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  A Deep Dive into Gallstones!

  Posted by Daniel on August 24, 2023 at 8:43 pm

  Gallstones are common in developed countries. They affect about 10% of adults and 20% of those over the age of 65. Today I will do a deep dive into this topic. Why are gallstones more common in elderly people? Why are females more affected by them? How are cholesterol and gallstones related? And what have red blood cells got to do with gallstones? Today we dive deep into this fascinating topic!

  Important things you will learn:

  • What gallstones are.

  • How they are caused.

  • How to recognize symptoms.

  • The different types of gallstones

  • And of course… what you can do to prevent them from forming.

  What are gallstones and how are they caused?

  Everyone who ever made a vinaigrette knows: fats & water don’t mix. If we want these substances to mix, we need something that will help emulsify these liquids. In the case of a vinaigrette, you could use for example, mustard. The body makes its own mustard to blend fats and water so that digestive enzymes can get everywhere. The substance that is doing this is called bile.

  The liver, depending on which literature you read, produces about 600 to 1000 ml of bile per day. The bile then gets concentrated and stored in the gallbladder. What is bile made from?

  • Water…. lots of water (around 95% according to this article)

  • Bile salts (around 70% of the 5% that is left)

  • Cholesterol (around 10% of the 5% that is left)

  • Phospholipids & Proteins

  • Bilirubin (around 1% of the 5% that is left)

  But wait… isn’t cholesterol a fatty substance? How does that mix with water? This is where the bile salts come in. Bile salts are fatty structures attached to glycine or taurine. Glycine and taurine have more affinity with water. If the fatty ends of these bile salts meet a fatty substance (like cholesterol for example), the fat-loving end of the bile salt will group together with the fats. The water-loving ends of these salts orientate away from the fats and feel attracted to the watery environment. This is how fatty substances mix with water.

  But what happens when there aren’t enough bile salts? Or what happens if there is too much cholesterol? Now the fatty substance can’t mix well in the bile and form crystals.

  These crystals can grow and form gallstones.

  The Different Types of Gallstones

  Since cholesterol is the most abundant substance in bile right after the bile salts, most gallstones are made of cholesterol (around 75%). As I mentioned: not having enough bile salts or elevations in cholesterol can be a cause.

  But besides eating fatty food, not exercising enough, being overweight, smoking and drinking alcohol, what causes cholesterol to elevate? A lot of you are already experts, but here are some reasons:

  • Insulin resistance

  • A slow thyroid

  • Elevations in estrogen (Estrogens appear to influence several key steps in gallstone formation)

  • Oral Contraceptives

  There are other, less common, compositions of gallstones possible.

  Gallstones made of Bilirubin

  Once red blood cells turn 120 days old, they die. The liver breaks down the red blood cells and bilirubin is a waste product of this process. Also, bilirubin can be used to form gallstones. The color of these stones is different from stones made of cholesterol. The cholesterol gallstones have a yellow or green color, while the stones made from bilirubin are brown or black. Stones made from bilirubin are also sometimes called pigmented stones.

  The bilirubin stones usually are bound to calcium and are for that reason seen on X-rays. The cholesterol stones however are often invisible on X-rays.

  When red blood cells are broken down too quickly, the bile will contain more bilirubin and this can then increase the risk of gallstones.

  An autoimmune problem in which the immune system mistakenly sees your own red blood cells as foreign substances and destroys them could for example be a root cause. Two examples of such diseases are sickle cell anemia and thalassemia. These stones are often black in color.

  What causes the brown gallstones?

  Brown stones can be caused by an infection of the gallbladder for example by E. coli, roundworms and a bacteria which is more common in Asian countries called Clonorchis sinensis. This means that gallstones are also more common among Asian people.

  What happens is that the bacteria metabolize the bilirubin in the gallbladder, bind it to calcium and the phospholipids and because of the addition of the phospholipids, the stones turn brown.

  What happens when the gallbladder doesn’t empty fully?

  Have you ever bought organic peanut butter? Often, when you don’t consume peanut butter regularly, you can see the oil floating on top. As a result, you will need to stir and mix the peanuts and the oil again.

  When the gallbladder doesn’t empty enough or when it empties partly, the same happens. The heavier parts will ‘sink’ while the light fluids will start floating. The bile gets ‘sludgy’, which can also increase the risk of forming gallstones.

  Can liver disease increase the risk of gallstones?

  The gallbladder stores bile, but the liver produces it and is responsible for its composition. This is why inflammation in the liver can contribute to the formation of gallstones as well. What can cause inflammation in the liver? Fatty liver disease and Hepatitis for example (Read this article if you like to learn more!)

  An inflamed liver often causes gallstones made of bilirubin.

  A fatty liver is more common in the elderly. This is why people over a certain age are suffering more from gallstones.

  Summary

  To summarize what can cause gallstones:

  • Having a bad lifestyle (smoking, drinking and eating too much fat)

  • Not enough glycine and taurine to form bile salts

  • Insulin resistance

  • Slow thyroid

  • Elevations in estrogen

  • Autoimmune issues that cause rapid breakdown of red blood cells

  • Infections (E. Coli, roundworms, Clonorchis sinensis and Hepatitis)

  • Bile remaining too long in the gallbladder

  • Inflammation in the liver.

  What are the signs & symptoms of gallstones?

  Aren’t you sure if you’re experiencing gallstones? These signs & symptoms are common if you’re having gallstones:

  • A sudden intensifying pain in the right upper part of the abdomen or

  • A sudden intensifying pain near the chest bone

  • Back pain between the shoulder blades.

  • Pain in your right shoulder

  • Nausea and vomiting

  • Itchy skin

  • Jaundice (yellowing of the skin & eyes)

  • tea-colored urine and light-colored stools.

  • With infections, you might experience a high temperature as well

  Gallstone pain may last several minutes to a few hours.

  What can you do when you are experiencing gallstones?

  There are some things you can do when you are experiencing gallstones.

  • D-limonene is a cholesterol solvent, and the vast majority of gallstones are made from cholesterol. You can buy D-limonene as a supplement. Oils of orange, grapefruit and lemon are especially rich in D-limonene.

  • Avoid temporarily foods high in fats, eggs, refined carbohydrates, and sugar.

  • If there is an autoimmune dynamic at play: remove gluten and dairy 100%

  • Drink a lot of water

  • Consume foods (or supplements) rich in glycine and taurine

  • In the case of sludge, some foods will help contract the gallbladder and empty it. Try foods like olive oil, fish (oil), nuts, leafy greens and other fibre-rich foods.

  I hope this deep dive into gallstones gives you some direction on how to treat them.

  Stay Healthy!

  Daniel

  Daniel replied 1 year, 2 months ago 1 Member · 0 Replies
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