The gallbladder is one of the most under-rated organs. Digestion actually starts in the mouth where food is chewed and broken down into small pieces. But the mouth play an even more important role, as enzymes are added from your saliva and bacteria in the mouth which start to break down food. When the food reaches the stomach, acids and stomach enzymes start to break down the food into simple molecules. Fatty foods need to be broken down, and this is where bile steps in to help. Bile is produced continuously by the liver (liver bile) where it is then either passed into the small intestine or stored and concentrated in the gallbladder. The small intestine actually senses the presence of fat and sends a signal to the gallbladder to release bile into the intestine. The gallbladder has a capacity of about 50ml, but the liver produces around 1000ml of bile daily and much of this is recycled back to the liver.
Gallbladders often become infected or develop serious stones. Gallstones are solid particles that form from bile cholesterol and bilirubin in the gallbladder. Bilirubin is an orange-yellow waste product produced by the normal breakdown of haemoglobin found in red blood cells. High bilirubin levels usually means that there may be an underlying problem involving the red blood cells, liver or gallbladder.
In the US over 10% of the population are affected with gallstones. There are natural ways to reverse gallstones and other gallbladder problems, but the most common approach taken by doctors is gallbladder removal. Once the gallbladder is removed, patients often struggle with the digestion of fat. But there are strategies to overcome this. It's important to remember that your liver still continues to produce a lot of bile, even with the gallbladder storage gone.
- People with gallbladder worries should avoid fried foods, bad fats (processed oils such as corn oil) and highly processed foods such as doughnuts, pies & cookies. A major cause of gallstones is an over-consumption of hydrogenated fats and processed vegetable oils.
- Focus on quality fats and avoid poly-unsaturated fats.
- Give your gallbladder a rest and have a break from food by fasting.
- Drink plenty of water.
- Increase your intake of magnesium, folate (b9), calcium and vitamin C. Studies show that a deficiency of these nutrients can increase the risk of suffering from gallstones.
- There is a link between gallbladder removal and vitamin B12 deficiency. It would be wise to take a test (The methylmalonic acid (MMA) test or the Schilling test).
- There may be an issue with omega-3 absorption. 95% of fish oils are heavily processed and contain the rancid oils of farmed or low quality fish. The bioavailability of krill oil omega-3 is also said to be way better than fish oil. The omega-3 in krill oil is in the phosphor-lipid (PL) form which does not require bile acid to act an an emulsifier in its absorption within the body. The primary PL in krill oil is phosphatidylcholine (PC), and approximately 60–70 % of the omega-3 fatty acids in krill oil are bound to PLs. We recommend krill oil supplements in capsule form.
In some cases, gallstones can be treated with medicine. Ursodiol or chenodiol have been shown to dissolve some gallstones, are available in oral bile acid pills. These work by thinning the bile, which allows gallstones to dissolve. Phosphatidylcholine may help dissolve gallstones, this is found in egg yolks along with normal choline. Natural methods to dissolve gallstones include:
Guidance for people without a gallbladder
It is a misconception that people who have had their gallbladder removed should not eat fat. Even though the gallbladder is missing, the liver continues to produce bile acid. The only difference is that people cannot respond to a high fat load. There are three macros in your diet, these are fats, carbs and protein. Switching to a very low fat diet has to be balanced by an increase in protein or carbs. A high carb diet would have many other negative health consequences. Here are some practical solutions that can be adopted by people without a gallbladder (most would help people who have a gallbladder but want to be protective):-
- Eat small quantities of fatty foods throughout the day. This will not illicit an insulin response because insulin is largely triggered by glucose intake. This will then fit into your livers rythm of constant bile secretion.
- Don't eat a huge fatty meal in one sitting.
- Eat healthy fats such as omega-3, olive oil, coconut oil, argan oil, grass fed butter, duck fat, goose fat and saturated fat derived from grass-fed animals.
- Mix in some unrefined carbs (from fruit and veg) with each fatty meal. Low GI fruits such as guava, berries, cherries, grapefruit (perhaps banana) are excellent choices.
- Stay upright after a meal and don't eat close to bedtime.
- Certain foods can increase bile production. These foods include celery, radish, and artichokes.
- Get rid of inflammatory foods such as gluten, grains, breads and sugary foods.
- If you go for a long period between one meal to the next, go easy on fats at the second meal so you don’t overwhelm your system. This is also the case with the first meal after a fast. Good foods in these case would include fruit, celery, fermented foods, bone broth and soups.
- Take apple cider vinegar daily. It is a natural way to stimulate stomach acid production.
- Supplement with omega-3 (a quality fish oil or krill oil).
- The enzyme lipase is produced by the pancreas. Lipase is the major enzyme that breaks down dietary fats into smaller molecules called fatty acids and glycerol. 10-30% of dietary fat is hydrolysed in the stomach by lingual lipase (produced in the mouth). When the food you eat reaches the stomach, the cells in your stomach make a small amount of lipase called gastric lipase. This works mostly on butterfat and does not require bile. Lipase requires chloride as a coenzyme. Lipase-deficient people have low stomach acid so it's important to get plenty of salt in your diet.
- Take a lipase supplement. Standard lipase dosage is 6,000 LU or 1–2 capsules three times per day 30 minutes before meals on an empty stomach. Take some advice if you are taking it with betaine HCl.
- Have a lipase blood test.
- Avoid fluorinated water or fluorinated toothpaste. These are known to reduce lipase production.
- Take herbal bitters. These are an ancient tonic for stimulating the production of bile whiach improves the digestion and absorption of fats. Sufficient bile must be produced to digest fats and aid the absorption of the fat soluble vitamins A, D, and K which are critical to health.
- Avoid stress: It raises levels of the hormone cortisol, which depletes bile (both cortisol and bile are made from cholesterol).
- Restore stomach acid by taking the supplement betaine hydrochloride (betaine HCI).
- Take a bile salt supplement such as Dr Berg's bile salt.
So-called digestive aids, including proton pump inhibitors and H2 blockers (Pepsid AC, Prilosec, Zantac, etc) will actually endanger your health because they shut down stomach acid production.