Itching in Pregnancy: Could Bile Salts Be the Cause?
Have you ever felt an intense, unexplained itch—especially during pregnancy? Itchy skin can have many causes, but one lesser-known culprit is bile salts. If you've been scratching without relief, it might be time to explore how your liver and gallbladder play a role in skin sensations.
Caveat- If you have a raised, red rash in addition to the itching, it might be more of a vitamin B6 sensitivity! So look into that… but if you have no redness or rash, read on.
What Are Bile Salts?
Bile salts are substances produced in the liver and stored in the gallbladder. Their primary job is to help break down fats in the digestive process. However, when bile salts build up in the bloodstream, they can trigger pruritus (itchiness)—a symptom commonly associated with liver conditions like intrahepatic cholestasis of pregnancy (ICP) and other bile flow disorders.
How Do Bile Salts Cause Itchiness?
While the exact mechanism isn’t fully understood, researchers believe that when bile salts accumulate in the blood, they interact with nerve endings in the skin, leading to intense itching. Some theories suggest that these salts may activate opioid receptors in the body, which can amplify the sensation of itching.
When to Be Concerned About Itchy Skin
Mild itching is common in pregnancy (remember, your belly skin is being stretched!) but certain signs could indicate an underlying issue with bile salts:
Itching that is worse at night
Itching on the palms of your hands and soles of your feet
No visible rash, just persistent discomfort
Dark urine or pale stools
Yellowing of the skin or eyes (jaundice)
If you experience these symptoms, especially during pregnancy, it’s important to talk to your healthcare provider, as conditions like ICP can carry risks for both you and your baby.
What Can You Do?
If bile salts are behind your itchiness, there are steps you can take to help manage symptoms:
Get liver function and bile acid tests – This can help determine if your bile salts are elevated.
Talk to your provider about treatment – Medications like ursodeoxycholic acid (UDCA) can help lower bile acid levels and improve symptoms.
Support liver health – Eating a nutrient-rich diet, staying hydrated, and avoiding processed fats can help your liver function optimally.
Use soothing skin remedies – Cool baths, oatmeal lotions, and mild moisturizers may help relieve some of the discomfort.
The Bottom Line
Bile salts and itching are closely linked, and while occasional itching is normal, persistent or severe itching—especially during pregnancy—should not be ignored. I KNOW you are busy trying to prepare everything for your sweet baby to arrive. But if you suspect an issue with bile flow, checking in with your provider will offer clarity and relief.
You don’t have to suffer in silence. Your body is communicating with you—listening and responding with care can make all the difference.
Love,
Emily
