Fasting and gallstones/gall bladder attacks

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Fasting and gallstones/gall bladder attacks

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  • I suffer from gallstones and occasionally have attacks….is there any evidence that fasting will adversely affect my condition ?


    I started the 5:2 last Wednesday. No probs with not eating, although I discovered that my “normal” breakfast of muesli, skimmed milk, apple and black coffee actually contained the best part of my whole daily allowance. So after breakfast decided that my next meal would be ONE apple 200grams/104calories.

    One normal day later I woke up in the middle of the night with, what I now know to be, symptoms of gallstones.

    A hospital visit diagnosed a substantial gallstone that had not made it’s presence noticed previously…… Coincidence?…..I wonder

    Most “gall-bladder” problems are noted after ingesting fats.

    I have suffered from infrequent gallstone attacks for a number of years but since starting the fast diet last week I have had 3 attacks – more than I have ever had in quick succession before. I am concerned that the normal (not high-fat) eating after fasting is triggering these attacks …

    Hi Mair, like Carla says most gall bladder attacks start after ingesting fats. What foods are you eating on normal days? Even dairy foods could trigger an attack.

    My gall bladder attacks in the past have not usually started by eating fats but by eating quickly when I am very hungry – quite often an apple of pear has started them – and my doctor says a variety of foods can start them. Before yesterday’s attack I ate some white bread with olive oil based spread and marmite with a cup of tea with very low fat skimmed milk. The previous one, it was a blt sandwich with iced black coffee and before that bread and low fat spread with turkey slices followed by icecream … would bile build up in the gall bladder on fast days so that it is released quickly when we do eat?

    I’m not sure Mair. I just know from experience the difficulties I had before I had the stones removed. I guess it is possible that bile could build up. Olive oil based spread is still fat and bacon and icecream is also high. I couldn’t eat any fat whatsoever without suffering, you have my sympathy.

    I would think the most qualified person to answer that question would be your doctor.

    Fasting can actually help with gallstones as it helps with all bodily ailments by purging and eliminating toxins at a more rapid speed. I did a 15 day water fast, by day 10 I started passing the greenish gallstones that were around the size of a walnut and slightly larger. I was amazed. Our body’s are incredible in their own ability to heal. All that’s required is that we can step out of the way and trust in the process. But don’t take my word for it or anyone else s. Try and find out for yourself. Best wishes..

    I’m one of 3 people I know who have all had (first+ time) gallstone attacks since starting the diet..I was loosing weight really well, then had 3 attacks (VERY VERY painful – akin to childbirth) one month apart all in a row. i think its because of the LACK of fat in our diet, the gallstones don’t slide around like they do when we ingest some fat in our diets. so when fasting they get stuck? Just my hunch but until I have my gallbladder removed I have had to stop the 5:2 as I was getting too many attacks and I cannot afford to lose any more days off work, as I work for myself! any one else had these problems?

    Hi Puppet:

    Here is more than you want to know about gallstones:

    While lack of fat in the diet, or anything in the diet at all, is not one of the causes, unfortunately rapid weight loss is. However, two of the top causes are being a woman and being obese.

    I don’t think the problems are anything to do with eating fats or not. If anything, it would be better to eat fat regularly and keep the bile flowing.

    There is in fact some evidence that prolonged fasting (more than 14 hours) can cause gall bladder problems. I am in the midst of researching this as I have now had 4 painful episodes of abdominal pain since starting 5:2 over 2 and half years ago. I had put it down to trapped wind. With the most recent one however, I went to see my doctor who did an ultrasound. This showed an enlarged gall bladder and a probably obstructed bile duct.

    In my layman terms, what I think happens is that while fasting, the gall bladder is not required to release any bile, but continues to receive it from the liver. It concentrates the bile, and that increases the likelihood of raising the cholesterol saturation of the bile (particularly when you are burning fat, and as we know fasting can help lower circulating cholesterol). This can result in the formation of sludge (composed of cholesterol and bile salts). When you break your fast, the signal goes to the gall bladder to release bile, and at that point it can contract with such force that it ejects sludge or small stones, which inevitably get stuck, albeit temporarily, in the bile duct.

    Here is a relevant study:-

    I have also noticed a correlation in my own case with the consumption of legumes, and this may be relevant, as like sterols, they can help to lower circulating LDL and raise the concentration of cholesterol in bile. This effect was noted here

    Yes, rapid weight loss can lead to the formation of gallstones, as can certain types of diet, lack of fibre and a sedentary lifestyle.

    For me, the answer short term is not to fast for longer than 12 hours. I will see a specialist this week and hope to get more clarification. I would really like it if I didn’t have to have my gall bladder removed, as far as I am concerned it may not be essential, but it does have a purpose!

    @busybee may be right about keeping the bile flowing to avoid gallbladder attacks.

    Here’s a nice post about gallstones and how they might (note I said “might” not “can”) be gotten rid of:

    Perhaps it won’t work for everyone but her logic is persuasive and it did seem to work for her.

    I’ve had a few of what my doc thinks are gallbladder attacks since losing all this weight with Fast Diet and Perfect Health Diet. Worth noting is that I was eating a lot of butter for a while,right before the attacks started occuring, which I’ve now ditched almost entirely in lieu of coconut oil.

    After doing some research I’m trying the method of apple cider vinegar and keeping the bile flowing throughout the day by drinking small quantities of peppermint tea (especially when I fast), as recommended in the linked post above. Also got some chanca piedra tea. Chanca piedra is a rainforest herb with the colloquial name “stone breaker” and is supposed to help dissolve kidney and gallstones. No attacks in over a month, and (watch out for TMI) stools are already a better color after just a few days doing this. They went completely white for a few days after the last attack.

    We’ll see how it goes.

    Just luckily had my gallbladder removed Simple. NOTHING worked..fasting, fats, non fats, standing on my head!! so its gone now I can hopefully loose weight with NO PAIN !!

    I struggled on for far too many years with gallstones – trying to figure out what food triggered them – having painful attacks – not enjoying food!

    Finally had my gallbladder out around 5 years ago and wish I’d done it sooner. I’ve had no problems at all since and can eat what, when and how I like. Good luck!

    Those dreaded gallbladder attacks were killers. I started getting attacks 2013 before I started 5.2. They were mainly and definitely bought on by eating large fatty meals, hence then the gallbladder tries to release bile for digestion. I controlled my attacks somewhat by cutting out fatty food, then later on in the year watched the 5.2 doco and started 5.2. Not much changed with the attacks. I still got them every now and again, so after a year and a half I took the plunge and got the darned thing out. My life went back to normal. Did lots of research in my suffering time( as it was) on the gallbladder and found that there are numerous reasons why we develop them, obesity, losing weight quicky, being a woman,pregnancy. It’s hard to pinpoint exactly why each person gets them and how long they were even there without symptons. They could have been there for years alas. If it causes long term systematic symptoms whip it out! ?

    This is a question you should ask your DR but John Hopkins Medicine that Fasting is a risk factor to get Gallstones. “Fasting. Fasting decreases gallbladder movement, which causes the bile to become overconcentrated with cholesterol.”

    Hi Puppet Peg. I had my gall bladder removed 3 weeks ago. I had an attack and then my doctor said it had to come out. The attack started after 2 weeks on 5:2.
    I’d really love it if you could share a bit about how you’ve been since September 15. I would learn a lot from your experience. Kind of scared to go back on fasting. But I want to because for me it’s the best way to lose weight.

    Hi I haven’t gone back to 5:2 so I can’t comment..all I know that is I have NO PAIN I am much happier!! good luck!

    Hi Sigalkg, I had my gall bladder removed last September. I waited to restart 5:2 until after I had the followup meeting with my surgeon about 4 weeks or so later. He said I could eat whatever I like, and I can. I have been fasting once or twice a week ever since and nearly always do a 24 hour fast before having my 500 calories. All good! Now that you don’t have a gall bladder, there is no reason to be scared, as far as I can tell.

    I have had one attack since starting 5:2, but I am not a stranger to gallbladder stone attack.. They have not gotten worse, but I hope I clean these stones out. After all, we shouldn’t have them right?

    PinkQueen, you may find that fasting for long periods encourages the formation of sludge and stones – I think it helpful to limit the actual fast time to no more than about 14 hours before using some of your calories.

    Hi as someone who has recently been confirmed as having gallstones via ultrasound and who has suffered from very infrequent attacks – I have had three attacks in total between June 2013 and today (November 2016)I have had to research this whole topic to understand what dietary changes I need to make to minimise the risk of gallbladder attacks. What interests me greatly is the question of why the majority of gallstones are “silent” and do not cause symptoms while some gallstones cause symptoms. I have never found a satisfactory explanation or answer to this basic question in the scientific literature or anywhere which has led me to try to find an answer because I feel if we know the answer to this question we should be able to formulate a dietary strategy to minimise the risk of attacks.

    The best answer I have come up after reading various papers is as follows. Gallstones in general are denser than thin or new bile and so sink in new bile. However, when new bile enters the gallbladder the role of the gallbladder is to concentrate or thicken the bile. When this happens the density of bile increases and under certain circumstances can become equal to or denser then the gallstones which then causes the gallstones to become floating gallstones in the gallbladder. Normally the bile itself in the gallbladder is stratified so that the thickest and densest bile (also known as biliary sludge) sinks to the bottom of the gallbladder (which is furthest away from the cystic duct) while the least dense or thinnest bile is nearest the cystic duct. To have a gallbladder attack requires a gallstone to find its way to the cystic duct. The stratification of the density of bile is the body’s self-regulating mechanism of keeping the gallstones at the bottom of the gallbladder and far away from the cystic duct and “silent”. However, problems can arise when this normal balance or stratification of bile density is changed and fasting is one such process that changes the balance of bile density. When we fast no new thin bile is delivered from the liver to the gallbladder and the resident bile just thickens and becomes more dense making the risk of floating gallstones higher and hence the risk of gallstone entry into the cystic duct and blockage. This explains quite nicely in my view why most gallbladder attacks occur at night while we are asleep and fasting. But they can occur at any time after prolonged period of not eating. In all three of my attacks they occurred after several hours of not eating after having a heavy meal.

    As someone who has stones that are for the majority of the time “silent” but clearly can have symptoms I have decided that the best way to avoid symptoms is to eat regularly to keep the turnover of bile in the gallbladder frequent and to try to avoid heavy meals and keep my bile thin via the diet i.e. avoid fatty foods, sugars.

    So I’ve never had gallstones but would quite like to avoid getting them. So I’ve spent the last 3 hours or so obsessing about this.

    My vague understudying of what is going on is that cholesterol is produced in the liver and then ends up in bile and if the gall bladder isn’t emptied enough you can get gall stones.

    Vague things on the internet they I’ve read about this that may not be true:

    Fat causes bile release (this one is pretty true…)
    Caffeine causes bile release
    Coffee causes bile release
    Bolus mass can cause bile release
    Acidity can cause bile release
    Turmeric can cause bile release (seems a bit hippy)
    Vitamin C can prevent gall stones

    The fact that bile release causes uncomfortable symptoms for those with gallstones gives one a nice diagnostic.

    My personal plan is:

    I. Take up drinking bullet proof coffee (coffee + butter) and have it when fasting.

    II. Eat lettuce heads when fasting

    III. Occasionally wash these lettuce heads down with diet Coke (sacrilege and insulin)

    IV. Increase vitamin C consumption (maybe to 500 or 1000 percent RDA)

    V. Drink water

    VI. Ensure I have some fats

    I don’t understand how point III helps at all?
    But if you are really concerned about gallstones, then splitting calories so that you don’t go longer than about 14 hours without eating should help avoid a problem, including some good fats in your meal (yes, bulletproof coffee would do), together with ensuring that your weight loss is not too rapid (1 to 2 pounds a week is ok).

    Hi, A few years ago I did a VLCD (very low calorie meal replacement diet), as I needed to lose weight quickly prior to surgery. One of the requirements of that diet was a minimum 1tsp of added oil per day (the meal replacement products also contained some fat). I was told that this would reduce the risk of gall bladder attacks – although this was not an issue for me as I had mine out over 30 years ago.

    So the motivation for lettuce heads is very low calorie, high volume bolus mass without interrupting fasting state.

    Diet coke provides caffeine and acid.

    I imagine lemon juice and coffee would have a similar effect. But you can’t buy lemon juice everywhere.

    I should have thought that if you can buy lettuce, you can buy lemons…. Those artificial sweeteners in diet coke can be spiking insulin and interfering with the behaviour of your gut flora and are really best avoided. I would also say that you don’t need to do all of those things! So a cup of bulletproof coffee in the morning and a meal with some good fats in the evening should cover it, as far as keeping your gall bladder releasing bile every so often is concerned.

    Well buying lemons is all well and good, it’s just a matter juicing them and mixing them with water: convenience matters.

    But yes, you can buy portable containers of lemon juice. Which seems like an eminently reasonable alternative.

    Sorry back again,

    I found this quite nice review article of gall-bladder motility:

    which may be of use to people reading this post (unlike my earlier random collection of uncited half-disowned assertions…)

    I’ve tried intermittant fasting a couple of times but stop because it causes me gall bladder issues.

    What I think is odd is last year I had bronchitis and just didn’t eat for a week and I was fine. Year before that I had a medical problem where I was vomiting for the most part of eight weeks and had no gall bladder issues either time despite long periods of time with no food in my system and when I did eat – very little. It’s weird that it happens during the fast though, I wonder if it’s excessive coffee consumption on an empty stomach. I definitely don’t drink coffee when I’m sick. Just a thought.

    When I try this again I will skip the coffee and go for herbal tea

    Boy this post brought back memories. When I split with my first husband I was 3 stones overweight. Due to the emotional turmoil I barely ate more than one small meal a day if that. Within 9 weeks I had my first ever gallstone attack. Thought I was dying. After a year of continuing attacks I had my gallbladder removed.The surgeon told me that there is a heightened risk of gallstones if: There’s a family history,you are overweight,female,eat a refined carb diet,lose weight quickly or have embarked on prolonged fasting.Certain meds or diseases can also cause them. I knew of the first 4 contributors but not the last four. Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. And it isn’t true that once you have your bladder removed you can no longer form stones….my uncle had a pancreatic duct stone the size of a walnut, 32 years after having his bladder removed.

    I am sorry to hear that people are suffering with gallstones while intermittent fasting but this page was very helpful for me in identifying what has been causing my attacks. I have had 5 attacks in the last two years and certainly the last 4 have been while I had been doing 5:2. Everything I had read suggested that gallbladder attacks were triggered after eating fatty foods or a fatty diet which did not match to my experience as mine always started after a long period of fasting of 14-16 hours and then eating and I think I eat a healthy and varied diet with maybe the odd bacon sandwich! It was only yesterday, when suffering from my fifth attack that I thought fasting could be the issue and googled and found this forum. Feel quite disappointed that intermittent fasting is the cause as I’ve really felt the benefits of fasting and was able to do it much more easily than I thought it would be but now I am going to stop, certainly while I wait to have my gallbladder removed.

    However, I still believe in the virtues of the 5:2 and wondered whether it would be ok to continue but not to have such a long period of fasting. When I started the 5:2 I would have breakfast lunch and dinner for the 800 calories on fast days but then started skipping breakfast and using the 800 calories for lunch and dinner only. What are other people’s experiences?

    My experience was of generally doing 24 hours fasting, then 500 calories. After diagnosis with gallstones, I restricted my fasting period to a max of 12 hours. That worked really well for me while I was in the period between diagnosis and surgery. I wasn’t in a hurry, so it was about 4 months and I had no episode of gall bladder pain in that time. I also made sure that I had a little fat at each occasion of eating, my theory being to keep the gall bladder active and prevent sudden contractions which might expel sludge or stones. I should have liked to delay surgery longer, or altogether, but couldn’t convince my medical team that would be a good thing, so went with their advice, reluctantly. HOwever, I haven’t had any problems since and got back to doing 5:2 as soon as I was recovered from surgery. I hope thins work out well for you.

    Thanks Busybee for your response and suggestions. . Pleased to hear you’ve recovered well and been able to continue with the 5:2.

    Hi everyone I’ve taken the time to read over this thread and so glad that I found it. All of 2017I was low-carb high-fat. I have no gallbladder issues until I decided to do a three day fast. I broke my fast with half an avocado., shortly after felt like I had been socked in the gut. I felt lethargy and weakness and the socked in the gut feeling for like two weeks and then had the worst gallbladder attack. After that happened I was perfectly fine. And the holidays and eating all that crap gaining back 12 pounds I decided that fasting was going to be my new regimen. I’ve done well up to this point but recently started having gallbladder attacks again. I fast on the average of 19 hours a day…. I really like fasting, and it really works for me. But I can’t take this gallbladder pain and I’m considering having it out. So after reading some of these posts I think I’m going to have a bullet proof coffee break up my fast

    I thought I should add to this with what I’ve had happening. I’ve only been doing this fast 4 two weeks (or 4 36hr fasts) but have experienced the same thing every time. I had my Gall Bladder removed 10 years ago. Ever since then I especially had to be careful if eating some high fat foods (French fries)after eating maybe 30 minutes then I would have bile diarrhea. I’m having the same issue especially on the morning of the 36 hours. I’ll wake up and drink 20ozs of water then usually before I can even get a coffee 15 minutes later, I’m asking myself “are farts lumpy?”, nope! I’m having a bile dump. Then I’ll drink my coffee and not be able to make it to work, same thing. Usually a few more times over the next hour or two before I have my protein shake. Anyway, it definitely stirs up your bile and without a gall bladder to help regulate, it comes right out. So I can only imagine if you have resting stones all that extra bile pressure is probably pushing them out of the gall bladder. I’m not a doctor, but I am Spire Elite (highest level) at Holiday Inn Express! 😉

    PBMax, I actually find it is usually refined carbs that cause such a reaction, after a fast day, not fatty foods, and it has to do with overexcitable gut flora, rather than bile. It can help to break your fast with protein, such as plain yogurt or a boiled egg, and then a pause of 15 minutes or so before eating any carbs. You don’t get a bile dump as there is no source for storing bile, in fact digesting fatty foods may be problematic because there isn’t enough bile to assist.

    Are people confusing gallbladder attacks with the actual cause of gallstones? Let me explain, When people have an attack they decide to stop eating the food that caused the pain. They conclude that the behaviour,(fasting, drinking coffee, or eating a fatty meal)
    is also what causes the stones to form. (Stones take years to form). They think the attack is a bad thing. Perhaps the attack is the body trying to pass the stones through contractions and spasms and the inflamation is a result of that effort or from blockages. The food that cause the bladder to expel the stones may be the cure. That is unless they are too big to pass. We must find out how to dissolve them.

    I unfortunately had a lot of issues with gallstones and learnt the hard way about how to prevent them happening again. I struggled to find information easy to understand – in the end I started ( to help others that are suffering with gallstones. I hope you may find it of help to you.

    I just started the 5:2 and within just a week I had 6 attacks. NO dairy, no nothing about fats. just the same. So now I wonder.

    Hi Sarahshapiro1375
    I feel your pain I had similar situations to you, I will post a link (article) that might help you about how very low calorie diets may unfortunately effect some people differently to other

    hope it helps

    I DID suffer from Gallstone attacks for years where I do Intermittent Fasting and Extended Fasting.

    For a start, everyone that has Gallstones should be doing Gallstone Flushes. I suggest you read ‘The Amazing Liver and Gallbladder Flush’ by Andreas Moritz. These a reason why his book has 4.5 stars from over 500 people.

    I personally take apple juice every day with 2 tablespoons of Apple Cider Vinegar and Chanca Piedra table every morning. The apple juice keeps the Gallstones soft so they don’t cause an attack where the Chanca Piedra and ACV help dissolve them.

    Intermittent Fasting may cause GS attacks but that is due to GS in your gallbladder. Remember having GS in your body, especially in your liver that does over 500 jobs, really reduces your health. I’ve done about 15 flushes now. After each flush, the liver will move Gallstones down to your gallbladder in 2-3 days. The liver is what creates Gallstones mainly from eating bad food where people can have over 10,000 stones in their liver.

    After 2-3 days since our last flush, you may feel a little discomfort after you eat Fat. If it becomes painful, I take a Digestive enzymes tablet. Apple Cider Vinegar is great as well as stopping attacks.

    After some flushes, I can eat anything (no attacks) where I got into Intermittent Fasting after my 5th flush, 2 years ago. After some flushes, I have to keep my fat below 10g per meal or I’ll have an attack. Always after the next flush with problems such as these, I always pass very big GS (2+ cms).

    I have had some attacks but they are now mil this year. This is what I do to keep GS attacks at a miniminal… I drink Apple juice every day with a 2 TSP of Apple Cider Vinegar and Chanca Piedra tablet. If I eat a high fat food and I feel discomfort, I will have this drink twice or 3 times. Remember Apple juice softens the stones as well as ACV and Chanca Piedra.

    When I have an attack, I take Apple Cider Vinegar with Digestive enzymes tablet. The secret is to take it before the pressure builds up too much hence I always have both in my car or nearby. If it gets very bad, I break down 2x Paracetamol tablets with my teeth and swallow. I also take a Donnatab to relax my stomach. I have also found sitting down and leaning forward helps during an attack after taking the formula above.

    As you are still having problems, I suggest that you limit your fasting period without any food to no more than 12 hours, and make sure you have a little fat at each meal to keep your gallbladder active. It is inactivity that encourages the build up of sludge and stones, and losing weight increases the amount of cholesterol released from fat cells, and this is a major component of the most common type of gallstones. No amount of flushing will actually remove gallstones, what you are seeing afterwards are not stones from your gallbladder, but probably accumulations of fatty substances from your digestive system. Sorry, but the liver does not move gallstones into your gallbladder. What you are passing after a flush is certainly not gallstones, nor does cider vinegar soften them. That sort of advice has no place on this forum. Go to your doctor and get treated.

    I’m sorry to tell you this busybee but most doctors don’t care about you and only care about your money. Most are drug dealers for the drug companies that receive commission especially if they sign you up to a monthly subscription. The only real way to heal is naturally where when you break a bone, does a doctor heal it? No, your body does and it also is the one that fights colds and the flu. The problem is today, food is so bad for you that nearly everyone these days has some kind of health problem cause their system is so weak.

    I suggest you educate yourself better and read ‘The Amazing Liver and Gallbladder Flush’ by Andreas Moritz. I’ve also read another 5 books on the subject of Gallstones that have 4+ star rating that has clue GS naturally.

    I did go see a couple of specialists where it was hard for them to answer the question about if GS flushes do work or not. They instead tried to talk me into having my Gallbladder removed! Doctors love to cut things out, just like having your tonsils out! On a logic level, our body works the best with all parts and organs.

    Doctors make no money if you heal yourself naturally. 90% of health problems are due to poor lifestyle, mainly food, lack of sleep, no exercise and stress.

    What are the other four books?

    I have been suffering from a strong pain on the right side of my stomach, under the rib cage for the last 5 years. It became more frequent over time. The ultrasound done 5 years ago didn’t show any gallstones, that’s why I started investigating other things, but now it really look that is in the gallbladder.

    Saying that, every time I fast and eat after 6, 8 hours of fasting (not counting when I’m sleeping) I have a terrible and painful attacks that make me thing that labour pains could not be so different than what I experience.

    I had to fast recently for a HIDA scan and I had to drink (for the HIDA scan) some milk with a supplement. I was OK in the morning, just a bit sore, but later that afternoon I had an awful attack.

    For me is clear that fasting and eating after that is a trigger for these attacks

    My gall bladder attacks in the past

    I found your site and am convinced fasting has caused my gallbladder pain/attacks.

    I will have my gallbladder removed in a couple of days, but the attacks were preceded by intermittent fasting using the 9 hr eating period followed by 15 hour fasting period. After months of this, I started the get gallbladder pain now I have biliary sludge in my gallbladder.

    My doctor says this will only get worse, since the gallbladder is diseased, so it must come out.

    Strangely, my pain starts when my stomach is empty (worst is at night), not when I consume fatty foods. I have to eat something about every 3 hours to eliminate the pain.

    Has anyone else had this experience?

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