Beneath the Surface: Exploring 5 Common Gallbladder Issues

Gallbladder issues are way more common than you may think. Many are dealing with gallbladder related issues whether they know it or not. This is often missed until it is unfortunately too late, even in the functional medicine world. As with all things health-related it is important to understand the physiology at play before we dive into what may or may not be an appropriate treatment.

The gallbladder is a small pouch attached to your liver. It’s function is for the storage and secretion of bile into the small intestine. Bile serves two purposes: emulsification of fats for digestion and removal of certain toxins from the body. Bile is made up of three components: cholesterol, lecithin, and bile salts. Lecithin contains choline and phosphorus; and lecithin with bile salts thin the bile. Whereas cholesterol thickens. 

Most issues lie with the bile being too thick which can be problematic because cholesterol gets blame once again when other mechanisms are at play. It is still important to evaluate it, but when it comes to a need, often times it is we lack the ability to thin the bile. Either way it is very important to maintain a healthy lifestyle so our gallbladder can function optimally. 

There are many symptoms associated with gallbladder issues. It may be that you are slightly constipated. It could be that you have light colored or clay colored stools or even floating stools. Bouts of nausea are common. The most common complaints associated are gas, belching, and bloating soon after eating. These issues can get worse to the point of severe pain in the upper right abdomen or shoulder. These issues can become emergent too. And even when it is emergent and things are bleak, hope is not lost. Your gallbladder can still recover without the need for surgery. I am going to talk about 5 common issues that cause gallbladder issues.

Blood Sugar

High blood insulin and blood sugar dysregulation causes a tremendous amount of issues throughout the body and the gallbladder is no exception. This is one of the most common issues I see with gallbladder problems. Like many of the issues I will discuss, blood sugar issues cause the gallbladder to become sluggish and not empty properly. This can lead to gallstone formation and all the other associated symptoms I described above. 

But what do you do about blood sugar issues?

This can be fairly straight forward but not always. A lot of times a specific nutrient may be lacking keeping you from regulating your blood sugar correctly. Chromium is a fairly common one. You may notice it listed in certain blood sugar supplements. One the easiest and best things you can do not just for gallbladder health but overall health is to stop eating junk food and eat whole foods. The next will be to increase protein. It is a common thing I suggest on my podcast and tell my patients. Most people are drastically undereating protein. Protein is very satiating which help you get the nutrients you need while not overeating. Aim at first for between 75 to 100 grams of protein per day. (100 grams roughly equals 1 lb of meat) As this becomes easier shoot for equally the grams of protein to your ideal weight. For example, if your ideal weight is 150 lbs aim for 150 grams of protein per day. Last thing, decrease the carb intake, getting it below 100 grams per day will be helpful in stabilizing the blood sugar.

Ammonia and Aldehyde Toxicity

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Many of you may be wondering what this even means! Ammonia typically comes from protein breakdown. It is then removed via the urea cycle, think urine. However, other things can create ammonia such as bacteria and fungal infections. Aldehydes are chemical compounds associated with smells. The specific one I am talking about is acetaldehyde which is created from the breakdown of alcohol which I will get to later.  There is also something else that creates this commonly, fungal infections. When we have bacterial and fungal infections it can lead to a build up of these toxins leading to gallbladder issues. They will likely also be other symptoms not directly associated too such as brain fog and fatigue.

When I notice a patient has one of these toxicities I immediately wonder, “where is the infection?” Often times there is an infection in the gut. I then look for the appropriate herb to help with it. Common ones include Golden Thread, Melia, and Morinda. All are great herbs and can really help with these issues. They are not a one-size fit all though. I don’t ever see a common protocol that I can recommend, it is usually individualized. 

But what about the toxins?

These still need to be dealt with. Ammonia has several detox pathways including uric acid, creatine, and urea. Each require specific vitamins or minerals to help the pathway move along. It is important to find which pathway needs extra support and what nutrient is needed to support it. It could be B6 or Magnesium or it might be something else. Everyone is different here. Though with acetaldehyde the most common is molybdenum, a trace mineral. Another interesting thing with aldehydes, many with this toxicity cannot handle strong smells like perfumes. So take note, if you get headaches or feel sick in the perfume aisle you may have an aldehyde issue!


Estrogen dominance is all too common these days. For women, it is often noticeable because periods are often painful, longer, and heavier. Weight issues are common too. Men are not left out of this either. Weight gain is also common and the all dreaded gynecomastia. Estrogen issues often arise from the amount of exogenous estrogens in our diet and environment. Sometimes it is because the body is producing too much as well. Either way the liver often gets overwhelmed with the amount it needs to remove and much of the estrogen is removed via the bile. You can see where this is headed. As the liver becomes sluggish so does the gallbladder. 

Removing estrogen requires a little understanding of where the hold up is and what is causing the increase in estrogen. I always recommend eating organic whole foods and avoiding soy and sugar. I typically recommend a paleo diet of some sort too and drinking clean water. This will greatly minimize exogenous estrogens. As for detoxing estrogen one of the most common is a specific pathway called glucuronidation which occurs in phase 2 of liver detox, the most common supplement here is AMG Artichoke. Artichoke helps move this pathway along and gets the bile flowing. Another issue may be with methylation, several nutrients help with this pathway but B9 and B12 are common (the active, methyl versions). It can definitely get a little complicated, but once the right course of action is found, typically you will see resolution of symptoms and you start feeling a lot better.

Bad Fats

Another common one these days! It is very hard to avoid. Going out to eat almost always includes bad fats especially when it includes fried foods. What are the bad fats? Any oil that comes from seed oils such as canola, soy, corn, peanut, sunflower, and safflower. There are others, but these are the most common I see. These are prone to oxidation making them go rancid quickly, further they require a ridiculous amount of processing. Canola even more so because it is not edible until after all the processing. 

These bad fats make the gallbladder work overtime. They also cause general inflammation leading to cardiovascular issues and many other things. Immediate removal is always recommended. Try choosing restaurants that offer higher quality food or avoid until your symptoms resolve and then only moderation. 

What fats to eat instead?

Extra virgin olive oil is great for low heat or salads. Avocado oil can tolerate moderate heat, but you need to be picky about the brand, Chosen Foods offers a good one. Animal fats are my favorite such as pasture-raised/grass-fed lard, tallow, and butter. Among these, my all-time favorite is grass-fed butter, so long as you are not dairy sensitive. Eating fish or consuming high quality fish oil is also helpful. Now you may need to ease into this until your issue resolves. Some things other things that can help in addition to balancing with good fats are specific fish oils like EPA and balancing blood sugar. These will promote alternative, anti-inflammatory pathways.


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The one everyone wants to ignore. We all know alcohol is a toxin. It affects many things in the body including the brain and pancreas. The gallbladder is no exception either. Consuming alcohol is hard on the liver and therefore hard on the gallbladder. We already talked about aldehyde issues earlier. Alcohol is detoxed in a specific pathway. As it is detoxed it is turned into acetaldehyde. Accumulation of these toxins can lead to a sluggish gallbladder.

This is fairly straight forward. Removal of alcohol from the diet and supporting the detox pathway is a must. Like I said before, molybdenum is the most common, but it could also be B3 that is needed. Eating a whole food diet will also help. 


That is it! These are 5 of the most common issues I see with gallbladder. Determining what is causing your gallbladder issue is the first step and it is important. There is no blanket cookie cutter approach. Once you are able to determine what is causing the issue, then you can take the necessary steps to resolving it. Each of these issues are different though they may overlap some with each other as well as other health issues you are facing. I hope this brings some clarity and relief to your situation. If you need any help, please don’t hesitate to reach out. It can be complicated. It can be headache to do it on your own. No matter what, you are not alone!

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