Cholesterol Treatment

Lower Cholesterol with Bile Acids

Doctors prescribe various medications that help lower cholesterol levels in your blood. One such class of medications is a group of gels/resins known as bile acid sequestrants. They include cholestyramine, colestipol, questran, and colesevelam. What they do is to bind the bile acid to prevent its absorption in the intestines. Through this strategy bile is lost from the gall bladder.

A certain level of bile availability is central to the liver's task of efficient cholesterol disposal from the body. Moreover, cholesterol is essential for the liver to produce bile. So, an artificially induced bile shortage is effected through the bile acid binding activity of sequestrants.

The liver then strives to maintain bile production, for which it needs cholesterol. So, it takes and uses up the extra cholesterol in the bloodstream using the high density lipoprotein (HDL) as a transport vehicle. As a result, not only efficient cholesterol disposal from the body is effected, but the level of cholesterol in the blood is also lowered.

The sequestrants are usually in the form of powders. You need to take the powder mixed with water, fruit juice, or milk. Do not take it with a carbonated drink for then belching will occur. If you want, you can alternatively mix the sequestrants powder with canned food peach, pear, or apple juice. Sometimes, the sequestrants are available in tablet form.

Sequestrants are used in low doses in the case of patients who suffer from moderately high LDL (low density lipoprotein) cholesterol in their bloodstream. In the case of high LDL cholesterol patients, sequestrants are prescribed usually in combination with a class of medications known as statins.

The extent of improvement in cholesterol patients through use of bile acid sequestrants varies. Their use helps reduce LDL cholesterol in the blood by about 15 to 30%. HDL levels in the blood become slightly reduced by about 3 to 5%.

Sequestrants are not prescribed for patients who already have high triglycerides levels (300 milligrams per deciliter) in their bloodstream, because they tend to increase the levels even further. Their use is also not suitable for patients who have a family history of dysbetalipoproteinemia, which is a rare lipid disorder. Severe constipation in patients also precludes their use, because the result with their use is even worse constipation.

Other side effects from the use of bile acid sequestrants include fullness, bloating, gas formation, and nausea. However, the use of bile acid sequestrants is safe enough in most cholesterol patients. Every patient can minimize the side effects by starting out with a low dose and gradually increasing it to a level that you can tolerate the side effects. Simultaneously taking fiber laxatives also helps in tackling the constipation.

In case you need to take other medicines, space it at least one hour before or 4 hours after taking a bile acid sequestrant dose. This is because the sequestrant interferes with the absorption of other drugs.