Wheat: The gallbladder blocker

If you (or someone you know) has had their gallbladder removed while on a gluten-full diet, you may not want to read this article. “Approximately 20 million people in the United States have gallstones. Of these people, there are approximately 300,000 cholecystectomies performed annually.”¹

The pancreas and gallbladder are critical for digestive functions. A component of wheat and other grains, wheat germ agglutin (WGA), can decrease the functionality of these two organs.

Before the punchline, a few details need to be laid out.

Wheat Germ Agglutin (WGA)

WGA is a lectin in wheat and other grains. “Lectins are sugar-binding proteins and, through thousands of years of selectively breeding wheat for increasingly larger quantities of protein, the concentration of WGA lectin has increased proportionately. This, no doubt, has contributed to wheat’s global dominance as one of the world’s favored monocultures, offering additional “built-in” pest resistance. “² Please do click thru to that article, it is fascinating stuff. Counterintuitively from what we are told ad nauseam that ‘whole grains are healthier’- whole grains have higher lectins – they are a plant defense mechanism increased purposefully in GMO crops³.

Cholecystokinin (CCK)

CCK has important role in digestion, signaling both the gallbladder and pancrease to get to work on properly digesting incoming meals.

Cholecystokinin is the principle stimulus for delivery of pancreatic enzymes and bile into the small intestine.
The most potent stimuli for secretion of cholecystokinin are the presence of partially-digested fats and proteins in the lumen of the duodenum (a particularly potent stimulus is pictured above). An elevation in blood concentration of cholecystokinin has two major effects that facilitate digestion:

Release of digestive enzymes from the pancreas into the duodenum. Older literature refers to cholecystokinin as pancreozymin, a term coined to describe this effect.
Contraction of the gallbladder to deliver bile into the duodenum. The name cholecystokinin (to “move the gallbladder”) was given to describe this effect. Cholecystokinin is also known to stimulate secretion of bile salts into the biliary system.
Vivo pathophysiology
⁵

Two more quick statements on the mechanism from a 1994 article (this has been known a while):⁶

CCK contracts strips of gallbladder muscle in a concentration-dependent way with a potency in the nanomolar range in all tested species. The potency is 1,000-fold better than that of gastrin; thus, the receptor is of type CCKA.
CCK and the CCKA gallbladder muscularis receptor are main regulators of postprandial gallbladder emptying.

Sorry if this is causing uncomfortable flashbacks to classes in school previously taken and promptly flushed from memory with strong intent.

CCK + WGA = Problems

Here is where we connect some dots. WGA inhibits CCK binding by up to 70%⁷. The gallbladder and pancreas then receive 70% less instruction to perform their jobs. The gallbladder stores bile, CCK tells it to release said bile – reduced signal – bile backup – stones. Best summed up by the anti-wheat crusader that got me started on an optimized diet, Dr. William Davis, author of Wheat Belly:

Wheat germ agglutinin is a very potent blocker of CCK. It means that your digestion is impaired. That can lead to acid reflux, stomach upset, heartburn, and over time, disrupts bowel flora, because you’re not fully digesting food. It can also lead to gallstones,because there’s bile stasis. When you have bile stasis, there’s crystallization in the gall bladder. That’s what leads to gallstones over time.
Wheat belly blog⁸

This stat from the top bears repeating, 20 million people have gallstones. That is an astounding number. Add in the acide reflux too and its almost like there might be some bad dietary advice around?

Gluten Removal Restores CCK Function

Building on this concept that gluten removal (which would also remove WGA) is a viable option, looking toward Celiac Disease patients should give us information as these patients are often prescribed gluten abstinence. Samples from three studies:

It is concluded that the abnormally decreased gallbladder contraction in celiac patients is the result of a reduced endogenous CCK secretion and not of a lack of end-organ responsiveness to CCK. ¹⁰
The aim of this study was to evaluate the concept that pancreatic dysfunction in patients having gluten sensitivity (celiac disease [CD]) or cow’s milk protein enteropathy (CMPE) may result from the lack of pancreatic enzyme stimulation in the absence or decrease of cholecystokinin (CCK) secretion caused by villous atrophy. CONCLUSION:
Exocrine pancreatic dysfunction in individuals having villous atrophy may be the consequence of decreased CCK secretion. Cholecystokinin and pancreatic secretion is restored to normal, with intestinal mucosa regeneration. ¹¹
In patients at diagnosis, elevated somatostatin levels were associated with increased gallbladder fasting volume, whereas decreased cholecystokinin secretion was responsible for the reduced gallbladder emptying. Gluten-free diet reversed these abnormalities. ¹²

Gluten Free Cheaper Than Gallbladder Free

‘First do no harm’ includes patients health AND price – at least it should. There is zero downside to trying gluten avoidance to see if symptoms resolve – really any digestive symptoms. Getting actual medical procedure prices is an arduous task on a good day, but these procedures easily cost $10k, AND DECREASE YOUR DIGESTIVE CAPACITY FOR LIFE. Gluten removal is a nominal cost if done properly – not just replacing with problematic and more expensive gluten-free look-alikes. I have been gluten free for 6 years (I think), and have helped many patients with the conversion as well, please reach out if you want some help.

If you have had your gallbladder out, and have any digestive difficulties with high-fat meals, there are options. “Gallbladder obstruction or removal. One can easily compensate for the lack of a gallbladder though with the use of lipase and ox bile supplements. So a gallbladder removal does not eliminate one from using a high fat diet.”¹³ Gallbladder status is now one of my initial questions when people want to try keto or any low carb diet, and we have used ox bile supplements with great success, and even tested its effectiveness via ketone measurement. This is the product we have used the most.

Please spread the word on this topic. I sat down to write this article shortly after seeing a post on facebook that a friend was in the hospital – a few hours too late: “REDACTED is currently in the hospital with a naughty gallbladder and scheduled for surgery at some point today. He’s doing fine as long as he stays drugged up for the pain and I’ll update after surgery.”