Gallbladder Removal: What You Weren’t Told
WHY I’M MAD, AND WHAT YOU DESERVE TO KNOW
Three women in their 70s. Three surgeries. No gallbladders—and not one of them was given a real explanation. Not about why they developed gallstones in the first place. Not about what their bodies would need to function without this important organ. And certainly not about the deeper consequences of removing a gallbladder without addressing the root cause.
I’m frustrated. Because this is not just about gallstones—it’s about long-term health, nutrient absorption, digestion, and the way we care for women as they age.
Let’s talk about it.
YOUR GALLBLADDER IS LIKE A CEMENT MIXING TRUCK
Here’s the analogy I use with patients:
Your gallbladder is like a cement mixing truck. Its job is to take bile—made by your liver—and swirl it around until the mixture is just right.
Bile is made up of:
Water
Cholesterol
Bile salts
Other compounds that help break down fat
When this mix is well-balanced, bile acts like Dawn dish soap—cutting through fat and emulsifying it into tiny globules so your enzymes and gut microbes can do their job.
But if the mix is off?
Too much water = weak bile that doesn’t break down fat well.
Too little water (or too much cholesterol) = sludge or stones.
And that sludge doesn’t just disappear—it sits, thickens, and forms gallstones.
WHY GALLSTONES FORM IN THE FIRST PLACE
Here’s what throws off the cement truck:
High refined carb diets – Too much sugar increases cholesterol in bile. (Yup, sugar makes cholesterol, not fat.)
Low stomach acid – Without strong stomach acid, the signal to release bile weakens.
Not eating enough fat or protein – Which means your gallbladder rarely gets “called to action,” and bile stagnates (leading to stones).
Hormonal changes – Estrogen dominance (like during perimenopause, pregnancy, or HRT) can thicken bile and slow gallbladder emptying. After menopause, declining hormones + aging liver function can also reduce bile quality and flow.
Dehydration – Bile thickens when water is scarce.
Low-fat diets – Ironically, they can make things worse by keeping the gallbladder dormant.
So yes, you may have needed your gallbladder removed. But the real question is—what caused the stones? And more importantly, what now?
WHAT HAPPENS WHEN YOU REMOVE THE GALLBLADDER
Your liver still makes bile.
But now, there’s no “cement truck” to mix and store it.
Instead of waiting for the right moment (like when you eat a fatty meal), bile just drips continuously into your digestive tract—like leaving dish soap out on the counter all day. It gets diluted, it’s not well-timed, and it doesn’t work as effectively.
This can lead to:
Trouble digesting fats
Floating or pale stools
Constipation or loose stools
Bloating, especially after meals
Poor absorption of fat-soluble nutrients (more on that below)
THE HIDDEN COST: FAT-SOLUBLE VITAMIN DEFICIENCY
If you’ve had your gallbladder removed—or even if your bile’s been sluggish for years—you might not be absorbing fat-soluble vitamins properly.
These include:
Vitamin A – Supports immune health, vision, and skin.
Vitamin D – Crucial for mood, sleep, immunity, and bone strength.
Vitamin E – Protects mitochondria, supports antioxidant systems, and may help ease hot flashes.
Vitamin K – Essential for clotting and for working with vitamin D to maintain bone density.
Vitamin D helps your body absorb calcium, but vitamin K is what tells that calcium where to go—into your bones and teeth, not your arteries or joints. Think of K as D’s traffic director. Without enough K, all that extra calcium can actually do more harm than good.
Here’s the kicker:
No one’s telling women that these vitamins—not just calcium—are critical for preventing osteoporosis. And they’re not absorbed well without bile salts.
We blame declining estrogen for everything after menopause. But what if poor fat absorption—and subtle malnutrition—are also playing a role?
Also: stomach acid naturally declines with age. If protein feels heavy or unappealing, it might not be the food—it might be your digestion. Low stomach acid means reduced B12, iron, and zinc absorption. It also means weaker signals for the liver to release bile.
Instead of popping an antacid, try digestive enzymes, zinc, or bitters to support your natural digestive fire. And don’t forget hydration: our thirst signals weaken with age, so even if you don’t feel thirsty, aim for half your body weight in ounces of water daily to keep bile flowing smoothly.
HOW TO KEEP THE LIVER HAPPY (SO IT MAKES BETTER BILE)
Whether you have your gallbladder or not, supporting the liver is key to producing high-quality bile. Because it’s the liver that makes your bile.
Here’s how:
Nutrition First:
Eat whole foods, not processed junk.
Avoid trans fats and minimize refined sugar.
Eat leafy greens and fiber (bitters and helps bind excess cholesterol).
Stay hydrated (yep—still important!).
Include Enough Protein & Healthy Fat:
These signal your body to produce and release bile.
Meals without protein or fat = no bile signal.
Aim for at least 1.0–1.2 grams of protein per kilogram of body weight daily—more if you’re active, healing, or postmenopausal. Protein-rich meals signal your digestive system to release stomach acid and bile, helping you absorb nutrients and feel satisfied after eating.
Liver-Supportive Nutrients & Herbs:
Milk thistle (silymarin extract) – 150–300 mg, 1–2x/day. Promotes liver repair and detox.
NAC (N-acetyl cysteine) – 600–900 mg, 1–2x/day. Precursor to glutathione, supports bile flow.
Vitamin B6 (preferably as P5P) – 25–50 mg/day. Needed for detox pathways and hormone metabolism.
Beets, dandelion, artichoke – Often in tea, tincture, or capsule form. Follow product instructions. Promote bile production and flow.
Bonus: bitters (5–10 drops or 1–2 droppers in a little water) before meals can help “wake up” digestion.
LIVING WITHOUT A GALLBLADDER: WHAT YOUR BODY NEEDS NOW
If your gallbladder is gone, you’re not doomed—but you do need extra support. Think of it like getting a dishwasher installed but skipping the detergent and hot water.
Here’s what helps:
Ox bile salts – 125–500 mg with meals containing fat. Not just “more bile,” but concentrated bile salts—the active components that emulsify fats and help replace the gallbladder’s function during meals.
Digestive enzymes – Look for blends with lipase (2,000–6,000 FIP units), protease, and amylase. Take with meals to support breakdown of fats and proteins.
Taurine – 500–1,000 mg 1–2x/day. Helps the liver make better bile salts.
Phosphatidylcholine – 420–1,200 mg/day. Supports bile composition and liver cell membranes.
Bitters or bile salts – Use pre-meal to stimulate or mimic gallbladder function.
Zinc carnosine – 15–30 mg elemental zinc/day (supplements may read at 75-150mg of zinc carnosine). Supports gut lining integrity, stomach acid production, and even your sense of taste—which naturally declines with age. Zinc is also a cofactor in hundreds of enzyme reactions, including those involved in protein building and gut repair.
Some people benefit from supplementing vitamins A, D, E, and K in emulsified or micellized forms to improve absorption.
For high-quality practitioner-grade supplements, you can visit my Fullscript dispensary for personalized access to trusted products.
If you're curious to learn more about how the liver and gallbladder work together to keep digestion running smoothly, you can check out my earlier post: Liver + Gallbladder: The Detox Duo.
FINAL THOUGHTS
Gallbladder removal may have been necessary. But it wasn’t the solution. It was a response to a deeper imbalance—and that imbalance is still there unless we address it.
We need to start talking more openly about:
What causes gallstones.
How gallbladder removal affects digestion long-term.
What support the body needs afterward—especially as we age.
Let’s stop treating these surgeries like footnotes.
Let’s start educating, supporting, and nourishing our bodies—with or without the gallbladder.
