Alcohol and Gilbert’s Syndrome

People with Gilbert’s Syndrome can experience unpleasant reactions when they drink alcohol, although it doesn’t bother some people at all. Here is what happens in the body when you drink:

Alcohol is metabolized extremely quickly by the body – absorbed and metabolized before most other nutrients. About 20% is absorbed directly across the walls of an empty stomach and can reach the brain within one minute.

Once alcohol reaches the stomach, it begins to break down with the alcohol dehydrogenase enzyme. This process reduces the amount of alcohol entering the blood by approximately 20%. (Women produce less of this enzyme, which may help explain why women become more intoxicated than men).

About 10% of the alcohol is expelled in the breath and urine.

Alcohol is rapidly absorbed in the upper portion of the small intestine. The alcohol-laden blood then travels to the liver via the veins and capillaries of the digestive tract, which affects nearly every liver cell. The liver cells are the only cells in our body that can produce enough of the enzyme alcohol dehydrogenase to oxidize alcohol at an appreciable rate.

Though alcohol affects every organ of the body, it’s most dramatic impact is upon the liver. The liver cells normally prefer fatty acids as fuel, and package excess fatty acids as triglycerides, which they then route to other tissues of the body. However, when alcohol is present, the liver cells are forced to first metabolize the alcohol, letting the fatty acids accumulate, sometimes in huge amounts. Alcohol metabolism permanently changes liver cell structure, impairing the liver’s ability to metabolize fats. This is why heavy drinkers develop fatty livers.

The liver can deal with about ½ ounce of ethanol per hour (about one drink, depending on a person’s body size, food intake, etc.). If more alcohol arrives in the liver than the enzymes can handle, the excess alcohol travels to all parts of the body, circulating until the liver enzymes are finally able to process it.

If you are looking after your liver, then it pays to not drink alcohol!

For people with Gilbert’s Syndrome alcohol will likely raise bilirubin levels, and can result in a hangover that’s pretty quick to appear and may last for days.

17 Replies to “Alcohol and Gilbert’s Syndrome”

  1. I was told I had GS 10 years ago. I’m now 30 and for the last maybe 7 years whenever I drink alcohol I get stomach cramps. It’s unbelievable painful like I want to be sick or go the loo! So I’ve not had a drink for a years. I had a sip of baileys at Christmas and was in pain after a sip. So now I don’t touch it at all.

  2. I’ve stopped drinking as much recently after reading what alcohol does to people with GS, I tend to get hangovers that last a few days and most often will experience stomach cramps when consuming alcohol, anyone else experience this?

  3. Wow I was recently diagnosed with GS and my GP told me it was a totally innocuous condition with no issues. My gut instinct told me otherwise. I have always suffered from terrible hangovers but in recent years I have been unable to drink more than 2 alcoholic drinks without feeling awful the next day and it sometimes last for a further 2-3 days. I definitely think this is down to GS meaning my body can’t break down the alcohol.
    I also get crazy ill when there’s a stomach bug going around. My family will all recover much quicker than me. I am often tired, run down, have aching body (especially joints), have floaters in my eyes, and have frequent abdominal pain. I now believe I can attribute all of this to GS.

  4. I have always had bad hangovers, even in my late teens. I rarely drink anymore but the odd time I do my hangovers will last between 3-7 days. They actually get worse two days later. Very tired, irritable, headache (sinus) and this all over hot feeling. Was diagnosed with GS few weeks ago and it explains a lot..

  5. I feel that GS is very under rated, especially when it comes to alcohol intake.
    From my own experiences having GS and drinking is a no no: Between the headaches and the sickness even after a small amount of sociable drinking, my whole life seems to go into a spin, not to mention the fainting eposides the next morning. I wonder does this happen to any of my fellow sufferers, the fainting I mean. I can certainly relate to being lethargic and my brain, contentration and vision seem to be a victim also.
    This is a wonderful website. Thank you.

  6. Hi
    I am 61 and was diagnosed with GS about 20 years ago. Stress and alcohol is the worst thing for me. After a busy week my Saturday can be ruined as i feel very tired, lethargic and have a headache. I now hardly drink alcohol at all as I very quickly develop a headache which can last through the night.
    Milk thistle tablets seemed to help but not any longer. Any other suggestions?

    1. Nothing seems to help, but I know what makes it worse. Wintertime I seem to feel worse, and have been repeatedly diagnosed with Vit. D, Magnesium, and B12 deficiency. When I take these supplements, and the levels balance out my condition improves.

    2. Tony t – a few years late with my response but I experience the same exact thing.

      As little as 1 beer can immediately turn into a nagging headache. I’m 35, have had high bili levels since my late 20’s (at least that’s when I started getting regular blood work). I was dxed w/ GBs a couple years ago, I was a heavier drinker through my late 20’s and early 30’s but don’t really drink anymore, the hangovers aren’t worth it.

      I have not found anything at all that helps, except avoiding alcohol. It sucks, not that I miss drinking all that much but it’s just awkward explaining why I don’t drink during work and/or social situations.

  7. I have GS and have noticed recently when ive had four or more beers especialy guinness the next day i feel so hungover, but its not a normal hangover its worse. Mabe i should quit, i was told a few years ago that i had lump in my liver which was benign but they couldnt do a biopsy cause id bleed to death. I use to be a heavy drinker and i stoped drinking after they told me i had a lump i lasted about a year b4 falling of the wagon on my wedding night. I dont drink as much as i use to because i cant as it makes me realy ill the following day.

    1. I too really suffer after guinness. Such a shame – I used to drink a lot of it when I was younger.
      I still get these horrific hangovers from other drinks, but not as certainly as from guinness.

  8. I used to be able to drink a bit before I knew that I had gilbert’s, but the other day I drank less than I used to (trying to be more careful) but it didnt work. How do others feel if they have drank? I wasn’t drunk or even tipsy, but I was still sick a few hours after I went to sleep. What’s going on?

    1. Hi Tiffany, my ability to drink used to be much better, but it got worse as I got older. I just feel really sick after a few sips of wine now, and I know many other people with Gilbert’s Syndrome do too. It is worse when you are tired too. Basically the liver can only process so much, and if the alcohol is on top of other things then you’ll be able to drink less at that time.

      1. I used to be able to drink as always go out in a weekend but since I have had gs I just can’t take it I get drunk really fast and sometimes can’t remember things and that never happened before and now I only have a couple and feel like had loads !!!

    2. hey i have had the same problem i have gs and drank half a bottle of red wine last night to go to do my other tests today, but my body doesnt feel the same slept for like 12 hrs and still not fresh, body aches head aches and also black stool, so brother i think both of us need to get off the alcohol for a few years and rely on the green leaves of god.

  9. Explains alot. not touched it for 2 years and feel better for it. if i do drink its like having a mild hangover for 5 days

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