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Gallbladder Sludge in Pregnancy – What Now?

Go figure that pregnancy with all of it’s rapidly and vastly changing hormones is one of the most common triggers for gallbladder sludge, and it’s also one of the hardest times to do anything about it. Let’s look at why it happens and what you can do about it. If you’re unclear about what the gallbladder does, and what sludge is then read this post first.

Symptoms of Gallbladder Sludge in Pregnancy

Gallbladder can cause a wide range of issues ranging from mild to severe, but any issue is worth discussing with your doctor because untreated disease can lead to complications for the pregnancy. Symptoms include:

  • Itching – on belly, palms and soles or all over. This can happen with or without a rash. If it’s serious, go to your doctor.
  • Right sided digestive pain – at the bottom of your rib cage on the R side or radiating into the R shoulder blade, R shoulder or even L shoulder blade.
  • Gas
  • Bloating
  • Digestive discomfort
  • Diarrhea
  • Constipation

Why is Gallbladder Sludge So Common in Pregnancy?

Gallbladder sludge essentially happens when your gallbladder is overwhelmed by too much cholesterol and not enough bile.  You’ll recall that the bile acts as kind of a “soap” to emulsify fats and make them more water soluble so that they can be both excreted and absorbed in the digestive tract. Just like with dish soap, if there is too much fat or grease and not enough soap you get a sludgy goo that tends to stick to everything and generally get in the way. Hence gallbladder sludge. But why does this happen in pregnancy? Many reasons:

  • Huge hormone shifts – Rapid changes in hormone levels mean that lots of hormones (fat soluble) are being excreted by the liver, and fat soluble toxins are excreted via bile. In fact, below are pictures of a cholesterol molecule and an estrogen molecule – no doubt you’ll notice the similarities (and estrogen along with the other sex hormones is made in your body from cholesterol).

    Estrogen and testosterone (progesterone as well, but it's not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

    Estrogen and testosterone (progesterone as well, but it’s not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

  • High Water Use – Pregnancy uses a lot of water – your body is building a human and that’s no small task. It requires that you also create lots of extra blood, extra fluid to protect and support the baby and of course, all the water that goes into the baby.  Not only that but there are thousands of extra metabolic processes happening to make all of this go.  It’s just a big time for water, and so mild to moderate dehydration is incredibly common – especially in early pregnancy before mama’s intake has adjusted sufficiently to cover it all.  Dehydration is also a risk factor for gallbladder sludge just because all bodily fluids, including bile, get a little thicker and sludgier if there is less water to go around.
  • Estrogen – High estrogen is a risk factor for gallbladder sludge, or cholestasis, independent of pregnancy as well (at least it is in animal studies). In fact, the risk factors for gallstones are called the five F’s – Fair, Female, Fat Fertile and Forty. Lovely.
  • Genetics – There are some genetic conditions associated with gallbladder sludge (more specifically with Intrahepatic Cholestasis of Pregnancy, or ICP). So chances are if your mother, aunties, sisters or grandmother had troubles, you may be at greater risk.

Are There Natural Ways to Help Gallbladder Sludge in Pregnancy?

Yes and no. Pregnancy is a risky time to use any natural or medical treatment and many drugs and supplements are off limits because they may cause harm to the baby. If you’re not pregnant, then here’s a whole post about gallbladder sludge and stones. If you are, then here are the things you can do:

  • Diet – Pregnancy is a great time for a healthy diet anyway, so might as well do a healthy gallbladder-friendly diet. This means:
    • No fried foods
    • Lots of fruits
    • Limited red meat, butter, shellfish and eggs
    • LOTS of veggies – especially dark green leafy veg
    • Good lean meat, poultry and fish
    • High fiber foods – aim for 30 – 50 g per day – some examples below
      • Split peas – 16.3 g per cup cooked (split pea soup. Yummy.)
      • Lentils – 15.6 g per cup cooked
      • Black beans – 15 g per cup cooked
      • Artichokes – 10.3 g each and also gently boost liver function
      • Broccoli – 5.3 g per cup boiled
      • Raspberries – the yummiest 8 g per cup ever
      • Bran flakes – 7 g per cup
      • Avocado – 12 g each



  • Water – Bump the water WAY up. Aim for 12 eight ounce cups with 8 eight ounce cups being the absolute minimum. This will suck because pregnancy makes you pee all the time anyway and drinking this much water will have you running to the bathroom constantly. Sorry! It’s better than a gallbladder attack, believe me.
  • Lecithin – Lecithin is safe in both pregnancy and nursing because as it turns out, one of it’s major ingredients, choline, is great for baby. Typically midwives and doctors suggest 1200 mg 3-4 times per day with lots of water, but here’s more information about lecithin and it’s use in gallbladder issues. It’s also great for blocked ducts when you’re nursing and gallbladder sludge even when you’re not preggers.
  • Gentle Exercise Regularly – Exercise is good for everything in the human body, including the gallbladder. For many women this will actually eliminate mild symptoms.
  • Castor Oil – Topical (NOT INTERNAL) castor oil over the right side of your abdomen and back can help your body to deal with some of the sludge in a gentle way. Here’s a whole post on it with more detailed information. And Here’s info on a great lazy method of doing a castor oil pack. This is both anti-inflammatory and also good for the functioning of the liver and gallbladder.
  • Lukewarm Epsom Salts Baths – The magnesium in the Epsom salts will help to relax the bile duct and allow sludge to pass more easily, and the lukewarm bath can help to relieve the itching.

    Doing all of this in 9 months isn't easy! Great picture from free image.com/Jose Torres.

    Doing all of this in 9 months isn’t easy! Gallbladder is one of the places that fallout can happen. Great picture from free image.com/Jose Torres.

What About Not-Natural Ways to Relieve Gallbladder Sludge in Pregnancy?

If you’re having gallbladder attacks on top of the already uncomfortable state of being pregnant, then sometimes you want a faster option. Also severe gallbladder attacks with protracted vomiting, inflammation or infection can be a serious risk to your baby, so there’s that too.

  • Ursodiol – this prescription drug may be suggested by your doctor to help manage symptoms and increase bile flow.
  • Surgery – It is possible to have your gallbladder removed during pregnancy and sometimes it’s necessary. The second trimester is considered the safest time for both mother and baby to undergo this procedure. Depending on your doctor they  may suggest laparoscopic removal or open gallbladder surgery.

Remember pregnancy is a rough time anyway because your body is doing so much, changing so fast and generally working so hard. Be gentle with yourself, talk with your doctor, and don’t judge – sometimes you can use the natural methods for working with gallbladder sludge in pregnancy and sometimes you really do need something more intense, like surgery.



Lecithin for Blocked Ducts and Gallbladder Sludge

If you’ve had gallbladder sludge, blocked ducts in your gallbladder or blocked ducts in your breast you know just how painful and horrible this can truly be. In good news there is a reasonably simple food supplement that can make a huge difference while you’re working on clearing things out, called lecithin.

What is Lecithin?

Lecithin is naturally occurring in such common foods as soy, egg and sunflower seeds. It’s a compound called a phospholipid, which is a phosphate head bound to long lipid tails. The phosphate head is water soluble, and the lipid tails are fat soluble so lecithin is a great natural emulsifier, meaning it helps to blend fat and water. Lecithin  is used as a food additive frequently for this very reason – it helps to keep fats suspended in a water solution. As a supplement it is sold in both a granule form that you can add to cereal, oatmeal, soups or just about any other food as well as a capsule.  The granules have a nice, nutty sort of flavor that adds well to things and the capsules are , well, just capsules.

Lecithin helps emulsify gallbladder sludge and open blocked ducts in the gallbladder or breast. It's commonly found in soy, sunflower and egg. Photo by John Sullivan

Lecithin helps emulsify gallbladder sludge and open blocked ducts in the gallbladder or breast. It’s commonly found in soy, sunflower and egg. Photo by John Sullivan

Why Does Lecithin Work for Blocked Ducts And Gallbladder Sludge?

Gallbladder sludge is a thick waxy build up of cholesterol and other sterol-type fats bound to bile salts.  Under normal circumstances this is a fluid mixture, but when it gets too thick it becomes waxy and semi-solid.  Blocked breast ducts are also filled with a condensed form of breast milk that is very fat-rich.  Therapeutically , we are looking for this same emulsifying action – we want to allow water to easily add into the mixture to loosen things up and get them moving. Quite literally we want to emulsify the gallbladder sludge or thickened breast milk with water so that it can pass.Lecithen, as a potent emulsifier, does a great job.

How To Take Lecithin For Gallbladder Sludge

If you’re having mild trouble with gallbladder sludge that gives you low-grade symptoms or frequent mini-attacks then 4000 – 5000 mg per day in divided doses will help to prevent further attacks and keep the sludge moving.




If you’re having a strong acute attack that isn’t serious enough for the hospital then 4000-5000 mg every 4 hours with lots of water until it resolves (not more than 24 hours without talking to your doctor or knowing for sure that it truly is gallbladder sludge and not a gallstone emergency). If the lecithin isn’t producing any changes or the symptoms get worse please do seek medical attention because if gallstones get stuck in a duct and block bile flow completely it can be a medical emergency.

How to Take Lecithin for Blocked Milk Ducts

If you’re having recurrent blocked ducts or always feel like you’re hovering on the cusp of a blocked duct then 1200 mg four times daily will help to prevent further issues.

If you’ve already got a blocked duct that you’re trying to loosen up then 4000 – 5000 mg every 4 hours with lots of water until it resolves.

How to Make The Lecithin Work it’s Best

There are a few things you can do to support the action of lecithin so that you’re getting the most benefit from it:

  1. Water – obviously we’ve got the fat, but we need the water to make the emulsifier work.  Aim for 10 8 oz glasses per day if you’re having issues with blocked ducts or gallbladder sludge. **Lecithin will not work without water**
  2. Heat – physically warming up the area can help to relax and open ducts, as well as “melt” the fatty plug. A hot compress such as a hot water bottle, infrared heating pad or wash cloth soaked in hot water over the breast area or gallbladder area (on your right side just under your rib cage straight below the nipple from the front to the back at the same area) will help to loosen things up and get them moving.
  3. Castor Oil – if you’ve read my blog before you know how much I love castor oil. *Love* castor oil. It can be rubbed on the breast tissue (be sure to wipe off completely before your baby nurses) or over the entire liver/gallbladder area to reduce inflammation and help to get things moving as well.  Even better is the combo of castor oil + heat.  Just be sure to put on an old T-shirt because the oil is heavy and will stain clothes. Here’s more information about castor oil in general and castor oil for gallbladder health.
  4. Rest – blocked ducts and gallbladder sludge are both reasonably difficult for your body.  They produce a lot of inflammation and can lead to infection and other problems if left untreated so you will need more rest, more support and generally a little more TLC while this is going on.

Other Uses for Lecithin

Lecithin, as it turns out is great for lots of things:

  • Natural source of choline
  • Improves brain heath, cognitive function and memory, possibly even ADHD
  • Reduce cholesterol and triglycerides and increases HDL (the good cholesterol)
  • Used in the formation of neurotransmitters such as acetylcholine
  • Supportive in pregnancy, as a source of choline, to help prevent neural tube defects and help healthy brain development
  • Mildly anti-inflammatory
  • Helps to gently improve anxiety
  • Helps to supplement nutritional deficiencies created by alcohol consumption.

Lecithin is a simple, safe, low-cost, beneficial supplement for blocked ducts, gallbladder sludge, and blocked bile ducts but don’t forget the water!



How To Do A Castor Oil Pack the Lazy Way

A castor oil pack is something that sounds not-glamorous. Not-glamorous to the same extent as say a mustard plaster, or possibly even an enema (gasp).  I get that. This isn’t a sexy sounding topic, but the thing is, doing a castor oil pack is one of the simplest, gentlest, best life hacks for liver health, gallbladder function and even women’s hormones and breast health. I honestly think if everyone would do these on a regular basis, we’d have world peace. Okay, not quite world peace, but we’d all be a lot healthier.

What is a Castor Oil Pack?

Simply stated, this is a great way to help your body absorb castor oil through your skin to help the local area (meaning the skin in that area but also the underlying organs and structures) and your health in general. Why, you might ask, do you want to absorb castor oil through your skin?  There’s a whole post on it here, but the quick and dirty is that castor oil topically gives you a tremendous immune boost, anti-inflammatory benefit, and also a gentle detoxification.  Hard to get all of those things anywhere else with so little effort.

The Traditional Castor Oil Pack

There is a formal way to do this, popularized by Edgar Cayce and many other practitioners. I don’t usually do it this way, but it’s probably the best way to do it.

Castor oil pack - picture by Pete Markham from Loretto, USA

Castor oil – picture by Pete Markham from Loretto, USA. This bottle is from the light-keepers house at Split Rock Lighthouse in Minnesota.

You Will Need:

  • Organic flannel – about 1/2 yard (or meter) of organic flannel, folded into a square
  • Organic, hexane-free castor oil
  • A Mason Jar or something similar to put the saturated flannel in after
  • Plastic wrap to cover the outside of the castor oil (it’s preferable to use something non-plastic, but it’s also messier.)
  • A hot water bottle or heating pad
  • 90 minutes




Directions for a Castor Oil Pack:

  1. Saturate the folded flannel with the castor oil. The first time you do this it will take a fair bit of oil. You want the flannel to be full of oil, but not dripping everywhere.
  2. Put the flannel square over the area you’d like to treat – usually the right side of your abdomen under your rib cage (for liver/gallbladder), but it could be over your lower pelvis (for menstrual cramps, hormone balance, fibroids, or really any other uterine issue), over your breasts for fibrocystic breasts, or even over a sore joint, skin rash or other inflammatory issue.
  3. Wrap the pack and the area of your body that it’s covering with plastic wrap. This has no therapeutic value, but it helps to keep your house clean because castor oil is heavy oil and will stain.
  4. Put a hot water bottle or hot pack over the castor oil pack
  5. Lie back and rest for 90 minutes (NICE!!) This is potentially the best part of the castor oil pack.




So – this is great. It allows your skin to absorb as much castor oil as it possibly can because the cloth is saturated so it can just keep soaking up the oil for that gorgeous 90 minute rest.  The problem is, who *actually* has time for a 90 minute rest? Therapeutically it’s a great idea, but practically it’s a little difficult – hence Dr. Amy’s Slightly Lazy Castor Oil Pack…

Dr. Amy’s Slightly Lazy Castor Oil Pack – Castor Oil Life Hack

This is probably not quite as perfect as the traditional method, but it’s a whole lot easier, and because it’s easier it’s a lot more likely to get done. This is an awesome castor oil life hack.  It’s quick and easy detox, anti-inflammatory, pain-relieving awesomeness.

You Will Need:

  • Organic castor oil
  • A pair of pyjamas that can be dedicated for the rest of their natural lives to castor oil. They will never be the same again.
  • A hot water bottle of heating pad if you want.

Directions for The Lazy Castor Oil Pack:

  1. Slather a good layer of castor oil over the area you want to treat:
    1. Liver/gallbladder – the right side of your abdomen under your rib cage, including your right side and even the right side of your back. Honestly I pretty much just cover my whole stomach and back and leave it at that.
    2. Uterus – slather your whole lower pelvis
    3. Breasts – just cover the whole area
    4. Joints, rashes and other local inflammation – put a good layer over the whole area
  2. Throw on the chosen pajamas
  3. If you have a hot water bottle or hot pack, go for it.
  4. Go to bed for the night
  5. When you wake up the next morning the oil will be absorbed, your body will be working on the castor oil and enjoying the anti-inflammatory benefits, and you really only spent 5 extra minutes putting on the oil.

This method provides an easy way to work this into a busy lifestyle.  Granted, the 90 minute rest has it’s own therapeutic benefit and if you can do it, I would highly recommend it.  If you can’t work that in (like I often can’t) then by all means do the lazy method. This gives you the opportunity to work castor oil in more frequently – even doing it a few times per week.

After having my daughter I was doing lazy castor oil packs over my abdomen and pelvis 3-4 nights per week just to help my body to deal with the anesthetics, surgical recovery and pain.  I feel like my recovery was far more smooth and easy than it otherwise would have been, simply because I was able to use castor oil so frequently.  If I had to take 90 minutes and do the full castor oil pack experience I wouldn’t have been able to fit it in at all.



Castor Oil – The Best Thing You Never Knew You Needed

I was reminded the other day how many people don’t know about all of the cheap and easy old-timey remedies that people used to rely on, like castor oil.  Many of these remedies have been used for centuries, simply because they work.  Castor oil is one such helpful substance that really does fix just about everything as well today as it did in it’s first recorded use 3000 years ago.  Really, if it’s been working for 3000 years, chances are it’s going to keep working.

Castor oil - picture by Pete Markham from Loretto, USA

Castor oil – picture by Pete Markham from Loretto, USA. This bottle is from the light-keepers house at Split Rock Lighthouse in Minnesota.

There are internal uses for castor oil, but I wouldn’t necessarily suggest them simply because this isn’t a gentle plant – it’s a kick in the pants (literally).  Castor oil taken internally is a laxative strong enough not only to induce bowel cramping and diarrhea, but even to induce labor contractions in pregnant women.  I actually used it to induce labor for myself recently and I can honestly say the castor-oil cramps were almost as bad as the labor pains. Eek!   Not a lot of fun, but if you’re impatiently waiting for a baby it does work. The reaction is so strong that castor oil is even reputed to have been used by fascist mobs in Italy in the 1920s as a form of intimidation (I would be intimidated).  Essentially these mobs would force feed their victims castor oil and turn them lose to have an agonizing and embarrassing bout of violent diarrhea. This, I suppose, made the victims then comply with whatever it was the fascist mob wanted in the first place. Ummm… Yeah. So don’t use it like that please.




While I’m obviously not a big fan of internal use in all but the most dire circumstances, topical use of castor oil is a miracle strong enough to make it a necessary part of every medicine cabinet.   The uses for topical castor oil are threefold:

  1. Digestive – Castor oil over the liver and abdomen helps to treat constipation, inflammatory bowel, liver congestion, gall bladder disease, bowel adhesions, lymphatic congestion, hepatitis, liver cirrhosis and  even infections in pelvic organs such as bladder and vaginal tract. For anyone looking to cleanse the liver or eliminate gallbladder sludge, this is a necessary.
  2. Skin – Topically castor oil can help with bacterial or fungal skin infections, rashes, acne, boils, abscesses, age spots, sebaceous cysts, warts, preventing stretch marks, ringworm, skin keratosis, swollen lymph nodes and eczema. It takes redness out of rashes through a strong anti-inflammatory action and softens even the most resistant skin, so it’s also a great natural beauty tool and is often helped to encourage healthy hair growth. Here’s a great article from hairlossrevolution.com for more information about that one!
  3. Pain – Topical castor oil can also be used to mitigate or relieve internal pain and inflammation from many causes.  This includes uterine cramping and abdominal pain related to the menses, joint pain and inflammation from arthritis, bursitis or tendinitis, muscle and ligament sprains, pain due to fluid retention in extremities, painful lymph nodes, even pain from appendicitis (although you still need to get to the ER post haste)

So – let me say this a different way. TOPICAL castor oil can help with:

  • Constipation
  • Inflammatory bowel disease
  • Abdominal pain and inflammation
  • Adhesions after surgery
  • Lymphatic congestion
  • Hepatitis
  • Liver detox
  • Gallbladder sludge
  • Gallstones
  • Pelvic infections
  • Menstrual cramps or pain
  • Fungal infections
  • Acne
  • Boils
  • Abscesses
  • Age spots
  • Eczema
  • Stretch mark prevention
  • Keratosis
  • Rashes
  • Joint pain and inflammation
  • Muscle and ligament sprains and strains
  • Painful lymph nodes
  • Reversing hair loss

The reason for its dramatic success in so many areas is simply the size of the primary molecule, ricinoleic acid, which comprises about 90% of the oil’s volume.  Ricinoleic acid is strongly anti-inflammatory and is a small enough molecule to penetrate into the deepest layers of the skin as well as into the lymphatic channels.  This penetration and effect is even better if you use heat on the area being treated. I recently had to have a C-section to deliver my little girl (the same one that was induced with castor oil – as it turns out her head was bigger than my body could handle).  Castor oil topically over the C-section scar has helped it to soften and heal and really helped with the initial post-labor pain.

The best news is that 8oz of organic castor oil will run between $5 and $10 depending on how fancy a store you like to shop in.  That 8oz will last most of your natural life because there’s really only so much you can use at once. Stay tuned for instructions on how to do an at home castor oil pack – both the conventional instructions, and my own much lazier method. 🙂

The castor bean plant, also called Palma Christi, or Palm of Christ.  Possibly because of its hand-shaped leaves, possibly because castor oil is as close to a miracle as I’ve ever seen.



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