Why does intermittent fasting increase gallbladder sludge?

Intermittent fasting can lead to gallbladder sludge due to concentrated bile during periods of fasting, typically peaking around 10 to 15 hours after the last meal. Symptoms include right shoulder and abdominal pain, bloating, burping, and nausea. To mitigate these issues:

1. Add lemon or apple cider vinegar to water during fasting to help thin bile.

2. Gradually introduce fats in a ketogenic diet to avoid overwhelming the gallbladder.

3. Keto and intermittent fasting can lower insulin levels, reducing the risk of gallstone formation typically associated with high insulin.