Have you had your gallbladder removed and are suffering with metabolic changes? Check out our audio transcription to learn more.
Effects of Gallbladder Removal on Metabolic Health
Dawn (00:00):
Hello and welcome to the Gastric Health Show. My name is Dawn Boxell and this week’s topic is effects of gallbladder removal on metabolic health. So we are going to dive into what happens when you have your gallbladder removed and how that can influence your and just your overall metabolic health. So we’re talking blood, sugar and insulin and all of those things is where we’re going.
Dawn (00:34):
Now, I know that gallbladder removal or what is called cholecystectomy, this surgical procedure is really popular with over 700,000 people in the US that undergo this procedure. So that’s significant and I think it gets pushed off as it’s no big deal. You don’t have to eat any differently. You don’t have to do anything differently without a gallbladder. And I can show you that supporting your gallbladder can help support your overall health and helping you optimize just different areas so that your body functions appropriately.
Gallbladder and its Functions
Dawn (01:25):
So that’s what we’re going to kind of dig into. But cholecystectomy or gallbladder removal is really the most common way to treat gallstones. So if you have sludge or gallstones, your surgeon might be recommending you have it removed. There’s absolutely nothing wrong with having it removed. Sometimes you absolutely have to. So don’t, don’t mistake my conversation that I’m against gallbladder removal because I am not. I’ve actually had my gallbladder removed.
Dawn (02:00):
So it’s not something that you should shy away from. And if it’s recommended, have that conversation and understand how you can maybe support it and help support the sludge, help improve what the gallbladder is doing. So again, make sure that if you’re in that position, like, Hey, I might need to have my gallbladder removed, that you have those conversations with the doctor on are there alternatives and what could I do until I’m ready to have my gallbladder removed?
Dawn (02:38):
Or if it’s time and you have no option, have your gallbladder removed and work with somebody like myself who can help you optimize your digestion after so that you can live a happy long life without consequences. So if you have a gallstone sludge, a cholecystectomy might be necessary. And it’s also something that is removed when there’s gallbladder cancer and maybe other conditions that your doctor has deemed necessary so it can alleviate the symptoms and improve your quality of life.
Understand the risks that are involved and the connection with your metabolic health
Dawn (03:20):
You do have to understand the risks that are involved and the connection with your metabolic health. And in more recent years, there have been more research showing that there is a really, a fascinating link between gallbladder removal and your metabolic health and gallbladder removal can trigger metabolic changes that could lead to metabolic dysfunction. So first, let’s talk about your gallbladder and its functions. Gallbladders are small pear shaped organs that are located underneath your liver and your liver produces the bile, which is then stored in and concentrated in your gallbladder.
Dawn (04:05):
And fat containing foods trigger the release of bile from the gallbladder and it will do like a little squirt squirt. When your body recognizes there is fat on the way and it squirts it, then the, it’s connected to your small intestines. So it’s not going into your stomach, it’s going into your small intestines. And this is where your body can help break down all the fat molecules and then further break it down into smaller particles so that it can be absorbed and utilized more easily in your body.
Dawn (04:46):
So it’s, it’s a necessary function and when you haven’t removed, it’s now just coming from your liver. So it’s no longer getting concentrated in your gallbladder and it’s, it’s no longer squirting it’s dumping. That’s why, and I’ve had posts on acid malabsorption and how some people get bio acid diarrhea and that can be a side effect of having your gallbladder removed because of that.
Metabolic Changes Associated with Gallbladder Removal
Dawn (05:18):
But let’s kind of dig into the metabolic changes associated with your gallbladder removal. So there’s several studies that have linked your gallbladder removal with metabolic dysfunction, and number one is increased blood sugar and insulin. So several studies have shown that gallbladder removal can increase your blood sugar and insulin levels and potentially resulting in insulin resistance, the opposite of what you want that does not. When you have insulin resistance, it makes it super hard to lose weight, makes you super weight loss resistant.
Dawn (05:57):
And this is because the gallbladder helps regulate fat absorption from the intestines. So that bile sink of it is dish soap. And if you had a dish sink full of dirty dishes and you just used water, you would have a hard time getting clean dishes. Well, you can kind of think of bile as your dish soap where it kind of breaks up all of those grease fat particles and allows your body to utilize those fat molecules for your fuel and for your body processes because that’s what our body runs off of is proteins, carbohydrates, and fat.
Dawn (06:44):
And then vitamins, minerals, micronutrients, phytonutrients, and your, you got to fuel your gut microbiome. So again, having this one piece altered or removed impacts the metabolism of bile and how it actually works. Now, what is the link between gallbladder removal and insulin resistance? A change in bile acid metabolism can contribute to increased blood sugar and insulin levels after gallbladder removal because the gallbladder concentrates and stores the bile acids necessary for the digestion absorption of fats as a result of the gallbladder removal.
1. Increased Blood Sugar and Insulin Levels:
Dawn (07:27):
Bile acids cannot be stored or released normally causing changes in your inner hepatic circulation and metabolism. And these changes can affect glucose metabolism and insulin sensitivity. Additionally, changes in your gut microbiome. Cons, composition and function following gallbladder removal can also increase blood sugar and insulin levels. Gut microbes are crucial in bile acid metabolism, glucose metabolism and insulin sensitivity. And the gut microbiome may be disrupted once your gallbladder is removed because of that bio one not being concentrated the same and it maybe you getting excess and causing a different digestion of the bio.
Dawn (08:22):
And this kind of results in glucose regulation and imbalances. Now there are studies investigating diabetes risk and a cholecystectomy. So studies have shown that alterations in bile acid signaling and metabolism impact various aspects of glucose regulation. And researchers have found that bile acids interact with glucose and lipid metabolism receptors such as the farcinoid X receptor or the FXR and TETA G protein coupled receptor or the five receptor five TG R five.
Dawn (09:01):
The gallbladder removal can disrupt bile acid signaling and pairing glucose homeostasis and insulin sensitivity. And the research based on clinical studies, animal models and in vitro experiments supports the association between gallbladder removal and higher blood sugar in insulin levels. And the studies have revealed that gallbladder function, bio acid metabolism, gut microbiome and glucose regulation are intricately intertwined. So they all are connected and you disrupt that pathway and now you are messing with balance.
2. Elevated lipids and dyslipidemia
Dawn (09:39):
So again, that doesn’t mean you don’t get your gallbladder removed, it just means you might have to do some things to support the bile a little bit better so that, so that your body can function appropriately. Now, number two, elevated lipids and dyslipidemia. So the first one was the increase in blood sugar and insulin. So we covered all of those connections with insulin resistance and diabetes risk. And now we’re talking about elevated lipids and dyslipidemia.
Dawn (10:12):
Your gall bladder removal has been linked to think of dyslipidemia as your lipid panel is altered. So when your doctor does your annual labs and they’re looking at cly, cholesterol and triglycerides and your hdl, your ldl, all of those, those are this, those are disrupted. And with the gallbladder removal, it does lead to an increase in your cholesterol and triglycerides, which can increase your risk for heart disease and stroke.
The link between Gallbladder Removal and Increased lipids
Dawn (10:47):
So studies have examined how gallbladder removal impacts your cardiovascular health by demonstrating their the association between adverse lipid profiles and gallbladder removal. And they are showing that surgically removing the gallbladder disrupts the normal bile flow and the liver circulation of bile acids, which are really crucial for digestion and fat absorption. And it can result in changes in the metabolism of lipids, which can lead to an increase in cholesterol and triglycerides. So one mechanism contributing to an elevated lipid levels is the impaired absorption of fats.
Dawn (11:32):
So any of the fats that are in your diet, they are now not being broken down. The same when you don’t have a gallbladder. When bile acids are released from the gallbladder during meals, those fats are emulsified and absorbed and in the absence of your gallbladder. So now you’ve had your gallbladder removed, the release and delivery of the bile acids in the intestines to the intestines are altered, which can hinder your fat absorption, and this can lead to an accumulation of cholesterol triglycerides in the bloodstream.
Additionally, it can affect the composition and secretion of biolipids
Dawn (12:09):
Additionally, it can affect the composition and secretion of biolipids, which further contribute to dyslipidemia and bile acids and cholesterol ratios in the bile can change affecting cholesterol, solubility and transport really just leading to an increase in blood cholesterol levels. And your gallbladder removal alters the bile acid pool in the liver, which then kind of affects the synthesis and metabolism of lipids in the liver. Clinical studies have been used to investigate the correlation between gallbladder removal and your lipids.
Dawn (12:49):
And according to these studies, the gallbladder removal is associated with adverse lipid profiles emphasizing the importance of postoperative monitoring and managing your lip lipid levels. So if you’ve had your gallbladder removed and now all of a sudden your cholesterol and triglycerides are rising, you might want to work with a practitioner like myself, a registered dietician or somebody local, a registered dietician in your area that you can work with on improving this because this, there are several ways to approach it.
Dawn (13:28):
There’s no one way that everyone has to do, and I think it is really kind of different for each person on what’s going to work, but I think it can truly help support your cholesterol and triglyceride levels and improving those as well. When you support that bile flow and metabolism, that’s when you can see improvements in those. And then the third one is fatty liver development.
3. Fatty Liver Development
Dawn (13:54):
So gallbladder removal evidence does show that you have an increased risk for fatty liver, or it’s also known as a non-alcoholic fatty liver disease or N A F L D, and the liver builds up fat. Think of it as it’s more the visceral fat, it’s attaching to the organs. So you’re getting fatty deposits on the organ is really what we’re saying. And approximately 30% of American adults suffer from this. And it is more common in people who have had their gallbladder removed.
Dawn (14:35):
So that doesn’t mean you can’t have fatty liver with still having your gallbladder because you can get fatty liver from other ways. But let’s say you didn’t have a fatty liver, you got your gallbladder removed and now you’re showing signs of a fatty liver. That could be a red flag that we really need to support your liver better and we need to support that bio flow in metabolism. The disruption of the Biola metabolism has been proposed as one mechanism leaking gallbladder removal to fatty liver development.
The link between Gallbladder Removal and Fatty Liver Development
Dawn (15:14):
And in the absence of your gallbladder, the delivery and regulation of bile acids to the intestines are altered potentially leading to bile acid imbalances. And these imbalances can contribute to impaired fat digestion, increased fat accumulation in the liver, and in addition, your gallbladder remover may alter your gut microbiome because it’s your bile is now changed and you and your colon can conjugate excess bile.
Dawn (15:44):
So say your liver dumps a bunch of mild because it senses a lot of fat was coming and there maybe really wasn’t that much or it just didn’t get reabsorbed in your intestines, so now it’s in your colon and it is creating digestive havoc. So that’s where having your gallbladder removed can create those digestive problems down the road. Some people get ’em right away and have ’em, and it just never really changes until someone works with them. And then other people, they don’t even notice any changes with their digestion or any type of fat absorption issues or anything like that.
DAwn (16:32):
So again, I think working with someone if you’re having issues with fatty liver or you’re having issues with fat mal absorption, I mean these are important things to consider. Some experimental models and clinical studies support the association between gallbladder removal and fatty fatty liver development, and they have been able to demonstrate the prevalence of fatty liver increases in individuals who undergo gallbladder removal.
4. Energy and Calories Regulation:
Dawn (16:59):
So again, it’s something that you have to work with someone on and make sure that they’re dressing that piece. So you may say, oh my gosh, I had my gallbladder removed 10 years ago, but I didn’t have any issues with my cholesterol triglycerides until 10 years later. Is that a problem? Yeah, it still could be a problem. Number four, energy and calorie regulation. So gallbladder removal can impact energy and calorie regulation, potentially leading to weight challenges. So there are studies that show that people do experience issues with weight loss or weight gain, I should say. They start experiencing weight gain after they’ve had their gallbladder.
Dawn (17:52):
The digestion absorption of the dietary fats is affect by your gallbladder removal and changes in this bile acid metabolism and signaling can affect your energy regulation after your gallbladder removal. And a disruption in vial acid signaling may affect metabolic pathways kind of related to its storage and utilization and energy balances. So it’s important to know that there is a connection. We do know it exists. Studies have kind of shown that it changes your resting metabolic rate and your energy expenditure and then also your fat utilization, which we already know
5. Gut Microbiome Influence on Bile Acids:
Dawn (18:44):
But I want you to realize that there is a connection with weight gain issues and gallbladder removal. Number five, your gut microbiomes influence on bile acids. Now your gut microbiome is just kind of a bunch of microorganisms that live in your digestive tract and there’s multiple of these microbiomes throughout your body. Bile acids interact with the gut microbiome through several mechanisms.
Dawn (19:16):
The first certain bacteria in the gut can modify the bile acids through enzyme reactions. And this microbial metabolism can produce secondary bile acids, which I was discussing, which have a distinct biological activity compare to the primary bile acids that are synthesize in the liver. The gut microbiome and the gut regulates bile acid reabsorption in the intestines, maintaining their balance and composition. And during digestion, bile acids are release into the small intestine which can reabsorb into the bloodstream or metabolize by gut bacteria.
The link between Gallbladder Removal and Gut Microbiome Influence
Dawn (19:57):
And the gut microbiome influences the recycling process known as the inter hepatic circulation of bile acids. And so this is the circulation of the bile acids from your gut to your liver. It’s believe that the gallbladder removal and subsequent changes to the gut microbiome is what influences that lipid changes, so causing dyslipidemia or lipid panel problems on your annual labs, and then also insulin resistance and fatty liver disease.
Dawn (20:39):
So we know that the gut microbiome is connected to this and is contributing to this occurring. So what are the risk factors for metabolic problems after gallbladder surgery? And there’s several, but having one or more of these puts you at a higher risk that you are going to have metabolism problems after your gallbladder removal. So number one is age metabolic problems after gallbladder removal are more common in older people and then your gender. So metabolic problems are more likely to develop in women after gallbladder removal than in men.
Risk Factors for Metabolic Problems After Gallbladder Removal
Dawn (21:26):
And then your weight, overweight and obese people are more likely to develop metabolic problems after gallbladder removal. Next is family history. If your family has a history of metabolic problems, when you have gallbladder removal, it increases the risk of metabolic issues for people with the family history of them. So if your family already has metabolic issues and then you have gallbladder your gallbladder removal, then it’s more likely that you will or you’re at a higher risk to have metabolic problems now compare to not having your gallbladder remove.
DAwn (22:14):
And then the last one is preexisting medical conditions. People with preexisting medical conditions like hypertension and diabetes are more likely to develop metabolic problems after having their gallbladder remove or more intense metabolic problems after. So they might struggle more with their diabetes or hypertension after they get their gallbladder remove. How can you naturally support bile flow without a gallbladder? So first and foremost, I want you to know that you should really work with a skilled practitioner who can really take your health history
DAwn (22:53):
and your symptoms into account before really choosing the right protocol because there’s not, again, like I’d said earlier, there’s there’s more than one way to approach this and just picking one and taking a supplement or taking certain food groups, focusing on certain food groups are not going to work equally for each person. So that’s why it’s important to work with someone like myself who can help guide you through that process and know that we can work through the body systems and focus on the different areas that are influencing how you’re digesting fats and how we can support that flow without a gallbladder.
How to naturally support bile flow without a gallbladder
Dawn (23:45):
So the first one is rule out low stomach acid. So first off, determine if your stomach acid production is adequate. For some, this really may be the only reason why bile flow is inadequate. So if you’ve had your gallbladder removed and you started having some digestive issues, work with a practitioner like myself who can help you rule out low stomach acid to determine if, hey, maybe we just need to do that so that the signaling occurs.
Dawn (24:22):
Because when you have adequate stomach acid, when you eat and you chew your food, it’s triggering these mechanisms to occur and signaling these other organs. So one thing signals to another or multiple organs that, Hey, we have food coming. We need digestive enzymes, we need ox bile, we need acid, we need pepin, we need all of these properties to break all this down that they’re consuming. The next one is ox bile or bile salts.
Utilize ox bile in our gastric health digestive enzyme
Dawn (24:56):
Supporting digestion of fats at meals can be done with bile. So this is just really what it sounds like. This is you’re utilizing the bile from OX so that you can add to that bio pool so that you were add in as a supplement form. Now biosalts are more of a prescription and those are things that you can get from your provider that sometimes after your gallbladder removal, the surgeon will prescribe these For people who are experiencing diarrhea, you can find oxy in certain digestive enzymes,
Dawn (25:47):
but it’s not in all of them, and that’s where working with someone to help you pick the right one. I know I do utilize oxy in our gastric health digestive enzyme, and that’s because I do find that a lot of bariatric patients do have their gallbladder removed and this can help support it. And if you still have your gallbladder, it can help you keep it.
Milk thistle can support your liver and bile production
Dawn (26:18):
It can help you maintain that gallbladder. The next one is milk thistle and taking adequate doses, OFM milk thistle can support your liver and bile production. So it’s kind of twofold because milk thistle has evidence supporting its ability in liver health and really just the mechanisms that your liver is doing for you, and it also then helps with the bioproduction. So it’s kind of twofold in helping you maintain a healthy liver and improve your bioproduction. The next is phospho tial choline, and this increases liver lipid secretion and flow.
Dawn (27:11):
So this again can truly help just that whole mechanism. The phospho tial choline is a great option for certain scenarios, but not every scenario. And the next one is lipase containing enzymes. Lipase is a digestive enzyme that kind of helps break down fats, and that’s one of the enzymes that your pancreas will release. You can find lipase containing enzymes in many of the digestive enzymes.
Our gastric health digestive enzyme formula does contain lipase
Dawn (27:43):
Our gastric health digestive enzyme formula does contain lipase, so it does help it with that whole bile and breaking down the fats. Touring is another. Consuming foods high in toine can help support, liver, can help support bile flow. These are foods such as scallops, muscles clans, dairy products, dark meat, poultry and sea vegetables. All of those do can contain high amounts of toine and can really help improve your bio flow. Vitamin C stimulates the metabolism of cholesterol into bile acids by influencing an enzyme known as seven alpha HLAs.
Dawn (28:30):
So again, another way work with the practitioner, so appropriate dosing and the appropriate forms so that you optimize your bio flow from the vitamin C. Next is bitter foods. So bitter foods increase the production of saliva, bile, stomach acid, and pancreatic enzymes. And incorporating foods like arugula, dandelion like the dandelion greens, citrus, and coffee are a few ways to increase that, that bile production.
Dawn (29:12):
Beets and beet root extract. So think of beets and beet greens contain bean, which pro promote the regeneration of your liver cells and the flow of bile. You’ll find that in many of the bile supplements as well as some of the digestive enzymes. So it’ll utilize the beet root extract because it can’t support your liver and bile flow. And the last one is leton, and this is a precursor to choline and their third constituent of what makes bile. So there are three things that bile is from cholesterol, bile acids, and choline. So again, lesser than is the precursor to choline.
Address the specific metabolic concerns and optimize your long-term health
Dawn (30:03):
And this can help your body naturally just have adequate choline levels and support that whole bile acid production. So let’s wrap this up. Gallbladder removal can impact your metabolic health, including weight management, lipid metabolism, glucose regulation, and your gut microbiome. However, each person’s metabolic response to gallbladder removal may be different and receiving individualized care and follow up from professionals like myself is crucial to help you address the specific metabolic concerns and optimize your long-term health.
Dawn (30:47):
So again, I think if you already have had your gallbladder removed, you’ve experienced digestive issues for years, but you also have metabolic health problems, you might have insulin resistance, diabetes, you might have high blood pressure, weight issues, all of these things can be a result of having that gallbladder removed. So work with someone, use the right tools so that you can have better fat absorption so that you can have better metabolic health so that everything works efficiently. It won’t be perfectly because your anatomy is different. You don’t have an organ, but that doesn’t mean you can’t function more optimal than utilizing nothing.
Conclusion
Dawn (30:47):
So again, I think if you already have had your gallbladder removed, you’ve experienced digestive issues for years, but you also have metabolic health problems, you might have insulin resistance, diabetes, you might have high blood pressure, weight issues, all of these things can be a result of having that gallbladder removed. So work with someone, use the right tools so that you can have better fat absorption so that you can have better metabolic health so that everything works efficiently. It won’t be perfectly because your anatomy is different. You don’t have an organ, but that doesn’t mean you can’t function more optimal than utilizing nothing.
Dawn (31:46):
So again, I would encourage you to work with someone so that you can get better results. I’d also like to encourage you to check out our gastric health membership because it is a great way to get this type of guidance. So this is where I would work with you on what supplement or what food or what should you do to help support better flow, better bioproduction, bio metabolism, all of that. We can also work on your cholesterol and triglycerides if those are elevate. Again, those are the things that you would have ad the advantage of working with myself on this one-on-one. And it’s personalize to you. We’re dealing
Dawn (32:39):
Whatever your past health history is and we are zoning in on the areas that we need to. So I hope this information has been helpful for you. And I really hope that you can think through maybe if you’ve had your gallbladder removal and you are experiencing digestive problems, reach out. I’d love to work with you and help you overcome those symptoms. So you guys have a great week and we’ll see you next time. Bye-bye.
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References & Links:
- Park, S., Zhang, T., Yue, Y., & Wu, X. (2022). Effects of bile acid modulation by dietary fat, cholecystectomy, and bile acid sequestrant on energy, glucose, and lipid metabolism and gut microbiota in mice. International Journal of Molecular Sciences, 23(11), 5935.
- Chen, Y., Wu, S., & Tian, Y. (2018). Cholecystectomy as a risk factor of metabolic syndrome: from epidemiologic clues to biochemical mechanisms. Laboratory Investigation, 98(1), 7-14.
- Park, S., Zhang, T., Yue, Y., & Wu, X. (2022). Effects of bile acid modulation by dietary fat, cholecystectomy, and bile acid sequestrant on energy, glucose, and lipid metabolism and gut microbiota in mice. International Journal of Molecular Sciences, 23(11), 5935.
- Xie, C., Huang, W., Young, R. L., Jones, K. L., Horowitz, M., Rayner, C. K., & Wu, T. (2021). Role of bile acids in the regulation of food intake, and their dysregulation in metabolic disease. Nutrients, 13(4), 1104.
- Garruti, G., Wang, D. Q., Di Ciaula, A., & Portincasa, P. (2018). Cholecystectomy: a way forward and back to metabolic syndrome?. Laboratory investigation, 98(1), 4-6.
- Yoon, W. J., Kim, H. N., Park, E., Ryu, S., Chang, Y., Shin, H., … & Yi, S. Y. (2019). The impact of cholecystectomy on the gut microbiota: a case-control study. Journal of Clinical Medicine, 8(1), 79.
- Zhang, B., Kuipers, F., de Boer, J. F., & Kuivenhoven, J. A. (2022). Modulation of bile acid metabolism to improve plasma lipid and lipoprotein profiles. Journal of clinical medicine, 11(1), 4.
- Cortés, V. A., Barrera, F., & Nervi, F. (2020). Pathophysiological connections between gallstone disease, insulin resistance, and obesity. Obesity Reviews, 21(4), e12983.
- Hawthorne, G. C., Ashworth, L., & Alberti, K. G. G. M. (1994). The effect of laparoscopic cholecystectomy on insulin sensitivity. Hormone and metabolic research, 26(10), 474-477.
- 10.https://blogs.cuit.columbia.edu/postdocsociety/2021/10/29/why-the-gallbladder-matters/
- Molinaro, A., Wahlström, A., & Marschall, H. U. (2018). Role of bile acids in metabolic control. Trends in Endocrinology & Metabolism, 29(1), 31-41.
- 12.Li, R., Andreu-Sánchez, S., Kuipers, F., & Fu, J. (2021). Gut microbiome and bile acids in obesity-related diseases. Best Practice & Research Clinical Endocrinology & Metabolism, 35(3), 101493.
- Vítek, L. (2018). Bile acids in the treatment of cardiometabolic diseases. Annals of hepatology, 16(1), 43-52.
- https://www.sciencedirect.com/science/article/pii/S0022227520319477#:~:text=Several%20in%20vitro%20studies%20showed,in%20cholesterol%20homeostasis%20(22).
- https://pubmed.ncbi.nlm.nih.gov/9748591/
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