Many women with digestive issues also have a poorly functioning gallbladder. Women are at higher risk of developing gallstones than men, especially if you’re over 40 or have experienced yo-yo dieting or rapid weight loss. Being overweight increases risk as well as having high blood sugar or diabetes. But there's plenty of choices you can make to help prevent gallstone formation. We’re covering symptoms, food, supplements and labs today.

What are symptoms of gallbladder issues? 

When abdominal pain is located in one spot, this is often associated with a problem with an organ like the appendix or gallbladder. Cramp-like pain (often from gas or diarrhea, or pain that comes in waves) more often happens with kidney stones and gallstones. If it’s located in the ‘V’ where your ribs meet you may also want to rule out an H.pylori infection (most commonly associated with reflux and GERD).

Pain under the rib cage, tightness between the shoulder blades, burping up fish oils, and bloating are also overlooked signs of sluggish gallbladder function. Bile acid malabsorption issues contribute to around 30% of chronic diarrhea cases since bile is a natural laxative, which also means that gallbladder issues can be a factor in constipation as well.

Your gallbladder is a little sack next to your liver that makes a yellow-green substance called bile to help digest fats. The gallbladder contracts and releases bile. The release of bile does two things – it breaks down fats and helps activate receptors and improve GI function. 

When bile starts to get thick (before gallstone formation) the technical term is “gallbladder sludge” which can be identified with an abdominal ultrasound and is a precursor to gallstone formation. When this sludge develops in the gallbladder, it becomes inefficient at releasing bile into the small intestine to emulsify fats setting you up for gallstone formation.

What helps to prevent gallstones? 

FOOD

Coffee thins the bile as does ginger, green tea, dandelion root, milk thistle, beetroot and the amino acid taurine (found in animal protein and in supplemental form).

Eating Nuts & Seeds: Nuts are rich in unsaturated fat, plant protein, fiber, minerals (calcium, magnesium), vitamin E/tocopherols, phytosterols and phenolic compounds. Nut consumption is associated with lower risk of gallstones, heart disease, diabetes, hypertension, cancer, cholesterol and inflammation. Consume them mostly raw and unroasted.

Eat more artichokes and bitter foods (lemon, apple cider vinegar, dandelion greens etc). 

Avoid fried foods and consider temporarily reducing overall fat content. When you can't absorb fat, you also are more likely to have deficiencies in fat soluble vitamins A, D, E, K and essential fatty acids like omega-3s.

SUPPLEMENTS

Toxins remain stagnant when there’s poor bile flow which can also lead to SIBO so supplements that boost bile flow include: Phosphatidylcholine (bile building block) and bitters (Gentian root and artichoke work synergistically to stimulate natural bile production to aid toxin removal and emulsification/digestion of fats in meals).

Supplements that thin the bile alongside a low-fat diet can also help to kickstart the gallbladder (gingerols, green tea, dandelion root, milk thistle, beetroot, taurine).

If you’ve already had your gallbladder removed, the long-term use of TUDCA and ox bile is a powerful combination to support its important functions.

LIFESTYLE

Rule out blood sugar/insulin issues, liver dysfunction and things like mold exposure (fungus can lead to sluggish gallbladder function and damage the pancreas's ability to produce insulin). 

Maintain a healthy weight, avoid being sedentary, and pay attention to any of the above symptoms to address them before gallstones become an issue.

LABS

A comprehensive bloodwork panel which includes Bilirubin, GGT and Phosphatase can point us toward gallbladder issues. High levels of each may be associated with gallstones. 

A stool test such as a Gut Zoomer will zero in on whether one needs gallbladder support in addition to other areas of digestive insufficiency including stomach HCl and pancreatic enzymes.

To hope, health & happiness, Sara

Function Medicine Clinical Nutritionist, CNS, LDN, FMHC, MS-HNFM