Funny thing about the gallbladder: If you don’t keep it busy squeezing out its bile contents into the bile duct and intestines to emulsify fats, bile can stagnate, a situation called “bile stasis.” Just as idle teenagers often get into trouble, so an idle gallbladder holding its bile contents develops bile stasis, the situation that allows bile crystallization that, over time, develops into gallstones.
In the Wheat Belly lifestyle, we keep our gallbladders very busy with unlimited intake of fatty meats, butter, coconut oil, olive oil, etc because fats:
- Do not cause heart disease
- Do not trigger formation of small LDL particles and liver de novo lipogenesis that creates most VLDL particles that lead to heart disease
- Are satiating and keep you from snacking or indulging in junk foods
- Stimulate release of cholecystokinin, CCK, that stimulates the gallbladder to contract and express its bile.
Recall that, in the Wheat Belly lifestyle, we also eliminate all grains and thereby sources of wheat germ agglutinin that would have blocked CCK. Yes: wheat and grains, by blocking CCK, contribute to bile stasis and gallstone formation.
You can therefore appreciate that the Wheat Belly lifestyle is, among numerous other health benefits, a gallbladder health program.
I’ve previously discussed how several clinical studies have now been conducted in which serial gallbladder ultrasounds have been performed in people embarking on a low-calorie and/or low-fat diet program. People are chosen at the start without gallstones. Surprisingly, many people (over 50% in some studies) develop gallstones, sometimes as quickly as four weeks after starting their diet program. Many go on to need gallbladder removal surgery, as illustrated in our recent survey. Not everybody, of course, develops gallstones, as there are other factors that weigh in such as the increased likelihood if you are female, older, and overweight.
Fat consumption is therefore necessary to not develop gallstones. The only downside to the Wheat Belly lifestyle is if you begin the program but already have gallstones, whether you are aware of them or not. When you convert from a low-calorie or low-fat lifestyle to an unlimited fat lifestyle, it can unmask the presence of gallstones when you begin to put your gallbladder to work more vigorously. This can bring out gallstone symptoms. Unfortunately, many people interpret this to mean that a higher fat intake causes gallstones. But you now know that it’s calorie and fat reduction that causes gallstones, an increase in fat intake that can simply unmask their presence.
Key takeaways: NEVER limit or count calories, NEVER limit fat. Enjoy healthy fats such as those in fatty cuts of meat, butter, coconut oil, and olive oil. But, should you develop symptoms of gallstones at the start of your Wheat Belly unlimited fat lifestyle, cut back on fat intake to minimize symptoms, then talk to your doctor about (prescription) ursodiol supplementation to encourage dissolution of the stones. Unfortunately, some people begin this program too far along with stones that are too big and cause cholecystitis and a surgical “solution” will be required.
Lastly, if you have gallstones, think long and hard about whether you also have SIBO, small intestinal bacterial overgrowth, as gallstones typically have colonic microorganisms in them—even though the gallbladder communicates via the bile duct with the duodenum, over 20 feet up from the colon.
Hi Dr. Davis. First, I stated by wheat free lifestyle by reading your first book and watching you on on PBS television program over 5 years ago. I’ve never looked back and I’ve never slipped or cheated. I have no desire as you have changed by life for the better! Thank you! Through reading your information, you also pointed me to others to read as well like Maria Emmerich, and then through her I’ve found even more. But, I ALWAYS come back to you when I need more information.
Anyway back in July I decided to try a carnivore lifestyle. Remember I have been grain free/keto for over 5 years now. July, August, September I went carnivore. I started having some issues that I went to see my OB/GYN for and they sent me for an MRI. Within days after the MRI, I started having gallbladder pain. I was sent for an ultrasound and they found what I am told is a 2 CM stone. Everyone, (doctors and not) keep telling me that the way I eat may have caused this. I didn’t believe them, but now that I read your article I’m sure it didn’t. I think eating carnivore my have brought on my symptoms or honestly, I think it was the MRI that really aggravated it.
The timing of your article is amazing to me because I just met with 2 surgeons (because I went for a 2nd opinion because the first one had no time to talk or answer questions, just said nothing can be done but surgery) in the last 3 weeks. The second doctor talked and explained and was a little more open to listening to me. Because of my age and the fact that I’ve never had a colonoscopy, he wanted that done first to make sure that my pain was nothing else. He said that just because you have gallstones is not a reason to remove the organ. See he, in my opinion, is better than first doctor. So I did the colonoscopy the other day and it is clean. I am to call him to discuss my gall bladder further. Luckily, I saw your article first and will talk to him about it. However, do you have any advice to offer me that could help? I prefer not to remove an organ that my body uses even if the body will work around it. If I have no other option, then ok. But it’s very hard to find doctors like you anywhere. Thank you for your consideration.
Kim Kaiser wrote: «…I decided to try a carnivore lifestyle.»
What did that involve insofar as eating intervals and fats consumption? Extended fasting and/or low fat might play into gallbladder issues (on the blog here, and here).
And what forms of animal food? Although it’s not hard to make an ancestral case for an extended carnivore diet, that would have been based on ancestral snout-to-tail practices, including organ meats and offal. This usually doesn’t describe modern carny dieters.
And if you were basing your diet just on the original 2011 book, which overlooked the gut flora cultivation topic, you might have overlooked it as well. I have the PBS DVDs (2014), and the WBTH book did cover gut flora, but don’t recall if the PBS main presentation covered it (and it couldn’t have gotten into a useful level of implementation detail in any case).
re: «Within days after the MRI, I started having gallbladder pain.»
Was a contrast agent used? If so, what was it?
re: «So I did the colonoscopy the other day and it is clean.»
That’s another common procedure that is not exactly risk-free. Glad you sailed through it.
Blog Associate (click for details)
Enlightening article Dr Davis. I have gallstones and have know about their connection with Sibo but I was very glad to hear in your article and then read about the medication that can be used to reduce gallstones.