Metabolic Syndrome, Gallstones, and Gallbladder Removal

If you think that a little extra fat around the waist, slightly elevated glucose levels, and occasional high blood pressure won’t hurt you, you are dangerously wrong. Just because you don’t feel sick doesn’t mean that you’re healthy. You might just not be feeling anything… yet. Those three red flags are already enough for you to worry about Metabolic Syndrome (MS), also known as Syndrome X. But what is Metabolic Syndrome?

What is Metabolic Syndrome?

Metabolic Syndrome is a group of metabolic disorders characterized by the following:

  • High blood pressure
  •      systolic mm Hg of 120 and above, diastolic mm Hg of more than 80
  • High blood sugar
  •      fasting blood glucose of 100 mg/dL or greater
  • Abdominal obesity
  •      a waistline of more than 40 inches in men and more than 35 inches in women
  • High cholesterol levels
  •      total cholesterol levels of more than 200 mg/dL
  • High triglyceride
  •      triglyceride levels of more than 150 mg/dl

Any of these symptoms is a warning to wake up and take steps to make necessary lifestyle and dietary changes, including supplementation. Addressing the first signs will likely prevent the others from developing. If you have three or more of these indicators, you have metabolic syndrome.

Signs of High Blood Sugar

You can recognize blood sugar problems, high or low, by:

  • sugar or carbohydrate cravings
  • fatigue or low energy
  • headaches
  • increased urination
  • increased thirst
  • weight fluctuations
  • blurry vision
  • mood swings
  • anxiety or nervousness
  • dryness
  • shortness of breath exercising

Metabolic syndrome increases your risk of cardiovascular diseases, stroke, and type 2 diabetes. It is also closely linked to obesity and other chronic diseases related to it. People who have MS also often have low-grade systemic inflammation and increased risk of forming blood clots.

Causes of Metabolic Syndrome

 As more and more people are becoming overweight, more individuals are also developing metabolic syndrome. Around 34% of adult Americans have it.[1] And as we age, we have a greater probability of developing the symptoms if we don’t actively work on preventing them.

People who belong to the following groups are most likely to have metabolic syndrome:

  1. Overweight / Obese
  • This seems to be the common denominator among the various symptoms of metabolic syndrome. By itself, obesity can already lead to various chronic diseases. And while obesity is clinically defined by BMI (body mass index), data suggest that central accumulation of fat is associated explicitly with metabolism and may be an accurate predictor of metabolic syndrome.[2] Abdominal obesity is the main culprit in developing high cholesterol levels, hyperglycemia or high blood sugar, and high blood pressure (hypertension).[3]
  1. Insulin resistance (IR)
  • Aside from obesity, insulin resistance is also one of the signs of metabolic syndrome. It can often be a chicken and egg scenario – insulin resistance may lead to obesity and vice versa. Some people are also genetically predisposed to insulin resistance. People with insulin resistance have impaired sensitivity to the hormone insulin. To compensate, the pancreas deploys great amounts of insulin to control blood sugar levels and keep cells energized. When it happens over a long period of time, the pancreas can become worn out and may result in prediabetes or type 2 diabetes.
  1. Gallbladder Removal
  • Research shows that people have a tendency to develop metabolic syndrome within months or years following gallbladder surgery. This is due to the action of the bile acids in the bowel upon glucose and cholesterol metabolism.

Other causes of metabolic syndrome have a lot to do with our daily lifestyle choices:

  • High consumption of high calorie and low fiber foods
  • Sedentary lifestyle
  • Smoking[4] [5]
  • Poor gut health
  • Pre-existing digestive and biliary conditions
  • Hormonal imbalance

Previously, race and gender were considered to be risk factors too. Metabolic Syndrome was believed to be more prevalent in females than in males. Also, Caucasians and Hispanics from Western countries were considered to be at high risk for metabolic syndrome. However, with the pervasiveness of Western diet and lifestyle worldwide, these old notions of race and gender are now blurred. Whether you are male or female, and notwithstanding your country of origin, you can develop the various symptoms of metabolic syndrome.

Gut Health and Metabolic Syndrome

Among the various metabolic syndrome risk factors, its association with poor gut health may be the least known and understood.

The gut microbiota plays a significant role in host energy homeostasis and metabolism. There is already enough evidence that the gut microbiome and various components of the metabolic syndrome are closely linked. The gut microbiota is involved in the modulation of inflammatory signaling pathways, the immune system, and the hormone system that regulates blood pressure and fluid and electrolyte balance and systemic vascular resistance (also known as RAS or renin-angiotensin system).

Given this connection, evidence tells us that modification of gut microbiota via prebiotics, probiotics, or other dietary interventions may have a positive effect on the treatment of components or complications of metabolic syndrome.[6] In an animal study, introducing a specific prebiotic (oligofructose) was able to correct MS in obese mice. Another example is the prevention of obesity by addressing leaky gut and improving overall gut health. Cardiovascular diseases may also be avoided by having a healthy microbiome.[7]

Gallbladder and Metabolic Syndrome

Aside from the presence of pre-existing digestive issues, gallbladder problems may also increase the risk of metabolic diseases. [8] Among the five symptoms of MS, three are all associated with gallstone disease – increased cholesterol levels, abdominal obesity, and high blood sugar. Moreover, groups at risk for MS also have a high probability of developing cholesterol gallstones. This is why some studies call cholesterol gallstones a fellow traveler with metabolic syndrome.[9]

Patients with gallbladder disease who have had their gallbladder removed are still not out of the woods. Cholecystectomy is greatly linked to the development of metabolic syndrome. When an organ like the gallbladder is taken out, the body’s normal function is disturbed, causing a lot of metabolic changes.

Metabolic Syndrome and Insulin Resistance

MS or Syndrome X is associated with a 5-fold increased risk of Type 2 diabetes mellitus. One of the various qualifiers for metabolic syndrome is high blood sugar of ≥100, which is considered prediabetes. Levels of 126 or greater are diagnostic for diabetes.

Systemic and chronic inflammation, common among patients with metabolic syndrome, is also one of the main causes of insulin resistance and diabetic complications. The presence of cytokines and inflammatory mediators can also make both metabolic syndrome and insulin resistance worse.

How to Reverse Metabolic Syndrome

So what do we do if we have most of the symptoms? Is there a way to reverse it?

If your metabolic syndrome still hasn’t progressed into a chronic disease or if you are just starting to see and feel the various symptoms, that’s the best time to do something about it. But if the ship has sailed and you have been living with the condition for a long time, don’t fret. You can still reap benefits from making healthier dietary and lifestyle choices today.

Lose Weight

Obesity is the major cause of metabolic disease and other related health issues. It is therefore important to address this, specifically the predominant around-the-middle-body fat. Excess organ or visceral fat is more strongly associated with insulin resistance than fat in other body parts. Fat cells in this area tend to release fatty acids that contribute to the accumulation of fat all over and alter metabolism in the liver. Having a big belly and a big waistline can also be a source of increased inflammation in the body. [11]

Watch your Diet

No single diet is recommended for individuals with Syndrome X. There is still an ongoing debacle as to what proportions of protein, fats, and carbohydrates are ‘just right’ for the body. Having said this, none of the diet fads can claim to be the perfect fit to address the needs of those with MS. And if you are looking for a way to lose weight quickly, we also strongly discourage crash diets.

Eating natural foods, i.e., unrefined and organic, is always good. Eat a lot of vegetables and moderate amounts of low-glycemic fruits like berries. Remember, avoid sugar and refined foods as much as you can. Avoiding inflammatory food allergens is also recommended. Whether or not you have had your gallbladder removed, anyone with Metabolic Syndrome may benefit from following the Allergy Diet, which is an anti-inflammatory diet. This is important because allergens cause inflammation.

For a list of gallbladder-friendly foods, you may also download a list from our Gallbladder Diet page. 

Engage in Regular Physical Activity

Exercise has been shown to reduce fat in skeletal muscles regardless of BMI. This means that any physical training, no matter how big or lean you are, has benefits in terms of insulin resistance since skeletal muscle is the most insulin-sensitive tissue in the body. In fact, high-intensity training benefits the body for as long as 24 to 48 hours and only disappears within 3 to 5 days. Therefore, consistency is the key.

Physical activity doesn’t have to be high impact. A combination of resistance training and aerobic exercise is best to achieve the best results, but any activity is better than nothing. You may start by making small alternatives to your daily life, like taking the stairs instead of the elevator, riding your bike to work, or simply walking more. Gradually, you can increase duration and intensity. Coupled with a disciplined diet devoid of junk food, sodas, refined foods, and bad fats, exercise can definitely significantly lose abdominal fat.

Supplementation Support

We realized that a huge percentage of our gallbladder patients also have metabolic syndrome through the years. While there are many factors that lead to metabolic syndrome, the role of bile acids is definitely involved. Without a gallbladder, the bile acids that come straight from the liver are not the same as those acted upon by the gallbladder. Some gallbladders, such as one full of stones or not contracting and emptying properly, are not doing a proper job with the bile either. The different bile acids perform major functions of cholesterol and glucose balance as they interact with the microbiome in the intestines. So, it is not just after-removal people who tend towards MS, but gallbladder people as well. And, of course, there is also the fact that the type of diet that leads to metabolic syndrome also leads to gallstones.

To support our gallbladder clients, we recommend taking natural supplements that may help improve the different metabolic markers.

  1. Dyglofit – for support blood sugar, excess belly fat, appetite control, cholesterol
  2. Berberine – 500 mg dose 2-3 times daily to support blood sugar[12]
  3. Alpha Lipoic Acid – to support blood sugar; a daily dose of 600-1200 mg for three weeks may help improve diabetic neuropathy
  4. Resveratrol – to support inflammation and blood sugar; supplementation of more than 100 mg/d is enough to improve fasting blood sugar levels[13] 
  5. L-carnitine – 3,000 mg a day to support healthy triglyceride levels and to support fat burning for energy
  6. Fish oils for omega 3’s – to support inflammation and blood sugar levels
  7. Choline – 1,500 to 2,500mg dose to support fatty liver
  8. The Gallbladder Starter Kit or the After Gallbladder Removal Kit – to support digestion and bile flow
  9. Gallbladder Formula Elite – to support fat digestion, blood sugar, healthy cholesterol, liver detox and bile flow
  10. Bile Salts Booster  – 1 to 2 per meal to support fat digestion and healthy bile

(Products without links are available on Amazon)


[1] American Heart Association (2015) PDF File. What is Metabolic Syndrome.

[2] Bentley-Lewis, R., Koruda, K., & Seely, E. W. (2007). The metabolic syndrome in women. Nature Reviews Endocrinology, 3(10), 696.

[3] Engin, A. (2017). The definition and prevalence of obesity and metabolic syndrome. In Obesity and Lipotoxicity (pp. 1-17). Springer, Cham.

[4] Oh, S. W., Yoon, Y. S., Lee, E. S., Kim, W. K., Park, C., Lee, S., … & Yoo, T. (2005). Association between cigarette smoking and metabolic syndrome: the Korea National Health and Nutrition Examination Survey. Diabetes care, 28(8), 2064-2066.

[5] Balhara, Y. P. S. (2012). Tobacco and metabolic syndrome. Indian journal of endocrinology and metabolism, 16(1), 81.

[6] Mazidi, M., Rezaie, P., Kengne, A. P., Mobarhan, M. G., & Ferns, G. A. (2016). Gut microbiome and metabolic syndrome. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 10(2), S150–S157. doi:10.1016/j.dsx.2016.01.024

[7] Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current hypertension reports, 20(2), 12.

[8] Lin, I. C., Yang, Y. W., Wu, M. F., Yeh, Y. H., Liou, J. C., Lin, Y. L., & Chiang, C. H. (2014). The association of metabolic syndrome and its factors with gallstone disease. BMC family practice, 15(1), 138.

[9] Grundy, S. M. (2004). Cholesterol gallstones: a fellow traveler with metabolic syndrome.

[10] Di Ciaula, A., Garruti, G., Wang, D. Q. H., & Portincasa, P. (2018). Cholecystectomy and risk of metabolic syndrome. European journal of internal medicine, 53, 3-11.

[11] Alshehri, A. M. (2010). Metabolic syndrome and cardiovascular risk. Journal of Family and Community Medicine, 17(2), 73.

[12] Dharmananda, S. (2005). New uses of berberine. A Valuable Alkaloid from Herbs for “Damp Heat” Syndromes.