June 2, 2019
We’re explaining who is more likely to develop gallbladder issues – one of the most common digestive diseases in the US – and what the gallbladder does to begin with. For those who have had their gallbladder removed, listen into the tips we share with clients about the food and supplements that help with digestion post-surgery.
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Cassie: Welcome to Dishing Up Nutrition. This show is brought to you by Nutritional Weight and Wellness, and I'm not going to beat around the bush this morning at all. I'm just going to tell you right off what our topic is because I know it's a topic that will resonate with many of you. Our topic today is how the gallbladder impacts digestion. I'm Cassie Weness. I'm a Registered and Licensed Dietitian. Our long time listeners know my back story, which is that my big focus in life right now is being a mom to my two middle schoolers, who only have two days of school left. Can you believe that?
Kara: I can't believe it's June.
Cassie: June 1st, crazy. So that's where my big focus is. A lot of you know that both of my kids have multiple food allergies and so just cooking for them and staying on top of all of their social activities and sleepovers and birthday parties and extracurricular activities keeps me on the go. I do also really enjoy teaching a variety of different nutrition classes to businesses and community groups throughout the Minneapolis/St. Paul area, and I do that on behalf of Nutritional Weight and Wellness.
Cassie: In the studio with me today, I have my co-host Kara Carper who is also a mom, and she's also a Licensed Nutritionist with a master's degree in Holistic Health. I'm going to turn the radio over to her in a minute to tell you a little bit about herself, but I'm just so excited to be in studio with you today because it's been a really long time.
Kara: It's been a while. I think I saw you at the nutrition conference. Good to be here, and good morning to all of our wonderful listeners. And like Cassie said, we have a topic of interest today on how the gallbladder impacts digestion. You know, gallbladder problems are one of the most common digestive diseases in the United States.
Kara: About a million cases are diagnosed every year. Billions of dollars are spent on gallbladder treatment. Today we want to explore some possible symptoms of having a gallbladder problem. We'll spend a brief amount of time on the symptoms, because what we really want to focus the majority of our time on is what food and what supplements are really going to help people with their digestion after they've needed to get their gallbladder removed. Because let's be honest, we hear that all the time. In fact, I have several family members, I have some friends, even some colleagues, who have had their gallbladder removed. And a lot of people are struggling. So we want to focus on what those people can do.
Cassie: I think this is the first time we've really focused on this aspect of it. Like, okay, you've now you've had it removed, we can't put it back in. Now what? I know many of you listening have had your gallbladder removed, and if you have, you might remember your doctor telling you, "Oh, you don't really need that gallbladder anyway, let's just take it out." I've heard that story so many times and I can't say that I agree with that statement. Our gallbladder does have a purpose. I think maybe what the doctor is trying to say is: "You won't die if I take your gallbladder out." And I will say I have met people who don't seem to have any digestive issues after they have their gallbladder removed, but I've met many more people that have a lot of problems after that gallbladder is gone. Some people have more problems after it's gone than they had before the surgery. And as dietitians and nutritionists at Nutritional Weight and Wellness, we specialize in helping people who are experiencing digestive issues for all kinds of different reasons. And when it comes to the gallbladder, we usually are quite successful in helping people after that gallbladder removal surgery. Of course, we prefer that people keep it if they can, but often times they don't find Nutritional Weight and Wellness until after they've had the surgery. And so then that's what we have to address.
Kara: That's right, that's right. So we will certainly spend some time giving tips on the prevention of needing to have your gallbladder removed. But we're going to cover a few different aspects of this today. Let's first talk about some of the symptoms that people experience when having what we call a gallbladder attack. Oftentimes people will have nausea, vomiting, gas, burping or belching, and the pain can be very excruciating. The pain can often last for anywhere from 15 minutes up to 24 hours. And this pain is typically in the right side of the chest, just below the rib cage. It can go into the shoulder blade also into the back. Usually by this point, when someone's having this excruciating pain called a gallbladder attack, surgery really might be needed. And if you or your family have had an attack, you really know what we're talking about with this agonizing pain.
Cassie: Yes. I can only imagine. Having had kidney stones, I can imagine it's on that same level.
Kara: Sounds similar. Yeah.
Cassie: Really, really excruciating. I mentioned just a minute ago that I firmly believe that that gallbladder has a reason, so let's talk a little bit about that. What does the gallbladder actually do? While the primary function of the gallbladder is to store bile. You've probably heard that word before. Our liver makes bile. Bile is needed for digestion, digesting fats mostly, but we also use bile to digest protein, in part. Now the digestion takes place in the small intestines, but let's back up. I'll start with the liver. The liver makes the bile. The bile then gets transported to the gallbladder. The gallbladder is sort of like a storage tank for the bile. And then when we eat, especially if we eat a high-fat, high-protein meal, then the gallbladder is responsible for secreting just the right amount of bile into our small intestine in order to break down and digest that particular meal.
Kara: So what you're saying Cassie, is if somebody has a meal with fat and some protein, mostly the, you know...
Cassie: The fat I'm thinking of is when my brother sent home some rib eye steaks from the ranch when we were home.
Kara: Great example.
Cassie: And I grilled those up because that's a fatty meat. So you get a little bit of both.
Kara: Depending on the amount of fat and the protein that someone is ingesting, then the liver is going to be secreting this bile. It goes into the storage tank, the gallbladder, and then that's kind of trickled in according to how much is needed based on how much fat and protein was eaten.
Cassie: Exactly. So your gallbladder is pretty precise, spitting out just the right the right amount based on what we ate.
Kara When the gallbladder is removed, there's no storage tank. But the liver is still going to be making bile for digestion. However, because there's no storage tank, there's really just a slow, constant drip of the bile into the small intestines. There's no longer a controller; there's no longer a regulator of the amount of bile that's needed for each meal based on what we ate. So that may be what is causing digestive problems after the gallbladder removal, depending on what the person's eating.
Cassie: Right. Because now think about eating a rib eye steak and you just have this really slow drip, like you said, coming straight from the liver.
Kara: When really you're going to need more bile for a meal like that. But the small trickle is not enough. So if somebody has that meal with more fat and more protein, that slow drip likely will not be able to break down that fat and protein. And there could be symptoms like we had just talked about: gas, bloating, diarrhea, loose stool is very common. There may be some heartburn as well.
Cassie: opefully listeners are connecting the dots. Is this happening to you? And I want to talk a little bit about who is more prone to have gallbladder issues. Unfortunately for you and I, Kara, women are more at risk of having gallbladder problems And when we look at that segment of the population in particular, meaning women during pregnancy and during menopause, gallbladder problems seem to happen more often. So think about what that tells us. That would tell us that hormones play an important role in the development of gallbladder issues.
Kara: And that may help you understand why this can happen to women. When women are pregnant, there's a decrease in stomach acid, which is really interesting. So a lot of pregnant women tend to experience digestive disorders. So to get rid of the symptoms, they may be prescribed acid-reducing medication or purchase it over the counter. And it's that combination of the acid blockers, along with that high estrogen during pregnancy, that can increase the likeliness of gallbladder problems. And so I think after the break maybe we could touch a little bit more on why people need hydrochloric acid, and acid blockers are kind of doing the opposite.
Cassie: Yes, great point. Let's do that when we get back from break. If you're just tuning in, you're listening to Dishing Up Nutrition. This show is brought to you by Nutritional Weight and Wellness. Before we head off to break, I just want to let all of you know that we've been presenting this nutrition education show for the past 15 years. Boy, do I sound old when I say time flies? Now I've had the privilege of being a co-host on this program Dishing Up Nutrition for 12 of those years. And I'm pretty proud to say that every week, we try our best to present life-changing nutrition information. And we really try to do it in a way that is practical and that is easy for everybody to understand. And with that, I just want to thank each and every one of you for listening, and I do hope that you pass on the information that we share with you on this program to your family, to your friends, to your coworker. If the information we share can help out someone you know, please encourage them to listen to that podcast. It's so easy. They can either listen online at weightandwellness.com or they can listen on their smart phone through iTunes or by downloading the free Dishing Up Nutrition app. I mean, think about it. You could help change someone's life for the better. Just by hooking them up with one of our podcasts that you know will really speak to them.
Kara: Welcome back to Dishing Up Nutrition. One of the goals that we have for the Dishing Up Nutrition radio show and our podcasts, we really want to deliver quality, well researched information. Another goal of course is to hopefully inspire you listeners to eat better, which is going to help you to feel better. So if you're reaching for a slice of pizza, you know, I don't know if people know how much sugar is actually in pizza with the combination of bad fats. We all want you to be thinking about Dishing Up Nutrition. So you might just pull back your hand and say, "Oh those, those gals at Nutritional Weight and Wellness told me that pizza has sugar and bad fats. It's not a health food. I am able to make a better choice." Right? We want us to be in your head during those times.
Cassie: Yep. We're your conscience, your conscience in your head. And I know, I mean, there are times for me when I get tempted, but I think, "No, who am I? I Work at Nutritional Weight and Wellness. That's not a good food for me. And it's become such a good habit for me. I don't know about you, Kara, but pizza, ice cream, those types of things. If I get a little urge, then I think, "Okay, a moment on my lips, it's going to taste good, and then I'm gonna feel like crap. Which is the truth. If I spike my blood sugar and then it falls, I feel awful. It's not worth it.
Kara: Right. I mean, for some people it might be about the weight, but for a lot of people, it's about how you feel after you eat food like that.
Cassie: Before we went to break, we were talking about people that are more prone to having gallbladder problems. I want to mention one that came to mind as we were at break and that is people with low thyroid function. So maybe you've been told you have low thyroid function, or maybe they've even said hypothyroid. Some people have a particular type of hypothyroid called Hashimoto's Disease. All of these can contribute to a slower functioning of your gallbladder. And then when you think about it, it's sort of like the bile stagnates in the gallbladder because it's not working as efficiently as it should. And so you kind of get this thick sludgy bile, and that can sit in your gallbladder and eventually gallstones can form. So again, think about: is your thyroid at the root cause of your problems here? Some common body signs of low thyroid would be hair loss. And you reminded me Kara in the break room before we went on air, losing the outer third of your eyebrow can be a sure sign of low thyroid for many people. Fatigue, being cold, especially if the extremities like your hands and your feet are cold are all signs of low thyroid function. And that could in turn be causing your gallbladder issues which cause digestive problems. It's all connected. I really encourage any of you listening that think your thyroid might be contributing to your gallbladder problems, go back to our past podcasts and listen to the August 27, 2018 show. We had a special guest on that was Ann Louise Gittleman and the title of that show was Radical Metabolism, but she really talks more in depth about this connection with the thyroid and the gallbladder, and then how that can contribute to unwanted weight gain as well.
Kara: I'm glad you brought that up because we can only give so much time today on the thyroid-gallbladder connection. And so if somebody is suspecting that they can get a lot more information from just listening to that wonderful podcast.
Cassie:That was a fascinating show.
Kara: Thank you for bringing that up.
Cassie: You are welcome.
Kara:So in addition to thyroid, low thyroid, hypothyroidism being connected to gallbladder issues, we had touched on another reason for gallbladder problems: low stomach acid. And I had mentioned that because when women are pregnant, they really tend to have decreased stomach acid and a lot of them will go on the acid blockers, which is not the answer almost all of the time. Because we really do need stomach acid. So there are so many people who are taking these acid reducing medications, not realizing that the gallbladder actually needs hydrochloric acid to function, and it needs it to function well. So with these reducing medications, and maybe we could just list off a couple. I know there's a Prevacid.
Cassie: Prilosec, Nexium, Zantac
Kara: Most are over the counter these days. So these acid reducing medications, obviously they reduce or block the acid production. And again, if the gallbladder needs this hydrochloric acid to function, this is going to put somebody at risk for getting gallstones.
Cassie: Right. I mean, don't get me on my soapbox about those acid reducing medications because my son Riley was put on those very, very young before I figured out his celiac disease. So I've done quite a bit of research on acid blockers, like Prilosec and Prevacid. There are so many bad side effects when you use them long-term. Like you mentioned one, which could be gallstones, but they can also cause osteoporosis if used long term. They can cause memory loss. They can cause B12 deficiency. So if you are taking an acid blocker long-term, I think what Kara and I are trying to say here is get to the bottom of that problem because that will help you stave off gallstones, hopefully. But also, your body's trying to tell you something. If you're having heartburn, and it's not trying to tell you that you're low in Prilosec. Something else is going on.
Kara: It's often a food that someone's eating that they're sensitive to. So getting to that root cause is really important.
Cassie: Yeah. Or else other things are gonna start to go wrong as well. Okay. Back to our question. What else can cause gallstones, or what can cause an inflamed gallbladder? Well, here's another one. Studies have found that food sensitivities for some people are directly related to gallstones and to gallbladder inflammation. One example that I think we don't talk about enough is eggs. Eggs are actually one of the most common food sensitivities or food allergies, especially when we look at people with gallbladder issues. In fact, I was reading a study getting ready for this show that said 95% of gallbladder suffers who eat eggs will have a negative reaction to them.
Kara: That is so interesting. I know we don't talk a lot about egg sensitivities.
Cassie: No. Because we're always saying how good eggs are, and how healthy they are. And if you don't have a sensitivity to them, they are. But again, they are a highly allergenic food for a lot of people. Another category would be dairy. A lot of people have a dairy sensitivity or a dairy allergy. So that's things like cows milk and ice cream and cheese. And then of course the grains. And we talk about that quite a bit. How gluten grains especially; the wheat, the barley, the rye, most oats, those grains can really inflame the gallbladder. And on that note, I want to share some words of wisdom from my cousin back in North Dakota who had her gallbladder removed years ago before she discovered Nutritional Weight and Wellness.
Cassie: Before we went to break, I was saying that I wanted to share some words of wisdom with you from my cousin back in North Dakota. She had her gallbladder removed gears before she discovered the power of eating the Nutritional Weight and Wellness way. So I reached out to my cousin, Patty, in preparing for the show. And I have to say, the very first thing she said was, "I would definitely recommend to all of your listeners not to have their gallbladder removed." But we do know that many people listening have already had that organ removed. And so what do we do now? So I want to share with you that my cousin Patty, and I think this is common with many people, said that in hindsight it wasn't really her gallbladder that was the problem. It was all of the gluten and the processed carbs. So processed carbs are things like bread and pasta, bagels and chips. It was those things and the gluten that she was eating, that were causing inflammation for her in her gallbladder. So what I want to say to the listeners is if you are listening and you're having gallbladder like symptoms, the nausea, the indigestion, maybe even diarrhea, first stop and think: When are these symptoms flaring the most? Is it after eating pizza? Or maybe it's after you stop at the coffee shop and order that big blueberry muffin to go with your cup of caffeine. The pizza, the muffins, the pasta, the bread. These are all processed carbs, and they're all sources of gluten and you might be like my cousin and be inflaming your gallbladder with these food choices.
Kara: So it really sounds like those foods that she didn't know she was sensitive to were creating all these digestive issues.
Cassie: Yes, and the doctor was, I think, sort of at his wit's end and said, "I'm a not sure what's wrong. Let's try taking the gallbladder out."
Kara: We have heard that a similar story before from others. Sometimes it surprises people to learn that it is the processed foods and flour that are high in sugar and bad fats, and a lot of foods have that combination. But those types of foods really are the biggest cause in the rise that we're seeing in gallbladder issues. Isolated cultures or cultures who don't have like this western or modern civilization, and they don't have processed foods in their diet, they don't have gallbladder problems. It's a very, I call it like a westernized disease. A lot of cultures don't even know what a gallbladder attack would be. For my own clinical experience, I have found that when I had clients remove bad fats such as trans fats or refined oils from their diets, their gallbladder function improved. And at Nutritional Weight and Wellness, we really believe that the removal of sugar, flour, and those refined oils is critical for healing the gallbladder and the whole body. And when we say refined oils, Cassie, the oils that we're talking about, you know this...
Cassie: There are four biggies, aren't there?
Kara: They are soybean, corn, cottonseed and canola. And actually, I would throw a sunflower in there as well.
Cassie: Yes. And go to your kitchen cabinets. They are in so many products. And these are inflammatory for the gallbladder. So if you still have your gallbladder, and you're having digestive issues, get these bad oils out now and see if that doesn't really calm down that inflammation. But now I think we need to move on and talk about what should you eat after you've already had your gallbladder removed. Because like I said, we can't put it back in you anymore. So if you're sitting listening, and you don't have a gallbladder, what can you do so that you don't have the diarrhea and the bloating, the nausea. Some people have constipation. Well, I think the first food group to really examine carefully is what we have just been talking about. And that's fats. A lot of times after gallbladder removal surgery, people are told to eat low fat. And I get the science there of what the doctor is saying, but we know that fats are so critical to so many different aspects of your health. So you don't want to cut out fats, but you want to stop eating the refined, damaged fats. Those ones that we just mentioned: cottonseed oil, corn oil, soybean oil, canola oil. And they're ubiquitous here in America. What are some of the foods that come to top of mind, Kara, that have these bad fats?
Kara: The first thing that comes to my mind would be something like French fries, or anything that's deep fat fried from mostly from restaurants and fast food places, but even some of those freezer foods. People might think that it's healthier to go to the frozen aisle and buy frozen French fries, but you have to be looking at ingredients and looking at what oil is being used to fry those. And it usually is going to be canola, soybean or corn. And those really fall under the category of damaged refined oils. They're really hard to digest. And when the oil is heated over and over throughout the day, like in the fast food environment, it's actually a rancid, oxidized-type product. So for most people, something like French fries are just going to be very difficult to digest and break down and almost impossible to digest if you don't have a gallbladder. So when you said what food comes to mind, I would say any deep fried food that's being fried in a bad oil.
Cassie: Yes. And they are found very frequently at our restaurants, aren't they? Now, if any of you listening are really sad, maybe shedding a tear because Kara is saying you can't have French fries anymore, I just want to give out a quick and healthy way to get a French fry fix. Buy those little fingerling potatoes. You know, those little long skinny potatoes. Thinly slice them up and you can toss them in either a little avocado oil or coconut oil. And then I like to put salt and pepper on there. Bake those at 350 degrees for about 20 minutes, until they get crispy. They're easy to digest because they have the healthy fat, but they have that crispiness and they are really tasty.
Kara: And we have found from clinical experience, that people cannot digest these refined oils when they don't have a gallbladder. But there are healthy fats that are much easier to digest. And those are healing fats such as coconut oil, olive oil, avocado oil, and even something like ghee. It's sort of like a clarified butter. Those can be used, and they don't create digestive distress.
Cassie: And we want you to eat healthy fats. We need those for good brain health, good skin health, so many aspects of our health. But just get out the bad fats. You know, thinking of what foods can cause that digestive distress, especially after the gallbladder has been removed, something that comes to my mind are those big commercial muffins. You know the kind. They're at the restaurant, they are certainly in the bakery, they're even, if you go into pay for gas, they're always sitting right there where you have to look at them.
Kara: They're tempting, I mean they call your name.
Cassie: I heard it said once, and I know this is true, that since the inception of the muffin, it has tripled in size here in America. So what that tells us is it is way too much sugar. If it's tripled in size, and we know it's made with flour, it's turning to too much sugar. Plus it's made with bad oils. I guarantee you if you're buying a muffin and not baking it yourself, it has either soybean oil or cottonseed oil or maybe both. So it's no wonder that a lot of people have heartburn and indigestion after eating these store-bought muffins.
Kara:And I cannot believe we already have to go to commercial break. But before that, I'm going to go off on sort of a complete tangent before we head to commercial and share with you a random question that we so often get from our female clients. That question is: why am I suddenly getting a bunch of facial hair? Some of you are laughing, but some of you are really relating. So if this is you, what can you do? Well, let me tell you some possible reasons why those black hairs are suddenly sprouting on your or your chin or that mustache area. For some people it's because they're eating way too much sugar and too many processed carbs. The breads, the bagels, the cookies. All of that sugar wreaks havoc on our hormones. For some of you, it might be drinking too much coffee. For some people, it's too much stress. And stress over time will stimulate your adrenal glands so they produce too much cortisol. This not only can lead to that unwanted facial hair, but it can also lead to unwanted weight gain. So if you're struggling with this ugly facial hair that suddenly sprouting up, and maybe you're struggling with your weight too, believe it or not, we can remedy both of those problems through our Nutrition 4 Weight Loss program. This program teaches you how to control your sugar cravings and how to eat to manage your stress, and it will help you lose weight. If it's time for you to make a change, call our office at (651) 699-3438. Inquire about our Nutrition 4 Weight Loss program.
Kara: We hope today's show has helped you to understand how your gallbladder impacts your digestion. And next week, you're not going to want to miss Dar and Marcy as they interview Dr Kyra Bobinet as she discusses her new book, Well Designed Life. The goal of her book is to help people look at their individual lives right now and design a life that they want in the future. You're going to hear some really new thoughts about living a well-designed life. It sounds like a great show.
Cassie: It sounds like a great book. There are just too many books and not enough years in my life to read them all.
Kara: Back to our topic of gallbladder. So what we were talking about before break is what do people do when they needed to have their gallbladder removed and and now they're experiencing diarrhea, constipation, nausea, heartburn, gas and bloating. In working with clients that do not have a gallbladder, we have found that most people are able to digest about one to three teaspoons of healthy fat.
Cassie: I think we need to say that again because that's lower than what we often recommend. But this is if you do not have a gallbladder.
Kara: Very specific to not having a gallbladder. Bile production is not regulated as well with no gallbladder. We need to just decrease the healthy fat. We still, it's very, very important that it's a healthy fat though. One to three teaspoons at a meal or a snack. So just basically in one sitting. And those natural healthy fats again are olive oil, avocado oil, coconut oil, butter, ghee, clarified butter. And we really do need the healthy fat to make up our cell membranes. Our body needs fat to hydrate our tissues. Of course we need it for our brain. So we just have to be careful with the amount.
Cassie: The amount and choosing the right fat. And long-time listeners know that we will always suggest eating vegetables, gallbladder or no gallbladder, in place of the pasta, the bread, the crackers. Here's a really interesting fact that I want you to think about. Our liver needs vitamin C to convert cholesterol into bile. So we need vitamin C to make bile, and we need that bile to digest our fats. Guess where you find a lot of vitamin C? In vegetables, things like bell peppers and broccoli and tomato, even though maybe some people call that a fruit. Those are all great sources of vitamin C. So eat your vegetables so you get plenty of vitamin C so you can turn that cholesterol into bile.
Kara: Right. And now Cassie, some people that have had their gallbladder removed may experience symptoms. Unfortunately others may experience ongoing symptoms and it's important to make an appointment with a dietician and nutritionist to get all the pieces in place.
Cassie: Because everybody's solution is a little bit different. We are all unique. We know that certain foods and certain supplements help to increase bile production and increase that flow of bile. And I should point out too that a lot of people, myself included, need to include certain foods and certain supplements to help with digestion even though we haven't had our gallbladder removed. So the information we want to give you now about certain supplements is really helpful for people without a gallbladder. But it can also be helpful for people that just have digestive issues even though they still have a gallbladder. The first recommendation is a supplement that increases hydrochloric acid. Remember we mentioned how you need enough hydrochloric acid in order for your body to produce and secrete bile. So this product is called Ortho Digestzyme. A lot of our clients take either one or two capsules of this supplement before each meal, so before breakfast, before lunch, and before dinner. This contains a little bit of hydrochloric acid as well as some enzymes. Now for some people though, that's not enough hydrochloric acid. So if you try the Ortho Digestzyme, it's not doing the trick, you might need more hydrochloric acid and in that case we would suggest a product called Spectrazyme. This has a lot more hydrochloric acid per tablet, and it also has a little pepsin, which is an enzyme that helps break down protein.
Kara: Both of those supplements are helping the body to break down and digest fats and protein. So it's almost like taking on some of the responsibility of what the gallbladder normally would be doing with that production of bile.
Cassie: Replacing what's lost.
Kara: Yes. Now I know many of our nutrition experts also recommend an amino acid called Taurine. Now, Taurine helps bile excrete chemicals detoxed by the liver. We have a supplement available at Nutritional Weight and Wellness called Pure Taurine. So that actually helps to increase bile production, and it helps as well to thin the bile. So it's not all sludgy like you were talking about earlier, because that can lead to gallstones. So it thins the bile, and we would suggest one to two capsules at bedtime. For those of you who are into organ meats, you know, I don't think that's super common, but some people are eating liver or tribe or tongue, you probably already have sufficient taurine. But if you're not, you very well could be deficient.
Cassie: Did you see the face I just gave you? *Laughs*
Kara: I did. *Laughs*
Cassie: That's great if you like organ meats. And I know some people do, my grandma being one of them. But it's just not my thing. So, hand me the taurine, please. One more supplement that we sometimes recommend to promote good digestion is something called digestive bitters. And this is something, if you heard the start of the show, you heard me talk about my cousin Patty that has had her gallbladder removed, and she finds digestive bitters really helpful. So for many people drinking just 5 to 10 drops in of of these digestive bitters in just a small amount of water about 10 to 15 minutes before each meal. And then do another 5 to 10 drops in a little bit of water after your meal. That can really help relieve the indigestion, the heartburn, the bloating that can go along with having a meal if you don't have a gallbladder. And I want to say here, in this case, brands do matter. We recommend Moonshine Digestive Bitters. This is a supplement that's very well tolerated. Some of the digestive bitters out on the market have been known to cause diarrhea, and we don't need to add insult to injury. And I should mention too that any of these supplements that we have been talking about, the Ortho Digestzyme, the Spectrazyme the Pure Taurine, the Moonshine Digestive Bitters, you can read more about them or you can purchase them if you want to by going online to our website and that is weightandwellness.com. We don't charge any shipping and handling on order over $50. So I just wanted to throw that out there too.
Kara: Gosh, and we are just coming to the wrap up of our show here.
Cassie: Yes. I think we just have to wrap it up by saying that are reminding everybody that our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. Yes, it's a simple message, but it's a powerful message. Have a healthy day!