What is a disease?


Gilbert’s Syndrome is a genetic condition, marked by raised blood levels of unconjugated bilirubin, caused by less active forms of the gene for conjugating bilirubin.

There are disagreements about whether this should be called a disease. Most experts say it is not a disease, because it has no significant adverse consequences. The elevated bilirubin can lead to mild jaundice, and some people with GS may have difficulty breaking down acetaminophen and some other drugs, and so be at greater risk of drug toxicity. They also have elevated risk for gallstones. GS may be linked to fatigue, difficulty in concentration, and abdominal pain. On the other hand, a large longitudinal study found that the 11% of the population possessing one of these Gilbert’s variants had its risk of cardiovascular disease reduced by 2/3.

WHAT? 2/3 lower risk of the greatest cause of mortality in western societies? That’s the “syndrome”?

Maybe we should rewrite that: anti-Gilbert Syndrome is a genetic ailment, marked by lowered blood levels of unconjugated bilirubin, caused by overly active forms of the gene for conjugating bilirubin. This leads to a tripled risk of cardiovascular disease. On the other hand, the 89% of the population suffering from AGS has lower risk of gallstones, and tends to have lowered risk of acetaminophen poisoning. They may have lowered incidence of fatigue and abdominal pain.

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