GALLSTONES | ABCG8 (rs6756629)

Understanding Your ABCG8 Result and Gallstone Risk

Gallstones are hard deposits that form in the gallbladder when bile becomes oversaturated with cholesterol, allowing cholesterol crystals to form and grow. The ABCG8 gene plays a key role in moving cholesterol from liver and intestinal cells into bile. Certain ABCG8 genetic variants change how much cholesterol is secreted into bile and can increase the likelihood that bile becomes supersaturated, which raises the risk for cholesterol gallstones.

How ABCG8 Affects Gallbladder Health

The ABCG8 protein works with ABCG5 to regulate cholesterol secretion into bile. When this transport increases, bile can carry more cholesterol than bile salts and phospholipids can keep dissolved. Excess cholesterol then crystallizes and can form stones. While genetics matter, so do non-genetic factors, including sex (females have higher risk), hormonal therapies, obesity, rapid weight loss, and diet.

Practical Steps to Support Gallbladder Health

Diet: Focus on a fiber-rich eating pattern with plenty of fruits, vegetables, legumes, and whole grains. Include moderate amounts of healthy fats such as olive oil, nuts, seeds, avocado, and fatty fish. Limit refined sugars, sugary beverages, and highly processed foods.
Weight management: Maintain a healthy weight with gradual, sustainable weight loss if needed. Avoid very low calorie diets and rapid weight loss, both of which increase gallstone risk.
Meal pattern: Eat regular meals. Very low food intake or prolonged fasting can promote bile stasis and increase stone risk.
Physical activity: Aim for regular moderate exercise (for example 150 minutes per week), which helps maintain healthy weight and supports overall metabolic health.
Medications and hormones: Be aware that some hormonal treatments can increase gallstone risk. Discuss options and risks with your healthcare provider if you use hormone therapy or hormonal contraception.
When to consult: If you experience repeated upper right abdominal pain, fever, jaundice, or nausea with eating, seek medical evaluation—these can be signs of gallstones or related complications.

Dietary and Supplement Considerations

These suggestions are intended to support gallbladder health and reduce gallstone risk. Always review any new supplement or major diet change with your healthcare provider.

Increase soluble and insoluble fiber: Oats, barley, legumes, apples, berries, and vegetables help reduce cholesterol and support healthy digestive transit.
Healthy fats in moderation: Small, regular amounts of monounsaturated and polyunsaturated fats (olive oil, nuts, seeds, fatty fish) help bile flow without excessively increasing cholesterol in bile.
Limit saturated fat and refined carbohydrates: Reducing processed foods, sweets, and high saturated fat items can help overall cholesterol balance.
Consider vitamin C from diet: Adequate vitamin C supports cholesterol metabolism. Prefer food sources (citrus, berries, peppers) over high-dose supplements unless advised by your clinician.
Fish oil and omega-3: May support metabolic health; discuss dosage with your provider.
Medically indicated therapies: In specific situations and under medical supervision, certain medications (for example ursodeoxycholic acid) can reduce cholesterol saturation in bile. This is not a routine recommendation and should be guided by a clinician.

Genetic Interpretation

Two effect alleles (AA) — Increased risk of gallstones

If your genotype at rs6756629 is AA, you carry two copies of the effect allele associated with higher cholesterol secretion into bile. This can lead to bile that is more easily supersaturated with cholesterol, increasing the chance that cholesterol crystals form and aggregate into gallstones.

What this means for you:

Elevated genetic predisposition for cholesterol gallstones related to ABCG8 compared to people without the effect allele.
Risk can be further increased by female sex, use of certain hormonal therapies, obesity, and rapid weight loss.
Practical actions: follow a fiber-forward diet, include moderate healthy fats, maintain gradual weight loss if needed, avoid crash diets, limit refined sugars and processed foods, and stay physically active.
Discuss with your healthcare provider whether targeted tests or monitoring are appropriate based on symptoms, family history, and other risk factors.

One effect allele (AG) — Likely increased risk of gallstones

If your genotype at rs6756629 is AG, you carry one copy of the effect allele and have a likely increased risk for cholesterol gallstones compared with people who have no effect alleles. The ABCG8 variant may modestly increase cholesterol secretion into bile, which can encourage cholesterol crystallization when additional risk factors are present.

What this means for you:

Moderate genetic predisposition for gallstones related to ABCG8.
Risk is influenced by sex, hormonal therapies, body weight, and diet.
Practical actions: emphasize a high-fiber diet, maintain a healthy weight with gradual changes, avoid very low calorie diets, limit refined sugars and processed foods, and maintain regular physical activity.
Consider routine discussions with your clinician about symptoms and preventive strategies if you have other risk factors.

Zero effect alleles (GG) — Typical risk

If your genotype at rs6756629 is GG, you carry two copies of the non-effect allele. This genotype is associated with typical cholesterol transport into bile through the ABCG8 complex and does not increase gallstone risk from this particular variant.

What this means for you:

Your ABCG8-related genetic risk for cholesterol gallstones is not elevated.
Standard lifestyle measures still matter because diet, weight, hormones, and other genes influence overall gallstone risk.
Continue balanced eating, regular physical activity, and weight management to reduce non-genetic risk factors.

When Genetics Is One Piece of the Puzzle

Your ABCG8 result provides information about one pathway that influences gallstone formation. It does not determine whether you will or will not get gallstones. Many factors interact to shape risk, including other genes, hormones, body weight, diet, medications, and life events such as rapid weight loss or pregnancy.

Next Steps and Follow-Up

If you have symptoms such as recurring upper right abdominal pain, fever, nausea, jaundice, or digestive intolerance, seek medical evaluation promptly.
Discuss your genetic result with your healthcare provider to interpret it alongside your medical history, family history, and other risk factors.
Consider basic blood tests your clinician may recommend to evaluate liver and gallbladder function if warranted by symptoms.

PlexusDx provides educational information about genetic predispositions only. This content is not medical advice. Always consult your healthcare provider before making significant changes to diet, supplements, medications, or lifestyle based on genetic information.