This guest article was written by my friend Debbie Graefer, L.Ac. MTOM
Licensed Acupuncturist and Masters in Traditional Oriental Medicine. Debbie is the mastermind behind the great site called GallbladderAttack.com. If you have ever searched online for gallbladder information (like symptoms, attack, foods to avoid, etc), you probably came across her site.
I’ve asked her is she could write and educate us on the very important topic of the connection between the gallbladder and our hormonal balance. You see, I’ve seen many women after having their gallbladder removed develop many hormonal problems. It seems that Western medicine is failing us again – liberally and mindlessly treating the gallbladder like a useless organ that we can easily disposed of to address an immediate pain. At the cost of other issues developing further down the road – only to be treated with more meds.
Here is what Debbie has to say.
What and where is the gallbladder
Although digestive symptoms may be brought on by any number of things, what is often overlooked is the gallbladder. The gallbladder is a small organ that sits under the liver on the right side of the rib cage and stores liquid bile which is used to digest fats. Even without eating a fatty diet, the gallbladder can begin to act up with symptoms ranging from pain or tenderness under the right rib cage, pain between the shoulder blades, indigestion especially after fatty foods, a feeling of fullness, gas, bloating, nausea, vomiting, burping and the list goes on. For symptoms of a full-on gallbladder attack, visit GallbladderAttack.com.
When the idea of gallbladder problems is first mentioned, one automatically jumps to the conclusion of gallstones. While gallstones are the most common cause of these digestive symptoms, they are not the only one. Symptoms occur even without the presence of stones, usually brought on by a sluggish or low-functioning gallbladder. In fact, this low-functioning probably allows the gallstones to form in the first place.
The gallbladder and hormone connection
Hormones are always involved in one way or another. A hormone is simply a protein that is used to deliver a message or a command from one part of the body to another, usually initiating or terminating a function. Considering how many functions are going on in the body at all times, it will not be so surprising to learn that there are more than 50 different hormones and several that are involved in the proper functioning of the gallbladder. And there are others yet that affect it less directly. This article will discuss only a few of them.
Motilin is a hormone found in the cells of the intestines. It is released in response to fat intake or acidity in the small intestine. Motilin initiates the contraction of the gallbladder to induce its emptying of bile. In pregnancy, motilin is found to be profoundly reduced, especially in the 2nd and 3rd trimester. It is postulated that this may contribute to gastrointestinal hypo-motility (or a slow-moving GI tract) which symptoms include constipation, indigestion and gallbladder disease, all of which are quite prevalent during pregnancy.
Melatonin is a hormone that is secreted in the dark and stops secreting in response to light. It regulates not only sleep, but your whole biological clock. Traveling through several time zones can really throw melatonin production out of balance. But did you know that melatonin may also inhibit gallstone formation, reduce the cholesterol in the bile by inhibiting its absorption as well as increasing the conversion of cholesterol into bile salts? Studies show that melatonin therapy could possibly assist in the recovery of the neuromuscular function of the gallbladder wall during or following acute gallbladder inflammation, allowing it to contract more fully.
Cholecystokinin or CCK is a hormone that initiates gallbladder contraction and pancreatic enzyme secretion. If you have had a HIDA scan to test for a low-functioning gallbladder, they will have injected CCK to initiate gallbladder contraction and measure the amount of bile that is secreted. Normal is from 32-44%.
Thyroxin (also spelled thyroxine) is a thyroid hormone which helps to regulate metabolism. Low thyroxin levels or low thyroid function is connected with low gallbladder functioning as well as low bile flow, both which contribute to the formation of gallstones.
The sphincter of Oddi, which controls the release of bile into the small intestine, has receptor sites for thyroid hormones, and the sphincter relaxes in response to the thyroxin. A relaxed sphincter of Oddi allows for free flow of bile which is less conducive to the formation of gallstones. Lack of thyroxin such as found in hypothyroidism could result in a contracted sphincter. This phenomenon is thought to contribute to the formation of CBD or common bile duct stones that form from the bile left sitting in the duct.
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Gallbladder Surgery and Its Aftermath
There are several common side-effects following gallbladder surgery which can be read about here. It is the hormone related side-effects that I’d like to touch on as they are not generally acknowledged.
It was complaints from women, mostly, following gallbladder surgery that prompted my research into the why. Comments that their body was thrown out of balance or that “things have just not been the same since” as well as “weight gain that I’ve never had an issue with before.”
Some of the reasons could be coincidental, or hitting at the same time as surgery such as age-related peri-menopausal symptoms, insulin resistance or poor eating habits catching up with you. But what is more likely is that the stress from both the gallbladder disease and the surgery are triggering hormonal imbalances all over the place.
Everyone will react to an affront like surgery differently, but in everyone, surgery will stimulate a major stress response that is accompanied by both hormonal and metabolic changes. It activates the sympathetic nervous system (SNS), the hypothalamic-pituitary axis ( HPA), and the adrenal cortex. The hormones ACTH, catecholamine, cortisol and glucagon all play major roles in regulating the stress response.
Specific markers increased in gallbladder surgery are somatropin (growth hormone), CRP (acute inflammatory markers) and cortisol (the adrenal hormone involved both in stress and in reducing inflammation).
Somatropin is a protein anabolic hormone which basically means when protein cells are destroyed due to surgery, growth hormone is released in an attempt to rebuild or create new protein cells. There have been studies done showing that people given somatropin intravenously following gallbladder surgery recuperate from the surgery faster. To date this is not a practice that is used but it would be nice!
Inflammation can cause a cascade of hormonal havoc which people will react to and recover from differently. It can knock some people out for weeks to months, depending on their underlying health. Others are not affected. Also know that something as stressful as a surgery can bring on a latent condition such as Hashimoto’s and make it express.
For those of you who lost your gallbladder to surgery, this article discussed several things you can do to steer your health back on track; improving your digestion and hormonal balance.
Gallbladder and Sex Hormones (like estrogen, progesterone)
It has long been known that both pregnancy, long-term oral contraceptive use and hormone replacement therapy (HRT) contribute to the formation of gallstones and the accompanying symptoms of pain, indigestion, burping, gas and bloating, and possibly nausea. But what are the underlying mechanisms involved?
Estrogen and progesterone (known as the female hormones) when present in excess cause three separate alterations in the biliary (bile) system:
- a higher ratio of cholesterol to bile salts – also called super saturation of bile
- a higher propensity of the bile to aggregate or clump together – or stickiness of bile
- a lower than normal functioning of gallbladder emptying – leaving bile sitting stagnant in the gallbladder sac
Note from Magdalena: On the other hand, the bile helps the liver to excrete hormones like excess estrogen and its harmful metabolites. That explains why women who have their gallbladders removed often suffer from symptoms of estrogen dominance a few months after the surgery.
Counteracting the effects of the female hormones on the biliary tree
There are always choices that can help – pregnancy excluded.
- Choosing contraceptive measures other than hormones.
- Chinese and western herbs including adaptogens, nutrients and adrenal support to manage the symptoms of both menopause and peri-menopause.
- Support bile thinning, bile flow and liver detoxification.
These can make a huge difference when taken in tandem with any increased presence of hormones. All of these methods, excluding the liver detox can be used during pregnancy and nursing.
What kind of diet helps the gallbladder and bile as well as hormonal balance?
This is a two part process – what to avoid and what to include. General principles are listed here but
for a list of specific gallbladder-friendly foods, foods that trigger gallbladder symptoms, or to download our 30 day menu plans, check out the gallbladder diet page.
- all common allergens such as gluten, dairy, eggs and soy
- all refined foods – sugar, flour
- trans fats such as fried foods, hydrogenated and partially hydrogenated oils
- red meats which are inflammatory
- organic foods with a focus on fresh vegetables and fruits
- small amounts of complex carbohydrates such as rice
- moderate amounts of wild-caught (not farmed) fish
- good oils such as olive oil, fish oils, coconut oil – all in small amounts
DO NOT OVEREAT – EVER!
It’s the worst thing for your digestion and for your health overall. And it can trigger gallbladder attacks if you have a gallbladder problem.
Regardless of which hormones are off balance within you, as you work to harmonize those, begin now to address your specific gallbladder condition as well. First of all, take into consideration what may be the cause of your gallbladder symptoms. Address the ones that you are able to. And simultaneously, eat foods and take products that help to thin and gently move the bile. And apply castor oil packs over the abdomen which research shows have the ability to reduce inflammation in the area and which may also help you with much-needed relaxation and stress reduction.
Deborah Graefer is a Licensed Acupuncturist with a Masters in Traditional Oriental Medicine. She has been specializing in gallbladder and other digestive issues since 2001 with the launching of her website GallbladderAttack.com. She consults with people who are looking for answers or for alternatives for their symptoms. You can read more about her story here.