Fatigue – or how can I boost my energy?

As many as one in five people feel fatigued at any time. If you’ve been feeling exhausted then you’ll want to know: Why am I so tired all the time; how can I get more energy?

Fatigue – what is it?

Fatigue is a symptom of many health conditions and life circumstances. Technically fatigue is one or more of these:

  • Overwhelming exhaustion that lingers beyond a good night’s sleep
  • Sleepiness and a lack of motivation to move about that doesn’t go away if you rest
  • A limiting lack of energy that prevents you from getting normal tasks done
  • Feeling like your muscles are too heavy and moving about takes energy you don’t have
  • Foggy achy head, finding it difficult to think or concentrate
  • Apathy and disinterest – everything feels too much

If you feel like this for more than a few days, for a reason that’s not clear, then you must see your doctor.

Is fatigue common?

Yes! Numerous studies across different populations show fatigue is common. You can find many studies, such as this one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557471/ which illustrate that women tend to report fatigue more than men, and those of lower socioeconomic status also experience more fatigue. Across populations it appears above 20% of people report fatigue. 

What causes fatigue?

Excessive tiredness can be caused by simple or serious health conditions. Common deficiencies of vitamins and minerals have tiredness as a symptom. There are many life circumstances which can leave you feeling exhausted. Let’s look at a few in more detail:

Life Stage : A new baby, a new job, grief or a crisis, moving house, caring responsibilities, overwork, stress at home or in the workplace.

Medical conditions: commonly, as you can see on the NHS website, and the Mayo Clinic , conditions causing fatigue include diabetes, depression, cancer, thyroid, coeliac disease, fibromyalgia, liver problems, MS, hormonal changes, heart disease and sleep apnoea, and so many more. This is why it is so important to receive a diagnosis if you experience fatigue which doesn’t let up over time. 

Deficiencies: Iron deficiency (experienced by many women with heavy or prolonged periods), Vitamin D deficiency (common if you live in the northern hemisphere where we aren’t exposed to strong sunlight which generates vitamin D), magnesium (particularly common in women), and an imbalance in good nutrition generally. Some people have metabolic conditions which prevent them from absorbing nutrients well and this can result in multiple deficiencies.

Poor choice of foods which attack energy levels: Food high in sugar or refined carbohydrates provide instant energy. Your body will then have a crash in blood sugar which will make you feel exhausted. Wholegrains, plant based proteins, and wholefoods containing natural sugars will balance your energy levels and make you feel a whole lot better. A high intake of caffeine may also leave you struggling later in the day. (For more about the pro’s and cons of caffeine read this).

A combination of the above!

Unpicking the causes of your fatigue is really important. You must rule out serious health problems, working with your Dr.

Does Gilbert’s Syndrome cause fatigue?

For people with Gilbert’s Syndrome lack of energy is a really commonly reported symptom. I hear all the time from people desperate with debilitating exhaustion, with energy levels that are unpredictable.

There are a number of reasons why people with Gilbert’s Syndrome may feel exhausted. 

  • Reduced liver function. If you eat highly refined carbohydrates such as white bread or sugary things, your blood sugar will rise and fall a lot. This means the enzyme we’re deficient in cannot work as well as it needs blood sugar. The result is your liver won’t do its cleaning job effectively and certain toxins and bilirubin will build up in your body. Typically feelings of exhaustion, jaundice, itching and nausea are reported. You may feel a bit like you have a persistent hangover.  Of course consuming toxins may add to that effect, eg alcohol.
  • Delayed gastric emptying. Food takes longer to leave your stomach if you have Gilbert’s Syndrome. I’m sure many recognise the abdominal discomfort that entails! This has been linked to fatigue .  It is also worth noting that it is also linked to Chronic Fatigue Syndrome. Which itself has often been linked to Gilbert’s Syndrome.
  • Excess serotonin. People with Gilbert’s Syndrome have defective processing of certain neurotransmitters (chemicals that send messages around the brain and nervous system). This can lead to raised levels of Serotonin for example, which is linked to feelings of lethargy and lack of motivation as well as anxiety.

How do I get more energy?

Assuming you don’t have a particular condition or issue that is causing you to feel exhausted, then there are four simple foundations to build your energy on

  1. Good Nutrition
  2. Exercise 
  3. Good Sleep
  4. Mental resilience

The great thing about these four things is that they support each other. 

Eat well and be properly nourished and you’ll exercise better and get better sleep. Better sleep will help you be mentally resilient and give you more muscle energy for exercise. Exercise will help you be more mentally resilient etc etc 

  1. Good Nutrition. A plant based whole food diet has been overwhelmingly shown to provide you with the most sustained energy, lifespan and wellbeing. Eating a variety of plants, legumes, nuts, seeds and wholegrains will ensure you don’t need any vitamin supplements. With all food patterns you need to make sure you aren’t missing anything out. For vegans that means ensuring you get Vitamin B12. Things that will suck your energy and not enhance your wellbeing include refined sugar, other refined and processed foods. If you want the ultimate nutrition facts then dig in here nutritionfacts.org and buy the book ‘How not to die’ . I offer other thoughts on foods to eat here https://gilbertssyndrome.org.uk/the-liver-diet/ https://gilbertssyndrome.org.uk/detox-diets-and-gilberts-syndrome/ https://gilbertssyndrome.org.uk/sesame-magic-for-your-liver/ The How Not to Die cookbook has lots of tasty recipes and you can see from the reviews that many readers report increased energy.
  2. Exercise should ideally be a mix of activities that raise your heart rate and which challenge your posture and muscles both in terms of flexibility and density. Walking briskly combined with pilates (plenty free videos on youtube) are simple cost free and energising. If you aren’t up to a great deal of exercise, then just start with walking a small distance and build up. Even standing up for a while engages muscles. Adding in exercise is something that needs to become a habit or you won’t stick to it. Stand up whilst you are on the phone or watching a favourite programme, take a 20 minute walk at lunchtime, do squats in the shower or whilst brushing your teeth, dance to a favourite song for 5 minutes when you get home from work. Every bit of movement is helping you stay fit and well.
  3. Good quality sleep is vital. Research shows that our circadian rhythm (our body clock) is really important to when we feel awake and when we sleep well. Just making sure your bedroom is really dark can make a big difference to your body clock. Getting plenty of light in the morning will also help you feel alert and awake during the day and sleep better in the morning. There are lots of ways to deal with bad sleep – which I won’t go into here. It’s enough to say that regular sleep hours in a dark room without interruption are fundamental to good quality sleep. There are many books on the subject. Try the popular ‘Sleep Smarter’ by Shawn Stevenson  
  4. Mental resilience is a quality many of us feel we could develop more. It enables you to put the ups and downs of life into perspective. With mental resilience you will better cope when something bad happens in your day or your life, and will worry less about it. That’s not to say that you shouldn’t worry, be upset, grieve or be without feelings. It means you can do those natural things and then move on in time. If you want to understand more about living without anxiety you can buy ‘The Anxiety Solution’ by Chloe Brotheridge or find resources at www.calmer-you.com and Chloe’s podcast. You can also find out more about mental resilience and ‘grit’ here https://positivepsychology.com/5-ways-develop-grit-resilience/ Another great way to build up your mental resilience is through meditation. If it isn’t something you have considered or have found difficult in the past, then you could try these simple and effective tools from Mind Cards:

If you are doing the right things and are still feeling fatigued then you really need your doctor’s help to look into underlying medical conditions. 

Your personal biology will need a personalised response so that it works the best way it can for you and your circumstances. 

Sometimes this may mean prescription medication or balancing up other elements of your nutrition, supplements or lifestyle. 

Beating fatigue in Gilbert’s Syndrome

So, let’s take a look at what this might mean if you have Gilbert’s Syndrome. As mentioned, there are specific reasons you’ll feel fatigued. Everyone with Gilbert’s Syndrome will have other things going on for them too – other chronic conditions, lifestyle or life stage issues, hormonal changes etc. This means that some things may work some of the time and you may need to adjust because of what is going on for you right now. 

What you put in is key to what you get out

Many people with Gilbert’s Syndrome steer clear of alcohol as it really messes with their wellbeing and energy levels. You may want to consider this for other chemicals and potential toxins to lighten the load on your liver. This would mean a plant based wholefood diet which avoids processed and refined foods. Ideally organic! Particularly good foods include broccoli, nuts and seeds. https://gilbertssyndrome.org.uk/the-liver-diet/ . Keep it low in refined sugar and make sure to include limited good fats of plant origin. 

Drinking plenty of water will also ensure you stay hydrated and support the removal of toxins from your body. 

Eat little and often. For a couple of reasons. 

1) to maintain stable blood sugar levels 

2) with delayed gastric emptying a large meal will make you feel uncomfortable and make it harder to move about. 

This isn’t an excuse to pack in more food, unless that means eating more vegetables! Look at what you would like to eat over the day or week and portion it out. If you do it ahead of time you won’t have to think about it. 

Antidepressants in the form of SSRI’s (Selective Serotonin Reuptake Inhibitors) can help for some people. If you feel your anxiety or low mood are overwhelming then you must speak to your doctor and get their advice and diagnosis. These are also prescribed for IBS (again, something that people with Gilbert’s Syndrome have a high rate of) and may be a useful treatment option to consider – in dialogue with your doctor. This may improve your sleep, mental resilience and energy levels. However, as some people with Gilbert’s Syndrome may have raised levels of serotonin, as mentioned above, then you need to be cautious of side effects. Some brands may work better than others.

Supplements. Extra ingredients that can give you a boost or added support to your system are basically just plants in powdered form in a capsule. Some of the supplements offering additional energy balancing and support include types of ginseng, rhodiola rosea, ashwagandha etc available at Approved Vitamins and have been used safely for thousands of years. I list some supplements you can try in the Resources section. https://gilbertssyndrome.org.uk/resources/

I use rhodiola rosea and ashwagandha and have seen an impressive improvement in my ability to function. I occasionally add in gotu kola towards the end of the week or if I’ve not had a great night’s sleep, or have extra physical or mental demands. It works like a really gentle caffeine that doesn’t have the come-down effects.

Some people find caffeine works well at the right points of the day – find out more about caffeine here and let us know how it makes you feel https://gilbertssyndrome.org.uk/gilberts-syndrome-and-caffeine/

Sleep appears to be a really important factor in feeling well, when you have Gilbert’s Syndrome. A good 8 hours can make a world of difference. Some of the supplements I mention above can help sleep. Follow the suggestions in the four foundations section above. Resist the temptation to lie in bed and doze or rest without sleep. This won’t help you sleep later. Keep bed for specific night time hours if you can, and keep your sleep routine and hours regular. Being active during the day will help you sleep better later.

Anxiety can stop you sleeping and suck your energy whilst awake. If it’s overwhelming then seek help from your Dr. I mention Chloe Brotheridge’s work above, but also Mind and other websites have many pointers for help. Mindfulness is a well founded technique for calming your mind and should guarantee better sleep and more energy. You can find some free apps here. As mentioned above, these are also a really simple and effective tool to help try mediation:

I’d really like to hear what your experience is. If you follow the lifestyle above has it changed your energy levels? I found becoming vegan, eating plant based, adding in supplements and building mental resilience transformed my energy levels. What’s worked for you? Please comment. 

Remember – many people feel fatigued. There are basic principles to seize more energy. Plus – there’s the magic ingredient of you and your physiology to consider. Get medical support where needed, and understand your health conditions. You’ll then be in control of your energy and your life. 

Sesame – magic for your liver!

Can you take a moment to help with a survey on caffeine use? It won’t take a minute or two and the information could help us all live better with Gilbert’ Syndrome.

These small seeds pack a protein punch and produce more oil than most nuts or seeds. They bundle in calcium, manganese, copper, magnesium, phosphorous and Vitamin B1. Sesame seeds have properties that protect the liver, reduce inflammation and pain, level out blood sugar and reduce cholesterol. They are purported to be anti-cancer, anti-aging, and are antioxidant. 

A 2013 study by researchers from the Tabriz University of Medical Sciences reported that 40 grams of sesame seeds were better than Tylenol when it came to alleviating the pain caused by knee arthritis.’

Wow! With that much going on – why not get the wok out and start stir frying with a dash of sesame seed oil, ginger, garlic and some sliced veg right now! 

Studies indicate that sesame could be a ‘hepatoprotectant’ or liver protector. 

So what does sesame do?

Your liver faces stresses from toxins all around us: pharmaceuticals, pesticides, fumes and particulates in the environment, additives in food and overindulging in alcohol or other toxic stimulants and relaxants. It seems that sesame could be a much needed support for the liver, struggling with modern toxic impacts.

The technical bit: sesame maintains levels of glutathione (a potent antioxidant), reducing free radicals and inhibiting the oxidation of fats. (Antioxidants fight free radicals which damage the cells of your body. Free radicals are unstable molecules produced because of environmental pressures on your system). 

So, in more straightforward terms – sesame helps the good stuff in your body fight off the damage to your body caused by those toxins that we’re swallowing and surrounded by. 

Sesame also appears to be safe for you. As sesame can change blood sugar levels and lower blood pressure, then do be careful if you have diabetes or already low blood pressure. 

If you want to protect your liver, boost your immune system, lower your blood pressure, lower your cholesterol, reduce cancer risk and boost vital nutrients, then adding sesame into your diet is a great choice. Tahini (sesame seed paste) and sesame seed oil, as well as the seeds themselves, are available in all supermarkets, and can be used in cooking, spread on toast, added to dressings, used to make hummus, stir frys and so much more. 

To buy :

For recipes try this : ‘the magic of tahini’
Whilst you’re at The Vegan Kind Supermarket, you can stock up on these store cupboard essentials:

Meridian organic sesame oil 
Suma organic sesame seeds 
Al Fez tahini

Or from Amazon: Hatton Hill 1kg of sesame seeds

For more resources, food and supplements go here: https://gilbertssyndrome.org.uk/resources/

Sources:

https://www.greenmedinfo.com/blog/sesame-oil-may-heal-liver-damage

https://www.webmd.com/vitamins/ai/ingredientmono-1514/sesame

Gilbert’s Syndrome and Caffeine

What does caffeine do for the liver, and what is the relationship between Gilbert’s Syndrome and caffeine? Many studies now combine to illustrate the positive effects of caffeine on a number of aspects of health and wellbeing.

You can help reveal the impact of caffeine on people with Gilbert’s Syndrome. Get a free download here and answer a handful of questions – it will take less than 5 minutes, and you could help us all live better with Gilbert’s Syndrome. Thank you!

Naturally, it’s not a simple picture.  Everyone has a different genetic and metabolic profile (we’re all made differently!). Each individual has a unique way of processing any chemical or food. This can also be impacted by your lifestyle, age and even time of the month. My goal is to help you personalise your nutrition so that you can take the research, advice and your experience and see what works best for you.  

I’ve been through the research and summarize and link to it below. This post also gives you the benefit of looking through the science as it relates to Gilbert’s Syndrome, but ultimately – I am not a doctor, I am not YOUR doctor, and the best expert on you – is YOU. 

That said, let’s look at liver health and caffeine, and particularly Gilbert’s Syndrome and caffeine

As Professor Graeme Alexander President, British Association for the Study of the Liver Consultant Hepatologist at Cambridge University Hospitals and The Royal Free Hospital, London said, in a study published by the British Liver Trust in 2016, “At last, liver physicians have found a lifestyle habit that is good for your liver!’

The report pulls together studies that look at liver diseases which are developed or acquired, not genetic conditions that impact the liver, like Gilbert’s Syndrome. However, it’s worth looking at the conclusions and the basis of the studies to see what we can draw from those. 

The bottom line is that it appears caffeine can slow disease progression, help prevent liver cancer and support the anti-viral functions of the liver. 

Other conditions also show a beneficial impact, such as diabetes and stroke. 

‘eighteen studies involving almost half a million people that show overall that coffee, decaffeinated coffee and tea do slightly reduce risk of diabetes.’

One stunning assertion from a study in the report showed that :

‘Coffee appears to have a significant effect on all-cause mortality. The National Institutes of HealthAmerican Association of Retired Persons Diet and Health Study involving 229,119 men and 173,141 women demonstrated an inverse relationship between coffee consumption and mortality. In other words, coffee drinkers had a reduction in mortality compared with non-coffee drinkers.’

Any old caffeine? 

Some of the questions raised include the benefits of tea (or other caffeinated beverages) versus coffee. It appears that coffee itself contains beneficial compounds (particularly those found in the green beans) that other caffeinated drinks do not. And that decaffeinated coffee can have some benefits associated with coffee drinking. 

How much should I drink?

Rightly cautious advice about drinking too much coffee or consuming too much caffeine is flagged. Too much caffeine can have an adverse effect on other conditions, from pregnancy to conditions where medication might be impacted. The difference between men and women is only really significant if you are taking hormonal supplements or, as mentioned, you are pregnant. A moderate 2 to 3 cups a day is suggested by the report authors. 

One factoid of interest – caffeine metabolisation is twice as fast in smokers as non-smokers.

Coffee Caution

Everybody reacts differently to substances and caffeine is itself quite a powerful stimulant. If you have anxiety or depression then do NOT suddenly start drinking lots of coffee! It raises levels of stress hormones adrenaline and cortisol. Plus, it can raise blood pressure. 

Although coffee can enhance energy and alertness, it can also trigger certain conditions, and decaffeinated coffee might provide some benefits without the downsides for people who react strongly to caffeine. However, as noted in Medical News Today In 2013, a study published in World Journal of Biological Psychiatry suggested that drinking between 2–4 cups of coffee a day may reduce suicide risk in adults.

Caffeine is in fact a psychoactive substance and should not be overused. Most studies suggest that more than 400mg of caffeine a day could have adverse effects (probably more than 4 cups of coffee). Plus, as well as the caution for pregnant women, there is a lack of information about how it can impact the growing, changing and susceptible brains of children and adolescents. 

If you would like to read the studies and explore the associated articles on this, then do read the report. https://britishlivertrust.org.uk/wp-content/uploads/The-health-benefits-of-coffee-BLT-report-June-2016.pdf

You can also watch this video from Dr Greger at nutrition facts (buy his excellent book ‘How Not to Die’ which looks at many health conditions and how to optimise your diet to live longer and better).

Dr Greger rightly raises the fact that people metabolise coffee / caffeine very differently. This different metabolisation can result in very different responses, harms and benefits. 

Gilbert’s Syndrome and Caffeine

In the catchily titled piece of scientific research: Caffeine Clearance in Subjects With Constitutional Unconjugated Hyperbilirubinemia

The abstract concludes: ‘CAF altered kinetics in 27% of GS cases may suggest multiple deficits in the hepatocellular metabolism, thus confirming the heterogeneity of this syndrome.’

Ie. caffeine altered the reaction rates in 27% of Gilbert’s Syndrome cases, suggesting that the liver wasn’t processing as well, demonstrating (once again) that Gilbert’s Syndrome has different elements or characteristics. 

(It didn’t seem to impact bilirubin levels or bile acids, though.)

As with many studies into Gilbert’s Syndrome, the conclusions note that there are in fact differences in how our livers process things. But, as is so often the case, this is not taken further, to examine just what that means to the lifestyle management for someone with Gilbert’s Syndrome. 

The implication here is that people with Gilbert’s Syndrome might find coffee or caffeine impacts them negatively, and I’ve written elsewhere how coffee or caffeine can impact energy levels in a way that you may find unhelpful. Stable energy levels and blood sugar are important for the liver enzymes we are deficient in to work properly. We can also experience anxiety as a symptom. These both suggest we would need to be careful around our coffee / caffeine consumption. 

Of course, energy levels can also be an issue if you have Gilbert’s Syndrome. Fatigue is a common symptom of Gilbert’s Syndrome. It would be great to be able to reach for caffeine as a pick me up, to break through that brain fog and boost your concentration!

What caffeine to try when you have Gilbert’s Syndrome

If you want to try caffeine in a different format to coffee, this myprotein drink includes caffeine plus protein and vitamin B6 which can help supplement energy levels too.

Another option is a green coffee bean supplement, this one has additional ingredients to add to the energy boost.

If you don’t want the caffeine, but want the protective elements of green coffee beans (which appear to have the most beneficial compounds), then try this decaffeineated version.

If you want to explore alternatives to coffee then there are other natural stimulants which are more gentle which may help with your energy levels. I take adaptogens to balance my energy levels, you can find a range of supplements here at Approved Vitamins , such as Ashwagandha and Rhodiola (I only use Viridian Maximum Potency Rhodiola ), plus gotu kola which can provide an extra, but gentle, boost that can help concentration levels when they start to flag. I recently tried this one and it works a treat for giving me a gentle pick me up:

Nature’s Answer, Gotu Kola, 950 mg, 90 Vegetarian Capsules

I personally find coffee or caffeine makes me feel quite unwell. I don’t seem to metabolise it comfortably and it leaves me feeling frazzled and sick. I’d love to hear more about whether you find coffee or caffeine helps you, and what your experiences are with it. Please do comment and share your story here. 

This website is dedicated to helping people like you live better with Gilbert’s Syndrome, I hope you find the information interesting and useful – if you do, please consider donating to keep it going. Because so many people struggle to find help and support to live with Gilbert’s Syndrome, please donate today – THANK YOU!

Hack your liver to improve your mental health

We’re all talking more about mental health and that’s really important for people with liver conditions. Liver condition or not – looking after your liver and your mental health will lead to a happier healthier life. 

There’s a ton of evidence that liver disease relates to mental health:

These are serious clinical problems, but whether or not you have a liver condition,  if you aren’t looking after the organ that cleans all the rubbish out of your system (yes, that’s your liver), then you will feel like the bottom of a well used cat litter tray!

This is a two-sided coin – look after one and the other improves. Great! That means you’ve twice the opportunity to feel better. 

There are signs that your liver is stressed, and you should always go to your doctor if you experience jaundice, aches and pains, digestive problems, fatigues, darker urine, mood swings, weight loss, etc https://pharmeasy.in/blog/7-signs-you-suffer-from-liver-stress/

I’m not a doctor and this is not medical advice, this information is from research I’ve linked to (if you want to dig deeper) and curated with additional resources from well regarded books by scientists, doctors and other reputable authors. Links to those books will give me a small commission if you choose to make a purchase – just so we’re clear 😊

Diet

Everything you eat or drink passes through your liver – so let’s start there. 

Alcohol is a well known liver toxin. It’s also an emotional crutch and widely abused. You feel bad so you drink more, it harms your liver, you feel worse, you drink more – it’s a vicious downward spiral. Any alcohol will stress the liver, and if you have a liver condition it will do so even more. If you want to save your liver, and your mental health, save the alcohol for never if you have a liver condition, or in moderation if you are otherwise healthy. Here’s more on that:

https://www.healthline.com/nutrition/alcohol-good-or-bad#section15

Good food feels great! There are tons of wonderful foods that will help your liver and you feel great! Eat more of the good things and you will also keep a healthy weight which will prevent you from getting a fatty liver too.

Some of the foods that work best for supporting the liver include broccoli (and other ‘cruciferous’ veg such as cabbage, cauliflower and radishes), avocados, tomatoes, carrots, beetroot, fruits (apples, lemons, grapefruits) and nuts (Nuts are a good source of glutathione, omega-3 fatty acids that help the liver evacuate ammonia, the substance responsible for certain diseases. They also promote blood oxygenation https://www.myliverexam.com/en/detoxification-some-food-to-cleanse-your-liver/), garlic and turmeric. If you eat healthy food I guarantee you’ll feel better all round. I’m vegan and totally advocate for a completely plant based diet if you want to feel great, full of energy and bright-eyed (yup, helps with the jaundice). You can find out more about food and diets in the books below. 

Sugar – sorry, but it really does make you feel rubbish. Especially if you have a liver condition, such as Gilbert’s Syndrome, your liver will work better if you have a steady blood sugar level https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390583/. This is because the chemicals used by liver processes need steady blood sugar levels to be able to work. Plus, your liver does the hard work in managing your blood sugar levels when they’re high or you need to draw on energy for your muscles http://www.diabetesforecast.org/2012/feb/the-liver-s-role-how-it-processes-fats-and-carbs.html Too much sugar means your liver bgins to store it as fat and ultimately damages the liver. Keeping steady blood sugar levels can be achieved by  eating little and often, and not going long periods without food, plus not relying on high sugar snacks when you feel lethargic. For those of us with liver conditions who have trained their body to love good food just looking at a piece of cake can make me feel sick. If it’s a real treat for you though, don’t deny yourself completely, just don’t make it a daily crutch that keeps you on the uphill treadmill of feeling knackered and rough. 

Read this :

Oh my gosh – Dr Greger is just the most-evidenced expert in nutrition I have ever come across. Honestly, this should be your bible for living a healthy life and feeling great. It’s so persuasive you will be completely convinced and so much more likely to stick to a healthy way of eating: How Not To Die: Discover the foods scientifically proven to prevent and reverse disease by Dr Michael Greger

The Dalai Lama and Daily Mail both think Dr Greger is on the money!

This book may help those who are susceptible to illnesses that can be prevented with proper nutrition. — His Holiness the Dalai Lama

Dr Michael Greger reveals the foods that will help you live longer, Daily Mail

Get the cookbook to go with it: The How Not To Die Cookbook: Over 100 Recipes to Help Prevent and Reverse Disease

#BOSH! Healthy Vegan: Over 80 brand-new recipes with less fat, less sugar and more taste. As seen on ITV’s ‘Living on the Veg’ by Henry Firth, Ian Theasby

Healing Through Nutrition: The Essential Guide to 50 Plant-Based Nutritional Sources by Eliza Savage

Mental wellbeing

There are so many resources that can help your mental health. The less stressed you are the better your liver will work too. ‘Growing scientific evidence has demonstrated the detrimental effects of psychosocial stress on liver diseases in humans and animals ’http://www.ijcem.com/files/ijcem0089076.pdf https://pubmed.ncbi.nlm.nih.gov/16460474/

You can get pretty much instant results from some simple activities, and longer term calm through regular practice. 

Breathing deeply and slowly has a powerful impact on your nervous system. You feel calm instantly! https://www.nhs.uk/conditions/stress-anxiety-depression/ways-relieve-stress/

Be kind – just do one kind thing, and your brain actually produces happy hormones! https://greatergood.berkeley.edu/article/item/kindness_makes_you_happy_and_happiness_makes_you_kind

Meditation has been clinically proven to alter your brain for the better, https://www.healthline.com/health/meditation-for-depression#how-to-try-it

Exercise – a total liver/brain/body hack. Fortunately you don’t have to be a gym bunny or have an olympian body to do this one. Just get outside for a half hour stroll every day for starters. Yes, you WILL feel better. 

Here are some resources to check out to explore this one further. Find what works for you and your lifestyle:

Read this :

The 4 Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life Dr Rangan Chatterjee

Chloe Brotheridge is trained in so many disciplines and has a hungry mind for finding ways to live more calmly and confidently. Check out her website and podcasts, at calmer-you.com and buy her book The Anxiety Solution: A Quieter Mind, a Calmer You

These are books by scientists who use proven methods to improve your mental wellbeing –

Mindfulness: A Practical Guide to Finding Peace in a Frantic World (Includes Free CD with Guided Meditations) by Professor Mark Williams, and Dr Danny Penman

The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive by Dr Kristin Neff, a world leading expert in this field

Other resources:

https://www.mind.org.uk/

https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/self-care-for-anxiety/

https://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/anxiety-management-strategies

Meditation and mindfulness websites https://www.calm.com/ / https://www.headspace.com/

For young people https://youngminds.org.uk/

For men https://www.thecalmzone.net/

If you need more help, then you can try these helplines and websites

https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/

Extra Science bit for people with Gilbert’s Syndrome

People with Gilbert’s Syndrome may experience anxiety and IBS / gut symptoms. Findings that may explain this are the relationship between serotonin levels in the blood and your brain / gut. There’s a tendency for people with Gilbert’s Syndrome to have too much serotonin in the blood – something called hyperserotoninaemia http://www.hormones.gr/759/article/non-tumoral-hyperserotoninaemia-responsive-to-octreotide%E2%80%A6.html

Anxiety is a common reported symptom of Gilbert’s Syndrome.At the molecular level, recently emerging data have established the increased frequency of dual genetic polymorphisms in UDP glucuronosyl-transferases 1A1 and 1A6 in approximately 87% of patients with Gilbert’s syndrome, leading to defective glucuronidation not only of bilirubin but of several other endogenous and exogenous substrates, such as serotonin, coumarin and dopamine derivatives.7,8

Increased serotonin levels have been reported in patients with Gilbert’s syndrome, suggesting a possible explanation for the nonspecific symptoms described in these patients that are commonly attributed to anxiety.9,10’

There are also studies showing that this and ‘unconjugated bilirubin’ (associated with Gilbert’s Syndrome) may be more evident in people with bi-polar disorder, autism and schizophrenia. In fact people with those conditions are also more likely to have Gilbert’s Syndrome. https://pubmed.ncbi.nlm.nih.gov/16736395/ https://questioning-answers.blogspot.com/2014/05/neonatal-jaundice-and-risk-of-autism.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5924810/

So, if you’re more likely to have problems with your mental health, then it’s really important to look after yourself. Following the advice above and keeping to a healthy diet, exercise and mental wellbeing routine will absolutely help you lead a better life with Gilbert’s Syndrome.

Because your support helps keep this research and website alive, please donate today:

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

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.

Liver help – the basics

The liver is the body’s largest solid organ. It responsible for detoxifying many of the potentially harmful substances that can pollute the body.

The liver also plays a critical role in many other body processes including energy production, digestion, and nutrient storage.

What will help my liver?

The cornerstone of any liver-friendly programme is a diet that makes it easier for your liver to work. Lots of fruits and vegetables will help you and your liver work better.

Not only do these foods tend not to tax and stress the liver, they also contain an lots of nutrients such as vitamin C and carotenoids (e.g. beta-carotene) which can support liver function.

Organic produce is best as this is relatively free of potentially toxic herbicides, pesticides and fungicides.

Drinking plenty of water (about one and-a-half to two litres a day) really helps your body and your liver work well.

What won’t help my liver?

Foods that contain artificial additives such as sweeteners, colourings, flavourings and preservatives might cause your liver more problems.

People with Gilbert’s Syndrome often find that drinking alcohol gives them symptoms such as fatigue, brain fog and jaundice. Alcohol is hard for your liver to process and the less you drink the less stressed your liver will be. Watch out for hidden alcohol! You might find some herbal tinctures or food contains alcohol – worth avoiding if you are particularly sensitive.

You might also find fatty food makes you feel sick, and carbohydrates like sugar and white bread or pasta leave you drained and feeling rough. In Gilbert’s Syndrome you need to keep balanced blood sugar levels to help your enzymes work as well as possible (check out ‘What is Gilbert’s Syndrome’ for an explanation), so refined carbs are best avoided.

Recipes for your liver

BETTER than a sandwich!

For a quick boost try the following super tasty liver loving lunch:

Quick pitta lunch

Wholemeal pitta bread, sliced open, spread with humous or tahini, add slices of avocado, a handful of watercress and spinach, and season with a dash of lemon juice, salt and black pepper. For extra nutrition and yumminess add sesame seeds or pine nuts or sunflower seeds. Scrumptious.

Wow! Tasty, quick POWER salad.

Puy lentil salad with soy beans, sugar snap peas & broccoli

Serves 4

Ingredients

  • 200.0g Puy lentils
  • 1.0l hot vegetable stock
  • 200.0g tenderstem broccoli
  • 140.0g frozen soya beans , thawed
  • 140.0g sugarsnap peas
  • 1 red chilli , deseeded and sliced

Dressing

  • 2 tbsp sesame oil
  • juice 1 lemon
  • 1 garlic clove , chopped
  • 40.0ml reduced-salt soy sauce
  • 3cm piece fresh root ginger , finely grated
  • 1 tbsp clear honey

 Boil lentils in stock until just cooked, about 15 mins. Drain, then tip into a large bowl.

  1. Bring a saucepan of salted water to the boil, throw in the broccoli for 1 min, add the beans and peas for 1 min more. Drain, then cool under cold water. Pat dry, then add to the bowl with the lentils.
  2. Mix together the dressing ingredients with some seasoning.
  3. Pour over the lentils and veg, then mix in well with the chopped chilli. Pile onto a serving platter or divide between 4 plates and serve.

Per serving

302 kcalories, protein 22.0g, carbohydrate 42.0g, fat 7.0 g, saturated fat 1.0g, fibre 8.0g, sugar 9.0g, salt 1.41 g

Recipe from Good Food magazine.

Day or night, alone or with friends – tasty goodness.

Avocado and black bean wraps

Serves 4 for a filling meal, or halve the quantities and serve with a leafy salad for a lighter lunch.

Ingredients

  • 8 wholemeal wraps (in world food isle with Mexican stuff, or in bakery section)
  • 1 tbsp olive oil
  • 1 onion , chopped
  • 3 garlic cloves , chopped
  • 1 tbsp paprika
  • 1 tbsp ground cumin
  • 5 tbsp cider vinegar
  • 3 tbsp clear honey
  • 3 x 400g cans black beans , rinsed and drained
  • choose a few toppings-  diced avocado, salsa, sliced jalapeño peppers
  • crème fraîche / yoghurt or Tabasco / hot pepper sauce, to serve

Serve with green salad, sliced tomatoes, or green beans and sweetcorn.

  1. In a large frying pan, heat the oil. Add the onion and garlic, and cook for 5 mins.
  2. Add the spices, vinegar and honey. Cook for 2 mins more.
  3. Add the beans and some salt / pepper, and heat through.
  4. Remove from the heat and mash the beans gently with the back of your spoon to a chunky purée.
  5. Spread some beans over wraps, scatter with your choice of toppings and add a spoonful of crème fraîche / yoghurt to cool down, or a splash of Tabasco / hot pepper sauce to spice it up.
  6. Roll up and YUM!

Sin free sinning!

This wonderful recipe is from a very good friend:

Fat free fudgy wudgy brownies

Preheat the oven to 180C

Dry ingredients:

¾ cup of wholemeal flour

¼ cup cocoa powder

½ cup white flour

1 tsp baking powder

½ cup Demerara sugar (or brown sugar)

¾ cup broken walnuts (optional)

Handful dark chocolate chips (optional)

Mix the dry ingredients together in a bowl.

Wet ingredients:

1 ½ cups black beans (one tin drained and rinsed well)

1 cup pitted medjool dates (this can be anywhere from 7-10 dates depending on their size, or just use ordinary dried dates if you don’t want to fork out for medjool)

¼ cup maple syrup (or date syrup, which is particularly tasty, or indeed any other kind of syrup)

Whiz the wet ingredients together in a food processor until completely smooth.

Then add:

1 TB balsamic vinegar (or cider vinegar)

3 tsp instant coffee (optional but enhances the flavour)

1 tsp vanilla essence

2 TB flax meal (ground flax seeds) or other ground seeds such as hemp powder

1 cup water

Whiz that all up until it is smooth, then mix in with the dry ingredients.

Spoon into a greased 9×12 or 9×13 pan.

Bake for 14 minutes then take the pan out and rotate it and put it back in for another 14 minutes. Test with a toothpick to see if it comes out clean. If not put it in for 2 more minutes.

Let cool before you slice. Slice it into 16 brownies-4 by 4.

Store in an airtight tin. I think they taste better the next day. Yum!

 

Detox diets and Gilbert’s Syndrome

I’ve been monitoring the ‘de-tox diet’ phenomenon for many years, and each year my scepticism grows. Avid marketers have spotted a desire for many people to find a solution to the modern malaise of feeling tired and sluggish, and there is a proliferation of products – powders / pills / soups /  excercises / regimes / books / websites / treatments etc that claim to help powerfully cleanse the body and leave you lighter, fresher, and generally bright eyed and bushy tailed.

However, on the one hand many run of the mill Doctors will tell you that the liver does a perfectly good job of dealing with toxins. On the other hand many people feel generally under par much of the time. Although I agree that the liver generally does an excellent job, some of us may need a wee bit more help for our liver to do the job we want it to.  Given the disadvantage that those with Gilbert’s Syndrome experience, with a reduced capacity to process certain toxins, it makes sense to me to look after my diet so that I can help my liver. But I don’t want to burden my body with the shock of suddenly changing my diet to all fruit or liquid or pureed broccoli or whatever. My message would be to make a lifestyle choice to ensure you feel better EVERY day.

So, what can we all agree on?  Well, water is good for you. Drink plenty of it. Alcohol may be ok in small quantities, but personally it makes me feel awful so I avoid it. Caffeine can mess up your blood sugar levels and so reduce your ability to maintain consistent energy, particularly because those with Gilbert’s Syndrome are lacking in an enzyme that needs stable blood sugar levels for it to work properly. Eat little and often to keep your energy up, but make sure you stick to wholefoods such as brown rice, wholemeal bread, crackers, jacket potatoes etc and plenty of vegetables and fruit and not high fat food. This will help you maintain a steady weight, not experience hunger pangs, as well as avoiding over burdening your liver with fat processing. Protein is supposed to help with extra energy. I avoid eating animals and animal products for environmental reasons as well as health and compassionate reasons, so my sources of protein tend to be marmite (full of an awesome range of vitamins), and nut butters, such as peanut butter and cashew butter (high in fat but replace margarine and used as my only source of fat– don’t rule it out completely as your body does need fat), avocado, hemp powder added to soups and dressings, plus lots of soya milk.

Star liver foods include: broccoli, garlic, turmeric, avocado, beetroot, apples, lemons, walnuts.

If you need caffeine then try swapping to green tea which is better at cleansing the liver, and more gentle to your system than coffee.

Don’t forget a little naughty treat is ok. But use it as a reward for staying generally more liver conscious and once a week rather than every day. I like the 80 / 20 rule – stay 80% within a good diet, then the other 20% ain’t so bad.

Helping your liver deal better with toxins

Good news! The detox process of the liver which won’t work as well for people with Gilbert’s Syndrome is called Glucuronidation and this process can be helped with Calcium D-Glucarate, glycine, magnesium, and b vitamins.

  • Calcium D Glucarate can be taken as tablets or capsules, but is also available in apples, brussels sprouts, broccoli, cabbage and bean sprouts.
  • Glycine is an amino acid and in high-protein foods, such as fish, meat, beans, milk, and cheese. Glycine is also available in capsule and powder forms, and as part of many combination amino acid supplements.
  • Spices, nuts, cereals, coffee, cocoa, tea, and vegetables are rich sources of magnesium. Green leafy vegetables such as spinach are also rich in magnesium as they contain chlorophyll. Magnesium supplements are widely available and often with calcium and vitamin c which help its absorption. The best absorbed types of magnesium are citrate and malate, rather than the cheaper form of oxide.
  • B vitamins are available in many different foods (see the NHS website), but the easiest ways of accessing them are through yeast extracts such as Marmite, and fortified cereals.

So why not help yourself and make sure your diet contains a good balance of foods that may help your liver to work better.

Pharmacist survey finds ‘Medicines detox’ puts people at risk

A recent article from Net Doctor has food for thought for those of us on long term medication. Please don’t take initiatives with your medication – talk to your Doctor or Pharmacist first! :

Patients are putting themselves at risk of serious harm by believing it is beneficial to occasionally stop taking long-term medicines in order to given their body a ‘detox’, experts have warned.

Research by the National Pharmacy Association (NPA) suggests that one in five people believe a so-called ‘medicines detox’ is beneficial.

However, the NPA warned that this could be seriously harmful for patients with conditions such as diabetes, asthma or depression, as they could lose control of their illness.

The survey also revealed that nearly one in three people believe it is safe to take non-prescription medicines that have been recommended for other people.

And some wrongly assume it is okay for a child to take an adult’s medication, as long as the dosage is reduced.

NPA head of information Leyla Hannbeck said: ‘There is a lot of misunderstanding about how medicines work in your body.

‘It’s important to get the right treatment and the right advice – which you can get from your local pharmacy, often without an appointment.’

Pharmacies provide a wealth of services in addition to dispensing medicines.

These include the disposal of unwanted medicines, promotion of healthy lifestyles and support for self-care.

Pharmacists can also provide personalised advice on medicines, smoking cessation support and guidance on sexual health.ADNFCR-554-ID-800789373-ADNFCR

General anesthesia in a patient with Gilbert’s syndrome.

Having had an operation this year, with a very understanding anesthesiologist, I know that this is an area of poor knowledge in the health service, and that all the advice you as a patient can offer is helpful, and will of course help yourself. We decided that morphine would be avoided and took an approach that would mean using as few drugs as possible. This also meant I would come out of the procedure more alert and able to get going.

There has been some recent research in India which follows the clinical experience I have personally had – namely that the best outcomes are if the drugs used avoid using the enzyme that people with Gilbert’s Syndrome are deficient in:

Source

Department of Anaesthesiology and Critical Care, Tata Main Hospital (TMH), Jamshedpur, India. Nag DS, Sinha N, Samaddar DP, Mahanty PR.

Abstract

Gilbert’s syndrome, caused by relative deficiency of glucuronyl transferase is the commonest cause of congenital hyperbilirubinemia. We report anesthetic management in a case of Gilbert’s syndrome for laparoscopic cholecystectomy under general anesthesia. Avoiding drugs which use this enzyme for its metabolisim or excretion, and minimizing the stress during the perioperative period allows safe conduct of anesthesia for these patients.

The Liver Diet

Think Raw
Eat plentiful amounts of raw fruits and vegetables, especially dark green leafy vegetables and orange, yellow, purple and red colored fruits and vegetables. Thirty to forty percent of the diet should consist of raw fruits and vegetables. Try to eat some raw fruits or vegetables with EVERY meal as they contain living enzymes, vitamin C, natural antibiotic substances and anti-cancer phytonutrients.

Oil but Don’t Grease Your Body
Avoid the fats that present a high workload for the liver and gall bladder. These are full-cream dairy products, margarines, processed vegetable oils (hydrogenated fats), deep fried foods, foods that are not fresh and contain rancid fats, preserved meats, animal skins and fatty meats. In those with a dysfunctional liver, I recommend avoiding all animal milks and substituting them with oat, rice, almond or soymilks. Eat the “good fats” which contain essential fatty acids in their natural unprocessed form.

These are found in cold pressed vegetable and seed oils, avocados, fish (especially oily fish such as salmon, tuna, sardines, herring, sablefish, flounder, trout, bass and mackerel), shrimp, prawns and crayfish, raw fresh nuts, raw fresh seeds such as flaxseeds (linseeds), sunflower seeds, safflower seeds, sesame seeds, hemp seeds, alfalfa seeds, pumpkin seeds and legumes (beans, peas and lentils). Seeds such as flaxseeds can be ground freshly everyday (in a regular coffee grinder or food processor) and can be added to cereals, smoothies, fruit salads and vegetables. Spirulina, evening primrose oil, black currant seed oil, borage oil and lecithin also contain healthy oils to help the liver. Do not use butter and/or margarine on your breads and crackers. Replace them with tahini, humus, pesto, tomato paste or relish, freshly minced garlic and cold pressed oil (chilli or other natural spices can be added if enjoyed), nut-spreads, fresh avocado, cold pressed olive oil or honey. The good fats are essential to build healthy cell membranes around the liver cells. As we get older we need to “oil” our bodies and not “grease” our bodies.

Think Natural
Avoid artificial chemicals and toxins such as insecticides, pesticides, and artificial sweeteners and colorings, (especially aspartame), flavorings and preservatives. Excess alcohol, particularly spirits, should be avoided.

Be Diverse
Consume a diverse range of proteins from grains, raw nuts, seeds, legumes, eggs, seafood, and if desired, free range chicken (without the skin), and lean fresh red meats. If you do not want to eat red meat or poultry this is quite acceptable as there are many other sources of protein. It is safe to be a strict vegetarian, however you may need to take supplements of vitamin B 12, iron, taurine and carnitine to avoid poor metabolism and fatigue. To obtain first class protein, strict vegetarians need to combine 3 of the following 4 food classes at one meal – grains, nuts, seeds and legumes, otherwise valuable essential amino acids may be deficient. If your body is lacking amino acids you will be fatigued and you may suffer with mood changes, reduced cognitive function, hypoglycaemia, poor immune and liver function and hair loss. I have met many strict vegans who felt unwell because they were lacking amino acids, iron and vitamin B 12, and after supplementing with these nutrients and modifying their diets they quickly regained excellent health.

Let Food Be Your Medicine
Many diseases can be overcome by eating healing foods that contain powerful medicinal properties. Optimal health and the prevention of disease is only possible by including these healing foods regularly in the diet. The healing substances found in certain foods or therapeutically active chemicals are known as phytochemicals. The culinary habits of different cultures have been recognised for decades as being influential in the incidence of diseases. Mediterranean countries have a lower prevalence of cardiovascular diseases because of the protective effect of traditional Mediterranean foods, such as olive oil, tomatoes and legumes. Broccoli and other vegetables in the cruciferous family are known to reduce the risk of bowel cancer, but it is only recently that scientists have isolated the phytochemicals which confer this protection. Broccoli has been found to contain a phytochemical called sulphoraphane, which enhances the phase two-detoxification pathway in the liver.

Tomatoes contain a powerful antioxidant called lycopene, which according to a paper published in the American Journal of Clinical Nutrition (1997:66:116-22), is the most powerful of all the dietary carotenoids. The researchers found that the dietary intake of lycopene was linked to a lower risk of prostate problems. They also found that higher levels of lycopene in the blood lowered the risk of cell proliferation, which would theoretically exert a powerful anti-cancer effect. Cooking or chopping tomatoes increases the absorption of lycopene into the body. Cooking tomatoes in oil increases the availability of the lycopene to the body, which is another reason that Mediterranean cuisine confers health benefits.

Beetroot is a beautiful deep purple colour because it contains the antioxidant anthocyanidin. Constituents of beetroot have been shown to exert anti-viral and anti-tumour effects in animal studies. Other foods, which also exert these properties, although to a lesser degree, are red and green peppers, red onion skins, paprika and cranberry. These foods contain healing phytonutrients such as carotenoids, capsanthin and anthocyanins.

Certain foods have high concentrations of plant hormones, which are known as phytoestrogens. Examples of these are the isoflavones genistein and daidzein (found in soya beans and red clover), and lignans (found in flaxseed). Asian communities consume a high intake of soy (approximately 25 – 50 grams daily), and have a significantly lower incidence of hormone dependent cancers of the prostate, uterus and breast. All legumes such as beans, peas and lentils contain beneficial phytoestrogens.

A study published in the British Medical Journal in 1990, looked at a group of postmenopausal women who were given 45 grams of soy flour for 2 weeks, followed by 25 grams of flaxseed meal for 2 weeks, and then 10 grams of red clover sprouts. This produced improvements in various blood hormone levels and menopausal symptoms.
Asian and Mediterranean cuisines are now integrating themselves into the old fashioned Western diet consisting of meat, bread and 4 vegetables. This culinary multiculturalism has enormous and proven benefits for our health and also for our enjoyment. We all know that variety is the spice of life, and Asian and Mediterranean foods can add spice to our often-bland ways of eating. A wide range of Asian foods is now available from supermarkets and greengrocers as well as Chinese grocery stores. Typical Asian foods and vegetables such as ginger root, chilli, garlic, Chinese water spinach, bok choy, lemongrass, coconut, tumeric, curry, Chinese mushrooms and many others can be experimented with, and gradually introduced into the diet if you want to expand the horizons of your taste buds.

Watch That Sweet Tooth
Use natural sugars from fresh fruits and juices, dried fruits, honey, molasses, fruit sorbets, fruit cakes, fruit jams, carob, date sugar, maple sugar or syrup or rice syrup. Avoid refined white sugar and candies, fizzy drinks, cakes and biscuits made with refined sugars. If you find you crave these foods on a regular basis you may have the very common metabolic imbalance known as Syndrome X. By following the eating principles and taking nutrients to rebalance the metabolism you can get cravings under control making weight loss and maintenance of energy much easier. See ‘Syndrome X’

Rehydrate Your Body
Drink large amounts of fluids such as water, raw juices and teas (green tea, herbal and regular weak tea is fine). Aim for 2 liters of fluid daily and this will avoid constipation problems and help your kidneys to eliminate the toxins that the liver has broken down. Use a household water filter. Water filters with sub-micron, solid carbon block filters are able to remove parasites and many toxic chemicals. Shop around and take a look at different types of filters before you buy and get professional advice as technology is improving rapidly.

The liver is the major organ involved in detoxification, however it is still important to support the other body organs of elimination. The skin and the kidneys eliminate toxins through sweating and urine and this is why saunas and a high intake of filtered water can reduce symptoms of toxic overload.

Go Organic
ALTHOUGH IT IS IDEAL TO BE ABLE TO PURCHASE AND CONSUME ORGANIC PRODUCTS, THIS MAY NOT ALWAYS BE FEASIBLE OR POSSIBLE BECAUSE OF FINANCIAL OR LOGISTICAL REASONS. PLEASE DO NOT BECOME TOO STRESSED BY THIS, AS EVEN IF THE FOOD YOU CONSUME IS NOT ORGANIC, THE TYPES OF FOODS YOU EAT ARE EVEN MORE IMPORTANT !!!

Not many people want to eat fruits and vegetables that have been sprayed repeatedly with insecticides and fungicides, ripened with ethylene gas and perhaps waxed with an insect secretion. It is a little off putting while biting into your lovely red juicy steak to think that this animal may have been fed antibiotics and the ground-up remains of thousands of dead animals, and had potent sex hormones implanted into it to accelerate its growth.

Organic food is sometimes called biodynamic food and is produced without synthetic herbicides, insecticides, fertilisers, post-harvest fungicides, antibiotic growth-promoters, or size enhancing hormones. It relies upon Mother Nature’s forces, recycling of nutrients and sustainable methods of production. Foods certified as organic must be grown on farms that are inspected and fully certified according to a stringent set of standards. Packaged and/or processed organic foods are free from artificial preservatives, colourings, flavourings or additives, and should not contain irradiated or genetically modified ingredients.

Pamper Your Liver
Eat foods to increase nutrients beneficial to liver function.These are:
Vitamin K – green leafy vegetables and alfalfa sprouts. Arginine – this helps the liver to detoxify ammonia, which is a toxic waste product of protein metabolism. Arginine is found in legumes (beans, peas, and lentils), carob, oats, walnuts, wheatgerm and seeds.
Antioxidants – found in fresh raw juices such as carrot, celery, beetroot, dandelion, apple, pear and green drinks like wheatgrass and barley-grass juice, and fresh fruits, particularly citrus and kiwi fruit.

Selenium – sources of the antioxidant selenium are brazil nuts, brewers yeast, designer yeast powders (very good source), kelp, brown rice, molasses, seafood, wheatgerm, whole-grains, garlic and onions.

Methionine – is essential for detoxification. Is found in legumes, eggs, fish, garlic, onions, seeds and meat.

Essential fatty acids – Seafood, cod liver oil, and fish oil. Seafood may be fresh, canned or frozen such as sardines, salmon, mackerel, tuna, trout, mullet, blue mussels, calamari, tailor, herring, blue eye cod, gemfish. Fresh avocado, fresh raw nuts and seeds, legumes (beans, peas, lentils), wholegrain, wheatgerm, green vegetables such as spinach, green peas and green beans, eggplant, cold pressed fresh vegetable and seed oils, freshly ground seeds, especially flaxseeds (linseed), evening primrose oil, black-currant seed oil, star flower oil. Essential fatty acids are required for healthy membranes in every cell of the body and plentiful amounts are required for healthy liver function. This is why strict low fat diets are not beneficial for general health, weight control or liver function.
Natural sulphur compounds – are found in eggs (preferably free range), garlic, onions, leeks, shallots and cruciferous vegetables such as broccoli, cauliflower, cabbage andBrussels sprouts.

Practice Good Hygiene
The liver filter removes microorganisms from the blood stream, which prevents them from getting deeper into the body where they may cause serious infections. To avoid overloading the liver filter it is important to avoid eating foods that are contaminated with high loads of unfriendly or dangerous (pathogenic) microorganisms.
Although standards of living and sanitation have improved, cases of food poisoning from parasites, bacteria and viruses have been gradually increasing. This is often due to poor hygiene, such as inadequate cleansing of areas where food is prepared and stored, and lack of hand washing before preparing and eating food. This is more common today because people have a false sense of security brought about from antibiotic drugs, however many new viruses and pathogenic bacteria resistant to antibiotics are emerging.

The excessive practise of feeding antibiotics to animals is contributing to the rising incidence of antibiotic resistant strains of bacteria such as E.coli, Staphylococcus and Salmonella. Other microorganisms that can cause food poisoning are Campylobacter, Listeria, Yersinia, Clostridium Botulinum and Shigella. Food poisoning can also occur from the toxins produced by some bacteria, algae and moulds. Shellfish grown in waters polluted with toxic algae bloom can accumulate their toxins, which can cause severe neurological dysfunction. Foods contaminated by certain moulds or fungi, which produce their own mycotoxins, can make you sick. The fungus Aspergillus flavus produces the dangerous mycotoxin called aflotoxin. This can grow on damp maize, wheat, corn, peanuts and some other crops.

People are eating out more and there is less cooking done in the home so it is difficult to control standards of food preparation for your family. People purchase foods from supermarkets where food may have travelled long distances and be stored or refrigerated for long periods, picking up microorganisms along the way. Many processed foods contain

preservatives, which do not eradicate microorganisms, but merely keep them in a dormant state. When this food gets into your intestines the preservatives are diluted and the bugs start to multiply. This is why it is important to purchase only fresh high quality foods. The risk of food contamination is increased by long storage times, the number of people who handle and package food, and inadequate cooling and re-heating temperatures.

The intensive mass production of animal meats has helped to spread infections in food supplies. Chickens fed stock-feed infected with the bacteria Salmonella (sometimes from the remains of other chickens), allow bacteria to recycle and multiply in the same way that cow cannibalism caused the epidemic of mad cow disease (BSE). Chickens infected with Salmonella or viruses, and other animals reared in crowded conditions, can easily cross-infect each other while alive or at the abattoir.

Tips For Good Hygiene
Wash your hands thoroughly with soap and hot water before preparing and eating food, and after handling any raw meat or seafood.

Only purchase fresh foods and avoid foods that are mouldy or look too old. Avoid processed or preserved meats such as hamburger meat, ham, smoked and pickled meats and fish, beef jerky, bacon, sausages, fritz, cabanossi, pizza meats, corned beef, meat loaf, rolled meats as found in delicatessens, and sea food that has been mishandled or poorly stored.

Do not let food stand in warm temperatures for more than two hours. Hot foods should be cooled quickly at room temperature and then refrigerated, because gradual cooling allows microorganisms to grow. For the same reasons, do not eat food that has been cooked, cooled and reheated more than once.

Refrigerate raw meat, seafood or chicken as soon as possible to reduce bacterial multiplication. Defrost poultry, seafood or meat in a microwave oven or overnight in the refrigerator and not on a counter. Cook all poultry, seafood and meat thoroughly because the centre of the food must reach 70°C (158°F) to kill bacteria.
Store raw meat and poultry at a lower level in the refrigerator to avoid their juices contaminating other foods. Always refrigerate eggs and foods containing eggs, and discard eggs with cracks.

Avoid nuts with mould on their shell or kernel, or those with a bitter taste.
Use antiseptics when cleaning the toilet, bath and shower recess. Antiseptic soaps can be used in large households or share type accommodation. Tea tree oil has useful antiseptic properties, and effective antiseptics are easily found in supermarkets and pharmacies at reasonable prices.

Avoid sharing toothbrushes and razor blades as serious blood borne infections can be transmitted this way.e nails with a nailbrush can remove inaccessible bacteria.
Wash kitchen utensils such as cutting boards, grinders, juicers, and blenders and can openers thoroughly after each use. Replace cloths and brushes regularly.

Jaundice

WHAT IS JAUNDICE?

The word “jaundice” comes from the French word jaune, which means yellow.

Jaundice is a yellowish staining of the skin, the whites of the eyes, and mucous membranes by bilirubin, a yellow-orange bile pigment. Bilirubin (read more about it here!) comes mainly from the breakdown of red blood cells, and is basically a waste product that your liver gets rid of.

Jaundice usually appears when the bilirubin in your blood is more than 3 mg per dL (51.3 µmol per L). The classic definition of jaundice is a serum bilirubin level greater than 2.5 to 3 mg per dL (42.8 to 51.3 µmol per L) as well as having yellow skin and eyes.

Your body processes bilirubin in 3 phases: prehepatic (before it gets to the liver), intrahepatic(whilst in the liver), and posthepatic(after leaving the liver). If any of these aren’t working properly you can become jaundiced.

PREHEPATIC

The human body produces about 4 mg per kg of bilirubin per day, from the breakdown of blood cells. Bilirubin is then transported from to the liver for conjugation (where it needs to link up with other enzymes and chemicals so that it can be removed from the body) .

INTRAHEPATIC

Unconjugated bilirubin (the bilirubin that hasn’t been removed by linking up with an enzyme) doesn’t dissolve in water but is soluble in fats. That means it can easily cross the blood-brain barrier or enter the placenta. The unconjugated bilirubin is conjugated (linked up with) with a sugar via the enzyme glucuronosyltransferase (the enzyme that people with GS don’t have enough of) and is then soluble in the bile.

POSTHEPATIC

Once soluble in bile, bilirubin is transported through to the gallbladder, where it is stored, or passed on to the duodenam. Inside the intestines, some bilirubin is excreted in the stool, while the rest is dealt with by the bacteria in your gut.

JAUNDICE AND OTHER SYMPTOMS

Some people with jaundice have no symptoms at all.  But some may have an acute illness, which is frequently caused by infection, may seek medical care because of fever, chills, abdominal pain, and flu-like symptoms. For these patients, the change in skin color may not be their greatest concern!

Patients with noninfectious jaundice may complain of weight loss or itching / skin discomfort. Abdominal pain is the most common symptom in patients with pancreatic or biliary tract cancers.Even something as nonspecific as depression may be a symptom in patients with chronic infectious hepatitis and in those with a history of alcoholism.

‘False’ jaundice can happen if you eat foods rich in beta-carotene (e.g., squash, melons, and carrots). Unlike true jaundice, you don’t get yellow eyes, or changes in bilirubin level.

CAUSES OF JAUNDICE:

PREHEPATIC CAUSES

Unconjugated hyperbilirubinemia (this is when you’ve too much bilirubin in your bloodstream because it’s not been processed in the liver, as in Gilbert’s Syndrome) might happen before bilirubin has entered the liver cells or within the liver cell. If you’ve had an unusual breakdown in your red blood cells then there may be too much of the waste product, bilirubin, for your liver to process as normal.

This will usually result in mild bilirubin elevation, to about 5 mg per dL (85.5 µmol per L), with or without clinical jaundice. The blood might be breaking down because of a number of causes in the blood cells or your enzymes which mean your red cells have stayed alive longer than normal, and built up.  Other causes include autoimmune disorders, drugs, and defects in hemoglobin structure such as sickle cell disease and the thalassemias.

INTRAHEPATIC CAUSES

Un-Conjugated Hyperbilirubinemia Gilbert syndrome is a common, benign, hereditary disorder that affects approximately 5 percent of the U.S. population. It usually results in a mild decrease in the activity of the enzyme glucuronosyltransferase. Gilbert syndrome is typically an incidental finding on routine liver function tests, when the bilirubin level is slightly increased and all other liver function values are within normal limits. Jaundice and further elevation of the bilirubin level may occur during periods of stress, fasting, or illness.

Conjugated Hyperbilirubinemia. Main causes are when there’s a blockage preventing bilirubin from moving into the intestines. Viruses, alcohol, and autoimmune disorders are the most common causes of hepatitis. Inflammation also disrupts transport of the bilirubin and causes jaundice.

Hepatitis A can cause acute onset of jaundice. Hepatitis B and C infections often do not cause jaundice straight away, but can lead to jaundice when chronic infection has led to liver cirrhosis. Epstein-Barr virus infection occasionally causes hepatitis and jaundice that resolve as the illness clears.

Alcohol has been shown to affect bile acid uptake and secretion, stopping the normal flow through the liver. Chronic alcohol use may result in fatty liver (steatosis), hepatitis, and cirrhosis, with varying levels of jaundice. Fatty liver, the most common liver problem, usually results in mild symptoms without jaundice but occasionally progresses to cirrhosis. Hepatitis secondary to alcohol use typically presents with acute onset of jaundice and more severe symptoms.

More rare conditions that can cause jaundice: Autoimmune hepatitis traditionally has been considered a disease that affects younger persons, especially women. Two serious autoimmune diseases that directly affect the biliary system without causing much hepatitis are primary biliary cirrhosis and primary sclerosing cholangitis. Primary biliary cirrhosis is a rare progressive liver disease that typically presents in middle-aged women. Fatigue and itching / skin discomfort are common initial complaints, while jaundice happens later. Primary sclerosing cholangitis, which is also rare, is more common in men; nearly 70 percent of patients also have inflammatory bowel disease. Dubin-Johnson syndrome and Rotor’s syndrome are rare hereditary metabolic defects that disrupt transport of conjugated bilirubin.

Common drugs can also cause problems, such as acetaminophen, penicillins, oral contraceptives, anti-psychotic medication, and steroids. Cholestasis can develop during the first few months of oral contraceptive use and may result in jaundice.

POSTHEPATIC CAUSES

Gallstones in the gallbladder are fairly common in adults. Obstruction within the biliary duct system can inflame the gallbladder, and can lead to infection. Cholangitis is diagnosed clinically by the classic symptoms of fever, pain, and jaundice, known as Charcot’s triad. Cholangitis most commonly occurs because of an impacted gallstone, which might then be removed.

Biliary tract tumors are uncommon but serious causes of posthepatic jaundice. Gallbladder cancer classically presents with jaundice, enlarged liver, and a mass in the right upper quadrant (Courvoisier’s sign). Another biliary system cancer, cholangiocarcinoma, typically manifests as jaundice, itching / skin discomfort, weight loss, and abdominal pain. It accounts for roughly 25 percent of hepatobiliary cancers.

Jaundice also may arise with pancreatitis. The most common causes of pancreatitis are gallstones and alcohol use. Gallstones are responsible for more than one half of cases of acute pancreatitis, which is caused by obstruction of the duct that drains the biliary and pancreatic systems.

Evaluation

The initial work-up of the patient with jaundice depends on whether the hyperbilirubinemia is conjugated (direct) or unconjugated (indirect). A urine anlysis that is positive for bilirubin indicates the presence of conjugated bilirubinemia. Conjugated bilirubin is water soluble and so passed through urine.

SO IF YOU’RE JAUNDICED WHAT DO THEY DO TO WORK OUT WHAT’S CAUSING IT? Here’s the clinical information :

BLOOD TESTING

First-line serum testing in a patient presenting with jaundice should include a complete blood count (CBC) and determination of bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transpeptidase, and alkaline phosphatase levels.

Depending on the results of the initial tests, further serum tests or imaging studies may be warranted. The second-line serum investigations may include tests for hepatitis A IgM antibody, hepatitis B surface antigen and core antibody, hepatitis C antibody, and autoimmune markers such as antinuclear, smooth muscle, and liver-kidney microsomal antibodies. An elevated amylase level would corroborate the presence of pancreatitis when this condition is suspected based on the history or physical examination.

IMAGING

Ultrasonography and computed tomographic (CT) scanning are useful in distinguishing an obstructing lesion from hepatocellular disease in the evaluation of a jaundiced patient. Ultrasonography is typically the first test ordered, because of its lower cost, wide availability, and lack of radiation exposure, which may be particularly important in pregnant patients. While ultrasonography is the most sensitive imaging technique for detecting biliary stones, CT scanning can provide more information about liver and pancreatic parenchymal disease. Neither is good at finding stones inside the ducts.

Further imaging that may be done by a gastroenterologist or interventional radiologist includes endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography.

LIVER BIOPSY

A liver biopsy provides information on the architecture of the liver and is used mostly for determining prognosis. It also may be useful for diagnosis if serum and imaging studies do not lead to a firm diagnosis. Liver biopsy can be particularly helpful in diagnosing autoimmune hepatitis or biliary tract disorders (e.g., primary biliary cirrhosis, primary sclerosing cholangitis).

Bilirubin explained

Bilirubin explained

All about Bilirubin.

If you’ve been diagnosed with Gilbert’s Syndrome, then you’ve most probably been told that your bilirubin levels were high.  It’s one of the most common ways of determining that a patient has Gilbert’s Syndrome, and usually happens after general blood tests.

But what is Bilirubin, what does it do and will it harm us? 

Bilirubin comes from the blood when blood cells become old, and die.  Hemaglobin, the substance in blood that carries oxygen, is broken down to heme and globin and is passed onto the liver. Bilirubin is formed from the heme part of hemaglobin, and is a bright greenish yellow colour.

The bilirubin is not water soluble when it gets to the liver, and needs an enzyme to become so, then it can be easily passed out of the body.  The water soluble substance now passes through the gall bladder as bile and into the small intestine where it continues to be processed by bacteria in the intestines, and is passed out through the faeces and urination.

This enzyme that makes the bilirubin water soluble is called glucuronyl transferease, known as UGT for short, and is what people with Gilbert’s Syndrome are genetically lacking.  This means that the bilirubin is not ‘conjugated’ or converted so that it can easily leave the body.

The enzyme also uses blood sugar to help in processing bilirubin, which is one reason why missing meals can affect you.  It’s best to ensure you have regular small meals, and cut down on unrefined sugar and carbohydrates like white bread and pasta, so that the amount of enzyme you have can always have a stable supply of blood sugar to do its job.

There is always some bilirubin that is in the blood but this is chemically different from the ‘conjugated’ bilirubin.  GS sufferers however, have a lot more of this ‘unconjugated’ bilirubin because it hasn’t been disposed of as it should through the usual process. It’s the difference between the 2 types that tips off those conducting the lab tests on your blood that you have GS.

When bilirubin builds up in the blood at more than around 2.5mg/dl, then the skin and eyes become discoloured with yellow, otherwise know as jaundice. There are a number of reasons bilirubin builds up in the blood other than the lack of the enzyme, and it’s important to rule those out before diagnosing Gilbert’s Syndrome.  For example the patient’s bile duct could be blocked, or they could have a type of anaemia, or hepatitis.

Drugs can also affect the measurements of bilirubin, and many can increase it such as  steroids, some antibiotics, antimalarials, codeine, diuretics, MAO inhibitors, nicotinic acid, oral contraceptives, and others.  Drugs that decrease bilirubin measurements include barbiturates, caffeine, penicillin and high dose salicylates.

You’re likely to be diagnosed between the age of 10 and 30.  Males are more likely to have Gilbert’s Syndrome than females, and there are some slight differences in the gene depending on racial background.  Many people will not even notice they have it.

Glucuronidation – where Gilbert’s Syndrome works in your liver

Glucuronidation
The UGT enzyme (that people with Gilbert’s Syndrome don’t have so much of) works in one particular part of your liver and is responsible for the part (or pathway) of your liver’s processing called ‘glucuronidation’. Glucuronidation happens when toxins are bound to glucuronic acid which is produced by the liver. Chemicals processed by glucuronidation include common opiate based drugs used in pain relief or during surgery  (Liston, H.; Markowitz, J.; Devane, C. (2001). “Drug glucuronidation in clinical psychopharmacology”. Journal of clinical psychopharmacology). Other things that affect glucuronidation include smoking, obesity, age and gender.

You can find a list of drugs affected here: https://en.wikipedia.org/wiki/Glucuronidation#General_influencing_factors

Some herbal supplements may help glucuronidation (Effects of herbal supplements on drug glucuronidation. Review of clinical, animal, and in vitro studies. March 2011 Mohamed ME, Frye RF.Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida 32610, USA.)The use of herbal supplements has increased steadily over the last decade. Recent surveys show that many people who take herbal supplements also take prescription and nonprescription drugs, increasing the risk for potential herb-drug interactions. In vitro and animal studies indicate that cranberry, gingko biloba, grape seed, green tea, hawthorn, milk thistle, noni, soy, St. John’s wort, and valerian are rich in phytochemicals that can modulate UGT enzymes. However, the IN VIVO consequences of these interactions are not well understood. Only three clinical studies have investigated the effects of herbal supplements on drugs cleared primarily through UGT enzymes. The need for further research to determine the clinical consequences of the described interactions is highlighted.

Essential for Glucuronidation are the nutrients L-glutamine, aspartic acid, iron, magnesium, B3 (niacin) and B6. Thyroid should also be adequate. Cruciferous vegetables (cauliflower, cabbage, cress, bok choy, broccoli and similar green leaf vegetables) are helpful. Glucuronidation efficiency can be improved by calcium-d-glucarate. However, you have to start very gradually with the calcium-d-glucarate, and be very consistent.

You can find out more about glucuronidation here https://youarethehealer.org/health-conditions/optizmize-your-health/detox-biotransformation-pathways/glucuronidation/