1. Blood Sugar Imbalances: When we have poor blood sugar regulation, it causes stress and inflammation in the liver increases the production of cholesterol which concentrates in the bile. This causes a thicker, slower moving bile. Poor blood sugar regulation will lead too higher LDL cholesterol, higher triglyceride levels and lower HDL cholesterol. This triad is not only a risk for heart disease, but also gallstones (6).
2. Estrogen Dominance: When we have an overabundance of natural estrogen production or a buildup of artificial estrogen substances within our body it leads to increases in cholesterol that create thicker, sluggish bile. Women who have used birth control pills, hormone replacement therapy (HRT) or have an IUD are at a higher risk for gallstone formation (8). Several studies have shown that the use of HRT doubles or event triples the risk of developing gallbladder disease (9)
3. Food Allergies and Sensitivities: Food allergies and sensitivities cause a stress response in the body and cause the liver to work harder. Additionally, food sensitivities dehydrate us as our body uses water to deal with increased stress. This hampers proper bile production and leads to the development of a thicker, sluggish bile.
In 1968, Dr J.C. Brenemen published a paper in the Journal Annals of Allergy (10). He was remarkably able to relieve the symptoms associated with gallstones in 100% of the subjects with a one week elimination diet. Once he added the foods back into the diet, the symptoms returned.
The most common foods these individuals were reacting too included eggs (93% of the time), pork (64%) and onion (52%). By removing these foods, people saw relief from their symptoms.
4. Chronic Stress: Chronic stress reduces digestive juice production and dehydrates the body. We also use key electrolytes at a higher rate under stress. This all leads to a thicker, sluggish bile production.
5. Low Fiber Diet: Fiber is critical for the elimination of cholesterol and estrogenic molecules in the body. Additionally, fiber helps to feed good bacteria that enhance the detoxification processes of the body. A low fiber diet has been shown to cause that same thick sluggish bile production.
6. Low Stomach Acid Production: Stomach acid is necessary to sterilize the gut environment, metabolize proteins and stimulating all the digestive juices – including bile production in the liver and its release from the gall bladder.
7. Obesity: Individuals who are overweight or obese produce more cholesterol which thickens the bile and causes sluggish movement through the bile duct. This processes increases the production of gall stones.
8. Rapid Weight Loss: Weight loss in one who is overweight or obese is a great thing, however, if it happens too quickly it can increase the risk of gall stone formation. The most common example of this is a bariatric surgery where the individual’s stomach is shortened.
Additionally, yo-yo dieting increases cholesterol production in the liver creating a super saturated, slow moving bile. Healthy weight loss would be no more than 3 lbs per week over a period of time. Getting the weight off is key, but doing it in a gradual way and keeping it off long-term is important.
9. Low Fat Diets: A low-fat diet for a long-period of time reduces the overall secretions of bile, which can cause the bile to become stagnant. The stagnancy of the bile increases the risk of bile stone production.
10. Cholesterol Lowering Medications: Certain types of cholesterol lowering medications increase the amount of cholesterol being bound into the bile. This will cause more concentrated bile that is sluggish and at greater risk for forming stones (11).
11. Leaky Gut Syndrome: When we have damage to the intestinal lining, it reduces CCK and secretin levels. This inhibits the ability of the gall bladder to contract effectively and can lead to biliary stasis.
It is important to remember that the environment (sluggish bile motility) that creates the production of gall stones has been causing issues with poor digestion and sterilization of the small intestine for many years before a stone would develop. It is important to focus on optimizing bile well in advance of developing gall stone like symptoms.