Which Vitamin Deficiency Causes Gallstones? A Comprehensive Guide

October 18, 2025 •

4 min read

Did you know that individuals with low vitamin C levels may face an increased risk of developing gallstones? While no single vitamin deficiency causes gallstones in isolation, imbalances in specific nutrients play a significant role in the complex process of gallstone formation.

Quick Summary

This article explores the vitamin deficiencies linked to gallstone formation, particularly focusing on the roles of vitamin C and vitamin D, and explains how these deficiencies can alter bile chemistry and gallbladder function.

Key Points

Vitamin C Deficiency: Low vitamin C hinders the conversion of cholesterol into bile acids, leading to bile that is supersaturated with cholesterol, a key cause of gallstones.
Vitamin D and Gallbladder Stasis: Insufficient vitamin D levels may be linked to gallbladder stasis (poor emptying), allowing bile to become overconcentrated and increasing gallstone risk.
Bidirectional Relationship: Gallbladder problems can impair the absorption of fat-soluble vitamins like A, D, E, and K, potentially leading to further deficiencies.
Multifactorial Condition: Gallstones are not caused by a single deficiency but by a combination of genetics, obesity, rapid weight loss, poor diet, and hormonal factors.
Dietary Prevention: A diet rich in fiber and healthy fats, alongside maintaining a healthy weight and regular eating patterns, is key for prevention.

Understanding the Complex Origins of Gallstones

Gallstones are hardened deposits of digestive fluid that form in the gallbladder. While genetics and lifestyle factors like obesity and rapid weight loss are well-known culprits, research has illuminated the vital role specific vitamins play in preventing or contributing to their development. The most common type of gallstone is the cholesterol gallstone, which forms when bile, a fluid produced by the liver, becomes supersaturated with cholesterol. This supersaturation is often influenced by underlying nutritional imbalances.

The Primary Role of Vitamin C Deficiency

Scientific evidence strongly points to low vitamin C levels as a contributing factor to the formation of cholesterol gallstones. The mechanism involves the conversion of cholesterol into bile acids. The body's ability to perform this conversion relies on an enzyme, 7α-hydroxylase, which requires vitamin C as a cofactor.

When there is a deficiency of vitamin C, this conversion is less efficient, leading to an excess of cholesterol in the bile. This imbalanced bile, with a higher cholesterol-to-bile-salt ratio, becomes a perfect environment for cholesterol to crystallize and aggregate into gallstones.

Clinical studies have provided supporting evidence for this link. For example, a population-based study found that subjects who regularly supplemented with vitamin C had a significantly lower prevalence of gallstones compared to those who did not. Another observational study noted that women with low plasma levels of vitamin C showed a higher risk of gallstone disease.

The Complex Link with Vitamin D Deficiency

Another crucial vitamin that has a complex relationship with gallstone formation is vitamin D. Unlike vitamin C, the link is less about direct chemical conversion and more about indirect physiological effects, particularly on gallbladder motility and nutrient absorption.

Studies have shown an association between vitamin D deficiency and a condition known as gallbladder stasis, which is the sluggish or incomplete emptying of the gallbladder. When the gallbladder doesn't empty properly, bile can become overly concentrated, increasing the risk of crystal precipitation and stone formation. This is particularly noted in populations with a high prevalence of vitamin D deficiency, such as pregnant women. While some large studies have found no direct association between serum vitamin D levels and gallstone disease, the link with gallbladder function remains a point of interest for researchers.

There is also a bidirectional aspect to this relationship. Since vitamin D is a fat-soluble vitamin, its absorption in the intestines is dependent on the presence of adequate bile. Therefore, compromised gallbladder function due to gallstones can itself lead to or exacerbate a vitamin D deficiency by hindering absorption.

The Importance of Other Fat-Soluble Vitamins

Just as vitamin D absorption can be hindered, other fat-soluble vitamins (A, E, and K) also depend on healthy bile production and flow for proper absorption. This means that chronic gallbladder issues, whether caused by or leading to gallstones, can contribute to deficiencies in these vitamins as well, further impacting overall health.

Beyond Vitamins: Other Key Gallstone Risk Factors

Gallstone formation is rarely caused by a single factor. A holistic view is crucial for prevention and management. Important non-vitamin risk factors include:

Genetic Predisposition: A family history of gallstones increases your risk, as certain genes can influence bile composition.
Obesity: Being overweight significantly raises the amount of cholesterol in bile, promoting stone formation.
Rapid Weight Loss: Losing weight too quickly, especially after bariatric surgery or on very low-calorie diets, causes the liver to release extra cholesterol into the bile.
Diet: Diets high in refined carbohydrates, sugar, and unhealthy fats can increase cholesterol levels in bile and promote gallstone risk.
Hormones: Women, especially those who are pregnant or on hormone replacement therapy, have higher estrogen levels, which can increase cholesterol in bile and decrease gallbladder movement.
Age and Gender: Gallstone prevalence increases with age, and women are more likely to develop them than men.

Comparison of Key Vitamin Impacts on Gallstone Formation


Feature	Vitamin C Deficiency	Vitamin D Deficiency
Primary Mechanism	Inhibits conversion of cholesterol to bile acids.	Associated with poor gallbladder motility (stasis).
Effect on Bile	Increases cholesterol concentration, leading to supersaturation.	Allows bile to become overconcentrated over time.
Directness of Impact	More direct causal link influencing bile chemistry.	Less direct, influencing gallbladder function.
Evidence Level	Supported by animal studies and observational human data.	Mixed human study results; some show no direct link but some show a link with stasis.
Prevention Strategy	Ensuring adequate dietary intake or supplementation.	Addressing deficiency through diet, supplements, or sunlight.

Conclusion: No Single Deficiency, But a Combined Effect

In summary, while a deficiency in vitamin C has a more direct and documented influence on the chemical composition of bile, other nutrient deficiencies, such as vitamin D, play a role by affecting gallbladder function and overall digestive health. Gallstone formation is a multifaceted issue involving genetic, hormonal, and lifestyle factors. Addressing vitamin deficiencies, alongside adopting a healthy diet rich in fiber and healthy fats, is a proactive strategy for maintaining gallbladder health and reducing gallstone risk. NIDDK: Symptoms & Causes of Gallstones

How to Reduce Your Risk

Increase fiber intake: Incorporate fruits, vegetables, beans, and whole grains into your diet to improve bile flow.
Consume healthy fats: Olive oil and fish oil help the gallbladder contract and empty regularly, which prevents bile concentration.
Maintain a healthy weight: Gradual weight loss (1-2 pounds per week) is crucial, as rapid weight loss can trigger stone formation.
Eat regular meals: Skipping meals and fasting can increase the risk of gallstones by causing bile to become too concentrated.
Stay active: Regular physical activity helps maintain a healthy weight and supports overall digestive function.

Frequently Asked Questions

The primary vitamin deficiency linked to cholesterol gallstones is vitamin C. This is because vitamin C is needed for the enzyme that converts cholesterol into bile acids, and without enough vitamin C, cholesterol can build up in the bile.

Yes, it can. Gallstones can impair gallbladder function, which reduces the release of bile. Since bile is essential for absorbing fat-soluble vitamins (A, D, E, K), having gallstones or gallbladder issues can lead to deficiencies in these vitamins.

Vitamin D is linked to gallstone formation by potentially affecting gallbladder motility. Deficiency can cause gallbladder stasis, or sluggish emptying, which allows bile to become concentrated and promotes stone formation.

Rapid weight loss is a known risk factor. During rapid weight loss, the body metabolizes fat, causing the liver to release excess cholesterol into the bile. This supersaturated bile is more prone to forming stones.

Preventative dietary changes include eating a high-fiber diet rich in fruits and vegetables, choosing healthy fats like olive and fish oil, and avoiding refined carbohydrates and saturated fats. Eating regular meals also helps the gallbladder empty consistently.

Some studies suggest that regular vitamin C supplementation may help reduce gallstone prevalence. However, it is not a standalone solution. A balanced diet and overall healthy lifestyle are more important. Always consult a healthcare professional before starting supplements.

Cholesterol gallstones are most common and form due to an imbalance of cholesterol in the bile. Pigment gallstones are less common and are typically associated with an excess of bilirubin, which can result from blood disorders or liver disease.