Bile: What is it? How to Improve Liver & Gallbladder Health

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bileBile: What is it? 

The liver and gallbladder are involved in the formation of bile. Bile is primarily well-known as a digestive secretion that helps to digest fats. Bile does way more than this however and is actually very important for overall health. In fact, if you are facing health challenges involved with digestion, you might be dealing with a bile production issue.

In this article, I am going to breakdown the functions of bile, why they are important for overall health, and how to make sure your liver and gallbladder are working properly to produce it.

Liver & Gallbladder Functions

The liver has many of its own functions. It works to filter toxins from the body, store energy and nutrients, and produce bile for fat digestion. This is a small list of roles the liver serves. In reality, the liver does many things that are all crucial for overall health. This may be why in some cultures the liver is seen as the most important organ in the human body.

The gallbladder on the other hand has a much more limited role. While bile is produced in the liver, it is actually stored in the gallbladder in quantities of about 50 mL to be released after we consume a meal. The combined role of the liver and gallbladder helps to ensure we are properly metabolizing fats and excreting unwanted toxins from the body.

Bile Liver

What is Bile?

Bile is a greenish-brown liquid primarily made of cholesterol, bile salts, and bilirubin. It is most commonly known as a digestive juice that emulsifies fats for absorption in the small intestine. As we will talk about in a moment, the proper digestion of fats is important for many other processes that occur in the body. If it is not being released properly or we develop blockages in the gallbladder, then many problems can occur.

In addition to aiding in the breakdown and absorption of fats, bile also contains waste products that are passed through the intestines and released through bowel movements. So, with just this information, you may be able to make the connection the poor bile flow can result in malnutrition and the accumulation of toxins in the body.

4 Major Functions of Bile

The fundamental functions of bile have been laid out already, but it is important to understand the implications of proper bile flow to truly understand its importance. Digestive issues can lead to things like poor nutrient absorption, unwanted bacterial growth in the digestive tract, inflammation in the gut, and ultimately conditions like leaky gut syndrome.

Leaky gut is an inflammatory condition of the gut that results in undigested food particles crossing into the blood stream. Once these particles cross the intestinal barrier they cause dysregulated immune activity. It is this dysregulated immune activity that ultimately leads to autoimmune conditions in the body (1). Autoimmunity can manifest in many ways including thyroid disorders, rheumatoid arthritis, and lupus if left unaddressed.

Fatty Acid Metabolism 

First and foremost, bile emulsifies fats. Fats in their unaltered form are actually of little use to the body. If they are not emulsified, then they pass through the digestive tract and often cause symptoms similar to IBS such as chronic diarrhea.

Emulsified fats also act as transportation vehicles for fat-soluble nutrients like vitamins A, D, E, and K. These nutrients in of themselves play many roles in the body including protecting the arteries from calcification, improving immune system function, and more.

Kill off Bad Microbes

The importance of the microbiome is something that we are still discovering more about every day. In fact, there are entire research funds dedicated towards analyzing the makeup of healthy and diseased individuals (2).

The bacterial makeup of your mucosal membranes can predict your risk of diabetes, heart disease, cancer, and even your risk of succumbing to certain neurological conditions. This is because different types of bacteria assist in the production of nutrients and neurotransmitters that can literally alter your emotional state (3, 4).

Bile, similar to stomach acid, helps to regulate our microbiome by killing off unwanted pathogens that can make their way into our body.

Excretion of Waste Products

The body gets rid of toxins through various passages in the body. These include the urine, sweat, breath, and bowel movements. As the liver filters out toxins from the body, they are primarily released in fat-soluble or water-soluble form.

Water soluble toxins are primarily excreted through the urine while fat-soluble toxins are released in the bile to be passed through the bowels. Bile also helps to stimulate peristalsis. Peristalsis is a wave-like muscular action that propels food matter and waste through the intestines.

If bile is not being released properly, then this critical detoxification pathway will not be functioning as it should.  Built up toxins can contribute to unwanted bacterial growth, chronic inflammation, weight gain, and several associated consequences.

Blood Sugar Metabolism

Another less talked about mechanism is that it helps to keep blood sugar stable. Having healthy blood sugar balance is absolutely critical for maintaining stable energy levels, emotional stability, and maximum brain performance.

Studies have shown that a poor metabolism of fats contributes to blood sugar instability issues (5, 6). In addition to this, bile actually stimulates two very important receptors referred to as FXR and TGR5. Stimulation of these receptors helps to regulate both fat and carbohydrate metabolism as well as the inflammatory response within the body (7, 8).

Symptoms of Poor Bile Flow

As you can see, proper bile flow regulates many important processes in the body. If it is obstructed for any reason, a number of complications can manifest including:

  • Weight Gain
  • Low Energy
  • Emotional Instability
  • Digestive Complications
  • Headaches and Migraines
  • Fibromyalgia
  • Inflammatory Skin Conditions (acne, eczema, rashes)
  • Chemical Sensitivities (due to toxic build up)
  • …and more

The remainder of this article will focus on strategies to improve liver and gallbladder function so that you can improve bile flow and prevent these unwanted side effects.

Improve Liver Function

First and foremost, bile production begins in the liver. We must ensure the liver is functioning optimally to reduce toxic exposure, improve toxin elimination, and ultimately improve digestion.  The liver is under constant stress from the air we breath, the water we drink and the food we eat.

Additionally, if you are under stress, have bad gut microbes or have poor relationships this can overload your liver and lead to poor bile production as well.  Here are the steps to improve liver health.

Avoid Toxins

In today’s society, we are constantly bombarded by toxins that were absent from our environment for thousands of year previous. While industrialization has brought many great innovations for a growing population, it has also introduced harmful elements that we must account for.

In the diet, these include things like pesticides, heavy metals, xenoestrogens, artificial hormones, and unnatural processed food ingredients.

Start by shifting your diet towards one that favors organic, whole foods. The bulk of your diet should be nutrient-dense vegetables and antioxidant-rich herbs and spices. Next, load up on healthy fats like avocados, coconut products, olives and olive oil, and (my favorite) butter or ghee from pasture-raised cows.

For more information on this style of eating, I have an excellent introductory guide here: 5 Benefits of a Healing Diet

Foods for the Liver

After eliminating the bulk of toxins from our diet by making better food choices, we can focus on incorporating foods that are nourishing to the liver. These are foods that provide valuable nutrients that assist in detoxification and even help to stimulate the formation of bile.

Some of the best foods for this include: pasture-raised liver, cruciferous vegetables, leafy greens, green tea, spirulina, chlorella, and organic berries.

For my complete list of the best foods for your liver, I have put together a graphic below.

Boost Detox Pathways

As toxins are filtered through the liver, they must pass through three phases that all require specific nutrients to occur. This is important because toxins are usually altered and converted into forms that are less toxic (or even beneficial).

There are three phases of this process that require certain nutrients to be present:

Phase I is regulated by the Cytochrome P50 enzyme and is the first step in converting toxins. This phase requires adequate amounts of amino acids, vitamins A, B2, B3, C, E, folate, iron, calcium, copper, zinc, magnesium, and selenium.

Phase II converts the toxins from phase I into water-soluble forms that are easier to excrete. This phase is highly dependent of methylating agents, glutathione, and sulfur.

Phase III is the final conversion where toxins are diverted for excretion in either the bile or urine. This is an enzymatic process that requires the nutrients mentioned in the previous two phases. Foods that stimulate bile flow and healthy sources of fiber both assist with this phase as well.

The top liver foods mentioned above all assist with these phases, given that you consume a variety of them on a regular basis. Bile stimulating foods and best fiber sources will be discussed shortly.

Boost Glutathione 

Glutathione is the master antioxidant and detoxifier of the body. By boosting this valuable element within the body, we assist with liver function by reducing toxic load and directly assisting in phase II and III detoxification.

There are also a great number of other benefits of boosting glutathione levels. These include slowing the aging process, improving energy levels, boosting the immune system, and supporting mental clarity.

The best strategies to boost glutathione include:

  • Consuming the liver-supporting foods outlined above
  • Engaging in short-duration, high-intensity exercise
  • Using glutathione-boosting agents
  • Supplementing with acetylated or liposomal glutathione

Clinically, one of my go-to glutathione boosting supplements is ThyroLiver Protect. It contains selenium, milk thistle, alpha-lipoic acid, and n-acetyl-l-cysteine which all play important roles in supporting the body’s own ability to create glutathione.

Balance Hormones

Something I see a lot clinically are elevated estrogen levels in both men and women. While estrogen is a critical hormone, we have many toxins in our environment that mimic estrogen and promote a condition called estrogen dominance.

Estrogen dominance is when estrogen levels become highly expressed relative to other sex hormones. When this happens, the liver is responsible for converting and eliminating these estrogenic metabolites. This can quickly become burdensome on the liver and contribute to side effects illustrated below.

Consuming cruciferous vegetables can partially assist with the elimination of excess estrogens in the body through the action of a compound called diindolylmethane (DIM). In more severe cases, using a concentrated form, such as EstroProtect, can be extremely beneficial.

Estrogen mimicking chemicals can come from many sources. Check out the graphic below and strive to minimize your exposure to the things listed. In most cases there are great alternatives to things like plastics, cosmetics, and household cleaners that do not contain hormone-disrupting ingredients.

Improve Gallbladder Function

Now that we’ve emphasized the importance of the liver in optimizing bile flow, strategies can be incorporated to support the gallbladder. Since these structures heavily rely on each other, they cannot be addressed in isolation.

Supporting the gallbladder ultimately comes down to ensuring bile is released as it should. If you have an obstruction, biliary sludge, or have had your gallbladder removed, then these strategies will still be very important.

Hydration

If you are chronically dehydrated, then it is possible that your bile will not have the viscosity it needs to flow well. If bile becomes thick and sludge-like, this will predispose you to poor digestion and potentially the development of gallstones down the road.

Start the day by super hydrating with 16-32 ounces of reverse osmosis water to flush out the digestive tract and kidneys. Additionally, aim to consume at least half but up to your full body weight (in lbs.) in ounces of water daily. For example, a 150 lb. individual would consume between 75-150 ounces of water per day.

Foods for Gallbladder Function

Next, consume foods that stimulate bile flow. Many of the foods outlined as being healthy for the liver will provide this effect. Some of the best foods for stimulating bile flow include:

  • Organic acids from apple cider vinegar, lemons, and limes
  • Bitter Herbs (parsley, cilantro, dandelion, milk thistle)
  • Warming spices like ginger, turmeric, and cinnamon
  • Prebiotic foods like artichokes, radishes, asparagus, garlic, beets

Intermittent Fasting

Every time you eat, your gallbladder will release bile. By taking breaks from eating, this allows more time for bile to become concentrated.

Additionally, this fasting period boosts liver health by allowing more time for detoxification processes to occur. By adding in the hydration practices outlined above, you go a long way in improving liver and gallbladder function.

Begin with a 12 hour fasting window between dinner and breakfast. Once you are adapted well, try increasing this window by 2 hours every few weeks until you reach a fasting window of 16-18 hours, this is the sweet spot for most people.

Ox Bile and Bile Salts 

If you are constantly dealing with digestive issues, especially with fats, then you may find it helpful to use supplemental support for a period of time. Using things like ox-bile or bile salts will help to make up for poor gallbladder function while providing the raw materials necessary for adequate bile production.

My go to Ox-bile formula is Bio-Gest which include ox-bile along with hydrochloric acid for proper protein and fat metabolism.

Bile Flow Support (here) is my go-to for boosting bile formation in the liver. It contains the necessary amino acids along with herbs like dandelion that not only provide the nutrients necessary for bile, but also stimulate the proper flow from the gallbladder.

Supplement Protocol to Clear Biliary Sludge 

If you have been diagnosed with biliary sludge or simply want to optimize bile flow, then this protocol may be very helpful for you. It is designed to stimulate bile flow while binding up and built up toxins to prevent negative side effects.  Good hydration is critical for this protocol to be effective so make sure you are drinking a minimum of half your body weight in ounces of water daily.

This protocol is designed to be followed for 30 days:

Activated Charcoal: Take 1-2 Capsules, 1 hour before meals to help bind to the toxic biliary sludge.  Do 1 cap if you are under 125 lbs or have lots of trouble with constipation.

Bile Flow Support: Take 2 Capsules, Twice daily after meals to help improve bile flow from liver and gallbladder

Cal Mag Support or Brain Calm Magnesium:  Take 1 scoop – 1-2 hours after meals to help improve peristaltic action and bowel elimination.  This is especially important if you have issues with constipation.

Conclusion

Bile is a critical digestive secretion. Without it, we become malnourished and toxic. This article lays out how to optimize liver and gallbladder function so that we can digest and metabolize fats properly.

The health consequences of an improperly functioning liver and gallbladder are extensive. Following the strategies outlined will help ensure you do not have to deal with these consequences.

Sources for this Article Include

1. Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):71-8. PMID: 22109896
2. NIH Human Microbiome Project (HMP) Roadmap Project (LINK)
3. Liu L, Zhu G. Gut-Brain Axis and Mood Disorder. Frontiers in psychiatry. 2018; 9:223. PMID: 29896129
4. Biragyn A, Ferrucci L. Gut dysbiosis: a potential link between increased cancer risk in ageing and inflammaging. The Lancet. Oncology. 2018; 19(6):e295-e304. PMID: 29893261
5. Wei J, Qiu de K, Ma X. Bile acids and insulin resistance: implications for treating nonalcoholic fatty liver disease. J Dig Dis. 2009 May;10(2):85-90. PMID: 19426389
6. Hylemon PB, Zhou H, Pandak WM, Ren S, Gil G, Dent P. Bile acids as regulatory molecules. J Lipid Res. 2009 Aug;50(8):1509-20. PMID: 19346331
7. Fuchs M. Non-Alcoholic Fatty Liver Disease: The Bile Acid-Activated Farnesoid X Receptor as an Emerging Treatment Target. Journal of Lipids. 2012;2012:934396.
8. Li Y, Jadhav K, Zhang Y. Bile acid receptors in non-alcoholic fatty liver disease. Biochem Pharmacol. 2013 Dec 1;86(11):1517-24. PMID: 23988487

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Comments

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Comments

  1. Have you researched bile acid malabsorption due to ileum resection? Wondering what you might recommend to overcome? Thanks.

    1. Hey Carolyn, you could try supplementing with 2-4 grams of activated charcoal throughout the day and see how you respond. Using digestive enzymes may be helpful as well!

  2. The article is very interesting but I had my gallbladder removed few years ago.
    What you suggest me to do? My digestion is very low and most of the time I feel swollen after eating.

  3. I have an problem with my mom she is now in nursing home. Well before she went in about Nov of 2017 she had several problems physically three things were happening that she had one her kidneys were swollen and her liver counts went up and also she had gallbladder inflammation; but they could not do surgery to remove her gallbladder because she had double bypass heart surgery and a valve replace since 2009. So to avoid complication cause she could died on the operation. Instead of surgery they suggested to put the tube to drain the fluids and it has helped her but she has gotten better but the problem is the tube is irritating her and have tube replace every three months. And that the stones are still in her and one is large one can not go thru the bile duct. Is there anything to dissolved the gallstone naturally so that she can no longer have the tube. I hate to see her in pain because of the tube. I really need your help in this area!

    Sincerely,

    Scott

  4. Any supplements/ways to reduce high ammonia blood levels? I don’t drink and eat well, liver enzymes are good, and the few bad bacteria on the GI MAP test are under their limit but have histamine intolerance and strong reactions to most supplements apart from a few. Might ox bile and digestive enzymes help?

  5. Hey Dr Jockers..I suffer a lot from heartburn and degistive problem..I had my gallbladder removed 30 yrs ago does this have anything to do with my degistive problem ..regards Betty Thompson …

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