ASK THE NUTRITIONIST

The Overlooked Keys to a Healthy Gallbladder

Keep your bile thin and free-flowing by focusing on supportive foods, supplements, and physical activity.

BY MELISSA DIANE SMITH

Q:A few weeks ago, I overate a fatty meal and experienced horrible pain. I went to the emergency room and found out I had a small gallstone. It passed on its own, but it left me wondering: Is there anything that I can do to help prevent the development of more gallstones?

AGallstones are the most common form of gallbladder disease, a significant and costly health problem in our society. In fact, 10–20 percent of Americans will develop gallstones at some point in their lives, although the majority never develop symptoms.

For those who do experience pain, it’s likely that the gallbladder is sending out a major SOS. The conventional medical approach is gallbladder removal, which is necessary in certain cases, especially in cases of life-threatening infection. But “there’s no thought as to what got you there,” says George Papanicolaou, DO, a functional medicine physician at The Ultra Wellness Center in Lenox, Mass.

In contrast, functional medicine seeks to uncover the root cause that led to the formation of gallstones and approaches treatment from there— usually nutritional therapy to support optimal, healthy, free-flowing bile. “If you’re not getting what you need to make good bile, then you’re going to put your gallbladder under pressure,” explains Papanicolaou.

The Basics of Gallbladder Health

The gallbladder is a small organ located underneath the liver. Its main function is to store the bile produced by the liver and release it into the small intestine to digest fats and enable the body to absorb fat-soluble nutrients—such as vitamins A, D, E, and K, and essential fatty acids. Bile also plays an important role in detoxification, carrying away toxins and hormone metabolites from the liver, and benefiting the balance of bacteria in the microbiome.

Bile in the gallbladder is 95 percent water, and it’s also made up of cholesterol, bile acids, bilirubin, fats, amino acids, enzymes, and hormones. Gallstones start to develop when the compounds in the bile connect to each other and form hard particles or crystals. The body sees these crystals as foreigners and sends white blood cells to attack them, according to Papanicolaou. The white blood cells get broken down and become damaged, which form matrices around the crystals that greatly increase their formation. When the crystals get big enough, they become stones, and some

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of these grow so big that they get stuck in the duct that leads from the gallbladder into the small intestine.

Women are twice as likely as men to develop gallstones because female sex hormones adversely influence liver bile secretion and gallbladder function. The frequency of gallstones also increases with age, escalating markedly after age 40. Other risk factors for developing gallstones include high triglycerides, high homocysteine levels, type 2 diabetes, and metabolic syndrome, a cluster of common heart-disease risk factors including abdominal obesity, high fasting blood sugar, and low high-density lipoprotein (HDL or “good cholesterol”) levels.

How to Support a Healthy Gallbladder Naturally

To give your gallbladder a little TLC and support the production of healthy bile, Papanicolaou offers these tips:

*Adopt a fiber-rich, veggie-rich diet.

Vegetables that are favorable to your gallbladder include celery, greens, and cruciferous vegetables such as broccoli, cabbage, and kale. * Stay away from processed carbohydrates such as sugar and white flour. Also avoid meats that aren’t organic. A high intake of processed carbohydrates increases the risk of gallstones, and meat that isn’t organic increases the toxic load on the liver and gallbladder. * Avoid food allergens. Gluten is a common one. Some people have gluten sensitivity without knowing it, which can lead to Hashimoto’s disease, a type of hypothyroidism that sets people up for gallstones. * Increase your fluid intake. Because water is a key component of bile, dehydration can lead to sticky, sludgy bile. * Take a supplement of bile salts made of purified ox bile with your meals, which can help your body appropriately break down fats.

This is especially important if you’ve had your gallbladder removed.

Gallstone Warning Signs

Many people with gallstones experience no overt symptoms. Besides gallstones, other unresolved symptoms that may indicate sluggish gallbladder function and inadequate or sticky bile or other problems include:

* Constipation

* Nausea or vomiting

* Pain just below the right rib cage or

between the shoulder blades, in the right shoulder, or up the right side of the neck that comes on suddenly and quickly worsens

* Headache over the eyes

* Burping, gas, bloating, constant

feeling of fullness

* Gastroesophageal reflux

* Bitter taste in the mouth

after meals

* Light-colored or floating stools

* Hemorrhoids

* Inability to lose weight

* Fibromyalgia

* Varicose veins

* History of prescription or recreational

drug use (need for more liver and gallbladder support)

* Easily intoxicated (need for more liver and gallbladder support)

Adapted from Radical Metabolism by Ann Louise Gittleman.

Nutrition pioneer Ann Louise Gittleman echoes the importance of gallbladder health in her book Radical Metabolism: A Powerful New Plan to Blast Fat and Reignite Your Energy in Just 21 Days. Gittleman believes that thick, sticky bile that has stopped flowing freely—which she calls toxic bile—is one of the major missed reasons why so many people are sick today, and it’s her hunch that 80 percent of women over age 40 have this condition or bile insu ciency.

How Herbal Bitters, Bile Salts, and Physical Activity Can Help

“If you give your gallbladder a little love by keeping your bile thin and free-flowing, your body will reward you by keeping your metabolism high and your toxin levels low, and by making sure your hormones play nicely together,” says Gittleman.

Toward that goal, Gittleman advises weaning yourself off sweet foods and developing a new love of the many plant foods that qualify as bitters— arugula, artichoke, asparagus, broccoli, cauliflower, collards, cucumber, dandelion greens, endive, radicchio, red leaf lettuce, romaine lettuce, spinach, Swiss chard, turnips, and even vinegar, coffee, and cacao. Some people also benefit from taking small amounts of herbal bitters formulas sold in natural food stores. Studies suggest that bitters “get your juices flowing,” stimulating the release of bile, saliva, hydrochloric acid, pepsin, gastrin, and pancreatic enzymes.

To accelerate healing, Gittleman recommends a combination of bitters and bile salts, especially if you’ve had your gallbladder removed. She says bile salts are more of a bile replacement, whereas bitters encourage your liver to produce more bile so that in time you won’t need to take bile salts.

Another important strategy is to make sure to move your body. Exercise gets your blood, lymph, bile, and bowels moving. In fact, questionnaire-based surveys report that exercise can reduce the risk of symptomatic gallstones by one-third.

And if you have trouble with your gallbladder, don’t fret. Feel empowered. “I have seen many cases of serious gallbladder disease—including gallstones—being reversed by following these strategies,” says Gittleman. “There is no downside in trying!”

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