Gallbladder and Bile Acids: Checking the Engine Fluids

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I started my blog last year in October writing about the liver and its critical role in detoxification, digestion, and immunity. This topic started a series of posts on how good health, nutrient absorption, immunity, detoxification, and reduction of inflammation starts with the digestive tract.
I have used a car engine to analogize how our bodies are exposed to cellular oxidation and stress just like an engine running on corroded oxidized motor oil.
Oxidation of our cells is the initial step to what becomes chronic inflammation and disease.
Digestion and absorption of nutrients is what drives our energy, maintains the quality of our organ’s cellular structures and how well they work.

It is important to understand that health begins with the digestive tract working at its best.

When nutrients are not digested and absorbed correctly, and the intestinal tract is damaged, then inflammatory conditions like chronic infections, intestinal inflammation, autoimmune diseases, food allergies and intolerances, consistent pain and exhaustion, etc will start to show up.

I will end my digestive health series looping back around to the gallbladder which sits on the right side of the abdomen under the liver.
What does the gallbladder do?

The main function of the gallbladder is to store and concentrate the bile that is made in the liver, and release it to the small intestine during digestion of fats. Bile is stored in the gallbladder where water is removed from it, and becomes more concentrated.
Bile is a yellowish-dark green fluid mix of water, electrolytes, bile acids, cholesterol, salts, lipids (fats), and bilirubin which is a protein from expired red blood cells.
The liver makes about one half to one liter of bile daily.

Bile acids are needed to break up fats during digestion, to carry digested fats and fat soluble vitamins into the body, and flush out excess cholesterol and other waste products.
Bile acids are made from excess cholesterol in the liver. 

The liver metabolizes and gets rid of excess cholesterol by breaking it down to bile acids.
Bile acids are both fat and water soluble.

gallbladder connection to liver and duodenum
Concentrated bile is released from the gallbladder to the small intestine when food containing fat enters the small intestine’s duodenum for digestion.

At this point, bile acids break up fat and make it easier for lipases (digestive enzymes) to digest the water-insoluble fat.
Bile salts are made from bile acids. They increase the pH of the small intestine to allow the digestive enzymes present there to activate and work at full capacity.
Once the fats are digested, bile acids carry the digested fats (fatty acids and glycerol), and  fat soluble vitamins (A, D, E and K) into the body from the small intestine. Most of the bile salts, around 95%, are recycled back to the liver to be used again.
Bile left in the intestines contains waste products like excess cholesterol and bilirubin from dead red blood cells, which are sent out to the colon to be excreted.
What are gallbladder stones?
When there is a lot of excess cholesterol in bile, it can saturate and thicken inside the gallbladder, which slows down bile secretion. Over time, the thickened bile can solidify and form gallbladder stones. 
Most gallbladder stones are solid particles of cholesterol. Women develop gallbladder stones three times more frequently than men. 

gallbladder and gallstones

The most common causes of gallbladder stones are:

  • poor diet : deep fried foods, high intake of refined sugar, hormonally supplemented meats, low fiber intake, fat free diet fads, lack of good fats in the diet
  • synthetic hormonal replacement therapy and birth control pills – (increase cholesterol level in bile)
  • obesity – (high levels of cholesterol in bile, decreased bile flow)
  • hypothyroidism – (cholesterol metabolism)
  • diabetes – (high triglyceride levels, insulin resistance)
  • rapid weight loss – (liver overproduces cholesterol to compensate)
  • Crohn’s disease, Celiac disease – ( poor intestinal reabsorption of bile acids from damaged intestinal wall )
  • pregnancy – (higher hormonal levels during this time)
  • genetic and ethnic factors – (excess cholesterol to bile ratio)
  • high triglyceride blood levels – (impair emptying action of gallbladder)
  • certain medications used to lower triglycerides and cholesterol – ( they force more cholesterol into bile)

Interestingly, high cholesterol levels in the blood are not a cause of gallstones.
What is important is how cholesterol is used and metabolized, and how much good cholesterol (HDL) vs triglyceride blood levels we have.
It appears that low levels of good cholesterol (HDL) and high triglycerides blood levels is the combination that can lead to gallstone formation.  HDL cholesterol helps by cleaning up plaque deposits in the arteties as it travels in the blood, and brings it back to the liver to be broken down. When trigycerides are too high, the leave fatty deposits on the arteries. They also impair the gallbladder from emptying properly.
Keeping a good balance of omega 3 fatty acids and monounsaturated fats is key to maintain good HDL cholesterol high and to lower triglycerides.
Fats in the diet from omega 3 oil sources like salmon, tuna, walnuts, and flaxseed oil can help to keep good HDL cholesterol levels high and trigyceride levels low. Other good fats, monounsaturated, are found in olive oil, peanut butter, avocados, almonds and cashew nuts.
Fat free foods and diets are detrimental to good health, and they can actually cause gallbladder stones because the liver will overcompensate and make more cholesterol. 

omega 3 oil capsules

It is important to remember what good fats are used for:  

  • make up the membranes of our cells          
  • potent anti-inflammatory activity
  • lubricate our joints and skin                                              
  • essential fatty acids and cholesterol make up most of our brain structure
  • make up most of the insulation in connective tissue of central nervous system
  • all major hormones are made from cholesterol
  • to make bile acids
  • help to maintain balanced insulin levels
  • vitamin D is made from cholesterol
  • insulation of internal organs and body temperature regulation
  • energy storage

Increasing fiber intake helps to prevent gallbladder stones by helping the body to remove excess cholesterol that would otherwise end up in the bile.
The reason why women are more likely to develop gallstones is because estrogen and progestins increase the levels of cholesterol in bile. Birth control pills and synthetic hormonal replacement therapy increase the levels of estrogen and progestins (which are not natural progesterone). Additionally, estrogen dominance which means natural progesterone is low in comparison to estrogen, causes decreased  gallbladder bile flow.
In summary, bile acid composition and quality is important to digest and transport fats and fat soluble vitamins effectively.

What natural supplements are useful to maintain healthy bile acid quality?

  • Milk thistle, artichoke, turmeric, dandelion root, ginger, celandine, radish root, and peppermint are herbs that keep bile from getting saturated. This helps to prevent stones, and helps bile to flow out easier from the gallbladder.
  • Vitamin C and the B vitamin group including choline – keep cholesterol from saturating in bile
  • Lecithin- keeps cholesterol fluid in bile
  • Amino acids taurine, glycine, methionine and glutamine increase bile quality and reduce inflammation
  • Glutamine-  also repairs intestinal wall damage and enhances absorption of bile acids
  • Omega 3 fatty acids- decrease triglyceride levels, and this enhances the bile flow
  • Digestive enzymes –  lipases enhance digestion of fats

Great supplement products for optimal fat digestion and gallbladder health maintenance: 

ginger root and powder


– Turmeric Force by New Chapter
– Ginger Peppermint tea by Alvita
– ChoLess Optimizer by Jarrow Formulas
– Cleanse and Detox Tea by Gaia Herb

– Glutamine Powder by Optimum Nutrition
– Maxi B-Caps with Taurine by Country Life
– Vitamin C Food Complex by New Chapter
– Lethicin  95 Granules by Solgar
– Omega-Zyme by Garden of Life
– Lypo Gold by Enzymedica

In the pharmacy, I have heard stories from women about their experiences after gallbladder removal surgery resulting from chronic stone formations or gallbladder infections.
Without a gallbladder, bile acids flow out from the liver to the small intestine continuously, and are not regulated by the same mechanism or concentrated as with a gallbladder.
Many of the women struggle afterwards with weight gain, abdominal bloating, abdominal pain, or diarrhea right after eating. They usually have a lot of questions, and many feel short of answers.
Gallbladder removal surgery is one of the most common surgeries, and it is primarily performed on women. This statistic reminds me of fibromyalgia, where 90% of diagnosed are women, chronic fatigue syndrome, lupus, hypothyroidism, irritable bowel syndrome, rheumatoid arthritis, recurrent migranes, osteoporosis, skin disorders like eczema and rosacea, and the list goes on with diseases mostly diagnosed on women!
My next topic series is going to cover women’s hormonal health issues, and the diseases that are diagnosed primarily on women.

Camille Medina, RPh
Natural Pharmacy C.l.i.n.i.c., llc

The information provided here is not intended to diagnose, treat, cure, or prevent any disease. Suggestions and ideas presented in this document are for information only and should not be interpreted as medical advice, or for diagnosing  illness. Seek advice from a health care professional before administering any dietary supplements.

HSM Smelt, Triglycerides and gallstone formations. Clinica Chimica Acta, Vol 411, Issues 21-22, Nov 2010,pgs 1625-1631
Inkinen J, Sand,J, Nordback I.,Association between common bile duct stones and treated hypothyroidism. Hepatogastroenterology, 2000, Jul-Aug47(34),pgs 919-21
Duke,James.The Green Pharmacy Herbal Handbook. New York: Rodale Press 2000

Nichols, Trent W., Fass, Nancy. Optimal Digestive Health. Innet Traditons/ Bear & Company, 2005
Sears, Barry.The Omega Rx Zone. New York: Regan Books, 2002


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