Gallstones and nutritional supplements

Various factors such as diet and obesity can promote the production of gallstones. An adapted diet and extra nutrients such as magnesium, lecithin and vitamin C can help prevent cholesterol gallstones.

What physiological mechanisms play a role in the formation of gallstones?

  • supersaturation (supersaturation) of the bile with cholesterol (insufficiently compensated by bile acids and phospholipids),
  • faster cholesterol crystallization (partly due to mucus formation, oxidative stress and (sub)acute inflammation),
  • insufficient bile flow and emptying of the gallbladder (bile stasis) and possibly
  • increased enterohepatic circulation of (secondary) bile acids.

Food, nutrients and herbs that positively influence lipid metabolism and bile composition, promote bile secretion (choleretic) and have an antioxidant and/or anti-inflammatory effect are therefore useful for preventing gallstones.

Magnesium

A magnesium deficiency may contribute to the development of gallstones. A magnesium deficiency is unfavorable for fat metabolism and promotes an increase in triglycerides and LDL cholesterol levels and a decrease in HDL cholesterol levels due to reduced activity of the (magnesium-dependent) enzyme lecithin cholesterol acyltransferase (LCAT). Low serum magnesium levels are strongly associated with metabolic syndrome, a major risk factor for gallstones. A high dose of magnesium sulfate causes a powerful contraction of the gallbladder. In an experiment, five healthy subjects ingested 25 grams of magnesium sulfate. After 20 minutes, this led to a highly significant increase in cholecystokinin levels (this hormone causes gallbladder contraction) and relaxation of the sphincter of Oddi. The result was that the gallbladder had only a third of its original volume 50 minutes after taking magnesium sulfate. In dogs it has also been observed that supplementation with magnesium sulphate (500 mg) causes significant contraction of the gallbladder.

Phosphatidylcholine / Lecithin

In-vitro and in-vivo research has shown that supplementation with phosphatidylcholine (lecithin) keeps cholesterol in bile better in solution, prevents cholesterol crystallization, stimulates bile secretion and counteracts bile stasis. In an animal experiment with mice with a hereditary predisposition to cholelithiasis, the effect of phosphatidylcholine as a supplement to a gallstone-promoting (lithogenic) diet was investigated. The animals did not develop gallstones when fed a standard diet; on a lithogenic diet, however, 47% of the animals had gallstones after four weeks, and 89% of the animals after eight weeks (control group). Animals fed a lithogenic diet containing 2% phosphatidylcholine had a greatly reduced risk of gallstones (22% of them had gallstones after four weeks, 44% after eight weeks) compared to the control group. The group of animals fed a lithogenic diet with 6% phosphatidylcholine did not develop gallstones during the study period (although 10% of these animals had precursors of gallstones after four weeks); the cholesterol saturation index in bile decreased significantly.

Vitamin C

Various risk factors for cholesterol gallstones in humans (overweight, aging, estrogen supplementation, pregnancy, diabetes, high triglyceride and LDL cholesterol levels, low HDL levels) are associated with lower plasma levels of vitamin C. In an experimental study, 16 patients used with gallstones a supplement with vitamin C (2 grams per day) for fourteen days prior to gallbladder surgery. In that short period, the vitamin C plasma level increased by 42%, the bile composition changed (more phospholipids, better composition of bile acids) and the nucleation time (in-vitro rate of cholesterol crystallization in bile) increased from two to seven days.
Other nutrients, supplements and herbs that can slow the formation of gallstones include taurine, dandelion, artichoke and milk thistle.

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