The NIH Says 25 Million Americans Have Stones Forming In A Fluid They Cannot Feel. Women Get Them Twice As Often. Nobody Checks The Ten Years Before.

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REPORTING ON FEDERAL HEALTH DATA AND PUBLISHED PHYSIOLOGY

By Nadia Brenner, Health Reporter
Published August 4, 2026 · 7 minute read · References in the footer

Claire Novak is 49, a dental hygienist in Boise, Idaho, and she found out about her family by accident, over a phone call about something else.

"My mother said it in passing," she says. "That she had her gallbladder out at 51 and it was the best thing she ever did. Then that her own mother had hers out too. Then that my aunt had scans about hers last year. Three women, one side of the family, same decade, and it had never once come up."

What had come up, constantly, for four years, was everything Claire could not get anybody to explain.

"I have been bloated after a jacket potato. I have been told I am stressed, I have been told I am too young at 45, and I have been told my tests are fine," she says. "Nobody joined it up. Not once."

Here are the numbers her mother's surgery came from.

Gallstones affect 10 to 15 percent of the US population, almost 25 million people. Nearly 1 million are diagnosed every year, and about a quarter of them need treatment, usually surgery. Women are more likely than men, and the risk climbs with age. Those are the NIDDK's figures, an institute of the National Institutes of Health, published on its own patient pages (1).

Cleveland Clinic puts the skew in one line: at least 10% of US adults have gallstones, and up to 75% of them are female (2).

The published review literature is blunter still. At all ages, women are twice as likely as men to form cholesterol gallstones, and that gap starts at puberty, which is exactly what you would expect if female sex hormones were doing something to the fluid (3).

Nobody argues about any of that. What nobody publishes is the decade before it.

The system nobody checked

Claire has had a thyroid panel, a blood count, iron, vitamin D and an FSH. Every value inside a reference range.

None of them measure bile.

There is no line for bile flow on a standard blood panel. Not a low result, not a borderline one. No line at all. It was never a question on the form, so it was never answered, and "we did not find anything" turns into "there is nothing" somewhere between the lab and your ears.

That matters more than it sounds, because bile is not a minor fluid. Your liver makes 800 to 1,000 millilitres of it a day, and your gallbladder concentrates it between meals (4).

It has two jobs. It breaks fat into droplets small enough to absorb. And it is how vitamins A, D, E and K get into your body. Not absorbed better with bile. There is no second route.

So it has to be thin, and it has to arrive the second food does.

Used estrogen does not evaporate. Your liver tags it and sends it out, and one of its main exit routes is bile. Roughly half of labelled estrogen turns up in urine and the rest in bile, with about 80% of what reaches the gut reabsorbed on the way through (9).

Claire is careful about this part. "Nobody has measured that in me and I am not going to pretend otherwise. But if bile is the door my used estrogen leaves by, and estrogen is what thickens the bile, then the exit is narrowing at exactly the moment I need it. That is the only version of the last four years that makes sense."

Your liver has to open the door to push the estrogen out. Opening it is what jams it.

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Claire has spent real money on the wrong end of this.

A $6,000 emergency room visit, with insurance, for symptoms that came back normal. Nobody said the word perimenopause. $250 for a specialist appointment where she was told, cheerfully, that hormone therapy would not help her weight anyway. $180 on a compounded prescription that lasted six weeks. Two years of $75 a month on things her insurance would not cover.

Then the shelf. Magnesium, collagen, a greens powder, digestive enzymes once soup started bloating her, two probiotics because the first made it worse, and a hormone balance formula promising to help her clear the excess.

"They never fail loudly," she says. "They work for three weeks, then quietly stop being mentioned, and the failure gets filed under you."

Here is why none of it held. Every one of those purchases enters your body downstream of the step that stopped working.

• The collagen promised hair and skin. Both are largely a story about whether A, D, E and K are getting in, and they have one route in.
• The enzymes promised digestion. Enzymes work on food that bile has already broken into droplets. Skip the droplets and there is less for them to act on.
• The greens powder promised a clear-out. The clear-out runs through bile. Bile is the exit.
• The hormone balance formula promised to clear the excess. Clearance runs through biliary excretion, aimed squarely at the door that jammed.
• The low fat months were the worst move available. Fat arriving in the gut is what tells the gallbladder to squeeze. Take the fat away and the bile is never called for. It sits. It concentrates.

You were never short of three products. You were short of one working step.

Failing is a verdict on you. Blocked is a description of a step. One you apologise for. The other you can go at.

And there is one piece of genuinely good news buried in the NIDDK's numbers. You are not at the surgical end of this. You are at the beginning, which is the only place the fluid is still thin enough to move.

Week one: the signal most people misread

In the first week your digestion may get louder. Looser or more frequent stools. Gurgling an hour after a fatty meal.

Do not stop. That is fat being broken down that was not being broken down before. It is the most common reason women quit in week one, and the clearest early signal the fluid is moving.