Living with PCOS can be challenging, especially when it comes with other health issues like gallstones and fatty liver disease. These problems are often connected due to shared risk factors such as obesity and insulin resistance. Understanding the link between PCOS, gallstones, and fatty liver disease can help you avoid, manage, or resolve these conditions more effectively.

Fatty liver disease (also called non-alcoholic fatty liver disease or NAFLD) is common in people with PCOS, due to the excess fat stored in the liver, which can cause damage over time. By knowing more about this connection, you can take steps to prevent or reverse it with lifestyle changes such as a healthier diet and more exercise. Gallstones can also complicate PCOS, making it important to stay informed and proactive about your health.

You’re not alone in this journey. Many women with PCOS face similar challenges and find relief by making small but significant changes to their lifestyle. Focusing on a balanced diet, regular physical activity, and appropriate care can make a big difference.

Key Takeaways

•       PCOS can be linked to gallstones and fatty liver disease.
•       Lifestyle changes can help manage or prevent these problems.
•       Staying informed and proactive is crucial for better health.

Living with Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) affects many parts of your health. It can lead to issues like insulin resistance, obesity, and even fatty liver or gallstones.

Understanding PCOS

PCOS is a condition where your ovaries contain multiple cysts and produce too many androgens, which are male hormones. Up to 20% of premenopausal women have PCOS[i]. This can cause a range of symptoms, including irregular periods, acne, and excess hair growth. You might also experience weight gain, especially around your abdomen[ii].

Insulin resistance is common in PCOS. This condition makes it hard for your body to use insulin properly, which can lead to higher blood sugar levels. Weight loss can be a struggle, and you may develop diabetes unless you make some lifestyle changes.

PCOS and Its Impact on Health

Living with PCOS can affect your overall health in many ways. One major impact is on your reproductive health. If you have PCOS, you might have trouble getting pregnant or experience complications during pregnancy. Managing your weight and keeping your blood sugar in check can help reduce these risks.

Other health issues linked to PCOS include mood swings, sleep problems, and high cholesterol. You might feel tired often or have trouble sleeping. It’s important to manage these symptoms with a healthy lifestyle.

Relationship to Fatty Liver and Gallstones

The relationship of PCOS to NAFLD is bi-directional in that each condition is a risk factor for the other.

•       Women with PCOS are at a higher risk of developing fatty liver disease and gallstones[iii].
•       Those with “genetically predicted” NAFLD are more at risk for PCOS[iv].

Fatty liver occurs when too much fat builds up in your liver and is often linked to obesity and insulin resistance found in PCOS. You can lower this risk by maintaining a balanced diet and exercising regularly.

Insulin resistance can also supersaturate your bile. Bile is a yellowish-green substance produced by the liver and stored in the gallbladder. It aids in the digestion of fats, protects the gut microbiome, and more. Supersaturation of bile can cause sludge and gallstones.

Gallstones are solid particles that form in the gallbladder. These can cause pain and may require surgery to remove. If you have PCOS, keeping an eye on your diet and maintaining a healthy weight can help reduce the likelihood of developing gallstones.

Understanding Fatty Liver Disease

Fatty liver disease happens when too much fat builds up in your liver. It can lead to health problems like liver damage, cirrhosis, and inflammation. Risk factors include PCOS, obesity, diabetes, and metabolic syndrome.

Causes of Fatty Liver

Fatty liver disease is often linked to obesity, diabetes, and poor diet. Eating too many fatty, sugary, or processed foods can increase liver fat. Metabolic syndrome, which includes high blood pressure, high blood sugar, and abnormal cholesterol levels, also raises your risk.

Recent research states that NAFLD is actually the liver manifestation of metabolic syndrome[v]. (Different aspects of the same syndrome.) Many are now referring to NAFLD as MFLD, or Metabolic Fatty Liver Disease[vi].

Symptoms and Complications

Many people with fatty liver disease don’t notice any symptoms at first. When symptoms do show up, they can include tiredness, abdominal pain, and jaundice (yellowing of the skin).

If not treated, fatty liver can lead to complications like insomnia[vii], liver fibrosis, cirrhosis, liver failure, intestinal permeability (“leaky gut”)[viii], and heart failure[ix]. These conditions can be very serious and sometimes life-threatening.

Relationship to PCOS

Polycystic Ovary Syndrome (PCOS) can increase your risk of fatty liver disease. NAFLD is found in 34 to 70% of women with PCOS, depending on the study[x]. Women with PCOS often have higher levels of insulin, which can contribute to liver fat.

Obesity and metabolic syndrome are common in PCOS, both of which are risk factors for fatty liver and gallstones. Managing PCOS symptoms with a balanced diet and regular exercise can also help reduce the risk of fatty liver disease.

Gallstones

Gallstones form when substances in your bile harden. They can cause intense pain and other serious health problems. This section discusses how gallstones form, symptoms to watch for, and their connection to PCOS.

Formation and Types

Gallstones form in your gallbladder, a small organ that stores bile. Bile helps your body digest fats. The two main types of gallstones are cholesterol and pigment. Cholesterol stones are yellow-green and made mostly of hardened cholesterol. Pigment stones are smaller, darker, and made of bilirubin, a substance from red blood cells. Factors like obesity, diet, and genetics can increase the risk of developing gallstones.

Recognizing Gallstone Symptoms

Gallstones can be silent, meaning they show no symptoms. When they do cause symptoms, it often means a stone has blocked a bile duct. You might feel sudden, sharp pain in the upper right side of your abdomen. This is called biliary colic. You may also experience nausea, vomiting, or even a fever if the infection or inflammation, known as cholecystitis, occurs. Severe cases can require gallbladder surgery.

Relationship to PCOS

Polycystic Ovary Syndrome (PCOS) can affect gallstone formation. Women with PCOS often deal with obesity and insulin resistance, both of which increase gallstone risk. Hormone imbalances in PCOS can alter bile composition, making stone formation more likely. Managing weight and insulin levels is especially important when dealing with both PCOS and a risk of gallstones.

Additional Connections Between PCOS, NAFLD, and Gallstones

These three conditions are independent but interrelated. In addition to the connections already discussed, PCOS, NAFLD, and Gallstones have three more things in common: Inflammation, thyroid hormonal dysfunction, and mental health implications.

Inflammation

All three conditions involve both direct and systemic inflammation.

•       Women with PCOS have cysts and inflammation in their ovaries[xi].
•       People with NAFLD have inflammation in their liver[xii].
•       Inflammation can cause a decrease in iron, and that can promote gallstones[xiii].
•       Those with gallstones have inflammation due to the irritation of the stones within the gallbladder[xiv].

Additionally, all these conditions can impact the gut and the microbiome. As the local inflammation increases, so does gut dysbiosis and permeability. This perpetuates local inflammation in the gut, and systemic inflammation throughout the body.

Thyroid Hormone Dysfunction

The thyroid gland, a butterfly-shaped organ located in the throat, produces thyroid hormones. T4 is the inactive form and T3 is the active form used by the body. Dysfunction of these hormones is commonly associated with all three conditions. The thyroid hormones are connected to PCOS, NAFLD, and gallstones in the following ways:

•       PCOS and thyroid dysfunction are commonly found together[xv].
•       The thyroid and the liver are intimately connected[xvi]. Thyroid hormones regulate metabolic activities and energy production of the liver[xvii].
•       Thyroid dysfunction causes slowed bile flow which can lead to gallstones.
•       Thyroid hormones are necessary for bile function and content, as well as for gallbladder motility[xviii].

Mental Health Implications

There is a strong incidence of mental health issues such as anxiety and depression amongst those diagnosed with PCOS[xix], NAFLD[xx], or gallbladder stones[xxi]. More studies are being done to understand the correlations.

We’ve covered a lot of ground so far and have explained some of the complex interrelationships of PCOS, NAFLD, and gallbladder stones. As a Integrative Gallbladder Nutritionist, my mission is to empower people like you with the knowledge and tools needed for optimal health. Let’s look at some of the ways you can help yourself if you have one or more of these conditions, or if you’re trying to prevent them.

Help Yourself with Diet, Exercise, and Lifestyle

Taking care of your body with the right diet, exercise, and lifestyle choices can make a huge difference if you have gallstones, fatty liver, or PCOS. Here’s how you can help yourself feel and function better.

Eating for Liver and Gallbladder Health and PCOS

What you eat plays a big role in addressing fatty liver, gallstones, and PCOS.

To support your liver, include more dark leafy greens into the diet. These greens are full of antioxidants that help reduce liver fat.

Wild-caught fish rich in omega-3 fatty acids like salmon and sardines are also excellent choices. They help reduce inflammation and improve liver health. Vitamins E and D also have been found to reduce inflammation in NAFLD[xxii].

Vitamin E:

•       The Recommended Daily Allowance is 15mg.
•       Food sources include almonds, beet greens, collard greens, spinach, pumpkin, red bell pepper, and avocado.

Vitamin D:

•       The RDA is 600 IU from ages 1 – 70, then 800 IU for those over 70.
•       Food sources of Vitamin D include wild caught fatty fish.
•       Vitamin D is best obtained through appropriate sunlight exposure.

Avoid ultra processed foods[xxiii], sugary drinks, and excessive alcohol as these can worsen fatty liver disease and disrupt hormones.

Herbs such as artichoke, burdock, and dandelion can help promote bile flow. This can minimize cholestasis and mitigate gallstone risk.

For PCOS, try to balance your meals with protein, vegetables, and healthy fats. Foods like eggs, nuts, and seeds can help stabilize blood sugar levels. Avoid refined carbs and sugars which can trigger insulin spikes.

To reduce risk of gallstones and to ease some symptoms of PCOS, optimize magnesium levels by incorporating beet greens, spinach, and legumes into your meals.

Magnesium

•       The Recommended Daily Allowance for Magnesium for adult women is 310-320 mg per day and for adult men is 400-420 mg per day.
•       Organic roasted pumpkin seeds, organic chia seeds, and dry-roasted almonds or cashews are also good sources of magnesium.

To replace amounts lost due to inflammation and help reduce your risk of gallstones, make sure you’re obtaining enough iron. Pasture-raised lean beef, free-range chickens and their eggs, and legumes are a good source of iron. Pair this with a food rich in vitamin C (asparagus, berries, leafy greens, citrus, etc.) to enhance iron absorption.

Iron

•       The Recommended Daily Allowance of Iron for those aged 19-50 is: 8mg/day for males and 18mg/day for females.
•       Adults aged over 50 years should have 8mg of iron a day.
•       Pregnant women should have an iron intake of 27mg/day. If you’re breastfeeding, you need 9mg/day (ages 19+).

Role of Physical Activity

Exercise is important for both managing fatty liver and PCOS. Physical activity helps reduce liver fat and improve metabolism. Aim for a mix of aerobic exercises like walking, swimming, or cycling, and resistance training like weightlifting.

Getting 30 to 60 minutes of exercise two to three times a week can make a big difference. Even if you don’t lose weight, consistent movement can help lower liver fat and reduce PCOS symptoms.

Find activities you enjoy, whether it’s dancing, yoga, or a group sport. This will make it easier to stick with a routine. Remember, the goal is to keep your body active and healthy.

Lifestyle Tweaks

Small lifestyle changes can greatly impact your overall health. Reducing stress is crucial, as stress can worsen symptoms of both fatty liver and PCOS. Try relaxation techniques like deep breathing, meditation, or even a warm bath.

Make sure you get restful sleep. Aim for 7-9 hours of sleep each night to allow your body to recover and balance hormones.

Some people find castor oil packs helpful for reducing liver inflammation. Apply a castor oil pack to your abdomen for 30-60 minutes a few times a week.

Remember, little changes in your daily routine can lead to big improvements in how you feel and manage your symptoms.

Conclusion

Living with PCOS, fatty liver, and gallstones can be challenging, but you’re not alone. It’s important to keep up with a healthy lifestyle. Eating a balanced diet, getting regular exercise, and managing stress can make a big difference.

It’s also crucial to get the right support. Make sure you have a good team to help guide you and provide personalized advice. I invite you to join my Gallbladder Saver Society Membership to be part of an awesome community.

Remember, taking care of your health is a continuous journey. Stay informed, stay motivated, and give yourself grace. The road to feeling better might take time, but with consistent effort, you can achieve better health and well-being.