Keto Weight Loss Without A Gallbladder: Is It Possible?

The keto diet is a low-carb, moderate-protein, high-fat diet that many people follow for weight loss, increased energy, reduced blood sugar, and other health benefits. But what happens if you don't have a gallbladder? Can you still do the keto diet after gallbladder removal?

The answer is yes, but there are some important steps to take to ensure you do it healthily. The gallbladder is a small sac located just beneath the liver, which stores bile, a green fluid that helps with fat digestion. Without a gallbladder, the liver can still produce bile, but it is not stored in the body, and the liver has to work harder to produce more. This means that anyone without a gallbladder relies on their liver to produce more bile every time they consume fats.

Since the keto diet is higher in healthy fats, it is important to pace your high-fat food intake and find your personal sweet spot of how much fat you need to consume to stay in ketosis. It may be easier to eat smaller, frequent meals rather than large meals, and to opt for medium-chain fatty acids over long-chain ones, as these are easier to digest and don't require bile.

It is also recommended to eat soluble fibre along with any fats, as this draws water into the colon and helps you digest more slowly, reducing the workload on the liver. Some good sources of soluble fibre include Brussels sprouts, avocado, broccoli, sunflower seeds, and hazelnuts.

You can also take supplements that help with fat digestion, such as digestive enzymes and bile salts.

The gallbladder's role in digestion

The gallbladder is a small, pear-shaped organ located beneath the liver. It is a bladder or storage organ for bile, a digestive juice produced by the liver. The gallbladder concentrates and stores the bile until it is needed in the digestive process.

The liver produces between 400 and 1,000 ml of bile per day. This bile travels down small canals that lead to the common bile duct and eventually into the gallbladder. When we eat fatty foods, the gallbladder contracts and releases the stored bile through the bile duct and into the small intestine. Here, the bile breaks down the fat into a form that can be digested and used by the body.

Bile is made up of water, bile salts, cholesterol, certain fats (lecithin), and bile pigments. The bile salts break down large fat globules into smaller droplets, which can then be processed by the digestive enzymes from the pancreas. The bile salts also help the cells in the bowel to absorb these fat droplets.

The gallbladder also plays a role in eliminating excess cholesterol, potentially harmful substances, and other heavy particles that cannot be filtered by the kidneys. It protects us from intestinal infections, improves blood sugar control, and delivers hormones and pheromones that contribute to the growth and development of the intestine.

How the body adjusts without a gallbladder

The gallbladder is a small organ located beneath the liver. It stores bile, a substance produced by the liver that helps with digestion, particularly the digestion of fats. When the gallbladder is removed, the bile flows directly from the liver to the small intestine. This means that the liver has to work harder to produce bile, especially when digesting fatty foods.

• The liver produces smaller amounts of bile at a time, releasing it gradually into the small intestine.
• The body may experience digestive issues such as diarrhoea, loose stools, and fatty diarrhoea. These issues are usually temporary and occur due to the more continuous release of bile into the intestines.
• The body can still digest most foods, but large amounts of fatty, greasy, or high-fibre foods may become harder to digest.
• The body may need to adjust to the change in bile levels, and it may take time for the body to adapt to the new digestive process.

Overall, while the body can adjust to life without a gallbladder, it is important to make dietary changes and adjustments to avoid digestive issues and ensure proper nutrient absorption.

Strategies for a keto diet without a gallbladder

The gallbladder is a small sac located just beneath the liver, which stores bile, a green fluid that helps with fat digestion. It is possible to follow a keto diet after gallbladder removal surgery, but there are some important steps to take to ensure it is done healthily. Here are some strategies for a keto diet without a gallbladder:

Take it slow

Immediately after gallbladder removal surgery, it is recommended to eat a low-fat diet with clear liquids and easily digestible foods. After a month, start adding small amounts of healthy fats, such as olive oil or butter, to your meals. It will take your liver time to learn to produce bile on demand, so it is recommended to wait at least four months after surgery before trying a high-fat diet.

Smaller meals, more often

Eat multiple small meals throughout the day. This will prevent you from eating one large meal, which can be difficult for your body to digest without a gallbladder.

Pair fats with soluble fibre

Soluble fibre pulls water into the digestion process, turning it into a gel-like substance that helps your body break down food and fat properly. Pair your meals containing more fat with soluble fibre, which can be found in nuts, seeds, and veggies.

Help your body digest foods properly

In addition to soluble fibre, certain foods can send a signal to your liver to secrete more bile, which will help your body break down your fat intake. These include dandelion root, mint, turmeric, and ginger. You can also take digestive enzymes and ox bile supplements to help trigger your body's own stomach enzymes and bile.

Stay hydrated

Drinking plenty of water supports your digestive system and reduces symptoms of constipation. However, avoid drinking liquids with or around meals, as this can flush out your body's digestive enzymes.

Opt for medium-chain fatty acids

Long-chain fatty acids, found in milk, beef, and egg yolks, are much harder to digest and require more bile to process. Medium-chain fatty acids, found in grass-fed butter and coconut fats, are easier to digest and do not require as much bile.

Supplement with nutritional shakes

Using a supplement powder and blender or shaker bottle to make nutritional shakes can be a good way to get a lot of nutrients without making your body work too hard to break down food.

Test your ketone levels

If you are doing keto without a gallbladder, your goal should be to stay in ketosis with as few fats as possible. To do this, you can test your ketone levels with a blood ketone meter, which is more accurate than urine or breath tests.

Recommended fats and supplements

• Start low and go slow: Begin with a moderate amount of fat and slowly reduce carbs simultaneously. Continue to adjust as tolerated, working your way to ketosis over about a month.
• Stay hydrated but strategize your fluids: Avoid drinking fluids during mealtime and 30 minutes before and after eating, as this may flush out the enzymes responsible for digesting your food.
• Supplement with bile: You can compensate for the lack of concentrated bile by taking an ox bile supplement. You don’t need to take ox bile with every meal, but digesting higher-fat meals will be easier if you supplement with bile salts.
• Choose the right fats: Foods high in long-chain fatty acids need bile to be absorbed. Medium-chain triglycerides (MCTs), however, don’t require bile. Coconut oil, grass-fed butter, and full-fat yoghurt contain MCTs and are excellent choices for keto after gallbladder removal.
• Pair fat with soluble fibre: When you add more fats to your meals and notice your stools becoming greasy or oily, there’s a good chance your body is unable to digest all the fats you’re eating. By pairing your meals containing more fat with some soluble fibre, you may be able to help your body safely transition and stay in ketosis.
• Stay hydrated: Liver function and bile production require good hydration. Drinking plenty of water supports your digestive system and reduces symptoms of constipation.
• Bile-supporting tea: Ginger, dandelion, and lemon tea stimulate your liver to produce bile, naturally supporting digestion and fat absorption. Drinking these teas shortly before or with your meals provides maximum digestive support.
• Digestive enzymes: You can also supplement with digestive enzymes to improve the digestion of fats, protein, and carbs.

Potential issues and how to avoid them

Diarrhea and floating stool

Diarrhea and floating stool are common symptoms of fat malabsorption, indicating that fat is not being digested properly. To ease loose stools, increase your intake of soluble fiber-rich foods.

Deficiencies in fat-soluble vitamins

Deficiencies in fat-soluble vitamins (A, D, K, and E) can lead to depression, vision problems, fertility issues, increased inflammation, osteoporosis, and hair loss. Ensure you are consuming enough of these vitamins through your diet or supplements.

Omega-3 fatty acids deficiency

An omega-3 fatty acids deficiency can lead to skin issues, eczema, and dry eyes. Include foods rich in omega-3 fatty acids, such as fatty fish like salmon, in your diet.

Acid reflux and gastritis

Acid reflux and gastritis are often a result of sluggish fat digestion. Adjust your diet to reduce the consumption of fatty foods that may trigger these symptoms.

Abdominal pain and gas

Abdominal pain and gas indicate that you may be consuming too much fat too soon after gallbladder removal surgery. Reduce your fat intake and slowly reintroduce fatty foods once your body has had time to heal.

High-fat meals

After gallbladder removal, your body may struggle to digest high-fat meals. Take an ox bile supplement to aid in the digestion of fat. Additionally, opt for medium-chain triglyceride (MCT) oils like coconut oil and grass-fed butter, which are easier to digest without a gallbladder.

Lack of bile

Without a gallbladder, bile production continues in the liver, but it can no longer be stored and concentrated. This can lead to fat malabsorption and vitamin deficiencies. Take bile salt supplements to compensate for the lack of concentrated bile.

Long-chain fatty acids

Foods high in long-chain fatty acids require bile for breakdown and absorption. Avoid consuming large amounts of these fats or supplement with digestive enzymes and bile supplements.

Dehydration

Liver function and bile production require proper hydration. Drink plenty of water to support your liver and digestive system and reduce the risk of constipation.

Lack of soluble fiber

Soluble fiber slows down the digestive process, giving your liver more time to produce bile. Include soluble fiber-rich foods, such as vegetables, in your diet to aid in fat digestion and absorption.

Frequently asked questions