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EventsGallstones and low carb
, medical review by Dr. Bret Scher, MD
in Gallbladder disease, Potential LCHF problems 
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 eating fatty foods 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 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: Avoiding fat increases your gallstone risk!
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. Theoretically stones will not have time to form, and pre-existing stones might (if you are lucky) be flushed out into the small intestine.
The risk is that if you already have gallstones, you may get discomfort as you flush them out.
The question is: Do you want to think short-term (low fat) or long-term (higher fat) solution?
Does high fat food work?
It’s logical to think that food higher in fat can result in a gall bladder free from gallstones, and the science supports it. One randomized controlled trial compared a higher fat to a lower fat diet in obese subjects over the course of 6 months. 1 The Higher fat group had better gallbladder emptying and no stones developed, whereas over 50% of the low-fat group developed gallstones. This was despite weight loss in both groups.
This fits with clinical experience and anecdotal reports from those who have experienced their gallstone disease disappear on a LCHF diet. Sometimes at the expense of initial gallstone attacks though.
Gallstones and kidney stones
Let’s compare the advice we give patients with kidney stones to the advice for gallstones. We tell patients with kidney stones 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 attack initially as you pass the stone. But doctors still advise this despite the short-term discomfort as it is the better longer term solution.
The reason we give the opposite advice when it comes to gallstones might be the misguided 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, would we surgically remove their kidneys?
What do you say?
Have you had gallbladder problems? Have you tested a LCHF diet? What happened?
More
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.
351 comments
Gallbladder ultrasound should be a standard part of health checkups. It's cheap, easy and non-invasive.
It makes perfect sense. But it would mean less income for surgeons and hospitals. So they don't do it.
People need to start asking for it.
Also, another related diet that doesn't get talked about much is Keto Vegan. Considering the terrible decline in quality of various foods Keto Vegan makes more and more sense.
Close to half of us will get cancer or heart disease in our lives. That's a terrible statistic!
Current research shows that most of that risk can be reduced by removing meat and dairy from our diets.
"Oh I could never stop eating meat and cheese and dairy! I don't care how much better it makes me feel or how many more disease-free years I'll live."
Hmm.
Im interested in adding ACV and lemon juice but what is the cocktail recipe?
I have been on the keto eating plan for a month now and have only lost 1 1/2 kilos. It is very dispiriting. I really advocate for the problems associated with metabolic syndrome as I have a couple of those offshoots namely: diabetes type 11, arthritis, hypertension. I am on medication for the last two. I haven't been hungry at all which makes for my 500 calorie days really easy. (twice weekly).I have had my gall bladder removed and just after the Tex Mex meal the other night I had indigestion, thinking there was a lot of fat in that meal. I am female aged 66, and live in Australia. The G.P who put me onto this diet recommended your web site. I always have black coffee with dollop cream (twice a day). I have to have Physillium husks in Greek yogurt for breakfast as I have been constipated all along. I am on Januven (Diabetes medication) as Metformin gives me diarrhea. The G.P who put me on this Keto says if it tastes sweet spit it out. Good one huh! I don't have a sweet tooth at all anyway. I exercise (fast walking) half an hour a day. Or get on my exercise bike. Just don't know what I am doing wrong!! HELP!! I am overweight by 10 kilos. Once I reach that will be in the normal weight category.
Thanking you.
Generally speaking, there are several different types of kidney stones and they have different causes. Keto is moderate protein, not high protein so it generally won't cause problems. Sodas and diet sodas are one of the main causes of the most common kind of kidney stones. If you have specific concerns about the type and cause of your kidney stones, you may want to give your doctor a call.
Please make sure to work with your doctor for the best food options while you still have gallstones.
Most people find that lack of a gallbladder does not hinder keto. Some do find they have trouble with the higher fats at first so you can try gradually raising your fat intake and/or using digestive enzymes.
It could be any number of things, and not necessarily keto related. If the pain persists or gets worse, please see your doctor.
The HIDA Scan is an MRI done of the liver/gallbladder/bile ducts. They inject you with a medication and then trace it through the paces to see how well those organs are working. Maybe that would give you an answer?
Good luck!
I am very interested in your diet plan as have had my gallbladder removed and after 6 weeks on the Keto diet found that my bowel movements became regulated by the high fat content to the point i had to stop.
My back and under rib cage was in pain also which ideally i would like to avoid down the track.
can you please provide me with some details re the ACV and what plan you took for eating ?
any help would be greatly appreciated.
Thanks
Lee
There are NO essential carbs.
You should do some research on plants defence systems. This one is a good start.
https://www.youtube.com/watch?v=fnjX3cZ4q84
Herbivores can run from predators, while plants cannot.
So, pls try to evolve and adapt, as those will survive and not the strongest.
And what is your current diet then?
Cheers,
iLap
I been having gallbladder pain off and on for 9 years now. I had ultrasound 4 years ago and there was no stone but there was sludge. I did go on HCLF vegan diet for 3 years and thought that it cures my gallbladder but I was wrong. Long story short my pain came back and I think I just made it worse.
So about 6 months ago I found Keto. I got on it and never looked back. Of course I do have some pain here and there but I learned that if I take ox bile, betain hydrochloride with bitters and some enzymes along with ACV and lemon juice, I don’t have any pain at all. I haven’t had it for few weeks now using these things. Dr Berg says that we have to slowly dissolve the stones or sludge and eat a healthy Keto with lots of veg. Also I started to take choline, which he said will help to clean it out and get it back to normal. So that’s what I’m doing and when I stick to this advice, it seem to work great for me! Keto is the way to go I believe, like this article mentions.
When I returned home I really started to study inflammatory pathways which led me to low fodmap, Gundrey and Keto. I found that the Keto diet was the ultimate diet and have been on the diet for almost a year. My levels of inflammation have reduced dramatically. Where I was heading for a knee replacement (with appointments and consultation with a specialist) I no longer need surgery. I had the beginnings of osteoporosis in my forearm and now have halted the bone loss. I had declining eyesight and now have reversed it to almost 20/20 vision. All of these problems I thought accompanied old age, as I am 71 years old, but now have a different mindset. I have no pain anywhere in my body, my energy levels have increased and I sleep more soundly, which I firmly believe it’s due to the Keto lifestyle
https://www.thelancet.com/journals/lancet/article/PIIS014067360566373...
I have been having some random nausea after eating and thumping gallbladder pain in the last 18 months but no attacks.
Today I hear from my Dr after an ultrasound that I no longer have any gallstones and everything looks fine and clear.
Yes in 18 months I have passed all the stones.
I believe the following is what did this
God
The fat I eat with Keto
Apple Cider Vinegar
Lemon Water
Also,I would disagree completely that people should only eat Herbivore or only carnivore. Studies of HEALTHY people show the benefit is greatest on the Omnivore diet. The issue of cancers and other diseases lies in the condition of the body prior to starting a strict diet. If you buy a used car, it runs but it’s knocking slightly, does adding a more quality oil fix the already damaged bearings? Or does it just prolong the inevitable? The body needs flushed of toxins, stones of all types, damaged and dead cells, and back to creating healthy cells before it gets back to running optimally.
You may find this PS at the bottom of the article helpful!
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.
The first one is known in the United States as a prescription medication, and it is called ursodiol. In the United States, ursodiol is very expensive. I have heard that a one month supply is upward of $400 per month in the United States. However, you can get the same medication for about 30 to $40 per month from Japan in a product called Liverurso. This medication has 50 mg of ursodiol per tablet, so, you would take six at a time in order to get the full 300 mg dose of the prescription version in the United States.
The next product is called Like Dan Pian. This is a Chinese medicine herbal concoction that is meant to reduce what they call damp heat. It is also very cheap. One bottle usually runs about $6 on eBay. It has a number of different herbal and natural ingredients, such as different flowers and roots.
The third product that you should look into is called chancha
piedra. This word means stone-breaker in Spanish. It is well known to not only reduce pain caused by the gallbladder but also to help dissolve gallstones.
Finally, another product you can use is called Rowachol. This is a German manufactured product that is also intended for gallbladder health and liver function and can help to dissolve gallstones. The price for this is about $45 for a one month supply.
All of these items can be found on eBay. Likewise all of them work by increasing the bile flow, increasing liver health, increasing gallbladder function, and thinning out the bile. In all of these ways the gallstones are encouraged to dissolve naturally
I am a person that has suffered terribly from gallbladder pain and gallstones. I have been to the emergency room more often than I want to admit.I have been told repeatedly to have my gallbladder removed. However, I would not accept that as the gospel truth. So, I decided to go on a quest and discover for myself what was available in the way of natural remedies for alternative 70s. And that is how I came across these four items that I have told you about here.
I do not know if these items have in fact reduced or dissolved my gallstones. I have not been back to the doctor as I do not have any medical insurance, so I don't know for sure. However, I do know that I'm able to eat basically anything I want. I don't take advantage of that fact. I know that I need to eat better regardless of the condition of my gallbladder. but thanks to these supplements I no longer have to live in fear of eating the smallest amount of fat and knowing that it's going to send me to the emergency room later on that night. And one day just to test it I decided to have an extra-long cheese Coney with extra cheese at Sonic. yes I ate every bit, and it did not bother me at all.
Also, the lemon juice in the water and apple cider vinegar does in fact help a lot. I do that as well along with the supplements that I mentioned above.
"Hi Amy. I read through your post and I am wondering if the issue is not gallstones, but a low ejection rate of your gallbladder...HIDA Scan...").
I don't know if you'll check this post but, if you do, I would love to know more. I think maybe I have what you are describing and I was hoping I might be able to dialogue on this. My GP is beginning to think I'm a hypochondriac because I keep returning to her with the very complaint you are describing. And I have gone for a few ultrasounds without any sign of gallstones. Hoping we could sidebar chat: j.fo@me.com.
Thanks kindly! Even if we don't connect, your input here is immensely helpful and appreciated.