I've been eating pseudo-paleo for a while, really starting to ramp up my saturated fats and completely dropping legumes earlier this week. I'm probably eating 150-200 grams of fat a day, mostly coconut oil/milk/cream, eggs, and beef, but do I eat sardines in water, olive oil, a tbsp of cod liver oil, so it's not all saturated. I'm getting some stomach problems, diarrhea, and since last night after eating a bacon/cabbage salad, I've noticed a low, somewhat subtle nauseous feeling that has lasted until this morning and made it impossible to eat more than one bite of my bacon/spinach omelot.
I had assumed it was just my body getting used to the increased fat intake, and this seems like the most likely explanation, but I started wondering if having no gallbladder (removed last summer) is to blame? I know it aids in fat digestion.
Anyone eat paleo without a gallbladder? I'd assume since it's a fairly common procedure (although I'm not sure I'd have it done at this point, I might try to make some dietary changes first) that there's some people out there doing fine on paleo without it.
asked byJosh_2 (174)
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on May 08, 2010
at 03:34 PM
Dr. Harris talked about this on his forum:
on November 20, 2010
at 11:40 PM
Update: It's been nearly 2 years since this answer, so an update is in order.
Supplementation priorities: Vitamin K2 ( apparently the gallbladder produces a lot of it), Magnesium, Liver (for fat soluble vitamins such as Vit A), Vit D (from sun when possible).
- Staple foods: butter, coconut (milk, cream, oil), lamb, beef, aged cheese (for K2), canned mackerel/sardines (in water), eggs. Lower fiber vegetables. Guessing the MCTs from coconut are helpful. Supplementing with magnesium, VitD when there is no sun.
Digestion is very slow (as expected without a gallbladder). Results in acne if I have a single extra slow day (i.e. no or a small BM), but within a day of digestion clearing out, skin clears. Noticeable by bit of belly pouch sticking out and bloating/gas.
- Black circles/rings under eyes and poor gums/teeth. This is likely a result of Vitamin K2 deficiency. Uping supplementation and intake of aged cheeses.
- My healthy gallbladder was removed in 2005 at the age of 23. Not a typical case for a cholecystectomy.
- After surgery I quickly noticed a slow down in digestion and at times diarrhea. It's still a bit slow but mostly regular.
- I had been eating 5-6 mostly paleo meals a day before the surgery and continued that for many years after though didn't go high fat until 2008. The small meals worked but took up too much of my life.
- Earlier this year I switched to 2 large meals a day (lunch and dinner) with absolutely no snacking in between before or in between. Works great!
- Choosing lower fiber & easier to digest vegetables & starches! This has been one of the most impactful choices. (Zucchini. Mushrooms. Spinach not kale. Potatoes/Rice not sweet potatoes. Cooked with a few exceptions such as rocket & carrots).
- Prioritize sleep: If I sleep less than 8 hours, digestion & skin are wrecked for days.
- Have good posture.
- Eat slowly.
- Move often. Saw a big improvement after moving to London. Likely due to increase in walking.
- Stop snacking! Eat 2-3 whole meals with nothing but liquid (mostly water) in-between.
- Emulsified fats feel easier to digest. Some emulsified fats: egg yolk, dairy cream/butter. Coconut is also easier to digest.
- Digest enzymes and ox bile seem to help a little but I don't always notice a difference. Could be placebo. Link  below recommends NAC, Glycine and Taurine instead of enzymes.
- Full day fasting does not work! Likely due to bile floating in my system instead of being excreted. But having a few raw carrots on a fast day remedies that. They are proven to bind to bile acids. Without them, I feel toxic and digestion is messed up for days.
-  Naturopathyworks: If you have gall bladder problems
-  Naturopathyworks: Lost your gallbladder? Here's what to do next
-  P??Nu Forum: High fat diet post gall bladder removal
-  Mark's Daily Apple forums: Pb without a gallbladder
-  Jack Kruse: Do You Need a Gallbladder?
- if digestion slows (due to bad eating or other stress factors) my skin will flare up. But then it clears and heals fast.
- although active, I find it almost impossible to loose stubborn fat. I have a much higher ratio of fat around the abdominals than is expected or someone of my build.
- every so often something will trigger my body to flush itself clean... you know what I mean.
p.s. It turns out my gallbladder was fine. The doctor and surgeon mis-diagnosed a minor issue. During surgery, while I was under, the surgeon found the gallbladder to be healthy but took it out anyway since, in their words, "you don't need your gallbladder".
on November 21, 2010
at 02:14 AM
Mileage will vary greatly for people who have had their gallbladder out. Some people have digestive problems for the rest of the lives, even when avoiding fat. Others seem to do fine as long as they don't eat giant hoards of fat all at once. The obvious point is that fat digestion will be impaired to some extent. But if your fat digestion was excellent to start with, you might still be able to get away with a lot of fat consumption. You will just have to experiment to see what your body can handle. Also, after being on paleo for longer periods, you might find your body improves its ability to handle fat as a matter of adaptation. Sounds like you are are already doing a good job of recognizing issues and working out potential solutions. Obviously, if you feel ill, then you will need to make some alterations. Luckily, you don't need to eat a super high fat diet to be healthy on paleo. Many do great with moderate fat intake, as long as all foods are healthy foods. In fact, we really don't know for sure what fat intake is healthiest for most people and there may be such individual variation that to quote specific numbers would be difficult.
on May 10, 2010
at 06:18 AM
take bile-tablets with every meal
on April 11, 2017
at 06:48 AM
The gb not only holds the bile to digest fat until you need to, the bile helps break fat down to absorb the nutrients. Paleo should be high protein not high fat unless you need extra animal fat to keep warm. Between meals try a T of apple cider vinegar to turn the liver off from making cholesterol. Take supplement to replace what you aren't absorbing. Many people have gallstones with no symptoms. Stones return if you don't learn why you got them then change so the GB is removed. There is a scary post on google for GB cleanse by drinking half cup olive oil and half cup lemon juice. This doesn't cleanse existing stones. You are making soap!!! Check your Paleo diet is balanced with roots like beets and carrots. The absence of the GB means your liver is a drip of bile, so should your fat intake be a slow flow: 1 drip for 1 nut . 1 drip 1 bite of meat. Go with the flow.
on May 09, 2010
at 02:33 AM
Medium chain triglycerides (coconut) is the answer, as you already seem to have discovered. Unique among fats, they can be absorbed without bile. Other than that, and Dr. Harris' suggestion to eat emulsified fats, I don't know of other ways to up your fat intake.
However, despite what some of the newbies in the paleo world believe, you can be very healthy on a high carb diet, provided your metabolism is not already too broken. Make sure to eat the right carbs-- starches are great. High GI starched like potatoes, sweet potatoes, etc are the best unless your metabolism is broken (insulin resistance). If so, concentrate on whole grains as they take longer to digest. Good luck