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 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?


Other health problems

LCHF for beginners


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.

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  1. mezzo
    I think that if anyone who has been on a low-fat diet for a long time and has already experienced gall problems needs to step up the fat intake gradually and not go from high-carb-low-fat to high-fat-low-carb overnight. Because if you do it may provoke a colic and that is enough to put anyone off LCHF.
  2. Gary Green
    Great information. I'll share this far and wide. Thank you.
  3. Marie
    I have gallstones but since I started eating HFLC I rarely have any attacks ( I used to get them most days prior to this) the only times I have since had any attacks is when I've eaten lots of sugar, wheat and fat in one day. As long as I eat natural fats away from any sugar and wheat, I have absolutely no problems at all which is brilliant and I get to eat lots of things that I was told to avoid like the butter, olive oil, crackling, chicken skin, cream, cheese etc.
  4. Nadine
    When I signed up for a low fat weight loss programme six years ago I had to sign a risk thing and one of the risks was gallstones. Sure enough I lost 25kg and gained gallstones! Over the next couple of years I got attacks on and off, then it disappeared. Anyway, LCHF didn't cause any attacks at all.
  5. Laura
    I must comment on this as i am a gall bladder amputee!! My gall bladder was choc-a-block with stones (both my parents had gall stones too and had undergone surgery) I am a geneticist and i know there is at least a 5% genetic component to this. The Western world statistics I was given are that 1 in 3 women in have gall stones in contrast to one in 6 men. So there are also gender factors probably related to the effects of oestrogen on lipid mnetabolism. However from a paleo perspective we know that gall stones disease is very rare if unreported in hunter gatherer societies.
    I was always chubby (until I went paleo/lchf) and ate a low fat high carb diet. And i got gall stones and gall bladder inflammation by the age 35 a whole 6-8 years before my mother and >10 years before my father. Interestingly my parents had very diferent gall stone composition. My father's stones were like river pebbles white and mostly made of cholesterol. My mother's stones were black pointed like garbanzo beans and mostly made of crystallised bilirubin pigment (a pigment naturally present in the bile). I did not get to see mine even though I requested them after the op!
    Finally I must add that after a week or so of adjustment to a high fat diet (i suffered a bit of dumping syndrome where fatty food came out very quickly at the other end) I am now completely adjusted but occasionally I take digestive enzyme supplements...all this would not have been a problem on an acrestral diet of UNcooked meat because a lot of our foods would have contained already many of the enzyme we needed to digest once mastication disrupted the tissues we were consuming...alas cooking destryoies these but there are other advantages to cooking in terms of parasitic load etc...sorry I digress...
    By the way for the ex vegan/vegetarian like me...the presence of such a strong gall bladder in man is a strong indicator of our ancient meat./fat consuming habit. In herbivore like cows/sheep etc the gall bladder is an insignificant tiny atrophic appendage. In carnivores like tigers and wolves etc is a strong organ. We are in between but more on the carnivore side in terms of gall bladder size and function during a meal. Dunno much although I will find out about the gall bladders of Chimps and more interestingly gorillas our giant plant eating cousins!
    Very interesting topic. Ciao for now
  6. Matt
    Hi diet doctor.
    My partner started lchf two months ago, he has lost about 1 kg a week, started at 115 kg, and it has been going well.

    For a few days he has suffered a dull pain in he's abdomen, lots of burping, general ache and bloating. Has this got anything to do with the diet change, what are your thoughts about this?

    Could it have anything to do with gall stones etc?

    Sincerely /worried girlfriend

  7. Justin B
    I have a friend who had to have her gall bladder removed after years of low fat dieting. My wife's mom nearly had to have hers taken out as well. Her doctor told her that its been very common ever since the low fat diet craze started. The amount of gall bladder surgeries over the last century should definitely be charted. I feel like it would give a very clear answer.
    Reply: #59
  8. I lost 50 pounds doing Weight Watchers, got gall stones and had to have my gall bladder removed. That's all the evidence I need that HCLF sucks. Just sayin'.
  9. ThatWriterChick
    Brandon, the EXACT same thing happened to me. 50 pounds on WW, eating 3 fat servings per day (1 fat serving=1 tsp. oil).
  10. I'm fascinated by this stuff - thanks for the post. Shared!
    (tip: advice is the noun, advise is the verb)
  11. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Thanks for the tip, hopefully that mistake is fixed now.
  12. Alexandra M
    It's too bad the first link is just to the abstract where it says nothing about the composition of the diet. Same problem with the second, and it looks like all they showed was that taking ursodeoxycholic acid prevents gall stones while dieting - which the low fat folks will construe to mean, "You don't have to risk a heart attack from fatty foods to avoid gallstones while dieting when you can just take ursodeoxycholic acid."

    Third one - pay dirt!

    The journal paywalls are the most annoying thing about trying to become knowledgeable!

  13. Lester
    I've come to expect better than supporting your case by invoking studies with tiny numbers of participants, or mentioning surveys that you readily concede be taken with "a huge pinch of salt" yet proceed to cite anyway. Hmmmmm.
  14. eddie watts
    is it better to cites small studies with the caveat that it is a small study, versus, citing no studies to back up your claims, versus citing studies with no caveat at all?
  15. My housemate had to have his gall bladder removed due to extreme pain--it was so packed with stones that the surgeon had severe trouble getting it out.

    What does my housemate predominately eat? Carbs. He's a soda addict. He complains bitterly when I cook a lot of fatty food, which I do more and more now that I've gone LCHF.

    Poor guy. I try encouraging him to switch, but he's one of those guys who do NOT respond well to nagging.

  16. JAUS
    #15 Don't nag on him, give him some low carb books to read so he can come to the conclusion himself. Forcing you belief on him is not the way to go, he has to realize it by himself. If he refuse to even read them then it's his own choice and there's nothing you can do. Some people are just close minded.

    People have to change themselves.

  17. ShannonCC
    We discovered my diabetic husband had heart problems so we immediately put him on a low fat, almost vegetarian, very high carb (lots and lots of healthy whole grains!) diet. He had never had gallbladder problems before but ten months after starting that diet he had a gallbladder infection and had to have it removed.

    It wasn't until a few months later that I found the low carb, high fat world. His blood sugar is worlds better, his last nuclear stress test was good and he lost a bit of weight eating this way. If I had figured this stuff out earlier he might still have a gallbladder I guess. Damn.

  18. Mike
    High fat = Clean,free flowing pipes
    Low fat = Clogged,backed up pipes

    I've been telling people this for years.It's just common sense.

  19. Tom
    The cartoons in the header aren't right for the site.
  20. Laura, Very interesting comment. Thank you for sharing.
  21. In the book "The Art and Science of Low Carbohydrate Living" by Volek and Phinney, which I highly recommend to anyone considering low-carb way of life, I found the information that during any major weight loss there is transient rise in LDL cholesterol that had accumulated in excess body fat. This cholesterol is taken up by the liver, then secreted into bile, which is in the gallbladder, and then it is dumped via gastrointestinal tract. The extra cholesterol transiting the gallbladder is not a issue if the gallbladder gets regular signal to contract and the contractions happen in response to dietary fat.

    If, during a rapid weight loss, dietary fat intake is low (below 30 grams a day), then the gallbladder doesn't get a signal to empty itself and the cholesterol can build up and increase the risk of new gallstone formation. So, dietary fat intake (above 30 grams a day) protects us from gallstone formation during our weight loss.

  22. Laura
    Hi Violeta
    Thanks! Ehi I have jsut ordered that book (great minds I say!)...I am awaiting delviery! Look forward to reading it

    Yes I am sure that my high carb vegan diet since 1995 (and actually I was indeed a rather greedy child for anything sweet and carby) must have contributd enormously to my gall stones. And the gastroenterologist who operated on me also told me that they are now seeing young children even under the age of 10 coming in with gall stones!!!

    I hope/think that as the problems of high carb consumption become more and more obvious in children and young people this might save us from a life long trail of chronic disease and dependency on medication, because it may motivate us to understand the strong link between diet and disease and reassess what we really need to be and stay healthy. Otherwise from a genetic point view the fact that the bad effects of carbs (and I should add plant oils because msot of them are indeed bad for us) only manifest in middle-late life might always convince someone that they are part and parcel of growing old.

    The high carb diet has indeed been good for civilisation...we have built metropoles on wheat but is has wrecked the back to looking after you with HFLC!!!
    I am doing my bit spreading the word with every friend/colleague/acquantance who cares to listen and using the amazinf physical change that this diet has brought on me to show them!
    Incredibly even with the evidence right in front of them (especially from people who knew from before) people are still sceptical and are waiting to see me die of heart attack any minute now!!
    bye for now!
    PS I hope my post also helps other gall-bladder-less people to adopt HFLC...expect adjustments for a few days but in the end you will be fine! Isn't the body a marvellous thing! it can heal even after years of battering!

  23. Megan
    I am also a gall bladder amputee. I had mine out when I was just 29 after ten years of eating low fat. I had just lost around 20 pounds when I had my first attack. At the time (due to my lack of knowledge) I assumed my awful high fat and high sugar diet was to blame. I never in a million years thought that eating fat would have prevented my gall stones.

    I do have a little concern about the advice to eat more fat if you already have gall stones. I was under the impression that the stone could be flushed out of the gall bladder during a high fat eating episode and cause problems with the pancreas or in the tubes on the way there. I might be wrong. But eating smaller amounts of fat more often might be better.

    But whatever happens, don't go on a low fat diet!!

  24. Mike C
    I recently lost about 60 pounds. At first I started with the traditional calorie counting and removing sugar and white bread/pasta, than I began doing research and trying out a variety of other diets because I knew I couldn't calorie count for the rest of my life. I eventually settled on a HFLC/Paleo style diet and have been following it for about 4 months with great success. Back in January I started feeling bloated all the time and began having severe gallbladder attacks, some lasting as long as 30 hours. After suffering from a major attack 3 weeks ago, and developing a case of jaundice, I went to the doctor to get checked out. After blood work and a sonogram, I'd been told my gallbladder was constantly contracted from having so many stones and one of them had been passed into my liver, hence the jaundice. Since this can cause permanent damage to my liver I will be having my gallbladder removed, as well as any other stones that may still be in my liver, this upcoming Monday, the 23rd. In my experience, the attacks came after eating fatty meals, eggs in particular. I've recently cut out the eggs and stuck to lean cuts of meat and haven't had an attack since. I still feel the air in my stomach constantly moving around, grumbling, which is very annoying but not painful. I still eat a decent amount of fat in addition to lean meats, from nuts, olive oil, small amounts of dairy, and butter.

    The reason I was overweight in the first place was from eating the standard american diet: lots of sugary drinks, junk food, vegetable oils, grains, ect. I'm assuming this diet is what caused the gallstones to form in the first place and my new LCHF/Paleo diet was causing the attacks. The attacks had become too frequent (about 5 since January) and painful for me to wait it out in hope of them stopping.

    I'm concerned that after the surgery I won't be able to go back to eating fatty foods. I've been reading up on recovery times and post-surgery diets and it seems a good amount of people are not able to digest fats properly, months after the procedure. It looks like it all depends on how the person reacts to the removal of the gallbladder, no one person reacts the same. I hope I am one of the lucky ones who is able to go back to my high fat diet.

    The one positive to come out of all of this is to see results from my HFLC diet. From all the testing being done, the doctors have told me I am incredibly healthy; great cholesterol profile, triglycerides, blood pressure, EKG results, ect. I told them I did it through diet and they were quite surprised. Even more surprised when I told them what the diet consisted of.

  25. Laura
    Dear Mike
    Read our posts above (moi and Megan jsut above here) reassure you you will be able to gorge on pork belly after the op but expect some adjustment. Remeber also that your bile withough a storage sack (the gall bladder) will be constantly trickling into your small intestine. I find it difficult to fast for longer thatn 15 hours...then I get post cholecistecmy sindrome (a painful diahorrea attack consisteing of yellow watery stuff...not nice....) but you will get to know your new self in a few weeks. It is your earlier diet that caused the stones but now the paelo/low carb is getting the gbladder to do extra work but the stones are in the way. Alas tehre is no other solution but amputation however the body will adjsut and you can go back to full fat...enojoy and GOOD luck with the op!!!!
  26. Zepp
    One trick is to shift to more coconut oil, it not need bile to be digested and to be taken up by your guts!

    "MCTs passively diffuse from the GI tract to the portal system (longer fatty acids are absorbed into the lymphatic system) without requirement for modification like long-chain fatty acids or very-long-chain fatty acids. In addition, MCTs do not require bile salts for digestion."

  27. Laura
    Hi Zepp
    I started to use coconat fat a lot it is my only other cooking fat apart from lard which I render myself (home made cracklings every couple of months or so is my well deserved reward!!) The only other oil I use is olive but this I use raw on salads or add after these are my added fats. I LOVE coconut fat I eat it by the teaspoonful if I feel peckish.
    Let's hope Mike is convalescing happilyby now after a few days of discomfort you are as good as new!
    SPeak later....I am recoverring from a stomach bug I am sure I got from eating out yesterday...groan
  28. Mike C
    The surgery went really well. Luckily the gallbladder small enough to be taken out laparoscopically. I had one of the top surgeons in my area and the chief of anesthetics in the hospital helping. I'm actually not in too much pain. I can walk up and down stairs, I've been eating whole foods already. I've got oxycodone for when the pain gets worse. I've been eating Greek yogurt, fruit, veggies, and some tuna. I'm going to try and add a little fat over the next couple of days, maybe add some almonds to the Greek yogurt. I'm hopeful I can go back to my fatty diet in 3-4 weeks.
  29. emma george
    hi all im 27 just had a baby(5 weeks ago) and iv just been diagnosed with gallstones. FINALLY after many a&e visits and being sent on my way with trapped wind. My attacks were so severe i was rolling around the floor crying begging for pain relief. The doctors told me to stay away from fat and dairy.I'm so afraid to eat iv been living on a brown bread ham sandwich a day(no butter).i have no energy and feel dizzy and sick. im so confused what to eat everyone says different. please help x
  30. Alexandra M
    emma - Read the blog post and the comments. There's a lot of helpful information in them.
  31. Vicki
    Has anyone here tried doing a gallbladder flush? This is where you drink some epsom salts to open the bile ducts and soften the gallstones, then drink a concoction of lemon juice and olive oil which causes the gall bladder to push out the stones.

    I've read that the gallbladder flush is just a hoax and that all you're really passing are stones formed by the olive oil and lemon juice you just drank. I was a vegan/vegetarian when I started getting pain in my liver area. Then found out my fasting blood glucose was in the diabetic range. Over a few months, I switched to a LCHF diet, but still have pain in the liver area with pain also being referred to my right shoulder. I've done a few of these liver/gallbladder flushes and have actually gotten relief from them. But after a few weeks or months, the discomfort comes back.

    I'm just wondering if anyone more scientifically oriented and knowledgeable than myself has an opinion on these flushes. thanks.

    Reply: #47
  32. Zepp
    Gallbladder flush is a hoax, and those lumps that should be gallstones is realy soap stones, that do came from oil thats react with gastric juices and epsom salt!

    Pain in shoulders could be Frozen shoulder, an symptom of diferent causes, but one of this is hyperinsulinemia.

    If you have pain in liver area then you should get it examinated, it could be gallstones.

    In any case you have only one liver.. take care of that!!

    Long time gallstone problem can do harm the liver by inflamation, and in the long run other internal organs, get away to have it investigated!!

  33. Kirk

    I was the guy on last week's low carb cruise who asked you for some advice regarding eating LCHF when one has had their gall bladder removed and can't tolerate many foods. Thanks so much for taking time to talk with me.

    As a follow-up, I am very interested in hearing how to deal with the concern about eating LCHF when the liver is unhealthy. Specifically, my sister has primary billitary cirrhosis (early stage) and her doc tells her to eat low fat, low protein so she doesn't stress her liver. How, then, does she lose the weight he wants her to lose?

    Do you have advice for anyone with autoimmune hepatitus, fatty liver, or other liver diseases? Is fat and protein stressful for the liver?

    Many thanks

    Reply: #200
  34. I'm adding to Kirk's question - What about Primary Sclerosing Cholangitis? A friend's doctor said that eating animal (i.e. saturated) fat would cause his bile to get thicker. Never heard that ... Bile is mostly water with some salts so how can that be affected by eating saturated fat?
  35. Zepp
    Bile is 85% water and the gallblader is a store thats concentrate the bile.. if one eats little fats!

    If one do eat a lot of fats.. its never gonna be stored and not so concentrated eighter.

    PSC is of atoimune causes of unknown reasons.

  36. Exactly, Zepp! PSC probably has nothing to do with the gall blather etc.
    But why would the doctor think that eating saturated fat can make the bile itself thicker? As far as I understand, bile is produced in the liver cells. How can the food influence that?
  37. Kirk
    When I boil my question down, I am really asking what does it mean when someone says "don't eat protein or fat because it is hard on your liver?"

    I don't know what this means and why one has to limit fats and protein if they are having trouble with their liver. Is there any validity in this guidance?

  38. Zepp
    Its means they do know nothing at all, about human metabolism and biochemical!

    There is probably some persons that have diseases that should awoid eighter fats and/or meat.. but as a diet advice to a whole population its rediculus.

    There are probably better science to say that many should lower there carb intake!

    "Non-alcoholic fatty liver disease (NAFLD) is one cause of a fatty liver, occurring when fat is deposited (steatosis) in the liver not due to excessive alcohol use. It is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states (e.g. diabetes mellitus type 2) such as weight loss, metformin and thiazolidinediones.[1] Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD this being regarded as a major cause of cirrhosis of the liver of unknown cause."

  39. I love this article. My experience of the past 3-4 months eating LCHF has been very positive, and is in line with the Swedish study mentioned. I was in the ER in early March with another gall bladder attack. My surgeons advice was to avoid fat and red sauces and to have the gall bladder removed. Instead, in the following weeks I went on a 30 day detox, which included olive oil, wheatgrass, kale, and avocados. Following this I added meat and have been LCHF ever since. I've been eating high amounts of fat and protein and feel much better than ever. My direct experience is that carbs are giving me problems, not fat or protein. I have not had good diet advice from anyone at the hospital. A nurse recently saw me purchasing almonds and told me I needed to be careful of them. I think she is nuts (pun intended).
  40. I had pain that I think was from the gall bladder the first few weeks eating iaw LCHF. I massaged where it hurt for 20 min, pushing downwards to dislodge any stones. The next day I was a bit sore, but the other pain was gone and has not returned. I agree with the thought that it's good to use the body and its organs for what they are "designed", and will therefor exercise my gallbladder with fat as well as drinking water to maintain my kidneys.
    The increase in stomach- and intestine-cancer in dogs is probably due to the fact that commercial dog food is mainly based on grains, something not found in the dog's natural food.You can easily tell by the way the digestive system is formed in different species which food is suitable, so why go against it? I used to believe humans were omnivores so we could live on meat when nuts and grains wasn't available, but that would be a bad design as that happens every winter! Now I realize that it's the other way around - we can survive on growing stuff when we sometimes miss catching pray(which is around all year).
  41. I went into the hospital for my very first anxiety attack a few months ago (working way too many hours) and they decided to do an ultrasound on my liver/gallbladder and found stones. I had lost 80+ pounds in my 20s on a very low fat diet. Until lately, I've also eaten a high sugar junk food diet. I've never had a gallbladder attack but it bothered me intensely that I had stones. It's on my mind a I did some research. I read that virgin coconut oil and chanca piedra, an Amazonian herb, both assist in DISSOLVING STONES!

    I take chanca piedra and coconut oil regularly now and hope to dissolve and then prevent stones indefinitely, especially in wanting to lose around 150 pounds in the next several months. Luckily, now I know about a high fat low carb diet and will do it the right way.

    If you have stones, check out virgin coconut oil (read Coconut Cures by Bruce Fife or Google it) and chanca piedra. I like Swanson vitamin brand for the chanca and Nutiva from amazon for the coconut oil and I've tried other brands.

    Someday I'd like to go back and have another ultrasound to see if my stones are gone after a year or so on this routine.

    By the way, when I found out about the gallstones, the nurse brought in tons of material for me to read and I found out that a huge percentage of people have gallstones and may never know, may never have's more common than you think so there's no stigma or guilt to be attached. I know that made me feel better about it.

    Good luck!

  42. hi my name is laura im 24 nd in the last week to two weeks ive being havin a cramp like pain in my right side beside my ribs i thought it was a pulled muscle nd went to doctor but he said were the pain is its probably gall stones am i not to young to b gettin these im really scared im not gettin attacks or anything just dis comfort
  43. Anna
    I guess it more depends on how susceptible you are to gall stones, and how much low fat food you've been eating the last few years. If the bladder hasn't been "exercised" by working on fatty foods one might end up in discomfort, as you have, when increasing the fat content in the diet. If you continue to eat fat, you might be able to flush it out, although it might be uncomfortable. If you stop eating fat the pain may go away, still, you may create even more stones, which might lead to an attack when they are just too many and too big for the body to deal with. This is a decision you will have to make for yourself. I opted to continue with eating fat, giving my stomach a daily massages for a few days, and haven't had a problem since.
    There's also a very graphic video on Youtube on how to flush out your stones.(In German with English subtitles) Again, it's up to you if you do it or not! I'm just amazed of how someone came up with the idea! Don't think I could go through with it........

    I am not a doctor, so please only take my suggestions for what they are; a layman's ideas.
    All the best!

  44. I began my Paleo lifestyle about 3 months ago. Pretty much overnight I went from a HCLF diet to a HFLC diet.

    Last week at work I suffered my first gallbladder attack. It was absolute agony. Without knowing what it was, I ended up in ambulance and sped off to hospital.

    I've been doing a lot of research about it since then and have been able to determine that my sudden increase of fat into my diet had triggered a reaction in my gallbladder. I've been debating whether I should cease my Paleo lifestyle which, up until this point, has been so good for me.

    This is a great article. I can identify with so many of the points. So I've decided Instead of returning to a "safe" HCLF diet (which really, won't do me any good) I will instead cut back on the fat intake and increase gradually.

    Because really, my gallbladder performs an important function in my body. If I can avoid removing it, then I will!

  45. Julie
    Thank you for the great article. The comments have been really helpful, too. I had my gallbladder removed when I was 14, after a summer full of many, many agonizing gallbladder attacks. No one explained to me what was happening or why, or what I could do to help the situation. They just cut me open and took one of my organs.

    I would actually consider myself very well adjusted. I've been trying out a LCHF diet for a few weeks now, and so far I've had no ill effects, and actually haven't really suffered too much because of my lack of gallbladder. I guess 14 years is enough time for my body to relearn how to break down fat. I have always wondered though if not having it would affect my health down the road or even cut my life short (you never know). But it seems like the body is an amazing creation that can learn to adapt to most anything.

  46. Betsy
    I was diagnosed with gallstones a little over a year ago, sent to a surgeon who said it needed to come out, but I opted to try to handle it naturally, so I went to a holistic doctor. That doctor suggested I eat basically primal and also do a program of certain supplements that would thin the bile, help dissolve the stones, etc. I found that my pain lessened as time went on doing this, so I can safely say that eating LCHF definitely helps, and whenever I eat sugar, wheat or other starchy foods, the pain comes back worse. I have never had an "attack" just dull pain in the right side. I'm also right now taking Chanca Piedra, which is a rainforest herb that is used to break up stones in the gallbladder and also in the kidneys! Chanca Piedra actually translates to "stone breaker" and apparently it's been used by the natives for that purpose for a long time. Anyway, so far, so good, and I thank the Diet Doctor for this article, as it makes me even more determined to stick with this approach.

    By the way, eating fat does not cause pain in the gallbladder for me. It's quite the contrary!

  47. nostents4me!
    I have never had pains in my liver or had gallstones. My belief is that we need to increase fat intake considerably to increase bile flow as it is through the bile that the liver itself is getting rid of the toxins it continually extracts from the blood and food. The is going out in the small intestine to dissolve new fat, but brings with it also these toxins that are meant to bind to other often indigestible things in our food that we eat together with the fat... An ingeniuous system, that hence easily can collapse with consumption of highly refined food that we obviously were never designed to eat! By adding lots of vegetables and sallads to a typical LCHF meal I believe most of the problems are however solved. If this is not added I am afraid that some dissolved toxins in the bile can recirculate into the liver eventually causing some kind of liver disease.
    To increase DAILY CLEAN OUT of the liver, increase the fat with for instance (magic) bullet coffee ( Mix coffee, coconut oil, pure butter with a strong immersion blender), once or twice a day. The blender is really needed to make the mixture smooth and nice to drink. Can be made on tea or cocoa as well!
    Since starting my low carb and higher fat diet my skin has improved - looking less gray, maybe even younger, and the so called "liver spots" that before increased in numbers and got darker are actually now getting paler and paler! So there may be something in the old name despite modern medicine's insistence that they are totally unrelated to the liver!
  48. Help! After being overweight for most of my life, last year I decided on a sensible eating plan with exercise. low fat high carb. I lost weight but developed excruciating pain sometimes which I self diagnosed as a gall bladder attack. I went back to eating atrociously and the weight piled back on but no pain! I want to know how I can switch to a low carb high fat diet as someone who doesnt eat meat only fish. Getting enough protein and not filling up on carbs instead is always a problem.
    Reply: #49
  49. nostents4me!
    Hi, See earlier post!
    Else start by adding lots of green salad and dressing with AN EXTRA spoon of good olive oil to meals, twice or even three times a day. Bile flow is triggered only by the fat in the food coming from the stomach into the small intestine, what I know.
    But more fat in the diet means more bile flow , and if stones are present they can get caught and block passages which cause pain if the flow/pressure is too high.
    But if you get pain reduce above salad/olive oil portions until they are tolerated and then increase gradually at a comfortable pain or no pain. This way bile flow is allowed to gradually increase allowing stones to be gradually dissolved by daily FRESH bile. The bigger the problem the slower the fix as of course then lower flow is required to keep pain away.
    After all the stones are just caused by crystallization of stagnated bile and a gentle regular flow of bile will dissolve them after a few weeks in most cases.
    Then try again the LCHF food, but increase it gradually of course! Years of low fat diet can have produced many stones that would be stirred up with too fast bile flow!

    If you have any age spots, take a couple of pictures before and compare after 6/12 months!
    Please post your results!

  50. Ruth
    Hi, I'm amazed at what I've read here. I'm 50 and have had gallbladder attacks several times over that last 5 years, the last one was over 2 years ago, and I had a scan then that showed I had lots of little gallstones or one large one. But I haven't had another one since, so the Dr didn't push having an operation. Now, my attacks came after starting a HFLC diet, and especially after eating dairy, so I presumed that was the cause. I never considered that the years of LFHC dieting, (or a sugar addiction) before that could have been the cause. When the attacks happened, I would usually vomit wiithin an hour and this ended the episode, I don't know if it was because the violent spasms dislodged the stone or that there was nothing left in my stomach to digest. But anyway, this post has given me so much to think about and research. Thanks for all the advice and experiences too.
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