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Gallbladder Rescue Toolbox Essential

April 29, 2020 | 28 Comments | Shannon Vanasse


 
This is an oldie but goodie that highlights a potent tool I don’t want you to miss! A powerful option to have in your functional medicine toolbox is D-limonene. A monoterpene extract from citrus fruits, especially lemons and oranges.

Hepatic-biliary congestion is an increasingly common dis-ease dynamic – and a potentially potent connection beween systemic imbalances and disease that begins in the gut.  D-limonene is a cholesterol solvent, and the vast majority of gallstones are cholesterol stones potentiated from over-saturation of cholesterol in bile.  Ideally we engage to reverse hepatic-biliary congestion and thick, sluggish bile early on, prior to actual gallstone formation – or soon after when stones are small.  But d-limonene can be a potent part of your toolbox in any stage of this dynamic.

Even with fully-formed gallstones, D-limonene has been shown in clinical study to be effective in reducing (67%)  and even fully dissolving gallstones when injected directly (and confirmed in vitro as well).  When taken orally, there is evidence of a marked distribution of d-limonene to fatty tissue that accumulates over time (e.g. breast).  Animal studies have confirmed its role in improving insulin sensitivity and reducing hepatic fat accumulation in high-fat-diet-induced obesity and inflammation (including lower ALT levels), reducing total hepatic cholesterol synthesis in response to a low-fat diet (here and also here), and preventing cholesterol nucleation into stones (with similar terpenes).  You may learn more about many other potential health benefits here and here.

Absolutely we need to help our clients to make upstream lifestyle changes that will prevent occurrence or recurrence of gallstones.  But we have to meet them where they are and help them to alleviate existing disease dynamics like hepatic-biliary congestion as a first priority!  We cover many options and solutions in our SAFM curriculum, and d-limonene is often a key component of successful interventions.

I hope this is of service to you and your patients!

Warmly,

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28 Questions for “Gallbladder Rescue Toolbox Essential”

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  1. 13
    Nurit pollak says:
    November 6, 2024 at 2:53 am

    Is D-limonene affected by extreme cold or heat? I usually blend whole lemons and ginger and freeze them in ice cubes molds, and then every morning I take a cube out of the freezer and prepare a tea with boiling water. Thanks!

    Reply
  2. 12
    Valerie Evans says:
    October 8, 2024 at 1:23 pm

    Is prescribing d-limonene supplements safe for women who are pregnant or breastfeeding? If it is not, what recommendations would you make to support these patients with a sluggish gallbladder?

    Reply
    • 12.1
      SAFM Team says:
      October 16, 2024 at 4:55 pm

      While D-limonene supplements may be beneficial for bile flow in non-pregnant women, it’s important to be cautious with supplements during pregnancy and breastfeeding due to the lack of extensive research on their safety in these stages. It’s best to consult with a healthcare provider before using D-limonene in supplement form. That being said, small, food-based sources of D-limonene can safely support bile flow during pregnancy and breastfeeding (consider blackberries, citrus fruits, and spices such as dill and caraway).
      Other gentle and safe recommendations to support bile flow include:
      – Bitter foods naturally stimulate bile production and flow (e.g., dandelion greens, arugula, radicchio, and artichokes.)
      – Proper hydration is crucial for maintaining bile consistency and flow. Pregnant and breastfeeding women need additional fluids to support their increased metabolic demands. Aim to drink plenty of water, and herbal teas (like ginger or chamomile), and avoid sugary beverages.
      – Include choline-rich foods. Choline is essential for liver health and bile production (e.g., eggs (with the yolk) and chicken are great sources of choline).
      – Healthy fats, like those found in avocados, flaxseeds, and olive oil, help stimulate bile production.
      – Regular physical activity, especially gentle movement like prenatal yoga or walking, can stimulate bile flow and support liver function. Certain yoga poses, such as gentle twists or cat-cow, can help promote better bile circulation in the body.

      Reply
  3. 11
    Casey Eldredge says:
    October 3, 2024 at 4:21 pm

    At the end of treatment for stage 4 NHL I started having GB attacks and thought I was dying from the cancer, so painful. At that time I had just become a colon hydrotherapist and was well aware of the Andreas Moritz Liver and Gallbladder Cleanse Book because I would receive a lot of clients that were working on that. After cancer, I would get scans every so often to make sure the cancer was staying at bay. What I did see was sludge in my gallbladder written every time, until I finally tried Stone Free by Planetary Herbals and had been following a GB diet per a website of an acupuncturist that specializes in GB. It was the first time on one of my scans that there was nothing to note and I was like WOW. That’s huge to me, and meanwhile 15 years later without symptoms and with a GB. <3

    Reply
  4. 10
    joanne lee says:
    February 25, 2024 at 3:47 am

    When someone has had a cholestectomy and the bile is dripping, rather than being stored in gallbladder and being released in a bolus, does this have a negative impact on gut microbiome due to absence of food to work on – does it become too strong an anti microbial on gut microbiome?

    Reply
  5. 9
    Jonelle says:
    July 24, 2023 at 4:44 am

    Are there any alternatives to d Limonene, if the client is allergic to citrus? Thank you.

    Reply
  6. 8
    Melaina Marion says:
    June 21, 2023 at 9:52 am

    Are there any contraindications for using d-limonene (e.g., with certain meds, etc.)?

    Reply
  7. 7
    Anne Lowenthal says:
    September 15, 2022 at 9:25 am

    How would you approach gallbladder polyps? The traditional recommendation is to remove the gallbladder to prevent the possibility of cancer.

    Reply
    • 7.1
      SAFM Team says:
      September 22, 2022 at 10:57 am

      First, we need to recognize that there are different types of polyps that can be formed in the gallbladder – this is a very good recent review on the topic:
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787897/
      To your point, the general conventional recommendation for suspicious polyps is to surgically remove the gallbladder, however, when you start looking at the root cause of why the polyps get formed in the first place, which often includes poor quality and/or sluggish bile flow and cholesterol metabolism issues, or gut dysbiosis. There certainly are opportunities to address those root causes. The recommendations could include choline (PC), inositol, and taurine in addition to d-limonene to improve bile flow. If you would like to learn more about how dis-ease starts in the gut and what to do about some of these issues we recommend the recording of our FB Live:
      https://schoolafm.com/ws_clinical_know/more-disease-begins-in-the-gut-surprising-sources/

      Reply
  8. 6
    Kimberly says:
    August 27, 2022 at 9:21 pm

    Does D-Limonene still help dissolve existing gallstones when taken orally? What other supplements can help break down and dissolve gallstones safely when taken orally?

    Reply
    • 6.1
      SAFM Team says:
      August 29, 2022 at 8:00 am

      Yes, as discussed in the video and the cited publications in the article, d-limonene is quite effective in targeting existing gallstones. Choline, inositol, and taurine can be used alongside d-limonene to improve sluggish bile flow and prevent gallstones from forming, as usually those are a result of precipitated cholesterol and can build up in the bile duct and/or gallbladder. Please keep in mind that all supplements should be used with caution, and it is best to do so under the supervision of a functional medicine certified practitioner. It is also key to identify the root causes of the sluggish bile flow and address them to prevent the gallstone issue from recurring.
      Also, poor bile flow is often connected to other GI issues and dis-ease dynamics. You may be interested in these posts as well:
      https://schoolafm.com/ws_clinical_know/psoriasis/
      https://schoolafm.com/ws_clinical_know/psoriasis-and-general-autoimmune-considerations/

      Reply
  9. 5
    Shaun says:
    January 24, 2022 at 2:37 am

    Outstanding video! Very comprehensive!
    Can you please tell me basic supplements I should begin with for a stuck gallstone in the gallbladder neck that has caused an attack? I also have bile sludge and thickening of the gallbladderthat needs to be taken care of.

    Would you recommend starting with d-limonene and/or artichoke extract before later progressing to bile salts to safely dissolve and expel the stuck gallstone?

    Thank you!

    Reply
  10. 4
    Karen Carpenter says:
    December 8, 2020 at 10:41 am

    My understanding is that artichoke and polyphenols like EVOO are helpful to stimulate GB contraction but do they also help with the emulsification process that we get from bile ? What would you recommend for a vegan patient who has had her GB removed and does not want to consume any animal products? Thanks!

    Reply
  11. 3
    Lanie Despreaux says:
    January 27, 2020 at 6:07 pm

    Have you had experience with a patient with a low gallbladder ejection fraction
    With no stones, sludge or blockages?
    Can anything be done to help fix ejection fraction?
    Thank you!
    Lanie

    Reply
    • 3.1
      SAFM Team says:
      February 5, 2020 at 10:06 am

      Yes, we’ve seen this before and what you want to look at is possibly an issue with the neural transmission/localized neuropathy; possibly low thyroid function; hepatic or biliary congestion that is evidenced by high alkaline phosphatase and/or bilirubin. Also, keep in mind that bile congestion typically happens way before the stones get formed. A good solution for this type of dynamic would be a daily dose of 1000 mg of limonene and possibly also an artichoke extract and concentrated polyphenols such as those in EVOO – all of this can support better GB emptying. Disease Begins in the Gut 101 p3 speaks to foundational knowledge of GB function and health.

      Reply
  12. 2
    Lisa Jones Clark says:
    October 26, 2018 at 4:05 pm

    In looking at different brands of D-limonene, I’ve noticed quite a price difference between two brands: Jarrow and Integrative therapeutics. Both sell 1000mg. soft gels. But Jarrow’s price is around $12 for 60 qty. and Integrative Therapeutics is around $28 for only 10 capsules. Do you have experience with either of these brands and have any insight as to why the price difference?

    Reply
    • 2.1
      SAFM Team says:
      October 29, 2018 at 8:53 pm

      You will actually find similar, quite dramatic differences in supplement prices across many different brands and formulas. In some cases, this is about ingredient quality or manufacturing process (e.g. tablet vs. capsule), while in other cases it’s all about profit expectations. In other cases however, like this one, it’s about serving size. Jarrow 1000mg requires 2 softgels, while I.T. requires only one. I have used both brands successfully. The I.T. formula contains only the small amount of capsules they typically advise/find necessary when using d-limonene specifically to counter acid reflux. However longer regimens may be necessary when addressing hepatobiliary congestion.

      Reply
  13. 1
    Molly Jean-Mary says:
    July 9, 2017 at 9:45 am

    Hello-just wondering if there is any reason to discourage d-limonene while breastfeeding. My nephew was born 2 weeks ago (!) and my sister-in-law is supposed to have her gall bladder out in a couple of weeks. She is a radiologist, and I am believing I might be able to dissuade her from pursuing this, at least imminently, thanks to your powerful insights. She is also a breast cancer survivor, in remission x 6 years.

    Reply
    • 1.1
      SAFM Team says:
      July 11, 2017 at 1:44 pm

      Even though d-limonene is a natural food extract and GRAS, there is no safety data regarding the higher therapeutic doses used in supplements during pregnancy or breastfeeding. I do not know of any overt concerns or risks, but the truth is that there is no test data either way of which I am aware. The timing re:breastfeeding is really unfortunate! I have indeed seen a combination of d-limonene and other gallbladder tonic herbs (e.g. Dr. Schulze’s L-GB formula) – started quickly and intensely – stop GB disease in its tracks and eliminate the need for surgery. Certainly using organic lemon and/or orange zest (e.g. in smoothies) is at least a step in the right direction. Maximizing artichokes in the diet (leaf and heart) as well as fresh lemon juice and fresh ginger will also be helpful.

      Reply
      • …
        Sharon Buechner says:
        June 18, 2018 at 11:43 pm

        Besides recommending d-limonene, you mentioned also recommending Dr. Schulze’s L-GB formula. I found the L-GB formula on Dr. Schulze’s website and they are saying to put 60 drops in 2 ounces of water 2 to 4 times daily. Is that what you recommend?
        Do you recommend doing both d-limonene and Dr. Schulze’s L-GB formula at the same time?

        Reply
        • …
          SAFM Team says:
          July 4, 2018 at 3:07 pm

          Yes, Dr. Schulze’s L-GB formula is also a very good multifactorial, broad-spectrum blend of liver and GB supportive substances. I would use it according to their recommendation, and as with any new supplement I recommend starting at a half or quarter dose to avoid surprise, unpleasant negative reactions. This formula does not contain D-limonene so it could be used in combination, when an overt liver, bile congestion, and gallstones are at play or on its own if the condition is milder or a client has an adverse reaction to D-limonene.

          Reply
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