The Gallbladder and Fats

Why do we have a gallbladder, and what is so interesting about it?  What does it feel like when it’s not healthy, and how does diet affect it?  Why are low-fat diets bad for you in the long-run?  Here I answer those questions and more in this fourth in an ongoing series of articles on oils, fats, and diet.

the gallbladder sits below the liver

The physical location of the gallbladder.

Why do you have a gallbladder?? The function of the gallbladder is tremendously important in digestion and assimilation of especially fats and oils (which are fats in a liquid state).

You might have trouble digesting fats, implicating your gallbladder, if you have had any of these signs or symptoms over time:

  • abdominal pain,
  • vomiting,
  • constipation,
  • diarrhea,
  • dry skin,
  • Stools may be pale or clay-colored, shiny, or greasy, or may float (indicating fat in the stool)

Physically, the gallbladder is relatively small and sits below the liver.  It stores bile that comes from the liver, for use when you eat.  Bile is necessary to absorb essential fats and other nutrients.

The Gallbladder in Traditional Oriental Medicine

Traditional Chinese Medicine and its offspring, as holistic medical systems,  integrate the physical and the pyscho-spiritual aspects of the organs in their theories and practices.

The gallbladder meridianIn Traditional Chinese Medicine literature, when the names of organs are mentioned, they are referring to more than just the physical aspect.  Here I’ll talk briefly about this perspective, mostly to spark interest and reflection.  The rest of the article will deal only with the physical gallbladder.

In Traditional Chinese Medicine, the Gallbladder system is associated with a variety of phenomenon beyond its obvious physical manifestation.  Here we’ll talk about one:

The gallbladder is associated with the range of issues having to do with indecision and decisiveness.  The gallbladder is said to give the courage and capacity to make decisions.  It gives us drive and passion to excel, and the action potential necessary for these to come to fruition.

If the Gallbladder is ‘weak’, a person will be timid and lack initiative and courage.    The gallbladder is also involved in dealing with adversity.  (Ever heard the term ‘have the gall’ to do something?  It seems that Traditional Chinese Medicine wasn’t the only place where these aspects of the gallbladder were recognized!)

Furthermore, the heart is the ruler, overseeing all mental functions.  It is often necessary to strengthen the gallbladder to support the functions of the heart.  Liver is considered to be responsible for the ability to plan life, and the small intestine gives clarity and wisdom to the decision making process.   To be able to plan and lead a harmonious life, all these functions must be harmonized, which implies that the organs need to be physically healthy.

Now, let’s get back to things about the gallbladder that will help you make some dietary decisions…

The Gallbladder and Nutrient Absorption

The bile released from the gallbladder is an emulsifier that enables us to absorb dietary fats, as well as fat-soluble vitamins A, D, E, and K, as well as essential fatty acids such as Omega-3’s.  The presence of the gallbladder enables us to process and assimilate these nutrients any time of day – which is a big clue as to how important those nutrients just mentioned are to our lives.

The roles of these nutrients:

  • Vitamin A is an antioxidant, and has major roles in vision and infections. Without vitamin A, the body can’t use proteins, minerals, or water-soluble vitamins properly –  so important that the body has stores to last at least a year.
  • Vitamin D promotes calcium absorption in the gut, and without sufficient vitamin D, bones can become thin, brittle, or misshapen.  Other roles include modulation of cell growth, neuromuscular and immune function, and reduction of inflammation.  Deficiency is a factor in numerous chronic conditions from autoimmune disease, to depression, to cancer.
  • Vitamin E is also an antioxidant, important for healing and repair, as well as for normal circulation.
  • Vitamin K plays a huge role in blood clotting, bone mineralization, and prevention of heart disease.
  • Omega-3 fatty acids have very important anti-inflammatory properties. Deficiencies can lead to depression, heart disease, joint pain, and so much more.

These days a lot of the biggest health issues we have are directly related to the oils and fats that we are eating, and NOT eating – and that is a reflection of the importance of the above nutrients.

The body needs a constant supply of healthy fats to build new cell membranes, to make hormones, and to maintain the health of the brain and skin.  The gallbladder is designed to empty several times per day in response to dietary fat and acidity, but it will continue to concentrate and store bile temporarily when fat is not consumed.

The low-fat/no-fat diet and the gallbladder

Not only are fat-less meals unappetizing, they create the environment for future gallbladder problems! When you eat a meal that contains little or no fat, the gallbladder will not empty itself.  Without bile, fat soluble nutrients above go unabsorbed.  Whether the gallbladder empties or not, the liver will continue to make more bile and send it to the gallbladder.  The gallbladder has the ability to concentrate the bile and save it for the next meal but if the next meal is low in fat as well, the bile begins to become thick, sludgy, and congealed.  This is called biliary stasis.

Over time this biliary stasis, the thickened bile, can crystallize into gallstones!

And this is especially true if the bile is constantly saturated with cholesterol.   Here is where you learn another reason why refined carbohydrates are so bad for you:  refined carbohydrates increase the cholesterol saturation of bile, making gallstones more likely!

Another problem with refined carbohydrates, with respect to the gallbladder, is that they also deplete magnesium rapidly from the body.  Magnesium helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong.  Magnesium deficiency is another factor that has been linked to gallstone formation.

Many to most people with gallstones don’t have symptoms.  Some symptoms of sludgy bile could be indigestion, flatulence, tension in the back of shoulders near the neck.  In some, the stones can become lodged in the cystic duct or common bile duct, causing painful gallbladder attacks characterized by cramping or pain in the upper right ab area or right shoulder blade, sometimes with fever, nausea, or vomiting. These attacks generally triggered by eating a meal that is moderate to high in fat makes it look like fat is the problem!

It is common to be advised to eat “low-fat” foods to deal with painful gallbladder attacks.  Unfortunately, most low-fat foods usually contain plenty of refined carbohydrates (exacerbating the stagnation of the bile in the gallbladder), along with plenty of chemical additives.

Eating a low-fat diet will minimize symptoms at that time, but will also contribute to making the problems worse over time!

How to Avoid Sludgy Bile and Gallstones:

1. Avoid refined carbohydrates (white flour and sugar) as much as possible. Not only are you not getting nutrients you need from them, it takes a lot of nutrients from the body to process refined carbs, and those nutrients (like chromium, magnesium, and some B’s) have to be pulled from the body’s reserves!

Nature has packed naturally sweet foods with the nutrients needed to process the sugars they contain. For example, sugar cane is rich in minerals and some vitamins (chromium, magnesium, and B6!)… but the refined version is stripped of these so that the product you’re left eating actually strips you of nutrients.

2. Eat plenty of healthy fats.  Basically, healthy fats include saturated fats from pasture-fed animals (butter, ghee, cream, tallow, lard, fatty meats, egg yolks, organ meats, etc…) and tropical oils (palm and coconut oils), as well as monounsaturated fats from extra virgin olive oil, and small amounts of polyunsaturated oil from nuts, seeds, and fish.

Avoid fats from corn, soy, canola, sunflower, safflower, cottonseed and hydrogenated oils.  Read my crucial primer on oils and fats.

Also seed oils are not to be used for cooking because the high percentage of polyunsaturated fats they contain are very delicate and are easily damaged by heat and light. These oils have been shown to increase the body’s need for vitamin E, probably due to the free-radicals formed when they are exposed to heat or light. They also have high levels of Omega-6 which Americans have too much of already.  More on those issues in my intro to fats.

Hydrogenated oils are evil!

Hydrogenated oils, (man-made trans fats) are completely unnatural to our physiology and increase the risk for heart disease. Reject anything that has partially or fully hydrogenated oils of any kind. Products labeled ‘trans fat free’ may still contain them! Check the ingredients. By the way, the processing that goes into making Canola oil makes it a trans-fat hydrogenated oil – so don’t use it!!

If you’ve been eating a low-fat diet for some time, the best approach is to gradually increase the amount of fat in your diet. A sudden increase might make you sick.

Coconut oil is the best kind of fat to start with because it is high in medium-chain fatty acids that don’t need to be emulsified by bile to be absorbed (this is very important for those of you who have problems digesting fat because of gallbladder issues).

3. Make sure your diet contains plenty of minerals, especially magnesium, which has been shown to prevent gallstones. A great source of mg is bone broth. Dairy, organ meats, seafoods, and organic vegetables (esp dark leafy greens) are other good sources of minerals.  Most of us have trouble with phlegm as a by-product of eating dairy, so I suggest you DO eat yogurt, but not a lot of other dairy.

4. Include Taurine-rich foods in your diet. Taurine is a major component of bile and is an amino acid found in animal proteins, including meats, seafood, eggs, and dairy products. It increases conversion of cholesterol into bile acids. Bile that is saturated with unconverted cholesterol puts you at increased risk for cholesterol stones, which make up almost 90% of all gallstones.

beets are good for gallbladder5. Eat beets. Beet roots and stem are natural bile thinners and can be eaten daily by people who are prone to gallstones.  Beet greens are also high in Magnesium.

6.  Also include radishes in your diet.  They help remove deposits from the gallbladder.  Drinking a couple of cups of Chamomile tea a day helps too.

7. If you’re trying to lose weight, avoid rapid weight loss and very low calorie diets. Obesity is associated with gallstone formation, but starvation diets and losing weight too quickly will also increase the risk of stones.  A good tactic is to put coconut oil in your diet (see above), and lose weight slowly but surely.  In fact good fats in the diet will go a long way towards helping lose weight versus eating a low-fat diet. (more on this in a separate article)

What to do if your gallbladder has been removed?

If your gallbladder has been out for more than a year (due to cholecystectomy), you should be assessed for vitamin A and D deficiencies, as well as mineral and essential fatty acid deficiencies.  Adequate vitamin D is protective against colon cancer which is common in the long run for those who have had their gallbladder removed.

Also, without bile you cannot absorb preformed vitamin A, and your body can only convert beta-carotene into preformed vitamin A in the presence of bile salts.

So consider supplementing your diet with bile salts. Without a gallbladder, the liver will still continue to make bile, but the bile cannot be saved for later use.  In order to have proper digestion and absorption of fats, bile salts can be taken with every meal.



    Very informative… Will share with my patients. Thanks so much


    What an excellent, informative article! Appreciate your wisdom, perspective, and recommendations.

      Afshin Mokhtari

      I appreciate your comment. Especially since its full of compliments!! 🙂

    Nora Romero

    Having been diagnosed with gallstones and drs. recommendations for gallbladder surgery, I’ve been doing more research on the subject. I am reluctant to have the surgery and was moving to a low-fat/no-fat diet. Your article was very enlightening and informative. Thank you!


    Some genuinely great information, Glad I discovered this. Good teaching is onefourth preparation and threefourths theater. by Gail. cddkakeegeek

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