Susan's Blog

Reasons You May Not Be Digesting Your Food Well–Not Enough Bile

Not having enough bile, or not having enough bile at the right time, is one of the main reasons people may not be digesting their food well.  Bile is something we don’t really think about or hear much about, and yet it’s so important!

What exactly is bile?

Bile is a soap-like substance made by the liver and secreted by the gallbladder.  It’s most known for helping us digest fat. 

Bile salts emulsify the fats that we get from or food by busting fat molecules into smaller pieces so that lipase, our fat-digesting enzyme, can better surround each fat molecule and break it down to be digested more easily.

When fats are better digested and absorbed, the fat-soluble vitamins (A, D, E, K) can be better absorbed!

Little-known benefits of bile:

  1.  Not only does bile help to break down fats and help us absorb fat-soluble vitamins better, but it is one of the main ways that we eliminate cholesterol from our bodies (that’s because bile is made from cholesterol).  When we have enough bile, our body stops making more cholesterol, but when our levels of bile are low, or bodies are capable of making up to 15 times more cholesterol!

Conversely, if a person’s cholesterol production is low, bile production is also likely to be low.

Side note:  That just really makes me wonder—would supplementing with bile salts help to lower one’s cholesterol?

2.  Bile is also one of the main ways we remove metabolic wastes, excess hormones, drugs, metals, and other artificial substances from our bodies?  Our livers store these things, and if there’s not enough bile, toxins can build up in the liver.  That is because it’s the bile that joins with and carries the toxins out of the body.

3.  And there’s one more thing that bile does.  It helps make calcium and iron (and it’s speculated other dietary minerals) more absorbable.  And remember, if a person’s cholesterol production is low, bile production is also likely to be low.

If bile is made by the gallbladder, what happens if it’s been removed?

People who have had their gallbladders removed don’t concentrate bile acids.  Their livers still produce bile, but it dribbles out in a constant, low stream rather than a big burst when it’s needed (when we eat fat).

People who have had their gallbladders removed often experience heartburn or a feeling of abdominal tightness.  This is because bile salts neutralize the food that is acidified in the stomach.  If this acid doesn’t get neutralized, heartburn or abdominal tightness can easily happen.

Those without gallbladders may also see small pieces of fat in their stool because the fat wasn’t broken down well enough by the bile salts for lipase (the fat-digestive enzyme) to fully break the fat down.

They may be low in vitamins A, D, E, and K since these vitamins are absorbed with the fat (they are the 4 fat-soluble vitamins) and if the fat didn’t get broken down well, then the vitamins were not absorbed well either.

It’s often very beneficial to get tested for the levels of these as well as other nutrients with a micronutrient test to see how much of these and other nutrients have been absorbed so that you can take appropriate measures to make sure you’re up to snuff on those nutrients!

I’ve noticed that a large number of people who have had their gallbladders removed tend to have Small Intestinal Bacterial Overgrowth or SIBO.  SIBO can be the result of a number of factors including food poisoning, a fall on the tailbone, a head injury or a sluggish thyroid, but also from any type of abdominal surgery, which would include gallbladder removal.  ​

Is there any way to tell if you are making enough bile?

How do you know for sure if you are producing enough bile?

On a blood test, if cholesterol levels are lower than 170, it is possible there is a bile acid insufficiency.

Also, liver enzymes (ALT and AST) that are too high or too low can indicate dysfunction and/or congestion in the liver, possibly caused by not having enough bile.

Typical tests for bile acid insufficiency include endoscopy or (less invasive) testing for fats in the stool with a comprehensive stool analysis such as Gut Zoomer which includes the composition of the fatty acids in the stool.

What do I do if I’m not producing enough bile?

Supplemental bile salts can help, so if you’ve had your gallbladder removed, have liver disease, see fat in your stool, have dry skin, have low levels of the fat-soluble vitamins (A, D, E, K), or have trouble absorbing calcium or iron, you might consider using bile salts.

A typical dosage of bile salts is between 200-1,000 mg with food.  Alternately, taurine at dosages of 500-2,000 mg daily enhances your body’s ability to make bile salts.  You will want to discuss IF supplemental bile salts or taurine is right for you and at what dosage with your doctor or dietitian.

Please note:  There are instances in which you do NOT want to take bile salts.  DO NOT TAKE BILE SALTS if you have diarrhea, are hyperthyroid, or can’t absorb the bile salts properly due to Crohn’s, Celiac disease, or (sometimes) if you have SIBO.

Are there foods that help to increase bile flow?

While supplemental bile salts or taurine can be very useful to increase bile flow, and this is probably warranted if a great deal of improvement is needed, you can use foods and herbs to help increase your bile flow as well!  I’m a big proponent of food first because it helps to improve our overall diet in the process.

Foods and herbs that help stimulate bile are called cholagogues (there’s your word for today!)  Here are the highest cholagogic foods and herbs.

FOODS:  radishes, dandelion, chicory, mustard greens, turnip and mustard greens, beets, apples, celery, fenugreek, fennel, and artichoke.

HERBS:  cinnamon, ginger, turmeric, wormwood, greater celandine, boldo, blue flag, and fringe tree.

One or more of these herbs are often found in herbal supplements for the liver/gallbladder, and they are usually in combination with dandelion.

One such supplement is Integrative Therapeutics Lipotropic Complex, which I offer in my FullScript Dispensary at 20% off!



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