Transcript #414 The Gallbladder Explained – How to Care for the Liver Without a Gallbladder with Michael McEvoy
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- Find out what’s in store on this Myers Detox Podcast with Michael Mcevoy, who joins the show to talk about how the gallbladder works, and how to support your liver and digestive functions without a gallbladder. Michael also discusses his top health protocols for people without a gallbladder, and how to help your body’s ability to detox.
- Find out exactly what the gallbladder is and the main functions it facilitates in your body.
- Find out Michael’s top recommendations for supplements to take if you do not have a gallbladder.
- Learn about some of the ways that you can help facilitate your bodies ability to detox when it does not have adequate bile due to a removed gallbladder.
- Find out Michael’s top protocols to care for your body if you have a missing gallbladder.
- Learn more about how coffee enemas and liver flushes can benefit those who do not have a gallbladder.
- Find out why Michael strongly suggests working to avoid having your gallbladder removed, and some ways to prevent having gallbladder complications.
Wendy Myers: Hello everyone, I’m Wendy Myers of myersdetox.com. Today we have Michael McEvoy talking with us about how to care for your liver without a gallbladder. We have lots of great information about your gallbladder and its function, as well, so Michael, thanks for coming on.
Michael McEvoy: Thanks for having me Wendy.
Wendy Myers: So Michael, tell us what your website is and your background.
Michael McEvoy: My websites are Metabolichealing.com and true.report . I’m a functional medicine practitioner living in California, at the moment. I’m an educator, a clinician, as well as a researcher and a teacher. I love to share information with people, including anybody who’s interested in how they can use nutrition, science, functional medicine, biohacking and genetics to improve their health. In order to, sort of biohack their way back to ideal health.
Wendy Myers: Yes, and that’s why I wanted to have you on today, to talk about how to care for your liver without a gallbladder. Is it safe to do liver flushing? Is it safe to do coffee enemas? What can you do to compensate for not having a gallbladder, if you’ve had it removed, and to prevent gallbladder surgery? Your doctor is not going to give you these tips, they’re just going to say, “Take it out. It’s bothering you.” It’s just so sad to me how many people I know that have had their gallbladder out, when it’s completely preventable. Not in all cases, but I think for the majority of cases, that could have been prevented. Let’s talk about what exactly is the gallbladder’s function.
Michael McEvoy: The gallbladder’s main function is to basically store and release bile. Bile is an essential degreaser, if you will. It’s also a very important anti-microbial and digestive aid that is the product of the liver detoxification cycles, processes. The liver hepatocytes will basically pull toxins and various conjugated molecules out and squirt them into the gallbladder in the form of these bile salts. Basically every time you eat food, especially with higher fat content, whether it’s butter, meat, olive oil, dairy products, et cetera, your gallbladder is basically programmed to squirt out some amount of bile to assist with that digestive process.
Michael McEvoy: Now that’s the basic function, is to basically emulsify dietary fats. As it actually turns out, the bile doesn’t only function for that purpose but digesting vitamin A, E, D, K, the fat soluble vitamins and for the purpose of absorbing fatty acids in the digestive tract. Remember that the bile is also important for removing toxins that the liver has removed from the process of liver detoxification. So, we often run into these sort of predicaments, whereby a person has had their gallbladder removed and remarkably, their symptoms don’t actually improve from that. They say that they feel the same and I think that that’s really curious. Now that’s not always the case, but it should alert you that just because that’s the standard procedure that’s recommended, doesn’t necessarily mean that that’s the right procedure.
Michael McEvoy: Now, if you had your gallbladder out, it’s really important to be proactive about what you can do to support your body’s digestive functions going forward. What I’ve observed over the years is that individuals that have had their gallbladder removed, often wind up with various types of digestive problems. We often see on stool tests, elevated levels of fecal triglycerides or fecal fatty acids and that’s simply because the bile that is being signaled to be released by the gallbladder, is triggered through different hormones like cholecystokinin, for example. All of these things are elaborately coordinated with food intake, with timing, probably circadian biology is involved in this process too.
Michael McEvoy: So, if that gallbladder doesn’t exist, this process of triggering the release of bile which is now having to occur exclusively by the liver, this triggering process is all screwed up. We often see all kinds of problems with digestion and malabsorption of nutrients. Sometimes, we see low plasma levels of vitamin A because nutrients that are fat soluble aren’t being absorbed in the way that they need to. So, the very fundamental, basic nutritional recommendation that I recommend to anybody that’s had a gallbladder removed is you’ve got to be on bile acids, basically for life. Bile acids are a type of a supplement that are simply bile. So this is going to ensure that you are able to break down your fats, ensure that you’re going to be able to metabolize your fatty acids and your triglycerides, that you’ve just consumed from your diet.
Wendy Myers: Yeah. And so what kind of supplements would you recommend? I mean there’s lots of options out there today for ox bile and digestive enzymes. What are some of your favorites?
Michael McEvoy: Yes, I like the standard process. Cholacol is an example. I like ox bile, particularly. Sometimes I’ll use TUDCA, which is another type of a bile acid. TUDCA actually works well if there’s mild cholestasis. It’s a type of a bile acid that is useful in helping to break apart mild stones, in the ducts. It also can do some other things that are useful to help break up some fatty acids down in the intestines. So, I’ll use that, sometimes I’ll use Beta-TCP by Biotics Research, which contains in it, I believe betaine, which is TMG, a type of a B vitamin. It also has some things that are going to help support gallbladder function.
Michael McEvoy: It’s useful sometimes to take pancreatic enzymes with the bile acid support because the pancreas and the gallbladder are triggered basically at the same time. You’ve got pancreatic elastase getting triggered by secretin and you’ve got cholecystokinin, which is triggering your gallbladder to secrete bile. In the absence of a gallbladder, we’re assuming that these processes are all screwed up, that they’re not being timed correctly. To try to bypass this whole problem, I recommend doing digestive support for the pancreas and the lack of a gallbladder at the same time with your meals.
Wendy Myers: Fantastic. Yeah. That’s key because I knew someone that had their gallbladder taken out and they had diarrhea for an entire year after having that done. It was a young person, 25 years old, just had a gallbladder attack, probably could have just taken something to dissolve the stone or done a liver flush and then prevented the surgical removal of their gallbladder. If you’ve already had that done you can’t cry over spilled milk. There’s lots of solutions to help facilitate digestion without a gallbladder. What about detox? What’s the effect on not having adequate bile to facilitate detoxification? We know that bile is one of the best binders on the planet. It’s used to remove toxins and chemicals and metals.
Michael McEvoy: Yeah, we believe that these processes are really not working as well as they would be in somebody who actually has a gallbladder. It’s just simply because the body is timing everything to occur in response to what its processes are normally supposed to be doing. If you don’t have a gallbladder, your ability to conjugate toxins in the liver is probably compromised because the timing of things is compromised. It’s always a good idea to look at and support the function of the liver, if you don’t have a gallbladder. I like to recommend phosphocholine for this purpose because it’s phosphatidylcholine that is actually sort of one of the raw materials needed for the hepatocytes to actually synthesize bile. If you don’t have a gallbladder, you’re relying entirely on your liver to produce bile. The hepatocytes produce bile.
Michael McEvoy: So use some basic hepatic support like phosphocholine. Digestive bitters can really go a long way, gentian, dandelion or bitter orange. These bitters can really help to not only improve hepatic function, but also support stomach acid so they actually can work. Digestive bitters are really wonderful to be able to kind of cover a lot of different ground of the digestive system. For somebody that doesn’t have a gallbladder, I like to use a combination of bile acids, pancreatic enzyme support, phosphocholine and bitters. Maybe, depending upon if we look at some further tests, we might look at using some other particular nutrients.
Michael McEvoy: Obviously it should go without saying, you’ve got to really optimize your diet first and foremost if you’re not doing so. Make sure that you’re eating according to what your body really needs. That means making sure you’re getting the right amounts of good quality, organic foods, protein, your plant fiber, et cetera.
Wendy Myers: Yeah, my biggest concern is that someone can’t metabolize, digest and break down the fat soluble vitamins like A, D, E and K. Their health can suffer dramatically because of that from bone loss, to just not getting adequate vitamin D intake, to vitamin A that you need for your eyesight. There can be a lot of health consequences to not compensating properly for not having a gallbladder.
Michael McEvoy: Absolutely, it’s a real need to be proactive about your overall liver health and your overall ability to really work on your digestive system. I should also point out, Wendy, that we do see people without a gallbladder who may be more prone to intestinal infections because of the so-called dysregulated bile flow. Remember that bile plays an important role as not only in helping to digest our nutrients but also to sort of eradicate pathogens. It’s very common that if somebody has an intestinal infection, they wind up getting some kind of diarrhea, right? Well, what is that? Why is that happening?
Michael McEvoy: It’s the intestine’s ability to detoxify. It’s the intestine’s ability to try to restore that intestinal balance. A lot of people that don’t have a gallbladder have a propensity towards gut infections. I often use bile acids as part of a protocol if somebody has parasites for example, or a bacterial overgrowth, because it really does help to improve and maintain the optimal intestinal environment. That includes our bacteria in our gut.
Wendy Myers: That’s such a gem. I hadn’t really thought of that consequence before, but when people start taking bile acids or start taking things to facilitate more bile, they might get a little diarrhea in the beginning. Just taper it down a little bit, increase slowly, give your body time to adjust to that because you’ll probably get diarrhea if you need bile salts, if you need more bile production or if you don’t have a gallbladder.
Michael McEvoy: Yes, one tip with that is I sometimes will recommend using either fiber or increasing fiber intake. If somebody is taking bile acids and it’s giving them more diarrhea, I would say start at a lower dose and take it with fiber. First of all, make sure you’re taking it with food. I would say make sure you take a little extra fiber. Just a little bit, maybe 20%. If that doesn’t fix it, I’m often going to recommend guggul, which is a type of resin. It’s a type of a binder but it helps to kind of constrict things in the small intestine. If somebody has for example, bile acid reflux, which is the actual sort of reflux of bile acids into the esophagus, I find that using guggul which is an Ayurvedic resin, oftentimes will help to correct that problem. That may also go across to people that have that problem that don’t have a gallbladder as well.
Wendy Myers: What protocols do you recommend for people to care for their body if they’ve had their gallbladder removed?
Michael McEvoy: Make sure that, number one, you’re staying adequately hydrated. Make sure that number two, you’re timing the use of supplements, digestive supplements, to be taken with your meal or sometimes taken at the end of the meal. Remember that digestion starts in the mouth. It starts with chewing your food thoroughly because the process of digestion starts when the salivary glands start releasing digestive enzymes. That’s triggering the stomach to start the digestive process. That’s going to start the process of releasing hydrochloric acid. When the stomach pH lowers enough is when you start producing more pepsin to start breaking down and churning the food in the stomach, preparing it for the next stage of digestion. The next stage is that once the bolus enters into the pyloric part of the small intestine, that’s when the gallbladder that’s not there in this case, and the pancreas should be producing the bile and the pancreatic enzymes.
Michael McEvoy: Remember that if you don’t have a gallbladder, you’ve got to be really proactive and pay attention. I would say chew your food thoroughly and then you might even need to take a little bit of betaine hydrochloric acid to help with that process, if you’re feeling upper GI bloating, for example. You could also use an adjunct to that, some people like using apple cider vinegar as they work similarly. I would also say time the use of your bile acid supplement with a digestive enzyme. Take it together, either in the middle of the meal or at the end of the meal. That’s if you don’t have a gallbladder, the middle or the end of the meal. If you’re more prone to diarrhea, use a little bit more fiber. You can even take a fiber supplement away from meals, for example, a spoonful of psyllium fiber or a tablespoon of flax seeds, to help add a little bit more fiber to the digestive tract.
Michael McEvoy: I would say that would be a really good sort of basic protocol to get started with. As you know, Wendy is a detox specialist, so she’s really good at helping you to create other liver protocols. It might involve supporting your liver’s ability to conjugate toxins by using different detox supplements like inositol cysteine, or glutathione promotion, or even Nrf2. It’s often useful to increase your intake of raw broccoli sprouts, which helps to increase this protein in the liver that leads to the production of all these different hepatic antioxidants. The overall objective, if you don’t have a gallbladder, is that you want to really be proactive and to make sure that you’re doing everything to optimize the digestion as well as the removal of toxins, that your liver is now going to be challenged to get rid of.
Wendy Myers: And what protocols do you think, like coffee enemas or liver flushes would be helpful to facilitate liver function, if one doesn’t have a gallbladder? Are there any contraindications or tips you have in doing those protocols if someone doesn’t have a gallbladder?
Michael McEvoy: A lot of people that I’ve worked with over the years have said that coffee enemas have been one of the most important therapies that have helped them for different reasons. We think that they’re somehow working because the caffeine is stimulating the hepatic portal vein in the intestines and that this process is inducing some type of expression of glutathione in the liver. Whatever the case may be, coffee enemas can provide relief and people with chronic pain have benefited from doing coffee enemas. As part of a kind of elimination protocol, coffee enemas can be very useful. Chronic digestive problems can be improved using coffee enemas or something that will help to stimulate the gallbladder.
Michael McEvoy: If you don’t have a gallbladder, then we’re looking at again, those bile acids as a way to be the main mechanism here. Liver flushes are often useful. So is olive oil for example, and phosphoric acid has an ability to sort of really squeeze things out. Basic nutrients that you’re going to really need are going to be more amino acids and protein. Remember that, and this is a really important point to repeat over and over again, in order to really detox the liver you need water, amino acids and B vitamins. Those are the real basic raw materials that you need to optimize the hepatic detoxification and the release of bile, with or without a gallbladder. These types of things work really well in combination with anything else that you’re doing, like a coffee enema or if you’re doing some kind of a liver flush, like using the olive oil with the phosphoric acid and/or using bitters with that.
Wendy Myers: Okay, fantastic, and so do you think that gallbladder surgery can be avoided? Say someone has had gall attacks, gallbladder stone attacks and inflammation in the past and that keeps recurring or their doctor is telling them the only solution is to have your gallbladder removed. What would you say to that person?
Michael McEvoy: I would say that it’s worth really working to try to prevent that surgery as much as possible because it is possible to break up stones. We know that there’s a number of different types of herbs that work in ways to help break up cholestasis. For example, rhubarb root is one of these important herbs. We also know that gravel root, like with kidney stones, can also be very effective. Sometimes I’ll recommend phosphoric acid and TUDCA as a way to start to help the gallbladder, or I should say, help the bile ducts to start to break up some of these stones that may be accumulating. I really think it’s possible and I think you should exhaust all possibilities before going through surgery.
Wendy Myers: One hundred percent, because a lot of medical procedures can be avoided by natural means through diet supplementation and natural protocols. This is advice that you’re not going to typically get at your medical doctor’s office because they’re more focused on using medications and surgery to alleviate symptoms, not getting to the underlying root cause to prevent and ameliorate symptoms. Any closing thoughts, Michael, that you have regarding the gallbladder or liver?
Michael McEvoy: Yeah, I think we covered a lot here. I always like to talk about prevention as well, and so my opinion on the matter is that there can be some genetic predispositions, such as UGT1A1, which is known to be associated with cholestasis. We can still always work to improve our health by paying attention to the fundamentals of health. Remember that the fundamentals of health are always going to be the most important things. Sometimes the solution to the health problems you have are right there in front of your face and you’re looking in a different direction, so you miss what the solution is. I would say to look at the fundamentals; hydration, sleep, exercise, high quality organic food intake on a regular basis and doing something to minimize stress and toxin exposure. These are really important, especially in the 21st century.
Wendy Myers: Absolutely, because you can do all the coffee enemas and liver flushes you want and take TUDCA and bile salts, but if you are eating lemon bars every morning with coffee and drinking a couple glasses of wine every night, you’re kind of throwing a wrench in all of your efforts to heal your body. You can’t have one without the other. So Michael, tell us where we can find you, learn more about you and work with you?
Michael McEvoy: My site is www.metabolichealing.com, and the other side is true.report, that’s true.report. You can go and read my blog and some of the other articles I’ve written over the years.
Wendy Myers: Okay, fantastic. Well thank you so much, Michael. And everyone, thanks for joining us for this video.
