HSA | FSA CARDS ARE NOW ACCEPTED

Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

Understanding Your ABCG8 Result and Gallstone Risk

Gallstones are hard deposits that form in the gallbladder when bile becomes oversaturated with cholesterol, leading to crystal formation and stone development. The ABCG8 gene plays a key role in how cholesterol is transported from liver and intestinal cells into bile. Certain variations in ABCG8 can increase cholesterol secretion into bile, making bile more likely to form cholesterol crystals and, over time, gallstones.

How the ABCG8 Variant Affects Cholesterol in Bile

The ABCG8 protein partners with ABCG5 to move cholesterol out of liver and intestinal cells and into bile. When cholesterol secretion into bile is higher than normal, bile can become supersaturated with cholesterol. If cholesterol exceeds what bile salts can keep dissolved, it forms crystals that can aggregate into gallstones. Your genotype at rs4245791 influences how strongly ABCG8 performs this transport and therefore affects your personal risk for cholesterol gallstones.

Non-Genetic Factors That Change Risk

  • Female sex, particularly during reproductive years
  • Use of estrogen or hormonal therapies
  • Obesity and metabolic syndrome
  • Rapid weight loss or very low calorie dieting
  • Diets high in refined carbohydrates and low in fiber

Genetic Interpretation

2 effect alleles (CC genotype) — Increased risk

If you have the CC genotype for rs4245791, you carry two copies of the effect allele. This genotype is associated with an increased risk of cholesterol gallstones.

Why this matters: The CC genotype can lead to greater cholesterol secretion into bile. When bile becomes oversaturated with cholesterol, crystals are more likely to form and clump into gallstones. Your risk can be amplified by female sex, hormonal therapies, obesity, or other lifestyle factors.

Practical steps to consider:

  • Follow a fiber rich diet with plenty of fruits, vegetables, legumes, and whole grains to support healthy bile composition.
  • Include moderate amounts of healthy fats such as olive oil, nuts, and fatty fish. Very low fat diets can reduce gallbladder emptying and increase stasis.
  • Avoid rapid weight loss. Aim for gradual weight reduction of about 0.5 to 1 kg per week if losing weight.
  • Limit refined sugars and processed foods that can worsen metabolic risk.
  • Maintain a healthy body weight through regular physical activity, which helps regulate bile flow and metabolism.
  • Talk with your healthcare provider before starting hormonal therapies that contain estrogen.
  • Consider routine monitoring if you have symptoms such as right upper abdominal pain, nausea after eating fatty foods, or unexplained jaundice.
1 effect allele (CT genotype) — Likely increased risk

If you have the CT genotype for rs4245791, you carry one copy of the effect allele. This genotype is associated with a likely increased risk of cholesterol gallstones compared with the non effect genotype.

Why this matters: Having one effect allele may moderately increase cholesterol secretion into bile. Bile that carries more cholesterol is at greater risk for crystal formation, especially when other risk factors are present.

Practical steps to consider:

  • Adopt a fiber rich eating pattern with fruits, vegetables, legumes, and whole grains to help manage cholesterol balance in bile.
  • Choose moderate healthy fats and avoid extreme low fat diets that can reduce gallbladder motility.
  • Prevent rapid weight loss and use gradual, sustainable approaches if weight reduction is a goal.
  • Limit refined carbohydrates and highly processed foods to reduce metabolic stress.
  • Stay active to support healthy weight and normal bile flow.
  • Discuss any hormone treatments with your clinician to weigh potential gallstone risk.
  • Be attentive to gallbladder related symptoms and seek medical evaluation if they appear.
0 effect alleles (TT genotype) — Typical risk

If you have the TT genotype for rs4245791, you carry two copies of the non effect allele. This genotype is associated with a typical level of cholesterol transport into bile via ABCG8 and does not increase gallstone risk from this specific variant.

Why this matters: Although your genotype at rs4245791 does not raise risk, gallstones can still develop because of other genetic variants, diet, lifestyle, obesity, hormonal influences, or medical conditions.

Practical steps to consider (general gallbladder health):

  • Eat a fiber rich diet with vegetables, fruits, legumes, and whole grains.
  • Include moderate healthy fats to promote normal gallbladder emptying.
  • Avoid very rapid weight loss plans and crash diets.
  • Limit refined sugars and processed foods to support metabolic health.
  • Maintain regular physical activity and a stable healthy weight.
  • Discuss with your provider if you start hormonal therapies or develop symptoms suggestive of gallstones.

Diet, Supplements, and Lifestyle Recommendations

Most strategies to lower gallstone risk focus on supporting healthy bile composition and promoting regular gallbladder emptying.

Diet

  • Prioritize dietary fiber: Aim for a variety of soluble and insoluble fibers from fruits, vegetables, whole grains, pulses, nuts, and seeds.
  • Choose healthy fats in moderation: Olive oil, avocados, nuts, and fatty fish support bile flow when consumed at moderate levels.
  • Limit refined carbohydrates and added sugars: These can worsen insulin resistance and lipid abnormalities that increase gallstone risk.
  • Avoid very low calorie or extreme low fat diets: These can slow gallbladder emptying and promote stone formation during rapid weight loss.

Supplements

  • Vitamin C: Adequate vitamin C supports normal bile acid synthesis. Use as part of a balanced approach rather than a single fix.
  • Omega 3 fatty acids: May support overall lipid metabolism and inflammation when included as part of diet or supplementation.
  • Do not start supplements specifically to prevent gallstones without discussing them with your healthcare provider.

Lifestyle

  • Aim for gradual, steady weight loss if needed. Rapid weight loss raises gallstone risk.
  • Exercise regularly to improve metabolic health and support regular gallbladder emptying.
  • Monitor and manage metabolic risk factors such as high cholesterol, insulin resistance, and obesity with your care team.

When to Talk to Your Healthcare Provider

  • If you develop symptoms such as persistent right upper abdominal pain, nausea after fatty meals, unexplained jaundice, or fever with abdominal pain.
  • Before starting or stopping hormonal therapies that include estrogen.
  • When planning significant weight loss so your provider can recommend a safe, slow approach.
  • To integrate your genetic result with family history, other risk factors, and overall health management.

Important Disclaimer

PlexusDx provides educational information about genetic predispositions only. This content is not medical advice. Always consult your healthcare provider or a qualified health professional before making medical, diet, supplement, or lifestyle changes based on genetic information.

If this genetic variant is present in your PlexusDx results, the following tests and reports are commonly used to explore it further:

🧬 Genetic Tests:

🧪 Blood Tests:

📄 Genetic Report:

Frequently Asked Questions About GALLSTONES and ABCG8 rs4245791

What does an ABCG8 rs4245791 result mean for my risk of cholesterol gallstones?

The ABCG8 gene helps transport cholesterol from liver and intestinal cells into bile. Your genotype at rs4245791 can influence how strongly ABCG8 performs this transport—higher cholesterol secretion can supersaturate bile, leading to crystal formation and over time cholesterol gallstones. Risk differs by genotype: CC (2 effect alleles) increased risk, CT (1 effect allele) likely increased risk, and TT (0 effect alleles) typical risk from this variant.

How do my rs4245791 genotypes (CC, CT, TT) change gallstone risk?

CC (two effect alleles) is associated with increased risk because it may drive greater cholesterol secretion into bile, making crystal formation more likely—especially if other risk factors are present. CT (one effect allele) is associated with likely increased risk with a more moderate effect on cholesterol transport. TT (no effect alleles) is associated with a typical level of ABCG8 cholesterol transport and does not increase gallstone risk from this specific variant, though gallstones can still occur due to other genetic, diet, lifestyle, hormonal, or medical factors.

What lifestyle and diet steps can help lower gallstone risk if my ABCG8 result shows increased risk?

Focus on supporting healthy bile composition and regular gallbladder emptying: prioritize fiber-rich foods (fruits, vegetables, legumes, and whole grains), choose moderate healthy fats (olive oil, nuts, and fatty fish), limit refined carbohydrates and added sugars, and avoid very low-calorie diets or extreme low-fat approaches. If weight loss is needed, aim for gradual loss (about 0.5–1 kg per week) and stay physically active. If you use or plan estrogen-containing hormonal therapies, discuss your gallstone risk with your healthcare provider, and consider monitoring if symptoms like right upper abdominal pain or nausea after fatty meals occur.

What tests can help me learn more about GALLSTONES and ABCG8 rs4245791?

The Longevity and Healthy Aging Genetic Test delivers over 200 genetic insights related to cellular repair, inflammation balance, metabolism, cardiometabolic health, and aging pathways. The Healthy Aging Genetic Report translates your results into personalized, actionable guidance. Your healthcare provider can also recommend targeted blood tests based on your specific pathway results and health history to complement your genetic insights with current biomarker data.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.