Gallstones and low carb
Gallbladder in pink
Do gallstones improve or worsen on a low carb / high fat diet? It’s a common question with an interesting answer.
The gallbladder stores bile, a yellow-green fluid manufactured in the liver. The bile is used to digest the fat you eat. The question is: Is it good or bad for the gall bladder to eat fat?
The conventional fat phobic answer
The usual medical belief today is that fatty food can result in gall stones. This is because what happens if you already have gallstones in the gallbladder and eat fat: A gallstone can get stuck on the way to the intestines and give you a gallstone attack (pain in the top right part of your stomach).
The conventional advice is thus to eat low fat – and take pain killers if you get a gallstone attack. If the attacks continue the gallbladder is removed by routine surgery and the problem usually goes away. Probably with the side effect of slightly decreased ability to absorb fat and nutrients from what you eat (there is a reason we have gallbladders).
The conventional low fat advice rarely makes gallstone disease go away. Instead it often gets worse with time, until surgery is necessary. That is hardly a coincidence.
How to get gallstones
If you eat low fat less bile is needed to digest your food. More bile thus stays in the gallbladder. Long enough, perhaps, for stones to form. It’s been shown that people who (instead of fat) eat more carbohydrates are at increased risk of gallstones.
It all sounds logical. And there is even better evidence. The risk of low fat diets have been tested at least three times:
Studies of extreme low fat diets
- In a study of 51 obese people using an extremely low fat low calorie diet (just one gram of fat a day!) the gallbladder was examined by ultrasound before the diet and after one and two months. After one month four of the 51 participants had developed new gallstones. After two months more than one in four (13 people) had new gallstones! This on an almost fat free diet. Three participants needed to have their gallbladder removed during the study.
- A similar study examined 19 people eating an extremely low fat low calorie diet over 16 weeks. At the ultrasound examination at the end of the study five people (again about one in four) had new gallstones.
- A third study compared an extremely low fat diet with a diet slightly higher in fat during 3 months. More than one in two (6 of 11 people) in the group eating extremely low fat developed new gallstones. Nobody in the group eating more fat did.
Conclusion: Do you want gallstones? Avoid fat.
What happens if you do the opposite?
What if you were to do the opposite of the usual advice? Regularly eat food with fat in it? Then more bile will be used to digest the food. The bile ducts and the gallbladder will be flushed through regularly. Probably no stones will have time to form, and pre-existing stones might (if you are lucky) be flushed out into the small intestine.
The risk is that you will get gallstone pain in the short term – if you already have gallstones.
The question is: Do you want to think short-term (low fat) or long-term (higher fat)?
Does high fat food work?
It’s logical to think that food higher in fat can result in a gall bladder free from gallstones. But as far as I know no study has tested high fat food to people with gallstones.
On the other hand I know quite a few people who have experienced that their gallstone disease disappeared on a LCHF diet. Sometimes at the expense of initial gallstone attacks though.
A Swedish low carb site conducted a survey of its members. 145 people who used to have gallstones answered what happened since they started eating LCHF. Take the result with a huge pinch of salt as this kind of survey gives very unreliable answers:
This survey gives some support to the theory that high fat food can cure gallstone disease.
Gallstones and kidney stones
Patients with kidney stones get better advice. They are told to drink a lot of fluid, increasing the production of urine, so that stones do not have time to develop. If you already have kidney stones this advice could give you a painful kidney stone attack initially – but you are still advised to drink a lot.
The reason why we give the opposite advice when it comes to gallstones might be the obsolete fear of fat. If we were afraid of water instead patients with kidney stones might have been advised to avoid drinking to avoid kidney stone attacks. If they did not improve their kidneys would be surgically removed.
What do you say?
Have you had gallbladder problems? Have you tested a LCHF diet? What happened?
Mer
PS
Another common question is if you can eat LCHF if your gallbladder is already removed. The answer is that this seems to work fine.
Some people without a gallbladder might have to increase their intake of fat gradually to allow their body time to adapt. Otherwise the body might not have time to digest the fat which could result in loose fatty stools initially. However this rarely seems to be a problem.
284 Comments
Thanks for including the studies with your hopeful reports and anecdotes. WHAT a comfort to me! Will print out and take to specialist when I go see on my first appt.
And I will keep up Keto, and let you all know the outcome as this goes along!
I was diagnosed with gallstones back in march but before that in February I had some very nasty pains that made me go on a struck diet of not eating any fried food at all, I would make me a lot of soups with mainly salary carrots onions and some chicken, drink lots of water no soda, no dairy, a lot of plain oatmeal and I lost 10 pounds in a month. The pain decreased but I was still having some discomfort. I did drink diluted apple cyder vinegar and that helped for the pain and for the weight loss as well. I decided to go see another doctor and he sent me for the ultrasound which showed the stones. Ok so my pain has been lingering I have not had a very painful attack since February but th pain was still there like on background mode. I work in the ER ion a hospital and you can imagine how many patients present with pain and get diagnosed and have their gallbladders removed. It's like sigs all over the place for me to decide to get my surgery. I finally decided to do it. I have it scheduled for the end of the month. I am not 100 % sure I want to do it after reading about so many stories about what appens after you. O longer have a gallbladder and I am so scared!! Over the past month I have not been watching what I eat anymore and have gone back to eating high fats good ones and bad ones ( less of these of course) and I even incorporated the spicy Mexican foods that I love. I did start cooking with olive oil and I am pain free I am almost terrified. Could it be that now that I am eating more fat my bile is flowing better but I'm the back of my mind I know the pain can come back any time. I don't know what to do? Should I cancel my surgery? I've been arguing with people in the er over the fact that you do need your gallbladder? On top of that I work graveyard and the heart problems are more prevalent?? I don't know!!!
Fortunately and unfortunately in July I ended up in the hospital and was diagnosed with gallstones. Surgeon suggested surgery and out came Ms. Unhappy Gallbladder.
I'm not going to blame the LCHF for the gallstones though, I'm actually going to thank it.
I've had "attacks" for almost 20 years, and every time I went in to my Dr. or Urgent Care, I was turned away with the advice to pick up some Antacid pills and take them regularly. Heartburn/acid reflux is always what I assumed the pain was.
Thankfully at the ER visit they did more than just poke at my stomach and had an ultra-sound done to see what was going on in there.
So, after years of misdiagnosis, I can go attack free.
Post-surgery I have returned to the LCHF diet with minimal issues. Mostly an unhappy stomach when I eat the wrong thing (bacon) and occasional sudden trips to the bathroom so far.
But I'm optimistic about being able to stay on this diet for a while longer. :)
A week ago I began the LCHF diet again and have again felt similar symptoms but much milder this time, maybe because it is early in the diet and may get worse as I lose more weight?
Anyway, the point is, after reading many sources, I have realised that it is most likely Gallstones, which I most likely already had due to my high carb diet for many years, and that the pain I experience while on a LCHG diet is the stones being flushed out. Therefore I am determined to persevere with the LCHG diet now I know that the diet is not the cause of it, but could be the remedy. Am I right in my conclusions? I do not wish to have my Gallbladder removed.
after went to high fat, i had my first gallstone attack, does that mean if i hang on the pain for awhile, the stone will shrink or disappear?
i know these stone developed over many years, if high fat can cure it i dont mind some pain
i think that high fat can mean anything, you can put some butter on vegatable or baked potato, and it can call high fat
Back on paleo/low carb and fat back up to 80+g thanks to Ox bile and enymes and removing the blocked gallbladder has removed most of the symptoms/issues.
Richard, I had gallstones and my primary doctor prescribed Ursodiol 300mg I took for a year twice a day and also my naturophatic doctor gave me digestive enzymes, probiotics and liver support supplements and I don't have any gallstones now in my last ultrasound. Ask your doctor for this Ursodiol capsules there are salts that helps dissolve the gallstones with prescriptions. I am free now of stones and follow an anti-inflammatory diet because I have arthritis, but with this diet I eat more salmon, fish, turkey and chicken and the good fats.
It's funny you should mention bacon, because that seems to set me off. I don't know if it's connected but I have had some unpleasant stomach upsets in the way of vomiting since July when I started LCHF. It was very acidic and mainly bile. I couldn't understand it as I was expecting to have less acid. No pain to speak of. This has happened a number of times and now I'm writing everything down to monitor it. The most recent vomiting was bacon related five hours after eating, it does seem to be an excess of bile upsetting the stomach. Heartburn followed by immediate vomiting. Heartburn symptoms are very few now. Out of interest has this ever been a symptom of yours? Was wondering whether to get it checked out, but afraid the GP would say go back to LFHC! That ain't gonna happen!
Thanks.
Please tell us where you found the protocol for the gallbladder flush. Thank you.
I had 3 attacks that happened 2 weeks apart each time because I was stressed out after a break up and had bad eating habits. I met a first surgeon who stressed me out by wanting to cut the gallbladder out. That afternoon, I had a super short gallstone attack after just having a peanut butter sandwich and banana. He wanted to have it cut out the next week!
Since I wasn't sure for this surgeon's way of going about it, my doctor recommended me to another one. She said he'll probably want to cut out the whole thing too. Fast-forward 4 months and he's harassed my mom and I to make me meet him to schedule a surgery date. I said no thanks and he said he'll see me in the ER. Very rude unfortunately.
In these last 4 months, I cut out heavy carbs and limited my unhealthy carb intake. I didn't go high fat, but I kept eating fatty foods in good doses and with hot tea (chamomile/green tea) to help melt the fat. No attacks so far and I'm planning to continue this way for as long as I can. So far, I've lost a lot of weight, haven't gotten a cold and feel amazing. I will accept the challenge set by this last surgeon. I'll do anything to heal my body without cutting it out. Thank you for this page, I don't know how the future will be, but I'm a very happy person now and I hope to keep all my organs intact like this. :)
After initial good beginning on LCHF (keto), I started to feel lousy on week 5. Sharp pains on lower-right, acid, nausea and bloating suggested gallstones.
This makes great sense, because I started to get more hungry (54kg woman, 2700kcal intake on worst days), no satiety with more fat (75-80%). Low bile means low utility of fat aka less energy (and by that time I should have been steady fat-burner). Also have struggled with constipation since day one even with 30-40g fiber and lots of water. Low bile is also to blame.
This is week 6 of LCHF, have started to soften stones with lemon and apple vinegar, feeling better and energetic. Aiming to do the flush in a weeks time.
I had a kindey stone 3 months after starting low carb which I understand could have been there already.
From scans at time I was told i had 2 more stones which decided to both come out together needing surgery to remove.
If that's the last of the stones, it will be an interesting test to see if I ever develop any more in the future now that I'm low carb.
In the past 2 years i was consuming a lot of lemon water and a bit of apple vinegar which had apparently reduced the size of the stone, down to an uncomfortably large 8mm.