Signs You Have Gallbladder Issues & What Labs to Ask For + Supplements to Take

and how to support it naturally

I got a message the other day from someone on Instagram asking an in-depth question about her gallbladder health, and I want to thoroughly answer it here because I see gallbladder issues a lot in my practice, and I’ve dealt with them myself.

Your gallbladder is way more important to your health than most people realize, and gallbladder issues are almost always tied to an under-functioning liver. You cannot address one without the other.

This matters a lot if you’re a woman with an autoimmune condition like Hashimoto’s, because your liver is responsible for hundreds of jobs in your body.

The bile your gallbladder secretes is what helps you clear out things like used-up estrogens, endotoxins, environmental toxins from everything we’re exposed to daily, excess cholesterol, metabolic waste, and stress hormones.

Bile also keeps your gut healthy by acting as a natural antimicrobial, it stimulates bowel movements, emulsifies the fats in your food so you can actually absorb fat-soluble vitamins like A, D, E and K, and it acts as a signaling molecule for your thyroid and metabolic system.

Have you ever had chronically low vitamin D that wouldn’t improve?

Look to the liver and gallbladder.

An under-functioning gallbladder is a huge red flag in a society where we are constantly bombarded with toxins. If your body’s main route of elimination is backed up, all the toxins your liver is trying to dump get reabsorbed and recirculated.

Cue inflammation.

Cue hormone imbalances.

Cue treatment resistant Hashimoto’s

Cue a worse perimenopause experience.

Cue “why do I feel so much worse when I detox”

Unfortunately, gallbladder and liver health are almost always overlooked by conventional and even functional doctors if your labs come back “in range.” But those ranges are designed to catch disease, not identify dysfunction. So you can be functionally struggling for years before anything shows up on a basic metabolic panel or an ultrasound.

In this article I’m walking through:

• The symptoms of gallbladder and liver dysfunction your doctor may not be connecting for you

• Why hypothyroidism disrupts bile flow and why poor bile flow messes up your thyroid

• Hormonal influences to gallbladder function that are rarely talked about (estrogen, progesterone, cortisol)

• The exact lab work to request and the functional ranges that help you identify if your own body is modeling dysfunction

• Simple ways to support your gallbladder through food

• The supplements that work well and frequently recommended ones you want to be careful with overusing

• How to support your body with fat digestion and absorption if you no longer have a gallbladder

Many of the information I’m sharing has been learned through working 1:1 with clients, my own personal experience with gallbladder disfunction, and through my advanced clinical training program.

I’m sharing much of this article for free because I want you to feel like you can trust me to support you on your healing journey, and in hopes that you’ll eventually join the Hashimoto’s Healing Society, my membership where I support women through their health issues for just $29/month.

Okay, let’s get into it.

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What Your Gallbladder Does for Your Body

Before we get into what can go wrong, I want to share why this organ matters so much despite doctors being trigger happy with cutting it out of women’s bodies.

Your gallbladder stores and secretes bile which does three really big jobs in your body.

1. Detoxification. Bile is the vehicle your liver uses to bind and excrete fat-soluble toxins, used-up hormones like estrogen, metabolic waste, environmental pollutants, and stress hormones. When bile flow is sluggish, these get reabsorbed back into circulation through a process called enterohepatic recycling, which burdens the liver, drives inflammation, bloating, and throws off hormonal balance.

2. Lipid digestion. Bile emulsifies dietary fats, breaking them down into smaller particles called micelles, so enzymes like lipase can actually do their job. This is how you absorb fat-soluble vitamins (A, D, E, K). Without efficient bile flow you get bloating, greasy (stick to the toilet) or floating stools, and long-term nutrient deficiencies that affect your immune system, your bones, your eyes, and your skin.

3. Microbial regulation. Bile salts are naturally antimicrobial. They keep harmful bacteria in check, especially in the small intestine. This is why compromised bile flow is so closely linked to SIBO (small intestinal bacterial overgrowth) and gut dysbiosis. If your bile is weak, your gut barrier suffers, bacteria overgrow, LPS leaks into your bloodstream, your liver gets even more burdened, and the cycle keeps reinforcing itself.

If you have Hashimoto’s like I do, then you’ll likely be fascinated to learn that about 80% of your T4-to-T3 conversion happens in your liver. And on top of that, T3 itself directly regulates the enzyme (CYP7A1) that your liver uses to produce bile acids.

So when your thyroid is sluggish your bile production drops, gallbladder motility slows (because CCK signaling weakens), bile sits and thickens, and you get more stasis and more sludge. The same low thyroid that’s making you tired and puffy can also clog up your bile flow.

This is one reason why many women with Hashimoto’s find themselves hitting a wall on their healing journey..

You optimize your meds, you go gluten-free, you eat nutrient dense foods… but still don’t feel great.

And your liver + gallbladder are a big part of that. Correcting your terrain is the solution (and it’s never super simple…)

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Why “Normal” Imaging and Lab Work Misses All of This

After taking a GLP1 for 30 days, i personally found myself with severe gallbladder pain and nausea that led me to stop taking it (you can read that whole story on my substack — I’ll post the article at the end).

I went in for an abdominal ultrasound because I had tenderness in my right upper quadrant area, under my ribs. I also noticed this constant “pulling” feeling when I would eat fattier meals.

The imaging came back perfect and my functional medicine doctor said all of my liver labs looked great.

But here’s what was actually going on..

An abdominal ultrasound tells you very specific, limited things. Does the gallbladder have visible stones? Is the wall thickened? Is there obvious obstruction? Is the liver structurally abnormal?

What it does NOT tell you:

• Whether your bile is actually flowing or sitting stagnant

• Whether your gallbladder contracts properly when you eat

• Whether your bile has thickened into sludge (which often happens years before a stone forms)

• Whether your liver is even producing enough bile to begin with

• Whether you have functional dysfunction, which is almost always what comes first

Imaging shows structure. It does not show function. And bile dysfunction is a functional issue long before it becomes a structural one.

Same goes for your basic lab panel. A GGT of 40 will be labeled “normal” by your doctor, but functionally that number is telling you your liver is under oxidative stress and your detox pathways are struggling. An alkaline phosphatase of 55 is ignored, even though it’s telling you that zinc deficiency and/or poor bile flow are at play.

So if your imaging looks good like mine did, but your body is telling you something is wrong, your body is always right.

You just need a better lens to see it.

And that’s why I decided to sign up for an advanced functional blood chemistry program that helped me learn exactly what was going on with my own body — and I’m going to share everything I learned with you.

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Signs Your Gallbladder and Liver Might Be Struggling

These are the patterns I see in women whose labs and imaging were called “normal.”

Digestive signs

• Undigested food in your stool, especially fats, seeds, or vegetable matter coming out looking exactly the way it went in

• Pale, clay-colored, gray, greasy, or floating stools (steatorrhea is the clinical term for greasy stool, and it’s a classic bile issue)

• Nausea after rich or fatty meals

• Bloating that gets worse with fattier foods

• Burping or reflux, especially after eating

• Feeling overly full from small portions

• Constipation or sluggish bowel movements (because bile is your body’s natural stool lubricant)

• A sense of “something stuck” in your right upper abdomen

• SIBO, food sensitivities, or recurring gut issues that won’t fully resolve no matter what you try (also symptoms I experienced)

Physical signs

• Tenderness or pressure under the right rib cage

• Referred pain to the right shoulder or between your shoulder blades, which is so often missed and blamed on posture

• A pulling, gnawing, or off sensation in the gallbladder area (this was something I experienced for several months after coming off GLP1s)

• Tenderness when you press on it

Hormonal and whole-body signs

• Hashimoto’s or thyroid symptoms that won’t budge no matter what you do

• Estrogen dominance with heavy periods, breast tenderness, PMS, fibrocystic tissue

• Worsening hormone symptoms in perimenopause, which is so common and so under-discussed

• Worsening symptoms during pregnancy or on hormonal birth control

• Itchy skin, jawline acne, weird rashes, slightly yellowish skin tone

• Right-sided or temporal headaches

• Low vitamin D no matter how much you supplement

• Recurring vitamin A, E, or K deficiencies showing up on labs

Energy, mood, and brain signs

• Fatigue that doesn’t match what you ate or how you slept

• Brain fog that gets worse after meals (huge one)

• Mood instability, irritability, low-grade depression

• Getting more sensitive to alcohol, caffeine, medications, or supplements over time

If you have three or more of these going on and your ultrasound came back clean, and your doctor is telling you everything is normal, your gallbladder is likely a large part of your stagnant healing.

And honestly, your gallbladder not showing up on a scan or screaming at you in your lab work is actually a gift, because catching this now means you can actually do something about it before it becomes a bigger problem. I’ll share interventions further down.

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Hormonal Influences

Estrogen. High levels of estrogen, whether from estrogen dominance, pregnancy, hormone replacement, or birth control, increase cholesterol secretion into bile AND reduce gallbladder motility by making the smooth muscle less responsive to CCK (the hormone that tells your gallbladder to contract). So you get thicker bile and a lazier gallbladder at the same time. This is why so many women develop gallbladder problems during or after pregnancy, after starting birth control, or in perimenopause when estrogen is fluctuating wildly.

Progesterone. Elevated progesterone (also common in pregnancy) slows gut motility and relaxes smooth muscle, including the muscle that controls bile flow. This is part of why pregnant women have such a high incidence of gallbladder issues.

Cortisol. Chronic stress and elevated cortisol divert resources away from the liver’s metabolic functions, reducing bile acid synthesis. Cortisol also messes with gut motility, leading to that alternating constipation and diarrhea pattern that disrupts bile flow even more.

Hypothyroidism. This is the one I want you to really hear. Low T3 reduces the activity of CYP7A1, the enzyme that converts cholesterol into bile acids in your liver. Less T3 means less bile acid production. On top of that, hypothyroidism weakens CCK signaling, which slows gallbladder emptying. And hypothyroidism increases cholesterol saturation in bile, thickening it further. So you have three mechanisms all pushing bile toward stasis at the same time.

If you have Hashimoto’s, your bile is almost certainly being affected, even if you don’t have classic gallbladder symptoms yet.

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Why This Matters So Much If You Have Hashimoto’s

This is really important and I can almost guarantee no one is connecting these dots for you if you’re reading this article….

As I mentioned before, your liver plays a huge role in your T4 to T3 conversion.

Most people are put on levothyroxine when they find out they have hypothyroidism, which is a synthetic T4.

If your liver is under functioning, then your body isn’t properly converting the supplemental thyroid hormone into the active form that you need for energy and metabolism.

That’s one of the reasons so many women come to me on their thyroid meds still feeling horrible.

You cannot heal your thyroid without addressing your liver and gallbladder.

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🔒 The rest of this article is for paid subscribers. Below I’m walking through the exact lab panel to ask your doctor for with the functional ranges that help you identify if you may have low key issues before they evolve into a diagnosable problem.

I also share supplements that support your gallbladder, and the ones that are often recommended, but not great long term.

Plus easy ways to gently support your gallbladder without supplements are included!

It’s just $7 to subscribe and have access to all of this information. The cost of a latte at my favorite coffee shop!