People tend not to think about their gallbladder unless gallstones become a painful and debilitating problem requiring surgery. However, your gallbladder could be causing gut problems or chronic inflammatory issues, even if you have no overt gallbladder symptoms.
In fact, gallbladder issues are one of the most common reasons people have chronic gastrointestinal symptoms that are difficult to treat. This is because people rarely consider gallbladder health.
The gallbladder is reservoir for bile, which it secretes to emulsify fats in the diet.
The issue with many cases of poor gallbladder health isn’t gallbladder stones but instead biliary stasis. This is a condition in which the bile becomes overly thick and doesn’t secrete well to help digest fats.
Gallstones are obvious and easy to diagnose. Symptoms of gallstones include:
Severe and sudden pain in the upper right abdomen and possibly extending to the upper back.
Fever and shivering.
Severe nausea and vomiting.
Jaundice (yellowing of the skin or eyes)
Clay colored stools or dark urine.
Typically, gallstones include a trip to the emergency room and gallbladder removal surgery, one of the most commonly performed surgeries today.
However, by paying attention to your gallbladder health, you can not only avoid an unnecessary surgery that raises the risks of developing other health problems, but also you can improve your gut function and lower inflammation.
Sometimes in cases of biliary stasis, an ultrasound can show gallstones that have formed but not yet obstructed the gallbladder. However, for many people, overly thick bile is the problem. This can be identified via symptoms.
Symptoms of biliary stasis include:
Bloating after meals
Burping after meals
Fish oil burps from fish oil capsules
Fatty foods make you feel worse
These are symptoms that a conventional doctor may dismiss altogether, and that can also be caused by other imbalances.
Biliary stasis is especially common in overweight women over 40 who have had children due to the effects of hormonal shifts on the gallbladder.
It’s important to address gallbladder function and biliary stasis as sufficient bile flow is necessary to digest fats. When fats aren’t digested, the undigested fats cause imbalances elsewhere in the body.
Undigested fats can lead to poor sphincter function in the digestive tract, which facilitates the transport of bacteria from the large intestine into the small intestine, causing a condition called small intestinal bacterial overgrowth (SIBO). SIBO causes myriad symptoms, including chronic constipation, chronic diarrhea, or both. Bloating is also common with SIBO.
Biliary stasis also backs up the liver’s detoxification pathways. As a result, the liver cannot effectively detoxify hormones, toxins, and other metabolites. This increases the toxic burden on your system, which in turn increases inflammation.
Many people with poor gallbladder function and biliary stasis naturally start avoiding fats, even healthy fats like olive oil and avocado oil. They also may avoid fish or fish oils because they get “fishy burps.” This increases health risks, particularly for the brain and the hormones, because we need ample healthy fats for optimal function. It also leads to deficiencies in the vital fat-soluble vitamins A, D, E, and K.
If you are taking all the right GI supplements and doing the right gut health diets but still not improving, your gallbladder health is one thing you may want to consider.
How to improve your gallbladder health
Fortunately, various nutritional compounds support gallbladder health, fat digestion, and liver detoxification, including dandelion root, milk thistle seed extract, ginger root, phosphatidylcholine, and taurine.
These compounds can also help if your gallbladder has been removed, along with ox bile.
In order to improve and maintain your gallbladder health, also include these practices:
In the world of functional medicine, it has long been known that gut health is paramount to the health of the rest of the body. For decades we didn’t fully understand why, although we knew the gut was the seat of the immune system and chronic inflammation. Now with the gut microbiome renaissance underway, we also understand how integral gut bacteria is to health.
As such, addressing gut health has always been one and continues to be one of the first steps in managing a chronic inflammatory or autoimmune condition. However, people tend to fall into the trap of thinking everyone needs to follow the same gut healing protocol, wondering why it works for some and not others.
As it turns out, repairing gut health is not a one-size-fits-all approach. There is not just one diet, one type of probiotic, or one gut healing powder that works for everyone. Although there are some basic foundations to gut healing — remove immune reactive foods, keep blood sugar stable, and create a healthy gut microbiome — the truth is you still need to know why your gut health deteriorated in order to address the root cause.
For example, a number of patients can come in with a complaint of constipation. While laxatives may help the patient, it is nevertheless important to understand why they are constipated in the first place. This goes for any digestive complaint and not just constipation.
Here are some different reasons why a person can develop a digestive complaint such as constipation:
A past brain injury has dampened activity of the vagus nerve, which carries communication back and forth between the gut and the brain. This slows down motility of the intestines and causes constipation.
The gut’s nervous system, called the enteric nervous system, has degenerated significantly due to chronic gut inflammation from immune reactive foods, too many sugars and junk foods, chronic stress, gut infections, or brain degeneration. Intestinal motility depends on a healthy enteric nervous system, and constipation develops.
Small intestinal bacterial overgrowth (SIBO) releases gases that shut down motility.
Medications impact intestinal motility and cause constipation.
Dysautonomia, a dysregulation of the central nervous system, prevents the body from getting into the “rest and digest” state that allows for healthy bowel function.
A one-size-fits-all gut protocol can completely heal one person, create improvement in another, do nothing at all for a third, and perhaps make another even worse.
It’s also important to screen for more serious conditions. These can include gastric ulcers from an h. pylori infection, intestinal permeability — or leaky gut — from damage to the microvilli of the small intestine, inflammatory bowel disease, ulcerative colitis, or Crohn’s disease. Knowing whether these conditions are an issue also impacts how you manage gut health.
Also vital is knowing whether gut autoimmunity is the root cause of your gut issues. You can test for this through Cryex Labs. If so, this changes your expectations of your outcomes and how you evaluate your progress. Autoimmune disease occurs when the immune system erroneously attacks and destroys tissue in the body. Eventually this leads to symptoms and breakdown of function.
Although autoimmune disease cannot be cured, it often can be dampened or driven into remission for long periods of time. However, unpredictable flare ups also happen, and the person with gut autoimmunity must have realistic expectations in order not to feel demoralized if their symptoms flare and recede. Also, there is still much we don’t know about autoimmunity. For some people it’s easy to manage and for others it’s a constant battle. In these cases, the goal can be as simple as “more good days.”
This is an overview of why common gut-healing protocols work gangbusters for some people and little to not at all for others. Our digestive system is one of the most fascinating, complex, and influential systems in the body. The more scientists learn about it, the more apparent it becomes that gut health largely determines the health of the rest of the body, including the brain.
This is why we are seeing so many chronic health conditions in modernized societies that subsist largely on industrialized agriculture and food processing. The commercialization of cheap, processed, chemically laden, and highly sweetened “foods” largely void of produce has inflamed and damaged the digestive tract, decimated the gut microbiome (some researchers call it an extinction event), and ravaged the brain in today’s modern populations.
Fortunately, functional medicine excels when it comes to repairing and maintaining gut health. Ask our office how we can help you.
If you struggle with heartburn or acid reflux, you just pop some pills for that, right? Turns out regular use of drugs to treat heartburn, acid reflux, and ulcers can lead to an earlier death. These disorders are some of the easier to manage using functional medicine protocols, so it’s unnecessary to risk shortening your lifespan through chronic disease when you can enjoy improved health instead.
A recent study found that chronic use of proton pump inhibitors (PPIs) is linked to an increased risk of death from cardiovascular disease, kidney disease, and upper gastrointestinal cancer. The degree of risk increases with duration of use, even if you take low doses. Other studies have linked PPIs to dementia, bone fractures, and pneumonia.
Common brands of PPIs include Prevacid, Prilosec, Nexium and Protonix.
The study looked through the medical records of more than 200,000 people over 10 years. They found those who took PPIs had an almost 20 percent increased rate of death over people who took other types of acid-suppressing drugs (unfortunately, they did not compare death rates to people who took no acid-suppressing drugs). This applied to both prescription and over-the-counter PPIs.
What’s even more alarming is that researchers found more than half the people taking PP!s had no medical need for the drugs and PPI-related deaths were more common in this group.
Why you should address the root cause of your acid reflux or heartburn instead of taking acid-suppressing drugs
It’s assumed overly high stomach acid causes heartburn and acid reflux, but in most cases it’s due to low stomach acid. Stomach acid is vital to the health of the body in its role of digesting foods, in particular meats. When stomach acid is too low your stomach is unable to properly digest foods. Your small intestine does not want to accept improperly undigested food — this will damage its lining and contribute to intestinal permeability, or leaky gut. The low pH of the stomach acid prevents the valve to the small intestine from opening and, as a result, the contents of the stomach shoot back up into the esophagus.
Although the food is not acidic enough to gain entry into the small intestine in a timely manner, it is too acidic for the delicate tissue of the esophagus, which it burns as it shoots back up toward your throat. The extra time the food spends in your stomach also causes it to putrefy, causing that acid stomach sensation, or the feeling of having a brick in your stomach. Some people quit eating meat not because they want to be vegetarians, but because eating meat makes them feel sick.
Low stomach acid contributes to digestive issues throughout the rest of the digestive tract. As undigested food travels into the intestines, it causes inflammation and damages the lining of the intestines. This leads to intestinal permeability, or leaky gut, a condition in which the lining of the small intestine becomes inflamed and leaky. Leaky gut allows undigested foods into the bloodstream, yet prevents micronutrients from passing through because of the inflammation. Undigested foods in the bloodstream trigger inflammation throughout the body.
Stomach acid serves another useful purpose in that it kills bacteria, fungi, and other pathogens that may be in your food, preventing them from getting into the digestive tract and the bloodstream. When stomach acid is low, you lose this additional layer of protection.
Sufficient stomach acid also prevents food sensitivities. Undigested food particles trigger the gut’s immune system to become over burdened and over reactive. This causes the immune system to start reacting to more of the foods you eat, creating immune reactions that become food sensitivities. This is called losing oral tolerance, and it can be a primary cause of food sensitivities and other health issues.
Symptoms of low stomach acid
Stomach ulcers (low stomach acid raises the risk of an pylori infection, which causes stomach ulcers)
Belching after meals
Hiccups after eating
Undigested food in stools
What to do for low stomach acid
You can help support your stomach acid by taking betaine hydrochloric acid (HCl) capsules. Take HCL after you begin eating a meal with meat or protein. How much do you take? Keep increasing your dose until you feel warmth in your stomach, then cut back down to the previous dose. You may need quite a bit in the beginning but then find you need to gradually lower your dose over time.
If you feel intense gastric burning with even one capsule, it means you may have ulcers and an H. pylori infection that can be treated with nutritional compounds.
Although the produce section at the grocery store may look vast, it only represents a fraction of edible, nutritious, and tasty plant foods. It’s estimated there are more than 20,000 species of edible plants, and that we only eat about 20 to 50 of them. As a result, this may be playing a significant role in the rapidly declining health of westerners. Our gut bacteria, or gut microbiome, is a foundation to our health, and healthy gut bacteria depend on a diverse and ample array of vegetables.
Ancient humans harvested wild fruits, nuts, and seeds that varied with the seasons. They also dug up underground roots and stems. Studies of the Hadza people, in Tanzania, one of the last remaining hunter-gatherer populations left on the planet, gives us additional insight into the human microbiome and health.
The Hadza have one of the most diverse gut microbiomes on the planet; Americans have the worst. The Hadza gut microbiome diversity is about 40 percent higher than that of the average person in the United States.
Americans consume an average of 15 grams of fiber a day, most of it coming from grains. The American Heart Association recommends eating 25 to 35 grams a day. Some microbiome authors suggest even higher amounts — at least 40 grams of fiber a day.
In contrast, the Hadza consume about 100 to 150 grams of fiber a day, with the average Hadza person eating almost 600 species of plants that vary with the seasons. They suffer almost none of the same diseases that have come to characterize the average American — obesity, diabetes, autoimmune diseases, and cancer.
If you would like help understanding Integrating ancient fiber to modern diet, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Studies show fiber also lowers heart disease risk by binding with “bad” cholesterol to remove from your body. A high-fiber diet also lowers high blood pressure and thus the risk of stroke.
They type of fiber you eat matters too. What gut bacteria need for optimal function are “prebiotic” fibers mixed in with a diverse array of produce.
Prebiotic fibers best feed the healthy bacteria in our guts, thus improving overall health. Good sources of prebiotics include all vegetables but especially:
Not only do prebiotic fibers help with bowel regularity, they also change the composition of the gut microbiome in a favorable direction. They help strengthen intestinal walls, improve absorption of important nutrients, produce hormones that control appetite, reduce anxiety, and help protect you against chronic disease.
If you’re not used to eating high amounts of plant foods loaded with fiber, don’t double or triple your intake overnight. Your gut may rebel with constipation, diarrhea, pain, bloating, and gas. It takes your digestive system and gut microbiome some time to adapt and be able to adequately digest large amounts of fiber. Gradually increase the amount of fiber you eat by 1 to 2 grams a day over several weeks to give your system time to adjust.
Also, you may have noticed legumes, or beans, are especially high in fiber. It’s tempting to make those a staple in your diet as a result, and if they don’t disturb your health then go for it. However, many people cannot tolerate the lectins in legumes — they trigger inflammation or autoimmune flare-ups. For people with SIBO, small intestinal bacterial overgrowth, they also cause intense digestive issues and inflammatory responses.
Also, some people need to avoid nightshade vegetables because they trigger inflammation, particularly in relation to arthritis. These include eggplant, potatoes (but not sweet potatoes or yams), peppers, tomatoes, tomatillos, hot pepper products (cayenne, Tabasco, etc.), and pepper-based spices. Simply removing nightshades from the diet has brought relief from joint pain for many, especially those with rheumatoid arthritis.
Lastly, some people have gut or immune disorders that make a high-fiber diet inappropriate until they resolve those. Ask me for more information if eating fiber makes you miserable.
What does a high fiber paleo diet look like?
Most people with chronic inflammatory and autoimmune disorders fare best on a paleo diet that eliminates grains and legumes. As grains and legumes are sources of high fiber, what does a high-fiber paleo diet look like?
The recommended produce consumption is seven to 10 servings a day. That may sound like a lot, but one serving is a half-cup of chopped produce, or a cup of leafy greens. Because sugary foods can be inflammatory, aim for veggies and fruits that are low in sugar and unlikely to destabilize your blood sugar.
Therefore, shoot for at least three to four servings of produce per meal – that’s 1.5 to 2 cups of chopped veggies or 3 cups of leafy greens. Or break that up into five meals if you eat more frequently to stabilize low blood sugar.
Ask my office for more ways to support your gut microbiome.
If you feel like you have a harder time staying slim than your grandparents did at your age, you are right. We are about 10 percent heavier than people in the 80s, even when we eat the same foods and exercise just as much. This may be due to changes in lifestyle and environmental factors that impact our BMI, or body mass index.
Recent research by York University’s Faculty of Health shows it’s harder to maintain the same weight at a certain age than it was for someone 20 or 30 years ago. Even if you eat exactly the same macros (protein, fat, and carbs) and do the same amount and type of exercise, you are likely to be heavier than they were at your age.
In fact, with all factors accounted for, the predicted BMI has risen 2.3 points between 1988 and 2006.
According to study author Jennifer Kuk, “Our study results suggest that if you are 40 years old now, you’d have to eat even less and exercise more than if you were a 40-year-old in 1971, to prevent gaining weight. However, it also indicates there may be other specific changes contributing to the rise in obesity beyond just diet and exercise.”
Specific factors contribute to our increased BMI
Historically we tend to look only to dietary and exercise habits when we consider our weight or BMI (body mass index).
However, weight management is much more complex than watching what you eat and how much you work out. Our BMI is affected by many factors such as:
Gut bacteria populations
Nighttime light exposure
While the study’s authors admit we need more research to determine exactly how these factors play into the changed BMI picture, they suggest three main players:
Increased environmental toxins. Compared to 30 years ago, we are exposed to a higher level of environmental toxins such as pesticides, air pollution, heavy metals, flame retardants, plastics used for food storage, and more. These toxins put a heavy burden on the endocrine system, altering the hormonal processes that affect metabolism and weight management.
Increased use of prescription drugs. Since the 1970s our use of prescription drugs has risen dramatically. Many antidepressant drugs are linked with weight gain and are the most prescribed drugs in the US for people between 18 and 44.
Our gut microbiome has changed. The gut microbiome, or the community of good and bad bacteria that naturally inhabit the digestive tract, have changed dramatically since the 80’s.
Americans eat differently than they used to. The products we eat are more filled with antibiotics, pesticides, and other toxins; we eat more artificial sweeteners; and we eat more junk food. All of these factors may negatively affect our gut bacteria populations.
A hot topic of research, the gut microbiome is linked to more and more aspects of health and disease. We now know that some gut bacteria are linked with weight gain and obesity. In fact, doctors are even using fecal implantation — insertion of gut bacteria from a healthy slim patient into the gut of an unhealthy obese patient — to reduce chronic obesity.
If you would like help understanding about keeping your weight balanced, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Support your microbiome with SCFA
In functional medicine we consider the gut microbiome to be a foundation of health. An imbalanced gut microbiome can prevent you from healing from many health disorders, so it makes sense to do everything you can to support yours.
One important factor is oral tolerance, or the body’s ability to properly recognize food proteins. When we lose oral tolerance, the immune system mistakenly thinks more and more foods are pathogens, and we begin to have more food sensitivities, increased hormonal issues, increased autoimmunity, and imbalanced metabolism and weigh gain.
You can support oral tolerance by fixing leaky gut, supporting liver function, taming histamine reactions, reducing stress, and balancing blood sugar. But one of the best ways to support it is by providing your body with plenty of short-chain fatty acids (SCFA).
SCFA are powerful gut signaling compounds found in fruits and vegetables that affect not only the gut but also the brain and other parts of the body.
Your gut bacteria not only make SCFA, they also need them as fuel to produce more SCFA. The more you eat them, the more your good gut bacteria can outweigh the bad.
Three main SCFAs include:
SCFA bind to cell receptors that control your hunger and appetite, turn off insulin resistance, and burn body fat more efficiently.
When you are low on SCFA you will:
Have a larger appetite
Be prone to insulin resistance (think pre-diabetes)
Store body fat better than you burn it
When gut diversity is ruined, SCFA can’t signal properly and you end up with what we call an “obese microbiome.”
How to support SCFA
To support healthy levels of SCFA, adopt the following habits:
Eat abundant and varied produce. Eat plenty of diverse vegetables so your gut bacteria stay adept at recognizing many different food proteins. Aim for 7 to 9 servings a day. One serving consists of a half cup of chopped vegetable or one cup of shredded greens. Go easy on high-sugar fruits to keep your blood sugar stable.
Supplement with SCFA. You may benefit from also supplementing with butyrate, the main SCFA. Start with one capsule a day and work your way up to two capsules twice a day.
Boost glutathione levels. Glutathione is the master antioxidant that helps dampen inflammation, a main factor in loss of microbiome diversity. Take absorbable glutathione such as s-acetyl glutathione (regular glutathione isn’t absorbed well), or its precursors such as n-acetyl cysteine.
There are many other helpful ways to support a healthy microbiome. Contact my office to determine your microbiome health and how to improve it, so you can maintain a healthy weight.
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