You may have fat malabsorption… and not know it
Fat malabsoprtion, also called steatorrhea or fat maldigestion, is the inability to properly digest fats. Many people experience fat malabsorption without knowing it! Fat malabsorption contributes to common issues like hormone imbalance and is the primary cause of gallstones and gallbladder pain.
I wrote this post to explain the role of fat digestion and gallbladder health. You’ll learn if fat malabsorption is contributing to your health issues and learn how to address it.
What causes fat malabsorption?
Fat malabsorption results from poor digestion and specifically from one or more of these three causes:
- Liver congestion – the liver can’t synthesize good bile
- Poor quality bile – the gallbladder can’t release thick, sticky bile
- Lack of pancreatic enzymes – these enzymes, along with bile, digest fat
Here’s how fat digestion works, if everything is working properly:
- The liver synthesizes bile. It packages up old hormones and toxins that need to leave the body in the bile. Then it ships the bile to the gallbladder.
- The gallbladder stores bile and secretes it into the small intestine when we eat a meal with fat. The bile breaks down the fat, so we can absorb it, and then the toxins in the bile exit the body with the feces.
- The pancreas secretes digestive enzymes into the small intestine. Some of these enzymes, called lipolytic enzymes, further break down the fat and allow us to absorb it.
Symptoms of fat malabsorption:
- Greasy, smelly, light-colored and/or floating stools
- Gas and belching after meals
- Very dry skin (indicates fat isn’t being absorbed or not enough is being consumed)
- Gallbladder pain (right side, under ribs)
- Nausea after eating
- Hormone imbalances, because fat is necessary to synthesize new hormones and eliminate old hormones
Bile: The key in fat malabsorption
When it comes to fat malabsorption, the first step includes supporting healthy bile production and secretion. When we experience fat malabsorption, it means that the bile in the gallbladder is thick and sticky. The gallbladder tries to squeeze it out, but it can’t. In a vicious cycle, toxins and old hormones are re-absorbed because the bile isn’t leaving the body.
The main factor that causes poor bile quality is a low fat diet. The presence of fats in a meal signals the gallbladder to release bile into the digestive tract, and the bile emulsifies the fat so we can absorb it.
What happens when we only have a few measly grams of fats in our meal? Bile release isn’t signaled, so bile sits in the gallbladder, turning thick and viscous. Then, if we do eat a meal heavy in fat, the gallbladder can’t squeeze out the thick bile and the fat passes through our digestive tract undigested and unused for critical tasks in the body.
Are you ready to improve your fat digestion? Here are 8 ways to correct fat malabsorption
1. Gradually increase the good fats
Quickly switching from low fat to a higher fat diet will temporarily cause fat malabsoprtion. This results because the bile will be thick and stagnant due to the low fat diet. For some individuals, the symptoms are slight and resolve quickly. For others, this transition causes severe symptoms of fat malabsorption.
Don’t go from 20 grams of fat per day to 80 grams of fat the next day. Gradually increase your consumption of healthy fats over a period of weeks. Healthful fats include traditional, unprocessed fats such as:
- Butter, preferably from grassfed cows
- Ghee, preferably from grassfed cows (I like this brand)
- Pure olive oil (I like this brand)
- Avocados and avocado oil
- Whole nuts and seeds, in moderation
- Cold-pressed nut and seeds, in small amounts
- Pastured whole eggs
- Meats and whole-fat dairy from grass-fed, pasture raised animals
Highly processed, non-traditional fats such as canola oil, soybean oil, safflower oil, cottonseed oil, peanut oil and grapeseed oil exacerbate liver congestion and should be avoided.
Wait, isn’t canola oil heart healthy? And doesn’t the cholesterol in butter clog arteries? Nope, you’ve got your fats mixed up! We know from study after study, as well as the dietary patterns of traditional cultures, that unprocessed fats support all aspects of health. I share the science in my post 10 Reasons Why Low Fat is Not High Nutrition.
2. Include coconut oil in your diet
Coconut oil, one of the most healthful foods ever, consists primarily of medium chain fatty acids. Coconut oil fights candida, boosts the metabolism, fuels weight loss, and supports skin health. Because of the fatty acid composition, coconut oil is absorbed without bile.
This is a good and bad thing. If you struggle with fat malabsorption, you will likely be able to absorb at least some of the fat from coconut oil. But because it doesn’t stimulate bile, you should consume it in addition to sources of animal fats.
3. Supplement with ox bile to improve fat malabsorption
Ox bile is what the name implies – bile from oxen. Because it is so similar to human bile, it works by breaking down fats in your digestive tract. As a “band-aidsupplement,” it improves bile quality so you can digest fats better in the long run.
Take 1-5 tablets of ox bile – I recommend this one – with each meal. Use it for 2 weeks and up to 2-3 months. After 2-3 months, take a break from it for at least a couple of months, otherwise your body can get reliant on it and stop producing its own bile.
If you have had your gallbladder removed, then you need a permanent bile replacement to digest your fats. In that case, most natural health practitioners recommend taking ox bile with each meal.
4. Say Goodbye to “Healthy Whole Grains”
When we lack an healthy digestive system, as in the case of fat malabsorption, grain consumption causes problems. “Healthy whole grains” like fiber cereals, whole wheat breads and pastas contain numerous anti-nutrients such as phytic acid that only stresses the body.
Grains fuel a vicious cycle called carbohydrate malabsorption. This wears down the filaments in the small intestine, called microvilli, that are responsible for absorbing our food. As the microvilli become damaged, it leads to a syndrome called Leaky Gut when the tight junctions between intestinal cells loosen. This allows undigested food to leak from the small intestine into the blood stream, causing inflammation and food allergies.
All of the recipes on Empowered Sustenance are grain free, and you’ll find thousands of more grain free recipes on my Pinterest boards.
5. Eat mindfully and calmly
It seems like common sense, but your body cannot digest any macronutrient – fat, carbs or proteins – well when it is stressed. Digestive juices, including stomach acid and bile, are secreted when the body is in parasympathetic nervous system mode. The parasympathetic mode is the opposite of the “fight-or-flight” sympathetic mode.
Sit down for meals. Focus on chewing and tasting your food. Eat with gratitude. Put down your phone and turn off the TV. Your body will thank you for it, and you’ll digest your fats better!
6. Enjoy fermented foods to help fat malabsorption
Naturally fermented foods pack a potent dose of probiotics, those friendly bugs that help restore balance in the digestive tract. Additionally, the enzymatic activity in the raw foods drastically increases during the fermentation process. These active enzymes support pancreatic health and improve digestion.
Low-fat, sugar-laden yogurts may claim “a rich source of probiotics” but don’t buy into this marketing hype. These highly-processed options pale in comparison to slowly fermented dairy and vegetables. Better options include making your own fermented veggies and dairy products.
Alternatively, you’ll find healthful options at your health food store. Look for naturally fermented sauerkraut and pickles, in the refrigerated section. Grassfed, full-fat yogurt and kefir also provide nutrient-dense options.
7. Supplement with pancrealipase for fat malabsorption
Pancrealipase is a pancreatic enzyme that helps digest fat. I use the supplement Beta-TCP, found here, in my Nutritional Therapy practice. It contains porcine-derived pancrealipase and this supplement makes a wonderful “transition supplement” to improve fat malabsorption. It can be taken alone or in conjunction with ox bile.
A general recommendation is 1-6 tablets with each meal, for a period of 1-3 months. After 2-3 months, take a break because your body can become reliant on the enzymes and get lazy with its own enzyme production. You can also take 1-6 tablets right before bed, to support liver health. As always, I recommend working with an experienced health practitioner when taking various dietary supplements.
For best results, chew the Beta-TCP tablets instead of swallowing them whole. They taste, um, not so good. But you can do it! When I used this supplement, I would chew them while holding my breath, swallow, chase with a sip of water, and then breathe. This helps 🙂
8. Improve overall digestion with hydrochloric acid
The stomach is supposed to be an acid tank. A very acidic stomach digests food and triggers the chain reaction of digestion. When the stomach isn’t producing enough acid, pancreatic enzymes and other digestive secretions are not signaled.
Doesn’t stomach acid cause heartburn? No. As a matter of fact, 90% of people with heartburn suffer from too little stomach acid. In this post, I explain how to correct low stomach acid naturally with foods and specific supplements including hydrochloric acid supplements.
Do you think you may have fat malabsorption? Have you tried any of these steps?
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I am suffering from fat malabsorption and really too thin for my age and height. Whenever I eat fats, natural or unnatural, thick mucus-like things come back into my throat at night! What can I do. Doctors cannot find anything wrong apart from saying I have duodenal ulcers. Please help
Hello Vasta, I just read your comment and empathize. I have similar symptoms. I have discovered that I am a Cystic Fibrosis carrier and that carriers can have mild symptoms of CF and fat malabsorption is one of those symptoms. You may want to get some genetic testing done to see if you are a carrier or if there is another reason for your fat malabsorption. There can be a link between CF and metabolic disorder. It’s called CMRS. Research and talk with your doctor about it and perhaps get a referral to see a geneticist.
Empowered Sustenance gives alot of good tips for managing symptoms with fat malabsorption. Pancreatic enzymes, HCl and ox bile salts are very important to supplement with and change of diet.
I hope this is helpful and that you have found out more about what you are dealing with.
All the best,
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