Weight loss and gall bladder issues

yup happened to me. I had three nasty gallbladder episodes earlier this year after several months of low carb, thankfully none recently. Had ultrasound where technician said "oh boy yes you've got gallstones!". I have an outstanding appointment to visit specialists. Can't really advise as I'm working it out for myself. I guess she should have a scan to establish if she has gallstones, then have a meeting with the specialists to determine her options. At least that's the route I'm taking. Word is that higher fat will help the gallbladder but can have nasty effects if gallstones already exist and then start shifting about. The keto diet isn't the problem, the already existing gallstones are. I'm undecided if I should see it forward and hope that the gallstones either stay quiet or (fantasy land?) disappear or just have gallbladder out and accept the damage has already been done.
Would be happy if you could report ongoing experiences in the interest of sharing.

I had gallbladder issues for years, misdiagnosed, before t2 diagnosis and low carb. Ultimately the gallbladder stores and concentrates bile to digest fat. If it doesn’t get used much, eg on a low fat diet, gallstones form from the uncirculated sludge. Introducing fat causes the bladder to work as designed and contract and if stones are present they get squeezed too and pain results and possibly stones stuck in duct. All = pain. Sadly too many drs blame this pain on the fat in diets rather than realising this is just the trigger for preexisting problems to disclose themselves.
There are drugs and procedures that can break down stones but drs don’t use them because they are slow and they assume the stones will just reform because they don’t believe the original cause will be addressed (partly because they don’t understand what the cause is and partly because they don’t believe people will change their lifestyle). I only understood all this too late for me to force this option for myself.

I was incredibly reluctant to have surgery but have to say it’s better than the gallbladder agony (worse than childbirth easily) and with slow and gentle adaptation I adopted LCHF with few problems afterwards as many others have done too.

Could be coincidence though. I've had gallstones (problem solved by having them take out my gall bladder), way before diabetes and never having been on any kind of diet.
They told me you have a higher risk of gallstones when being Female, Fat and Forty. I wasn't 40 years old yet but sadly fit the other 2 risk factors.
Not saying your wife is fat, but you mentioned she wants to lose some weight, being your wife I suppose she's female, and going by your age there's a good chance she's over 40. Sometimes we just have a bit of bad luck without a clear cause.

That said, I feel for her, a gallstone attack is pretty horrible! (And the thing becoming inflamed can make you very, very ill, not something I'd like to try again.)
All the best to her, and to you when having to watch without being able to help her.

I'm very happy without my gall bladder and can eat just as before (apart from the diabetes, that is).

HSSS said:

gallbladder agony

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yup it really hurt
the kind of pain where there is only the pain and nothing else.
and there's the risk of acute damage as the stones move around. but in principle a higher fat diet should allow the gallbladder to fix itself......maybe too late for me though.

copilost said:

yup it really hurt
the kind of pain where there is only the pain and nothing else.
and there's the risk of acute damage as the stones move around. but in principle a higher fat diet should allow the gallbladder to fix itself......maybe too late for me though.

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Kind of depends on the size of the stones and number of them. Loads of small ones and a couple of golf balls were never going to resolve themselves in my case. The odd smaller one quite possibly.

HSSS said:

Kind of depends on the size of the stones and number of them. Loads of small ones and a couple of golf balls were never going to resolve themselves in my case. The odd smaller one quite possibly.

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yup i think i might be there have to go consult and see (don't want to revisit the ouch any time soon)

One of the key factors for gallstones can be losing weight too quickly, particularly if you are on a low fat diet. Bile is used to break down fat and if you aren't eating enough of it the bile forms gallstones. Unfortunately once you have them you have to eat low fat until you have it removed. This happened to me and the pain is awful. I ended up with an infection in my gallbladder caused by a stone blocking my bile duct and in hospital for 14 days. Ended up screaming the ward down one evening as the pain was so bad. Would recommend low fat for now - stick to anything less than 5% fat. Not what you want to hear if you are doing keto but I lived off chicken, rice crispies, fat free yoghurt, fruit and quavers! One thing was that my h1abc ended up being in the non-diabetic range by the time I had my gallbladder out.

Should say that if I ate anything with any fat in it I soon knew about it - horrendous pain that resulted in trips to a&e.

junemc153 said:

One of the key factors for gallstones can be losing weight too quickly, particularly if you are on a low fat diet.

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So it’s not so much the weight loss but the low fat maybe!! If you don’t use the gallbladder the bile sits and turns to sludge effectively. Agree once you have the stones it might be different to avoid the agony caused by squeezing the bladder, exactly as it’s designed to be, but avoid getting them by eating fats regularly (imo)

HSSS said:

but avoid getting them by eating fats regularly (imo)

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I've never eaten low fat in my life, still got gall stones.
My guess is an unlucky draw.

Antje77 said:

I've never eaten low fat in my life, still got gall stones.
My guess is an unlucky draw.

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Perhaps it is. I do think it increases the odds though.

junemc153 said:

One of the key factors for gallstones can be losing weight too quickly, particularly if you are on a low fat diet. Bile is used to break down fat and if you aren't eating enough of it the bile forms gallstones. Unfortunately once you have them you have to eat low fat until you have it removed. This happened to me and the pain is awful. I ended up with an infection in my gallbladder caused by a stone blocking my bile duct and in hospital for 14 days. Ended up screaming the ward down one evening as the pain was so bad. Would recommend low fat for now - stick to anything less than 5% fat. Not what you want to hear if you are doing keto but I lived off chicken, rice crispies, fat free yoghurt, fruit and quavers! One thing was that my h1abc ended up being in the non-diabetic range by the time I had my gallbladder out.

Should say that if I ate anything with any fat in it I soon knew about it - horrendous pain that resulted in trips to a&e.

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Hello
I am new here
I am so interested in what you have written...I have been LCHF for over 3 years to reverse ...T2D and metabolic syndrome...so non alcoholic fatty liver disease, glucose intolerance, high triglycerides, high blood pressure...I reversed them all ...then with lock down...I stupidly started to eat a few potatoes in my diet of LCHF ...result...higher HB1C and now full in inflamed gallbladder ...the stones passing are excruciating ...my stomach is very distended and even the slightest amount of fat causes extreme painful episodes...my worry is...I need the LCHF to control my T2D and metabolic syndrome ...but I cannot eat the healthy fats at the moment...so actually stuck on what to eat. I am frightened of making myself really ill with a larger carb diet ...I eat upto 50 carbs per day ...and keep sugars out of my diet as much as possible ...how did you feel having to eat lower fat foods that contained sugars? Like low carb yoghurt etc? At the minute I am managing chicken, cucumber, tomatoes in tiny amounts , strawberries, almonds, and I mix small amount of potato with cauliflower mashed with a drop of milk ...where there any cheeses you could eat? Like feta or Halloumi? Could you use Olive Oil? Or are ALL cheeses and oils out? Reading here ...it would seam that cutting all fats out...makes things worse... I am struggling with what to eat ...many thanks

Migmogs said:

Hello
I am new here
I am so interested in what you have written...I have been LCHF for over 3 years to reverse ...T2D and metabolic syndrome...so non alcoholic fatty liver disease, glucose intolerance, high triglycerides, high blood pressure...I reversed them all ...then with lock down...I stupidly started to eat a few potatoes in my diet of LCHF ...result...higher HB1C and now full in inflamed gallbladder ...the stones passing are excruciating ...my stomach is very distended and even the slightest amount of fat causes extreme painful episodes...my worry is...I need the LCHF to control my T2D and metabolic syndrome ...but I cannot eat the healthy fats at the moment...so actually stuck on what to eat. I am frightened of making myself really ill with a larger carb diet ...I eat upto 50 carbs per day ...and keep sugars out of my diet as much as possible ...how did you feel having to eat lower fat foods that contained sugars? Like low carb yoghurt etc? At the minute I am managing chicken, cucumber, tomatoes in tiny amounts , strawberries, almonds, and I mix small amount of potato with cauliflower mashed with a drop of milk ...where there any cheeses you could eat? Like feta or Halloumi? Could you use Olive Oil? Or are ALL cheeses and oils out? Reading here ...it would seam that cutting all fats out...makes things worse... I am struggling with what to eat ...many thanks

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Cutting out all fats causes the problems in the first place for some,people. Once you have them the reverse is often true though. The only reason to cut fats is if they aggravate the gallbladder Stones already in situ. So if cheeses and yoghurts and olive oil don’t cause a problem in that respect, eat them. Some people find some fats better than others and it’s a bit of trial and error. Try and space out whatever fats you do eat across the day rather than lump them into one meal. Not sure why you feel the need to add potatoes specifically. They tend to be one of the highest carb options. The skyr and kvarg quark yoghurts are lower sugar and low fat. What about increasing protein if you’re hungry rather than carbs?

HSSS said:

Cutting out all fats causes the problems in the first place for some,people. Once you have them the reverse is often true though. The only reason to cut fats is if they aggravate the gallbladder Stones already in situ. So if cheeses and yoghurts and olive oil don’t cause a problem in that respect, eat them. Some people find some fats better than others and it’s a bit of trial and error. Try and space out whatever fats you do eat across the day rather than lump them into one meal. Not sure why you feel the need to add potatoes specifically. They tend to be one of the highest carb options. The skyr and kvarg quark yoghurts are lower sugar and low fat. What about increasing protein if you’re hungry rather than carbs?

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Thank you for your lovely reply ....I think I am a bit confused what to eat at the moment ...I was eating a great LCHF ...all right I cheated over lock down with some potatoes...but nothing else..but my T2D etc etc need the Low Carb ...but the gallbladder is kicking off in Excruciating pain with just my simple healthy fats ...I normally make a no sugar chocolate mouse less than 2 carbs per serving ...ate a 1/4 of normal serving ...oh my goodness ...I almost blacked out the pain was so extreme....I know that what we cannot do ...is eat a low carb low fat diet ...as that is also bad for you ....hence my addition of very small amounts of potato to balance up the fats that I have stopped eating ...and that I love...I by the way eat no bread, no pasta, no rice, no cakes , sweets etc...I am committed to my no sugar way of eating ..I am fully fat adapted...but I am missing the cheeses, butter and creams that I loved to add to my meals .I normally cook in butter and olive oil ..I like to make my cauliflower, cheesy mash etc etc ...shepherds pie with a creamy, cauliflower, cheesy topping, not moaning by the way ...I don,t like vegetables as such and the cheese and butter made them all palatable to me ...eating straight cauliflower mashed in milk ...is for me not good ......tonight I tried a tiny drop of olive oil on my very small salad served with chicken ...ate half..as frightened the olive oil would kick me off ...it didn,t ..thank goodness...but the fear stopped me eating ...at the moment I eat strawberries for breakfast frightened to try my full fat yoghurt ....some almonds for lunch time and one small meal...which at the moment is usually chicken....maybe as you advise...it is trial and error ...the pain though is so extreme I am now really frightened to add any cheeses ..Even light ones like feta etc butter , creams and olive oils ...my family all have had gallbladder issues ....but they absolutely do not understand LCHF and think I am mad for eating healthy fats ...even though I reversed so many illnesses eating this way ....sorry for rambling ...I feel stuck as to what way to eat ....If I go low fat for the gallbladder pain...it means more carbs...which means becoming sick again...I don,t want to get sick again as I was 3 years ago ...but the pain of eating even tiny amounts of fats is unbearable

Hi @Migmogs ,
If your gallbladder is causing you so much trouble, have you considered having it taken out?
You say it's inflamed now, inflammation causes higher blood glucose in itself, even without changing your diet.

Antje77 said:

Hi @Migmogs ,
If your gallbladder is causing you so much trouble, have you considered having it taken out?
You say it's inflamed now, inflammation causes higher blood glucose in itself, even without changing your diet.

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Hello
Thank you for your response
I hadn’t realized that my blood sugars where being affected also
And yes the surgeons plan is for surgery ASAP
As soon as my gallbladder has settled down a bit

Migmogs said:

Hello
Thank you for your response
I hadn’t realized that my blood sugars where being affected also
And yes the surgeons plan is for surgery ASAP
As soon as my gallbladder has settled down a bit

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That's great!
In that case I'd settle for less than perfect blood sugars with less pain, as it's only for a while.

When mine was inflamed I had to wait for 6 weeks for the surgery. After the surgery I went back to normal within the week, including eating whatever I wanted, high fat and all, and it's never bothered me.
Hope it will be the same for you!

Antje77 said:

That's great!
In that case I'd settle for less than perfect blood sugars with less pain, as it's only for a while.

When mine was inflamed I had to wait for 6 weeks for the surgery. After the surgery I went back to normal within the week, including whatever I wanted, high fat and all, and it's never bothered me.
Hope it will be the same for you!

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Thank you so much for your reply
I have also been quoted @ 6 weeks for surgery
It is such a difficult balancing act ...as you know
Great to hear that I will quickly be able to get back to my normal LCHF way of eating

Where you able to tolerate full fat yoghurt?
Or did you just give up on the healthy fats until your gallbladder was removed?
Take care and thank you

Migmogs said:

Where you able to tolerate full fat yoghurt?
Or did you just give up on the healthy fats until your gallbladder was removed?
Take care and thank you

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To be honest, I didn't really find a clear pattern as to when the attacks occured, high fat, low fat, whatever, so I just ate whatever and hoped for the best. This also happened years before diabetes, so I wasn't very aware of food in general, apart from what foods I liked or disliked .

Antje77 said:

To be honest, I didn't really find a clear pattern as to when the attacks occured, high fat, low fat, whatever, so I just ate whatever and hoped for the best. This also happened years before diabetes, so I wasn't very aware of food in general, apart from what foods I liked or disliked .

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Much my experience too. I did add fat gradually afterwards building up slowly as indulgences too early had their cost in the bathroom. Not horrific but definitely noticeable. By 9 months and diagnosis and going keto there was no problem.