Lab tests and markers that point to gallbladder dysfunction

Common lab tests and markers that point to gallbladder dysfunction include:

GGT

 • Blood (serum)

GGT is needed to recycle glutathione. A high level may indicate a higher need for glutathione.

If GGT is elevated in combination with ALP, it typically indicates gallbladder bile duct obstruction. This is commonly seen in gallstones.

ALP

 • Blood (serum)

If ALP is elevated in combination with GGT, it typically indicates gallbladder bile duct obstruction. This is commonly seen in gallstones.

Total bilirubin and Direct bilirubin

 • Blood (serum)

Bilirubin is normally conjugated with a molecule of glucuronic acid. This makes it water-soluble and also unable to be reabsorbed back into the liver to be recycled. Instead, it passes into the colon. Here it is further metabolized by colonic bacteria.

• Total bilirubin measures both conjugated and unconjugated bilirubin.

• Direct bilirubin is any form of bilirubin which is water-soluble. It is mostly made up of conjugated bilirubin and maybe 25% unconjugated bilirubin.

When you subtract the two markers, you get the indirect bilirubin number. Indirect bilirubin is the fat-soluble fraction. Direct bilirubin is needed to convert T4 thyroid hormone to T3 thyroid hormone. However, bilirubin can form stones that block the bile duct which causes direct bilirubin to rise, resulting in high levels on a blood test.

SIBO

 • Breath test

Measures the gasses methane and hydrogen formed by organisms in the small intestine. High levels of either gas is a positive test for SIBO.

Microbiome testing

 • Stool (feces)

Imbalances in gut bacteria (gut dysbiosis) are almost always associated with gallbladder dysfunction. Some organisms consume bile acids for growth. An overgrowth of these organisms may result in lower bile acids and impact gut health negatively.