Taking care of cholesterol hunger in the liver
A healthy lifestyle has a positive effect on cholesterol levels. No smoking, moderate alcohol consumption and plenty of exercise. However, sometimes this does not help enough to get the cholesterol level to an acceptable level. The doctor can then prescribe bile acid sequestrants.
A healthy lifestyle has a positive effect on cholesterol levels. No smoking, moderate alcohol consumption and plenty of exercise. However, sometimes this does not help enough to get the cholesterol level to an acceptable level. The doctor can then prescribe bile acid sequestrants.
Healthy lifestyle
About 25 percent of people between the ages of 35 and 70 have an elevated cholesterol level (>6.5 mmol/litre). The best way to tackle this is a healthy lifestyle. Most cholesterol is produced by the body itself, but 20 to 40 percent is determined by what we eat. A healthy and varied diet can therefore have a beneficial effect on cholesterol levels.
Unfortunately, a poor diet is not the only cause of elevated cholesterol. Overweight, smoking and hereditary factors also play a role. If lifestyle changes are not enough to bring the cholesterol ratio to an acceptable level, the doctor can prescribe a cholesterol-lowering agent. For example, bile acid sequestrants, although they are cumbersome to use and therefore not preferred.
fishy taste
Many people find taking bile acid sequestrants unpleasant. This is because of the large amount to be ingested, the fishy taste and the sandy structure of these agents. The resins are therefore generally not used for a long time. The usual dose is three to six sachets a day, dissolved in a glass of orange juice or in a bowl of low-fat yogurt.
Bile acid sequestrants, as mentioned, are less commonly prescribed than other cholesterol-lowering drugs, such as:
- Statins
- fibrates
- nicotinic acid derivatives
- cholesterol absorption inhibitors
How do bile acid sequestrants work?
Bile acid sequestrants bind the bile secreted by the liver. The bile can then no longer be absorbed by the intestine. As a result, the bile, together with the resin, is excreted in the stool. In response to this, a kind of ‘cholesterol hunger’ develops in the liver. To satisfy this hunger, the liver takes more cholesterol from the blood. The liver converts that cholesterol into new bile acid, which reduces the amount of cholesterol in the liver cells and in the blood.
Effect of bile acid sequestrants
With high doses of bile acid sequestrants, a 25 percent reduction in cholesterol levels can be achieved.
Side effects of bile acid sequestrants
The main side effect of bile acid sequestrants is that they can inhibit the absorption of a number of other drugs in the gut, making them less effective. The contraceptive pill is an example of this. Anticoagulants, diuretics, thyroid preparations and antibiotics are also less well absorbed by the body. The most common side effects are further blockage (especially at high doses), gastrointestinal complaints and a deficiency of fat-soluble vitamins (A, D, E and K) after prolonged use.
Skin rash, itching and hives are symptoms of hypersensitivity to bile acid sequestrants.
If side effects persist, it is wise to consult your doctor. Perhaps another cholesterol-lowering agent will suit you better.
Who should not use bile acid sequestrants?
Taking bile acid sequestrants is completely safe, even for long-term use and during pregnancy. Children can also use them. This is because this medicine is not absorbed into the blood, but stays in the gut, where it does its job. However, there may be an increase in the triglyceride level. Bile acid sequestrants should therefore not be used by people who, in addition to the elevated cholesterol level, also have an elevated triglyceride level, such as in familial combined hyperlipidemia (FCHL) and type 2 diabetes.