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What I Discovered About Gallstones Saved My Patients From Surgery
MD, Board-Certified Functional Medicine Physician — Women's Hepatobiliary Health
3,791 Ratings
By Dr. Michael Rawlings
November 25, 2025
If you're reading this, you've just been told you have gallstones — and that your only options are to remove your gallbladder, or to "wait and see" until the next attack puts you in the ER.
You didn't like either option.
You didn't agree to a binary choice between losing an organ and gambling on your next meal. I have sat across the desk from hundreds of women in your exact position.
I want you to know there is a third option — and that most doctors in the U.S. simply are not trained to mention it.
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Most U.S. surgeons are trained on a binary protocol: confirm the stones, schedule the cholecystectomy, send the patient home.
The European clinical literature has been telling a different story for over forty years.
A specific bile acid — long studied in Italy and Japan, naturally produced by your own liver, and available over the counter — can support the bile chemistry that determines whether cholesterol crystallizes into stones or stays safely dissolved.
It is not a fad. It is not a flush. It is what I now offer my patients as the third option between surgery and "wait and see."
What follows is what every woman with cholesterol gallstones on her ultrasound deserves to hear.
My Patient "Sarah" — The Case That Changed Everything
Three weeks after her daughter was born, Sarah came to my office in pain.
Right side, under the ribs, radiating up into the shoulder.
Worst at night.
Always after eating. She thought it was postpartum hormones. She thought it was stress.
Her ultrasound told a different story: a constellation of cholesterol stones lodged in her gallbladder.
The surgeon she had already consulted gave her the standard offer: removal the following week, or "wait and see" until the next attack landed her in the ER.
Those were the only two options on the table. Her daughter was four weeks old. She couldn't be down for surgery recovery. She couldn't risk a breastfeeding interruption.
And she couldn't accept that the only path forward was cutting out an organ she was born with — without anyone asking the obvious question: why were these stones forming in the first place?
Sarah is the patient who pushed me to look harder at the European bile-acid literature. What I found there — what was not part of my U.S. medical training — changed how I treat gallstones today.
This is the protocol I started Sarah on. Three days in, she could already tell the difference.
The reduction in her attacks has been very noticeable. She still has her gallbladder.
And she took her health into her own hands at the moment the system was about to take an organ instead.
What the Research Actually Says
What the European and Japanese medical literature has known for over forty years — and what is not yet part of standard U.S. surgical training — is that cholesterol gallstones can be addressed without removing the organ. Here is what is in the research:
1. Most gallstones are made of cholesterol. They form when bile gets too saturated with cholesterol — like sugar crystallizing out of over-sweetened tea. The underlying problem is not the gallbladder itself. It is the chemistry of the bile inside it.
2. A prescription bile acid called UDCA (ursodiol) has been FDA-approved for decades to support bile composition in patients with cholesterol gallstones. It works by shifting how saturated the bile is with cholesterol. In Europe and Japan, it has been first-line for cholesterol stones for over thirty years. In the U.S., it is rarely offered — not because the evidence is weaker, but because the surgical referral pathway is faster.
3. TUDCA is UDCA's naturally occurring cousin — a bile acid your own liver already makes (just usually not enough of). It is sold over the counter. It has been studied in Italy and Japan for over thirty years for cholestasis and bile-flow support.
This is the third option. Most patients are never told it exists.
But Here's the Part Most Patients Are Never Told: Why These Stones Form In the First Place
In U.S. medical training, gallstones are framed as a "fat, female, fertile, forty" problem — and the only treatment we are taught to recommend is removing the gallbladder.
That framing is dangerously narrow. The actual triggers for cholesterol gallstone formation are well documented in the international literature:
• Pregnancy and postpartum estrogen shifts. Estrogen drives cholesterol saturation in bile. Pregnancy and the months that follow are one of the highest-risk windows for cholesterol stone formation in women.
• Rapid weight loss — including the natural postpartum weight drop. Fast fat mobilization floods bile with cholesterol the system cannot keep dissolved.
• Hormonal birth control. Synthetic estrogen has a similar biochemical effect on bile composition.
• Low-fat diets. Counterintuitively, eating too little fat means the gallbladder doesn't contract enough to flush, and bile stagnates between meals.
• A genetically smaller bile-acid pool. Some patients simply produce less of the bile acids that keep cholesterol dissolved.
The point: gallstones do not form because the gallbladder is broken. They form because bile chemistry has tipped over a threshold. The gallbladder is just the place the stones collect.
Surgery removes the collection point. It does not fix the chemistry.
This is why so many of my patients who have already had their gallbladder removed end up in my office with chronic post-surgery digestive issues — bile reflux, sudden-onset diarrhea, food sensitivities that did not exist before.
The bile is still imbalanced. The stones simply no longer have a place to gather. Every woman who comes to me with cholesterol gallstones has at least one of these triggers in her chart.
And in every case, the question I ask first is the question no one else has asked her: is there something we can do to address the bile chemistry, instead of removing the organ?
There is.
So I Went Searching for a Solution…
Most of the TUDCA on the U.S. market is marketed to bodybuilders and biohackers — bro-supplement packaging, vague dosing, no third-party testing.
None of it was formulated for the patient population I see most: women in the postpartum window, on hormonal contraception, or in perimenopause — the same patients who are most vulnerable to cholesterol stone formation in the first place.
So I went looking for a brand that did this properly. Certificates of analysis I could verify. Sourcing I could trace.
Dosing built off the European clinical literature, not the cycle-support market. The brand I now use in my own practice is Rovella.
Introducing Rovella TUDCA — My Go-To Bile Acid Protocol
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Rovella TUDCA is a clinically-dosed, third-party-tested bile acid supplement formulated for the patient I see most often: a woman who wants to support healthy bile flow and healthy bile composition — without giving up an organ.
Each batch is verified for purity, identity, and potency. The dose is built off the European clinical literature, not the bodybuilder market. This is the protocol I now hand to every patient who walks into my office with cholesterol stones on her ultrasound.
What Sets Rovella TUDCA Apart Rovella is built around one thing:
a clinically meaningful dose of TUDCA — tauroursodeoxycholic acid — the naturally occurring bile acid your own liver makes (but, for many of my patients, not enough of).
Most TUDCA supplements on the shelf cut corners on dosing. Rovella does not.
The formula is dosed in line with the bile-acid research published out of Italy and Japan, not the bodybuilder cycle-support market
• TUDCA — clinically dosed. A bile acid that helps thin and support the flow of bile so it does not stagnate in the gallbladder between meals. Helps shift bile chemistry back toward keeping cholesterol dissolved instead of crystallizing.
• Bile acid pool support. Backs up the bile acid your body is under-producing — especially relevant for women in the postpartum window, on hormonal birth control, or in perimenopause.
• Cholesterol solubilization support. Helps keep cholesterol dissolved in bile, which is the mechanism the medical literature documents in the bile-acid research.
Think of bile like sweet tea. If you keep dumping sugar in without enough water, the sugar crystallizes at the bottom of the glass. TUDCA is the water. It thins the recipe back out so cholesterol stays dissolved instead of settling
How It Works:
✅ Supports healthy bile flow — so bile does not stagnate in the gallbladder between meals.
✅ Supports healthy bile composition — helping cholesterol stay dissolved instead of crystallizing.
✅ Backs up your body's natural bile-acid production — especially during hormonally vulnerable windows (postpartum, perimenopause, hormonal birth control).
✅ Supports healthy fat digestion and nutrient absorption — bile is what breaks down dietary fats and unlocks fat-soluble vitamins A, D, E, and K.
✅ Formulated for women who want to keep the organs they were born with — clinically dosed, third-party tested, no proprietary blends.
What My Patients Are Saying:
Over 10,000 units sold and 3,248+ 5-star reviews
I was told the only options to treat my gallstones after my pregnancy were either gallbladder removal or the 'wait and see.' I didn't like either…"
Beth H.
Verified Buyer
I'm a hard sell on supplements. I've tried half a dozen things for digestion in the past year and nothing did much. I figured I'd give Rovella a full month before deciding. "3 days in and I can already tell the difference." The dull pressure I'd been getting on my right side after dinner — gone. No attack since I started. I'm sleeping through the night again instead of bracing for a 2am episode. I'm not going to call it a miracle, but I'll call it what it is: the first thing that's actually moved the needle.
Sylvia P.
Verified Buyer
My surgeon was kind, but the offer he gave me — cut it out, or wait until it gets worse — wasn't one I was willing to accept without doing my own homework first. I'm not a doctor, but I am a stubborn woman who isn't willing to lose an organ without exhausting every option. "I took my health into my own hands." Found the European bile acid research. Found Rovella. Started the protocol while staying in touch with my doctor — never went against medical advice, just added something he wasn't going to bring up. "The reduction in my attacks has been very noticeable." I feel like myself again.
Sam G.
Verified Buyer
You Don't Have to Wait for the Next Attack
The "wait and see" approach is, by definition, the absence of a plan. It is the medical system telling you that until your gallbladder gets bad enough to land you in the ER, there is nothing for you to do. That is not accurate.
If your bile chemistry has tipped over a threshold during pregnancy, postpartum, hormonal contraception, or rapid weight change — that is a modifiable situation, supported by decades of international bile-acid research.
You do not need a confirmed surgical referral to begin supporting your bile flow and bile composition. And you do not have to burn the surgical bridge either.
Many of my patients use TUDCA to buy themselves time, reduce the frequency of their attacks, and make a calmer, less rushed decision about whether surgery is ever really needed for them.
GET THE TUDCA FORMULA WHILE STOCK LASTS
Special Limited-Time Offer for New Customers
Other TUDCA products on the market run between $79 and $120 a bottle.
Most are sold under bodybuilder branding, with no third-party testing, and dosed lower than the European clinical literature recommends.
Rovella TUDCA is dosed at a clinically meaningful level.
Every batch is third-party tested for purity, identity, and potency. The packaging, the sourcing, and the formulation are built for the patient population I see most:
women — not weightlifters. The suggested retail price for one bottle of Rovella TUDCA is $99.95.
Because this is the first-run launch, Rovella is honoring founder's pricing for new customers only:
$99.95 $79.95 $49 — one bottle, 30-day supply That works out to about $1.63 a day — less than a coffee — to support the bile chemistry that decades of research has linked to healthy cholesterol balance in bile.
Every Rovella TUDCA order is covered by a 60-day money-back guarantee. If your attacks do not reduce, if you do not feel a difference, if you simply do not like it — you send the bottle back (even an empty one) and Rovella refunds you.
You take no risk. Once founder's pricing closes, the retail price returns to $99.95.
First-run stock is limited and is not being restocked at this price. If you have been told the only options are surgery or "wait and see," this is the third option I now offer every patient who walks into my office with cholesterol gallstones on her ultrasound.
GET THE TUDCA FORMULA WHILE STOCK LASTS
Final Thoughts from Dr. Rawlings
I am writing this because the standard surgical pathway is failing too many women. Pregnancy, postpartum, hormonal contraception, perimenopause — these are the windows in which the body's bile chemistry tips over a threshold. And in too many cases, the only response on offer is to remove the organ rather than address the chemistry.
I am not anti-surgery. There are situations — acute cholecystitis, infected stones, bile duct obstruction — where surgery is the right call, and I refer for it when it is.
But for the patient who is sitting at home between attacks, eating fearfully, terrified the next attack is the one that lands her in the ER — there is a third option.
And it is the one I wish more of my colleagues had been trained to bring up.
Rovella isn't a cure. It is bile-acid support — the chemistry your body uses to keep cholesterol dissolved instead of crystallized. If your bile chemistry is part of the picture, this is what decades of international research point toward as the way to support it.
The choice is yours
— Dr. Rawlings, Board-Certified Functional Medicine Physician
IMPORTANT NOTE: Rovella TUDCA is sold only through the official Rovella website. We do not sell on Amazon, eBay, or any third-party marketplace. Any product appearing under our branding outside of this website is counterfeit and has not been third-party tested. Every authentic Rovella TUDCA bottle carries our batch testing certificate. To verify authenticity or request a copy of your batch's certificate of analysis, contact us at the email below. We respond to every inquiry within 24 hours