Intermittent Fasting and Gallbladder Health: What You Need to Know

This article explores the gallbladder’s function from both modern medicine and Chinese medicine perspectives, identifies those at risk for gallstones when practicing intermittent fasting, and provides guidance on maintaining gallbladder health.

• Modern Medicine View: In modern medicine, the gallbladder is a small organ located located below the liver. Its primary function is to store and concentrate bile produced by the liver. Bile helps break down and absorb dietary fats. When we eat fatty foods, the hormone cholecystokinin stimulates the gallbladder to release bile into the small intestine, aiding digestion.
• Chinese Medicine View: Chinese medicine attributes a broader role to the gallbladder, extending beyond digestion to influence energy levels, mental health, and psychology. For example, people with good gallbladder are brave and decisive; and people with weak gallbladder (poor gallbladder energy) tend to be timid, hesitant, and prone to vivid dreams and insomnia at night.

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Intermittent Fasting and the Risk of Gallstones

Bile needs to be concentrated by the gallbladder to aid in digestion. Extended periods without eating can lead to prolonged bile retention in the gallbladder, causing it to become overly concentrated. Too much concentration combined with excess cholesterol in the bile, may result in gallstone formation.

One study found that participants on a very low-calorie diet (500 kcal per day) were three times more likely to develop symptomatic gallstones requiring hospitalization or surgical removal compared to those on a moderate low-calorie diet (1,200 to 1,500 kcal per day).

Case Study: Anna’s Experience

Anna, who had been practicing intermittent fasting for several months to lose weight, developed severe pain in her upper right abdomen, accompanied by nausea and post-meal discomfort. Her doctor found that she had mild gallstones.

From the point of view of modern medicine, Anna’s extended fasting periods led to irregular gallbladder emptying and bile concentration, promoting gallstone formation. Chinese medicine would also consider Anna’s mood swings and sleep disturbances during fasting as contributing factors to her gallbladder issues. Therefore, not all intermittent fasters will experience such symptoms.

How to Protect Gallbladder Function

To protect the health of your gallbladder, you need to focus on the following five areas:

1. Adequate water intake

Getting enough water as part of your daily routine can help prevent over-concentration of bile and reduce the risk of gallstones.

2. Healthy fats

Consuming healthy fats (e.g., olive oil, nuts, avocado) promotes regular gallbladder emptying, preventing prolonged bile retention. Studies have found that a healthy diet rich in vegetables, fruits, fish, and nuts is associated with a lower risk of gallstones.

3. High-fiber foods

Eating more fiber-rich foods is good for gallbladder health. Fiber helps with the normal metabolism of cholesterol, reducing the amount of cholesterol in the bile and preventing gallstones. Research has shown that a higher intake of fiber significantly lowers gallstone risk.

4. Mood and sleep regulation

Chinese medicine practitioners believe that emotions have a major impact on the gallbladder. Maintaining a balanced mood, managing stress and anxiety, and going to bed before 11:00 p.m. and ensure a good night’s sleep are very important for gallbladder health.

Modern medicine has also discovered that cholecystokinin, which has receptors in the brain, has a regulatory effect on the gastrointestinal tract and the nervous system. The hormone can affect the mind and sleep.  Studies have shown that receptors for cholecystokinin regulate a variety of physiological functions, including digestion, satiety, pain, mood regulation, and memory processes.

5. Regular checkups

Schedule routine physical exams and seek prompt medical attention for any upper right abdominal discomfort or pain.

High-Risk Groups for Gallstones

The following groups should be particularly cautious when practicing intermittent fasting due to increased gallstone susceptibility:

1. People with a family history of gallstones.
2. Overweight individuals, especially those pursuing rapid weight loss.
3. Diabetic patients because diabetes itself affects the function of the liver and gallbladder, making it easy to develop gallstones. A 2021 meta-analysis found that obesity and Type 2 diabetes have an independent causal relationship with increased risk of gallstones.
4. People with high cholesterol.

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Views on Gallbladder Removal

Mark was overweight and tried to lose weight quickly. As a result, he developed serious gallstones and had his gallbladder surgically removed. According to Western medicine, removing the gallbladder does not seem to have much effect on the body’s functioning. However, from the point of view of Chinese medicine, removing the gallbladder may cause, not only digestive problems, but also headaches, tinnitus, visual issues, rib pain, sciatica, and other troubles.