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Home / Keto Basics / Can I Do a Ketogenic Diet Without a Gallbladder

Can I Do a Ketogenic Diet Without a Gallbladder

author avatar Dr. Eric Berg July 03, 2017

If you search Google for answers on whether or not you can go on a keto diet without a gallbladder, you’ll find a lot of frightening information. You'll be told your digestion of fat will be completely impaired; you'll have terrible side effects; and you must follow a low-fat diet OR ELSE.

Here’s the truth:

There’s no magical tip, trick, strategy, or bio-hack capable of replacing your missing gallbladder.

But if you want the numerous health benefits of the keto diet; if you want to lose weight in a healthy, sustainable way; if you want to go from so-so health to good, or even good to great, you can definitely go keto without a gallbladder.

You can get into ketosis. You'll be able to experience the boost in energy. And yes, you'll be able to digest fats properly.

You’ll just need to adjust a little bit. And I do mean, only a little. Take bile salts, and combine keto with intermittent fasting because eating less frequently puts less strain on your body to digest fast.

But I’m getting a little ahead of myself.

Let’s take a look at why not having a gallbladder could be an issue on a keto diet.

Why A Gallbladder Is Important On a Ketogenic Diet

On a keto diet, 75% of your calories come from fat. The purpose of the gallbladder is to store and concentrate bile, the detergent-like substance that helps your body break down fat and extract its key nutrients.

Without your gallbladder, there is only the small tube from your liver directly to your intestine. Your liver makes bile; so, the bile will trickle down to your intestine but not necessarily at the time best suited to digest the dietary fat.

You see, normally a gallbladder will contract in response to food being eaten. It will contract and squeeze out a concentrated amount of bile - up to 20 times more concentrated than fat that’s made in the liver. From your gallbladder, the bile goes to your intestine and dissolves the fat you eat, making its nutrients bioavailable to your body.

Without the gallbladder, there is less - and very much less concentrated - bile going to the intestine. You may run out of bile altogether in response to your meal, or there might not be enough to dissolve the fat you just ate.

As well, bile combines with enzymes from your pancreas to break the fat down into even smaller particles that will be more easily absorbed through your intestinal wall for use by your body.

Potential Issues On A Keto Diet When You Don’t Have A Gallbladder

Without a gallbladder on the keto diet, if you’re not careful you can end up with some issues such as:

  • incomplete fat digestion, the symptoms of which are:
    • loose but bulky stool with globs of fat and noticeable oil separation
    • foamy, frothy, or mucus-filled stool
    • stool that floats
    • stool that appears to be covered in a thick, greasy film
    • abdominal pain, cramping, bloating, and gassiness
    • heartburn and indigestion
    • general exhaustion
    • minor muscle, bone, and joint acheman doubled over clutching his stomach


  • deficiencies in these fat-soluble vitamins:
    • vitamin A, which supports the health of your eyes, skin, and immune system. It’s also critical for your thyroid
    • vitamin D, which is key in the absorption and distribution of calcium, and thus supports your bones, skin, and immune system
    • vitamin E, which prevents clotting that can lead to a stroke, decreases the need for oxygen in your tissues and supports your immune system
    • vitamin K2, which regulates calcium transport in your body; that is, moving calcium to the places that most require it for health, such as your arteries to keep them supple and maintain healthy blood pressure.

Right now I can almost hear you thinking, “Dr. Berg, is it really safe for me to go keto without my gallbladder?”.

The answer is emphatically yes. I want you to be aware of these health issues that could arise, but I also want to assure you that there are simple tweaks that will keep you healthy.

Let’s take a look at the tweaks.

How To Do Keto Even Without A Gallbladder

There are two very simple adjustments for you to be successful with the keto diet even without your gallbladder.

And I do mean simple; in fact, one is something I recommend for all people on keto not only those who’ve had their gallbladder removed.

The first and easiest of the two is to take purified bile salts. Bile salts are the main organic component found in bile. By taking them, you can replace some of the functionality you lost when your gallbladder was taken out. Then, when you’re eating the high-fat ketogenic diet, your body can complete its fat digestion.

You don’t need to take bile salts at every meal, but at least once a day would help. And, don't overdo the bile salts or you could experience some side effects.

If you start experiencing signs of fat-soluble vitamin deficiencies such as night blindness (vitamin A), osteoporosis (vitamin D), or high blood pressure (vitamin K2) - you’ll know you need to improve your fat digestion.

Now let’s dive into the second one.

a hand-lettered sign that reads Intermittent Fasting

I recommend that everyone on the keto diet also do intermittent fasting (IF).

IF is a powerful tool for serious weight loss and other health benefits such as improving the pre-diabetic condition of Fat Storing Hormone resistance. Intermittent fasting isn’t a diet; rather, it’s a pattern of eating and not eating. It also isn’t about cutting calories, it’s changing the times when you eat and don’t eat. Easy!

Additionally, when you don’t have a gallbladder but you’re on the keto diet, fasting will lessen the stress on your digestive system because you’re not eating - and thus, making bile demands - as frequently as you would if you weren’t fasting.

Fasting has been used for therapeutic and spiritual reasons for thousands of years, so it’s nothing new to us, humans. But if the idea seems a little overwhelming to you, you don’t have to do this by yourself. You can sign up for my complimentary mini-course Intermittent Fasting Basics for support.

You Now Know How To Do Keto Without A Gallbladder (But Knowing’s Just Half The Battle)

Most people who read this post will smile, nod their head in agreement, and implement none of this advice.

But not you.

You know knowledge that’s not put into practice is wasted. That’s why you’ve already committed to going on the ketogenic diet, and it’s why you can’t wait to start. Even without your gallbladder.

Following my recommendations will support you to get and stay healthy on keto. After all, there’s no reason you should miss out simply because you had your gallbladder removed. The benefits far outweigh any possible issues.

So, are you ready to follow the keto diet? To get the health and weight loss benefits you deserve?

Then it’s time to get going.

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