Tag: gilberts-syndrome-diet

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Gilbert’s Syndrome and Heart Disease

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Gilbert’s Syndrome protects against the leading cause of death globally. 

Here’s reason to celebrate for people with Gilbert’s Syndrome! One benefit of this genetic enzyme deficiency is a reduction in heart and cardiovascular problems. Heart disease is responsible for a third of deaths globally and rates are increasing.

For decades studies have shown that Gilbert’s Syndrome provides some protection from heart disease.  Recent  studies looking at differences for different populations. These validate the finding of reduced heart disease in those with consistently raised bilirubin levels and look deeper at other factors. 

Here you can find out more about why. Plus – why it doesn’t pay to think this means you can indulge in an unhealthy lifestyle. 

Why does Gilbert’s Syndrome protect people against death related to heart disease?

According to research, people with consistently higher levels of bilirubin in their blood lay down less fat in arteries. They are less likely to have thrombosis, and may have lower blood pressure. 

Raised levels of bilirubin in the bloodstream is one symptom of Gilbert’s Syndrome. Find out more here: https://gilbertssyndrome.org.uk/what-is-gilberts-syndrome/bilirubin/  . The enzyme people with Gilbert’s Syndrome are deficient in processes bilirubin, as well as other things in the body. This means we’ve got more bilirubin hanging around in our blood than most people. 

This study from 2002 https://pubmed.ncbi.nlm.nih.gov/11849670/ proposes that bilirubin acts as an antioxidant and protects arteries. This 2017 research discusses similarly how bilirubin levels in Gilbert’s Syndrome can reduce the levels of fats in arteries https://pubmed.ncbi.nlm.nih.gov/28300459/ . This 2013 published study notes that people with GS have less fat in their bodies more generally, as well as laid down in their arteries! https://pubmed.ncbi.nlm.nih.gov/23201182/ Thrombosis is less likely with raised bilirubin levels. 

This piece from 2018 https://journals.physiology.org/doi/full/10.1152/ajpheart.00417.2017 shows that aerobic exercise raises bilirubin levels. Athletes may have continuously raised bilirubin levels due to the regularity of their exercise. https://journals.physiology.org/doi/full/10.1152/ajpheart.00417.2017 : People with Gilbert’s Syndrome and people who exercise experience the benefits of raised bilirubin levels on their cardiovascular health. Higher bilirubin levels are also linked to lower systolic blood pressure measurements. 

How amazing is this!

‘Mildly elevated total bilirubin is consistently associated with reduced incidence of all-cause mortality (34). Remarkably, GS approximately halves all-cause mortality compared with normobilirubinemic controls (33).’

Does this mean people with Gilbert’s Syndrome live longer?

Well, it’s more complicated than that as this article attempts to explain. In short, there’s no evidence that is the case. If you read through the article you can also read more about the potential link of GS with UTI’s, gastric delayed emptying and issues with certain medications. 

https://academic.oup.com/ehjopen/article/3/3/oead059/7193306

This most recent research goes through other studies on millions of individuals. Excitingly it brings together a wide range of data to draw from, making it more robust than those studies observing far fewer individuals. 

‘We report significant findings: (i) White individuals with GS consistently exhibited protective effect as they aged, and furthermore its magnitude increased with age (due to small sample sizes, we could not determine this effect in Black subgroups); and (ii) mean total bilirubin remained constant despite increase in protective effect magnitude with age.’ 

(Although the effect was less in women than in men. )

I can just put my feet up and eat fast food then?

So, it looks like people with Gilbert’s Syndrome are less likely to have cardiovascular (CVD) disease. However, I know people with Gilbert’s Syndrome and who have had cardiovascular problems. Just because there is increased protection does not mean you are completely protected. We’re less likely to die a death related to CVD, but we may experience angina, or heart attacks etc. This means we may need to be prescribed drugs like statins. It’s important to know that such drugs need to be monitored, as they aren’t well processed by people with Gilbert’s Syndrome.

The UK’s National Institute for Health and Care Excellence, which is the body that prescribes how our health services standards should function, says of Gilbert’s Syndrome and statins: 

  • Be aware that certain drugs should be used with caution in people with Gilbert’s syndrome.
    • Gemfibrozil — inhibits uridine diphosphate (UDP)-glucuronyl transferase, the enzyme responsible for conjugation, and can cause variable hyperbilirubinaemia and jaundice.
    • Statin — people with Gilbert’s syndrome may have an increased risk of statin intolerance and should be monitored more closely while taking them. 
    • Gemfibrozil plus a statin — concurrent treatment with gemfibrozil plus a statin is contraindicated in all people due to an increased risk of myopathy.
      • In people with Gilbert’s syndrome, this interaction is further accentuated as glucuronidation is an important pathway for the metabolism of some statins and that pathway is compromised in people with Gilbert’s syndrome.
      • Simvastatin, atorvastatin, and rosuvastatin are only partially metabolized by UDP-glucuronyl transferase, but when combined with gemfibrozil, there is an increased risk of drug toxicity, including myositis.
      • If concurrent treatment with a fibrate and a statin is required, fenofibrate is a safer option than gemfibrozil but should still be used with caution.

https://cks.nice.org.uk/topics/gilberts-syndrome/management/management/

Finally – if you want to live a healthy happy life with Gilbert’s Syndrome, then your lifestyle is less likely to cause you heart disease. Eating plenty of fruit and veg for lots of fibre, vitamins and minerals, low fat wholegrains to balance your blood sugar, nuts, seeds, soya protein, broccoli and lots of other good things (find out more here https://gilbertssyndrome.org.uk/the-liver-diet/  ) will ensure you maximise your heart health. This is important due to the issues with prescribing cholesterol lowering medication. 

With the sort of lifestyle that ensures you maintain optimum health with Gilbert’s Syndrome, you’ll be even more protected against the world’s biggest killer. 

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Banish your Gilbert’s Syndrome Brain Fog

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Here you’ll find out what brain fog is and its causes. Why is brain fog a Gilbert’s Syndrome symptom? How you can banish brain fog with short, medium and long term tactics. I’ll also signpost you to more help if you need it. Read on!

What is brain fog

‘Brain fog’ describes a collection of different sensations that you feel in your head. Feeling fuzzy or that your thinking is unclear; inability to collect your words and express yourself clearly and concisely; losing the thread of your thoughts; forgetting something a moment after having thought it; disorientation or even dizziness; being easily distracted; a feeling of fatigue or tiredness that isn’t in your muscles.

There are many reasons you might have brain fog

Common causes of brain fog

  • Vitamin deficiency such as Vitamin D or B12, or lacking iron. 
  • Hormonal changes such as during puberty, the menstrual cycle, pregnancy or menopause. 
  • Low blood pressure.
  • Long term poor sleep quality.
  • Long term stress or depression.
  • Mental health conditions or neurodiversities such as schizophrenia or ADHD
  • Caffeine withdrawal. 
  • Alcohol dependency
  • Medication, including antihistamines or other over the counter meds such as cold remedies, as well as prescribed medications or medical treatments such as for pain or cancer. 
  • Medical conditions such as hypermobility, chronic fatigue, diabetes, multiple sclerosis, thyroid problems, Gilbert’s Syndrome and many more. 
  • Shift work.
  • Allergies or sensitivities to particular foods.
  • Environmental toxins and chemicals.
  • Trauma.

Why would Gilbert’s Syndrome in particular cause brain fog? 

There’s no definite reason we have brain fog with Gilbert’s Syndrome, but it is a recognised symptom. Let’s take a look at some pieces of scientific research examining bilirubin as a neurotoxin and its ability to pass through the blood brain barrier.

Jaundice and brain fog – Is bilirubin toxic to the brain?

If you have Gilbert’s Syndrome then you produce too much unconjugated bilirubin from time to time. And, yes, this bilirubin is a neurotoxin. But in adults this should cause little problem unless there are excessive levels of bilirubin that are life threatening. Excessive levels of bilirubin are not a part of Gilbert’s Syndrome. Gilbert’s Syndrome produces mild to moderate rises in bilirubin levels.

The science stuff:

Babies can have high levels of bilirubin just after birth, and their brains are not developed to process it the way adults are. This is why bilirubin can be dangerous to newborns. Adult brains have ways to deal with the bilirubin that prevent it from causing damage.  This is noted in the extract from a piece of research below. 

https://pubmed.ncbi.nlm.nih.gov/11001835/

However, because bilirubin is neurotoxic, hyperbilirubinemia in the newborn may exceptionally result in death in the neonatal period, or survival with severe neurological sequelae (kernicterus). Bilirubin enters the brain through an intact blood-brain barrier. Clearance of bilirubin from brain partly involves retro-transfer through the blood-brain barrier, and possibly also through the brain-CSF barrier into CSF. Work in our lab during the past 5 years has substantiated earlier work which had suggested that bilirubin may also be metabolized in brain. The responsible enzyme is found on the inner mitochondrial membrane, and oxidizes bilirubin at a rate of 100-300 pmol bilirubin/mg protein/minute. The enzyme activity is lower in the newborn compared with the mature animal, and is also lower in neurons compared with glia.

https://www.sciencedirect.com/science/article/abs/pii/S0188440914002641

This article notes some of the effects of Uncojugated Bilirubin (UCB) on the barrier of the brain. The tests are in an artificial environment not actual people. They do note that long term exposure to high levels can cause neurological damage. However, in Gilbert’s Syndrome the levels wouldn’t be high enough for long enough:

In spite of the increased awareness of UCB effects to brain cells (Brites and Brito, 2012), knowledge about its passage across the endothelial monolayer, the rate in which this passage is achieved, and its effects on the integrity of the brain endothelial barrier is scarce …

In conclusion, our data demonstrate that UCB impairs barrier function in an in vitro model of the human BBB. Interestingly, this interaction involves dual effects that depend on the time of incubation, with early transcytosis and late paracellular pathways facilitating UCB entrance into the brain (Figure 8). Collectively, these results underscore the need of prompt clinical intervention in cases of lasting hyperbilirubinemia to prevent BIND and related irreversible CNS damage.

https://www.frontiersin.org/articles/10.3389/fncel.2012.00022/full

As this piece notes, there are other enzymes in the adult brain that protect the brain from neurotoxic effects: 

Owing to its lipid soluble nature, bilirubin may cross the blood-brain barrier and thus enter the brain. Its clearance from the brain is ensured by the presence of an enzyme on the inner mitochondrial membrane, which aids in the oxidation of bilirubin, thus protecting against its neurotoxic effects. The mechanism of toxicity is yet obscure, but bilirubin has a higher affinity to settle in glia and neurons.

https://www.ncbi.nlm.nih.gov/books/NBK544252/

The question is – does the effect of higher bilirubin result in sensations of brain fog, although it doesn’t appear to cause long term damage? The studies don’t appear to answer that explicitly. Bilirubin might be a factor. If you manage your Gilbert’s Syndrome and have fewer episodes of raised bilirubin this should hopefully lead to less brain fog.

Solutions

If you’ve been experiencing a long term episode of brain fog it’s a good idea to go to see your health professional. I experienced brain fog and disorientation which I thought was Gilbert’s Syndrome at first. After a couple of weeks I went to see my Doctor. It turned out to be a vitamin deficiency and I got better after a week or two of treatment.

If you are experiencing a symptom flare up, or regular episodes, then you could try a number of things that might help relieve the symptoms. (Please do always consult your Doctor if your symptoms are unusual. I’m not a medical Doctor and I am not qualified to provide medical advice. )

Quick(er) fixes

Hydration! Ok, so it’s really true that a lot of people just don’t drink enough and this directly affects your ability to think. If you are feeling sluggish a glass of water could be the simple answer. 

Nutrition – I have already mentioned that some deficiencies can cause problems. If you’ve had a long episode of brain fog that isn’t going away then do see your Doctor. This is particularly important if you take medication that can prevent you absorbing vitamins.

There are lots of foods that can optimise your health and brain health especially. I talk more about specific foods below. A balanced plant predominant wholefood diet is the best for overall health. This reduces junk highly processed foods that can cause you to feel generally unwell over time. 

Alcohol, sugar and caffeine can all mess with energy levels and cause issues if you have Gilbert’s Syndrome. Of course as noted below and elsewhere, caffeine can help some people. 

Exercise – Encouraging blood flow to your brain through exercise is an easy fix, short, long and medium term. It helps your brain stay healthy for longer. Just don’t embark on sudden vigorous exercise if you have Gilbert’s Syndrome – or your symptoms may be triggered. Even standing and moving about the room on a regular basis can help.

Sleep quality is really important. There are many reasons you could experience poor sleep and brain fog can result. Improving sleep quality may resolve the issue. Sometimes life gets in the way of sleep! In which case you could try other tactics such as stress reduction, pacing or supplements to help bolster your energy.

Stress reduction or managing response to stress eg meditation, hypnotherapy, counselling, cbt, can help you deal with stressful or anxious thinking that are preventing you from thinking clearly. 

These are all lifestyle interventions that can reduce your Gilbert’s Syndrome symptoms overall. Other posts talk about some of these in relation to managing Gilbert’s Syndrome symptoms. Here are links to some:

https://gilbertssyndrome.org.uk/how-to-stop-feeling-exhausted/

https://gilbertssyndrome.org.uk/gilberts-syndrome-and-caffeine/

https://gilbertssyndrome.org.uk/hack-your-liver-to-improve-your-mental-health/

https://gilbertssyndrome.org.uk/the-liver-diet/

I have produced a Gilbert’s Syndrome Essentials course that can help you with the main Gilbert’s Syndrome symptoms. The course has additional advice and resources to help you get started on your journey to a happier and healthier life with Gilbert’s Syndrome. Read more

To develop a personalised programme you might want to work with a health coach who can help you get a plan to improve your wellbeing based on your individual circumstances. They can help you track and manage symptoms together with you. https://wellandgoodlife.co.uk/plans-for-health-and-wellbeing/

Tracking and managing symptoms

If you’ve tried a few things and they haven’t worked, then maybe you need to take a more detailed look at what’s happening and when.

Can you pinpoint episodes? Is there something that happens beforehand. Try a symptom tracker. It may be something that happens the day before or a couple of days before that is the trigger. You might then be able to avoid the problem or adjust your lifestyle to reduce exposure or experience the symptoms when they’ll have less impact. 

For example, I had a once weekly commute to a distant city which was an eight hour round trip on top of a day of long meetings. The next day I would feel absolutely drained, and overwhelmed by brain fog. I made sure that was my final working day of the week or adjusted my hours to ensure a short working day afterwards with no complex tasks. 

Pacing

A similar kind of symptom management is ‘pacing’. If you find that after certain activities or an active period you experience brain fog or fatigue, then balancing your activities might mean you have fewer episodes. If you have a chronic health condition then pushing through is not usually the best method of living better with your condition. Pacing, a practice tested and developed with people who have chronic fatigue conditions, has been shown to work well in managing symptoms including brain fog.

The organisation for people with Ehlers Danlos and other hypermobility conditions has a guide that is useful: https://www.ehlers-danlos.org/information/managing-fatigue-sleeping-problems-and-brain-fog/

Action for ME have a useful booklet on pacing that sets it out in great detail if you want to have a go https://www.actionforme.org.uk/uploads/pdfs/Pacing-for-people-with-me-booklet-Feb-2020.pdf

How pacing works: First you would analyse when your activities are triggering your brain fog. Then limit those activities by initially reducing considerably or down to within a minimum. Only increase activity if that doesn’t result in symptoms. It takes time and planning, but it can get you off a treadmill of repeated brain fog and fatigue episodes. Sometimes you may blow your activity budget for a special occasion. At least you know what to expect and can set time aside, or practice self care to recover more quickly.

If you have ensured you are deficiency free, don’t have other health issues that aren’t treated, are eating well, reducing your exposure to caffeine, sugar and alcohol, sleeping well and are managing stress, plus there are no specific triggers to avoid then you are likely to have fewer episodes. There are plenty of posts to help with some of those aspects of living better with Gilbert’s Syndrome. You can also take the Gilbert’s Syndrome Essentials course for a grounding in dealing with some of the key symptoms. 

Long term brain health

You can support your brain function for the long term too.

Adding berries into  your breakfast could increase concentration and focus. This may be because the antioxidants reduce inflammation and support blood flow. They also support brain plasticity, enabling it to organise itself better See this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192974/

And in this study, blueberry juice was found to help brain function https://www.labnews.co.uk/article/2025588/berry_aids_brain_function_improvement

Nut intake has also been linked to better capability to pass cognitive tests in later life for women in this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105147/

Caffeine can have short and long term benefits if you can tolerate it. It may protect against Alzheimer’s but this is thought to be because of the antioxidants. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554764/ https://pubmed.ncbi.nlm.nih.gov/26677204/ Although caffeine has its benefits, it can potentially work against you if you are trying to balance your energy levels and issues such as brain fog. Becoming reliant on a psychoactive stimulant can make it harder to manage your fluctuating fuzzy head symptoms. Here’s my post on Gilbert’s Syndrome and caffeine

Supplements

You can add supplements into your healthy living plan or toolkit. Or, you may just need an extra boost during an episode. Here are some you might try. 

Ashwagandha https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252722/ and

Rhodiola https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9228580/ are adaptogens that help balance stress and energy levels, enabling great energy stability. They don’t work overnight, but can provide a general foundation for balancing energy and improving sleep.

Add in Gotu Kola if you need a gentle lift more immediately. I find it acts like caffeine, but without the agitation, rapid heart beat and discomfort that I experience with coffee due to my sensitivity. I use it if I have a demanding task and I’ve perhaps had a poor night’s sleep or have a flare up of fatigue for another reason. Studies show its use in a wide range of conditions. It is thought to protect the brain, support brain health, help mood and even work as a painkiller https://examine.com/supplements/gotu-kola/research/#ref-71 

If you are experiencing an overall increase in your Gilbert’s Syndrome symptoms and feeling hungover, perhaps jaundiced, nauseous etc, you might want to add in supplements such as zinc sulphate to reduce bilirubin levels. Some people also take NAC. Read more about how they impact bilirubin here: https://gilbertssyndrome.org.uk/what-is-gilberts-syndrome/bilirubin/

Some people take calcium d glucarate to help with the glucuronidation (detox pathways in the liver), and dandelion root is also thought to help https://mastcell360.com/wp-content/uploads/2019/11/Glucuronidation-Assist.pdf 

More help and info

I hope I’ve given you lots of ideas to try to help banish brain fog. If you would like more support to develop a lifestyle that supports a healthier and happier life with Gilbert’s Syndrome, you can find the Gilbert’s Syndrome Essentials Course and plans for personal support and coaching to help you here. https://wellandgoodlife.co.uk/plans-for-health-and-wellbeing/

Get regular updates on the latest help for Gilbert’s Syndrome on twitter https://twitter.com/GilbertsSyndrom and instagram https://www.instagram.com/gilbertssyndrome.org.uk/

Do let me know if you experience brain fog and if anything has helped you by sharing your comments below.

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Beware B12 vitamin deficiency when you have Gilbert’s Syndrome

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Tell me more about B12…

B vitamins are vital for energy and to manage stress. Vitamin B12 is a superhero that helps support your red blood cells, nerves and is essential to your DNA, as well as many other processes in your body.

Why is understanding B12 vitamin deficiency even more important when I have Gilbert’s Syndrome?

For people with Gilbert’s Syndrome it’s particularly important to get enough of this vitamin because B12 deficiency can result in hyperbilirubinemia (the buildup of bilirubin in your body). Combined with Gilbert’s Syndrome this can be acute. But this symptom could also be dismissed because you have Gilbert’s Syndrome.  It’s vital to know you have Gilbert’s Syndrome, and its symptoms, so you can include that knowledge when in a medical situation. But it’s also important not to dismiss symptoms as JUST Gilbert’s Syndrome, when they could be something else. 

Having a B12 deficiency could give you similar symptoms to a Gilbert’s Syndrome flare up – so do not dismiss it when you feel unwell for longer than usual. 

If you don’t have enough B12 your ability to produce S-adenosyl-L-methionine (SAMe) is affected, which has been shown to help process bilirubin in people with Gilbert’s Syndrome.

Low on energy? Known as “The Energy Vitamin”, Vitamin B12 is essential for the production of red blood cells and also helps maintain a healthy heart. A deficiency in B12 can cause you to feel tired and fatigued, affect your nervous system and can also cause anaemia. Click to learn more and for your discount!

From Dr Vegan

Cases and research showing impact of B12 deficiency on Gilbert’s Syndrome.

Case reports and research: 

You might be interested to read about this case, where a woman with vitamin B12 deficiency also had Gilbert’s Syndrome. Treatment with vitamin B12 led to much improved symptoms.

This article on ‘food fadism’ and GS increasing jaundice is also interesting.

(In my opinion, the headline is misleading. Many people will be eating a predominantly plant diet for a variety of reasons which may be economic, cultural or religious – not just a ‘fad’). It may be worth noting that in this study all but one of the patients are male, and this is in an Indian cohort – which has a different UGT1a1 string (the Gilbert’s Syndrome gene) to other populations. However the case report I also link to above is for a caucasian woman, and it does corroborate the findings. This means these findings are relevant across different biological variations of Gilbert’s Syndrome. 

The research illustrates the need to ensure your diet has the right nutrition, whatever foods you eat.

Many people may be below optimum ranges for B12. This study : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540890/ shows that in India 47% of people may be deficient in B12 . Studies indicate that B12 deficiency may be at rates between 6% and 20% in the UK and US, 40% in South American countries, and up to 70% in countries on the continent of Africa. http://frankhollis.com/temp/BMJ%20B12%20deficiency%20review.pdf This is from a 2014 paper, and more recent studies 

Important things to take away from the research about B12 vitamin deficiency and Gilbert’s Syndrome. 

What’s important to note is that there are two main implications 

  1. You may have jaundice for a reason that is not directly due to Gilbert’s Syndrome, even if you have Gilbert’s Syndrome
  2. B12 deficiency will likely make your jaundice and other symptoms WORSE:

‘aggravating pre-existing indirect hyperbilirubinemia in Gilbert’s syndrome patients’

If you have jaundice that is not clearing up, or prolonged fatigue, brain fog etc – then it is always worth checking if there are other causes. If B12 deficiency is the cause then simple supplementation will have a considerable positive effect. Which is worth knowing!

What could cause B12 deficiency?

Causes of B12 deficiency are usually one of the following:

  • Age:  As we get older our stomach acid reduces which means we don’t break down the B12 into forms that can be absorbed easily by our body.  
  • Medical conditions: such as Celiac or Crohn’s disease will prevent the stomach from absorbing B12 properly, as will gastric bypasses or stomach parasites. You may also have a condition called pernicious anaemia, which results in B12 deficiency.
  • Some medications: such as metformin (used to support people with diabetes) and proton pump inhibitors (stomach acid suppressants) will interfere with how B12 is broken down and absorbed. 
  • Diet: if you aren’t careful to ensure that you are regularly eating food that contains B12, then you may become deficient over time. Modern industrial farming methods have depleted natural sources of B12 in our food.
  • https://www.nutranews.org/en–vitamins–is-everyone-lacking-in-vitamin-b12-why-is-there-such-widespread-deficiency-what-are-the-consequences–1481

What are the symptoms of B12 deficiency – and why you should know about them if you have Gilbert’s Syndrome symptoms. 

For milder deficiency you may feel tired, be pale or jaundiced if you have Gilbert’s Syndrome. You may get dizzy and feel weak, your heart may beat too quickly. A sore tongue and loss of appetite, plus other digestive disturbances might occur.

Longer term, more serious deficiencies can have very serious impacts. You may become clumsy as you lose nerve control and there is neurological damage. It may feel like you have dementia as your memory is impaired. You may even experience hallucinations and psychosis. Heart conditions and infertility can also result. 

What range is normal for B12?

The normal range for vitamin B12 can vary slightly depending on the lab. But a normal level of vitamin B12 in your bloodstream is generally between 190 and 950 picograms per milliliter (pg/mL). Between 200 to 300 pg/mL is considered borderline and your doctor may do more testing. Below 200 pg/mL is low and more testing is needed.

More on deficiency

It can take a long time for deficiency to occur as the body stores last for a long time. 

How should I make sure I am not B12 vitamin deficient?

In the past we absorbed it from the soil that produced our food. Modern farming and intensive production have exhausted our soil and sanitised our food. Now, sources of food that have B12 have to be fortified. You can get B12 from eating animals, but that’s because they’ve been given supplements themselves. You can cut out the middle by going straight to the supplement. https://www.veganfoodandliving.com/vegan-diet/the-truth-about-b12-and-where-to-get-it-on-a-vegan-diet/

Taking a supplement is an easy way to get around a deficiency. It’s thought to be safe to take in any volume, as it is water soluble and so too much will be passed out of the body. Only a small amount of the supplement version is absorbed. This fact sheet gives different B12 amounts based on source, and the percentage absorption of separate supplements.

You may need more if you are older or breastfeeding, for example. If you are already deficient then extra may be taken for a while ahead of reducing to a maintenance supplement. 

If you have a condition that affects the stomach or bowel, such as Crohn’s, you may need injections rather than an oral supplement. 

How much B12 should I take?

In the US the National Institute of Health recommends 2.4mcg for an adult, more for a pregnant person. In the UK the  NHS recommends 1.5mcg.

Dietary supplements

Vitamin B12 is available in multivitamin/mineral supplements, in supplements containing other B-complex vitamins, and in supplements containing only vitamin B12. 

Multivitamin/mineral supplements typically contain vitamin B12 at doses ranging from 5 to 25 mcg (https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional). Vitamin B12 levels are higher, generally 50–500 mcg, in supplements containing vitamin B12 with other B-complex vitamins and even higher, typically 500–1,000 mcg, in supplements containing only vitamin B12.

The most common form of vitamin B12 in dietary supplements is cyanocobalamin. Other forms of vitamin B12 in supplements are adenosylcobalamin, methylcobalamin, and hydroxycobalamin .

No evidence indicates that absorption rates of vitamin B12 in supplements vary by form of the vitamin. 

Basically – you can take a little extra in the form of a multivitamin, or you can focus on your B vitamins or B12 in particular, in which case you’ll get a larger dose. However, the type of B12 and massively increasing the dose to above 1,000mcg isn’t going to substantially increase your level of B12 absorbed. 

This supplement from Drvegan is high quality and dedicated to keeping your B12 topped up!

Final thoughts on staying well

The great news is that it’s easy to treat deficiency with supplementation and mild symptoms will quickly improve. More importantly, many people could have less than optimal B12 levels, which shows how important balanced nutrition is. 

A plant based diet is great for health and yeast extract and yeast flakes can be an important addition. Or – cereal, bread, multivitamins may all include your essential B12. 

Not everyone has the resources to afford food that has the best nutrition, or age, illness or other factors may mean that their food isn’t providing what is needed for good health. 

In the UK we are fortunate that our NHS Doctors will usually seek a blood test when symptoms mentioned present themselves. This would quickly highlight any concerns. The solution is then simple and cost effective. 

With increasingly poor diet quality and depletion of soil quality, it is important to be aware that your food intake may need to be addressed to ensure you get the best from it. Simple adjustments can balance out any gaps. You could address issues that are making you feel much worse than you need to, and are exacerbating your Gilbert’s Syndrome! 

More background reading sources on B12:

By staying informed you are taking a step towards protecting your good health and wellbeing. Try out the health and nutrition tips on the website.

Stay up to date with the research through these posts by subscribing. 

Follow @GilbertsSyndrom on twitter for regular tips and support. 

Get health coach support to ensure you are looking after your wellbeing with someone trained to help.

Wishing you good health and wellbeing!

image Michelle Blackwell Unsplash https://unsplash.com/photos/przZDqzZKpk

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Free apps to help you live well with Gilbert’s Syndrome

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Photo by James Yarema on Unsplash

There are lots of free apps available that could add to your quality of life. This post shares some that you might like to try. Maybe they can help you to deal with symptoms of Gilbert’s Syndrome, such as anxiety, as well as to support a healthier lifestyle. I’ve focused on free to use ones, so that there are no barriers to access (apart from having a smartphone!). Some also have websites if you don’t have a phone. Why not share any you have found useful by adding a comment?

Anxiety is a main symptom for people with Gilbert’s Syndrome.  There are plenty of apps that have tried and tested methods for helping people with anxiety and other mental health issues.

Insight timer is an app (and website) that provides free meditations and soothing soundscapes. You can listen to recordings, join classes and even add your own content! It’s a lovely community of folks from every tradition and there’s bound to be something that will fit your needs. The website is here https://insighttimer.com/

Calm is a well regarded app with free elements, although you can access most of its features if you pay a subscription. Check out the website here https://www.calm.com/

Sleep is closely associated with anxiety, and the two apps above may help improve your sleep. There are some that specifically deal with sleep. A good night’s sleep is really important if you have Gilbert’s Syndrome. It can help manage anxiety and prevent fatigue.

Tide. The app plays relaxing music that lulls you to sleep. It can actually stop the track once you’ve fallen asleep! Tide has a light wake-up alarm that awakens you during your lightest sleep phase. It also has calming breathing exercises, where your breathing in and out is guided by sound. Find out more here https://tide.fm/en_US/

PrimeNap. This app comes with sensor-assisted sleep tracking and an activity log so you can see how your day’s choices affect your sleeping patterns. Extra bells and whistles include a screen dimmer, sleep sounds, and dream journal. It doesn’t appear to have a website, however.

Food is a key ingredient in managing your health and wellbeing. Making positive choices will boost your energy, reduce unpleasant symptoms, and help you feel happier.

Feeleat – as a health and nutrition coach I’m always looking for an app to help people keep track of what they’re eating and how it affects them. It’s the first step in any food for health journey. Recording what you eat and how you feel is really powerful especially if working alongside a coach to find the best nutrition that works specifically for you. You could just begin by using it along with tips on gilbertssyndrome.org.uk , and see how you get on.  Here’s their website https://www.feeleat.fr/en/

Dr. Greger’s Daily Dozen. Highly rated, this app gives you a simple way of tracking easy healthy additions to your food. Dr Greger’s science backed approach is also not for profit – all proceeds from his books, etc go to charity.  The full website is here (you can also get a regular email) https://nutritionfacts.org/

Exercise is important in dealing with your mental health, sleep and energy levels. It can be a tricky subject if you have Gilbert’s Syndrome, as exercise must be moderated alongside your symptoms. If you over do it, you may kick off side effects such as fatigue, jaundice and nausea. In my experience moderate intensity exercise that you have built up to tolerate well will offer you the main benefits of exercise.

BetterPoints – get rewarded for exercise! There are a few apps that award vouchers or prizes for walking or exercising check out your app store to see which will work best for you https://www.betterpoints.ltd/app/. I use one that rewards me for walking the dog, which I love, called Biscuit, https://biscuitpetcare.com/ but you may not have a dog!

Couch to 5k, is an app produced by the NHS in the UK. This app aims to give you support to get yourself to a foundational level of fitness that will actually transform your health and wellbeing. Great if you are starting out to explore how to gently get yourself fitter.  You can find out more on the NHS website https://www.nhs.uk/live-well/exercise/running-and-aerobic-exercises/get-running-with-couch-to-5k/

Tree ID is a lovely app for identifying trees when you are out on a walk. Makes a walk more fun and educational!  Find out more here at the Woodland Trust website https://www.woodlandtrust.org.uk/trees-woods-and-wildlife/british-trees/tree-id-app/

Life saving! I had to add this one, as it just might save your life or someone else’s.

St John Ambulance first aid app is highly regarded for supporting lifesaving actions if you are ever in a situation where it is needed. It will walk you through how to deliver simple lifesaving actions. Worth knowing whatever happens!  You can find out more about the lifesaving work of St John Ambulance here https://www.sja.org.uk/ and more about the app here https://www.sja.org.uk/get-advice/free-first-aid-app/

I hope you find some useful and interesting applications here. There are always new ones coming on to the market too. Why not share any you know of that have helped you, by adding to comments below. That way we can help each other life a better life with Gilbert’s Syndrome.

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links and notes that might help people with Gilbert’s Syndrome

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Find out more about how Milk Thistle works. The effective ingredient is sylmarin, and you need enough of a dose for it to have an impact. Read more here: http://www.nlm.nih.gov/medlineplus/druginfo/natural/138.html

Diet plays a really important part in managing your health and wellbeing, and especially in helping your liver. However, there is an industry out there just waiting to push the latest ‘superfood’ your way. NHS ‘Choices’ gives the latest lowdown on the claims and offers the evidence to counter / support them here

Find ordinary household paints make you feel unwell? I’ve been using these for years and they are brilliant! www.ecosorganicpaints.co.uk Odourless, solvent free, totally non-toxic.

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The Liver Fortifying Diet

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The liver fortifying diet:

Cut down on the alcohol, salt, caffeine, tobacco, medication, sugar, and fat and stock up on these goodies.  Your liver will love you.

Essential Vitamins and Minerals

Vitamins C and E and minerals zinc and selenium are ‘antioxidants’ shown to aid liver healing. Sources include carrots, tomatoes, peppers, watercress, citrus fruits, berries, wholegrains seeds and oils.

B vitamins and choline are found in egg yolks, liver, legumes and brewer’s yeast and can help liver function.  Make sure your diet contains plenty of green leafy veg rich in folic acid, wholegrains and shellfish rich in vitamin B6, and vitamin B12 foods such as fortified cereals, seafood and seaweed.

 Cruciferous Veg.

Members of the cabbage family have been shown to activate the liver’s cytochrome P450 detoxification process and glutathione conjugation.  In plain English – a process that converts fat-soluble toxins into water-soluble ones, more easy for your body to get rid of.

broccoli cauliflower cabbage
food good for Gilbert's Syndrome

Try include broccoli, cauliflower, kale, mustard greens, radish, brussel sprouts and cabbage in your diet.

Sulphur rich foods.

Garlic, onions, eggs and legumes are rich in sulphur.  They can enhance the sulphuration detoxification process performed by the liver.

Detoxing superfoods.

You should add red fruits, berries, beetroot, and grapes to your diet, as these all help the liver to detoxify and are high in toxin fighting anthrocyanidines.  Papayas and pineapple contain useful enzymes to improve digestion and lemons have a strong cleansing effect.

Helpful Herbs.

Milk thistle, dandelion, turmeric and liquorice have all been shown to aid liver function.  Ginger is also an excellent cleanser.

Good Protein.

The liver needs protein to repair itself, and a diet high in protein gives some people with Gilbert’s Syndrome more energy.  Choose healthy alternatives to red meat such as fish, nuts, pulses and seeds as they are easier to break down and place less of a burden on your liver.

Water.

Once your liver has removed the toxins from your body, you must flush them out of your body.  The only way to do this is to drink lots of water.  Three pints or eight glasses a day minimum!  Although you may find this no problem as some sufferers have expressed how thirsty they seem these days.

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