Most patients think losing their gallbladder solved the problem. Functional medicine practitioners know it was only the first clue.   Tracy Harrison takes a closer look at what’s actually driving gallbladder dysfunction, and why removing the organ doesn’t remove the risk. Too often, upstream issues go unaddressed, allowing the same hidden dynamics to continue affecting the body. She walks through six of the most common contributors to hepatic biliary congestion: estrogenic overload, metabolic dysfunction, subclinical hypothyroidism, dehydration, toxic burden, and GLP-1 agonist medications. These factors can thicken bile, impair flow, and quietly disrupt other systems long after the gallbladder is gone.   You’ll hear strategies for identifying these patterns early, plus a case study that shows how easy it is to miss them, especially when the patient doesn’t fit the usual mold. For clinicians, this episode is a reminder that gallbladder disease is rarely an isolated issue and that upstream thinking is what leads to real progress.   Episode Breakdown: 00:00 The Gallbladder Crisis 01:18 What Causes Hepatic Biliary Congestion 03:04 Why the Gallbladder Isn’t Optional 03:46 Estrogenic Overload and Hormone Imbalance 08:36 Metabolic Dysfunction and Fatty Liver 12:34 Dehydration as an Overlooked Factor 14:42 Subclinical Hypothyroidism and Bile Flow 18:19 Toxic Burden and Everyday Chemical Exposure 20:32 GLP-1 Agonists and Gallbladder Risk 24:02 Case Study: Gallbladder Risk in a Young Male Patient 27:04 Why We Still Need Bile (and Gallbladders)   Links Take SAFM's 10 CME course - the Essential Gut Deep Dive: https://schoolafm.com/gut-course Get weekly Clinical Tips in your inbox: https://schoolafm.com/clinical-tips  Learn more about SAFM's practitioner training: https://schoolafm.com/our-program Subscribe to our Youtube channel: https://www.youtube.com/@safmchannel Access daily quick tips on Facebook: http://www.facebook.com/AppliedFunctionalMedicine/  Podcast production and show notes provided by HiveCast.fm