanted side effects.

Can You Drink With Gilbert’s Syndrome?

Drinking with Gilbert’s syndrome is technically safe, but it may lead to unwanted side effects. 

Short-term alcohol use with Gilbert’s syndrome may aggravate jaundice, but according to researchers, it doesn’t have many other concerning consequences. To quote an article published in The International Journal of Pharmacology, “There are no specific dietary restrictions/additions for GS, and alcohol can be consumed within the discretionary limits.”

In the long term, combining alcohol and Gilbert’s syndrome isn’t the best idea. If we develop alcohol use disorder (AUD), we may damage our liver, which is already having a hard time processing bilirubin. Further organ damage in the form of cirrhosis (extensive scarring) can impact liver function. This dramatically increases our risk of jaundice, which may also become more severe as our condition worsens.

Interestingly, some people with this disorder report strange symptoms related to the combination of alcohol and Gilbert’s syndrome. Let’s explore these anecdotal issues.

Gilbert’s Syndrome and Alcohol Tolerance

Whenever we discuss Gilbert’s syndrome, alcohol tolerance comes up. Many people with the condition have reported unusual side effects related to drinking, including a lower tolerance level. They may feel drunk more quickly and after consuming less alcohol than their peers. Whether this is related to individual differences or a genetic predisposition remains to be seen. While there isn’t much scientific documentation of this phenomenon, it’s a tale we’ll probably hear from our friends who have also been diagnosed with Gilbert’s syndrome.

After a night on the town, some sufferers report severe hangover symptoms like nausea, headaches, and stomach cramps lasting for days at a time — even if they used to drink more heavily. These stories may be explained by the way our body handles alcohol as we age. When we get older, our metabolism slows, and our liver becomes less efficient. We’re also less resilient than we used to be. All of those factors keep alcohol in our system longer, leaving us to feel its effects for more time than we’d like. 

How To Manage Gilbert’s Syndrome

Fortunately, Gilbert’s syndrome is considered a benign disease by most healthcare experts. This means that beyond making a few lifestyle changes, we don’t need to do much to manage it.

Most health advice related to this disorder centers around preventing episodes of jaundice. While we can’t avoid triggers like menstruation or illness, in the future, we’ll want to steer clear of catalysts like dehydration, overexertion, and chronic stress. There are a few steps we might take to manage Gilbert’s syndrome and prevent jaundice:

1. Stay hydrated. Drinking the recommended amount of water each day keeps our bloodstream’s bilirubin levels in check. It also aids crucial functions like digestion and circulation. Follow the National Academy of Medicine’s guidelines of 104 ounces and 72 ounces of water per day for men and women, respectively.

2. Opt for gentle exercise. Overexertion is a no-go for those with Gilbert’s syndrome, but a regular fitness regimen will help maintain muscle tone, improve circulation, and boost energy levels. Consider low-impact physical activities like swimming, walking, yoga, and tai chi.
3. Practice stress-relieving activities. Chronic stress and traumatic life events can trigger jaundice, but mindfulness, meditation, and breath awareness may help us find inner peace.
4. Eat at consistent times each day. As we’ve mentioned, fasting might cause our body to turn on its own tissue, resulting in excess bilirubin. Eating at the same times every day keeps us on track. Consider meal prepping to ensure there’s always a healthy, complete meal ready to go.
5. Prioritize self-care. Listen to your body and be kind to yourself. When we feel overtired, thirsty, or stressed out, we can think about ways to be more comfortable. Purposeful relaxation, journaling, listening to music, and getting a massage are all self-care activities that may help us navigate life with Gilbert’s syndrome.

6. Talk to a doctor about medications and supplements. Before starting any new supplement, it’s always a good idea to discuss it with a healthcare provider — this goes double for those of us with liver conditions like Gilbert’s syndrome. It may seem like overkill, but give the experts a quick call before taking new vitamins, medicinal teas, or herbal remedies. Our well-being is worth it!
7. Learn about this condition. Knowledge is power! The more we know about Gilbert’s syndrome and hyperbilirubinemia, the better equipped we’ll be to meet any challenges they send our way. Talking to a doctor, reading books, and combing through online resources are all great ways to learn about conditions like these.
8. Get regular checkups. Healthcare providers can monitor fluctuations in bilirubin levels. If we notice a bit of jaundice from time to time, we can call them to arrange a quick blood test. This way, we’ll know our baseline and can identify personal triggers.
9. Reevaluate your relationship with alcohol. Finally, it might be time to cut back on alcohol (or cut it out altogether). The occasional drink may stress our system only temporarily, but chronic alcohol use can damage our liver. This worsens its efficacy, meaning we’ll be more likely to experience jaundice along with other conditions related to liver damage. The combination of Gilbert’s syndrome and alcohol may not be worth it.

Live Well With Gilbert’s Syndrome

If you’ve been diagnosed with Gilbert’s syndrome, you have options to keep jaundice at bay. Little modifications like doubling down on hydration, balancing your diet, and avoiding alcohol can protect your health and prevent bilirubin buildup.

Struggling to cut back on drinking? Consider downloading Reframe — a revolutionary habit-change app developed with the input of medical and mental health experts. Our all-in-one alcohol reduction platform has helped 91% of users note a substantial decrease in alcohol use within three months of starting the program. To learn more, visit the App Store or Google Play.