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Bile Acid Sequestrant to Lower "Cholesterol" - 9B

Other Cholesterol Lowering Drugs

Many statin drugs are now “off-patent.” That means these drugs can be manufactured by generic drug companies and offered at a lower cost than when they were protected under patent laws. Subsequently, the pharmaceutical industry developed a whole new set of drugs to lower cholesterol that are "on patent" to garner higher profits.

Scientific American weighed in on the value of new versus old drugs in an article titled "When Older Drugs are Better Drugs."[i]

"The trend toward using newer medications often develops during doctor residency training. Pharmaceutical firms market their products to young doctors in all specialties. Whether with free meals, medical tools, or travel scholarships, pharmaceutical companies find ways to influence doctors’ prescribing practices. Because most physicians continue recommending the medications they learned in residency, these companies strategically expose residents to newer medications that are still under patent and thus far more profitable for the manufacturers."

Importantly, both new and old cholesterol-lowering drugs provide strong evidence that lowering LDL is not beneficial to your heart. According to the CDC, the following drugs lower LDL or cholesterol.

  • Statins. These drugs lower LDL cholesterol by slowing down the liver’s production of cholesterol. They also increase the liver’s ability to remove LDL cholesterol that is already in the blood.

  • Bile acid sequestrants. Bile acid sequestrants help remove cholesterol from the bloodstream by removing bile acids. The body needs bile acids and makes them by breaking down LDL cholesterol.

  • Niacin, or nicotinic acid. Niacin is a B vitamin that can "improve" (should say "change") all lipoprotein levels. Nicotinic acid raises high-density lipoprotein (HDL) cholesterol levels while lowering total cholesterol, LDL cholesterol, and triglyceride levels.

  • Fibrates. They mainly lower triglycerides.

  • Injectable medicine. A newer type of drug called PCSK9 inhibitors lowers cholesterol (wrong, they lower LDL exclusively). These medicines are primarily used in people who have familial hypercholesterolemia, a genetic condition that causes very high levels of LDL cholesterol. (Note, that was not their original intent).

Bile acid sequestrants

The United States Federal Government, through the website MedlinePlus, defines bile acid sequestrants. "Bile acid sequestrants are medicines that help lower your LDL (bad) cholesterol. Too much cholesterol in your blood can stick to the walls of your arteries and narrow or block them. These medicines work by blocking bile acid in your stomach from being absorbed in your blood."

The Feds, in just 2 sentences, are able to provide an astounding level of misinformation. The term "bad" associated with something your body naturally produces is incongruent. If our bodies truly produced "bad" things, we would not survive as a species - pure and simple. And "stick to the walls of your arteries" shows a complete lack of understanding of physiology.

Dr. Kilmer S. McCully is the former Chief of Pathology and Laboratory Medicine Services for the United States Department of Veterans Affairs Medical Center. McCully was the first to propose the homocysteine theory of cardiovascular disease and is the author of the book, “The Homocysteine Revolution.” He is a thoughtful man and historian. His path to brilliant discoveries and conclusions was not an easy one as highlighted in The New York Times article titled “The Fall and Rise of Kilmer McCully.”[i]

You see, McCully knew that cholesterol was not at the root of cardiovascular disease way back in the early 1960s, but Harvard did not want this “convenient” theory uprooted. Not only did they fire Dr. McCully, but they blacklisted him. Dr. McCully had to travel far from his home to obtain employment.

In 2009, along with his co-author, Uffe Ravnskov, he authored a “Review and Hypothesis” on how infection contributes to heart disease.[ii] Here, he explains that vulnerable plaques, the type that kills or debilitates us by way of heart attack or stroke, do NOT form from inside a blood vessel as stated by the U.S. Federal Government, as depicted on TV and, in your doctor’s office. Instead, they start on the outside of the vessel and work their way inside. Dr. McCully does not get full credit for this discovery as he was scooped by at least 140 years by a German doctor by the name of Koester.[iii]

Dr. Trempe explains this correct description of heart disease this way:

“Heart disease is a disease of the small vessels of the large vessel.”

Say this fast three times and then give it some deep thought! This means that large vessel walls are big enough to require their own blood supply. The smaller vessels that support the structure of large vessels become diseased first and lead to the disease of the larger vessels - and eventually to heart attacks and stroke. Figure 5.16 shows the incorrect and correct depiction of the heart and vascular disease process.

This may seem like nitpicking but since heart disease is the number one killer, how the disease develops should be properly understood and represented. More importantly, most of the vessels in the body are capillaries. The "correct" image above shows how the large vessel disease is really a small vessel (capillary) disease. Many ailments beyond the heart are vascular diseases. Alzheimer's is an example.[i]

In the brain, tissue is nourished, and the waste is removed by capillaries. The image on the right explains a disease like Alzheimer's more clearly. The small vessels become diseased, impacting the tissue they supply leading to the loss of neurons, thus neurodegeneration.

Now back to the topic of bile acid sequestrants. Granted, bile acid sequestrants lower LDL, but not directly. Bile acids make any fat bioavailable. That is, bile acids are soaps of the gut that digest fats. If fats are not available because of the lack of bile acids, then LDL production will go down. LDL goes up when there are fats to transport through your water-based bloodstream. Remember, your brain is 60 percent fat. A common phrase is "you are what you eat." However, this is actually false. You are what you absorb. Optimal digestion is at the top of the list of the most important physiological processes. When you inhibit the digestion of fats, your brain and eyes are first in line to suffer because they are composed of the highest levels of fats.

Some of the most common adverse effects of bile acid sequestrants are gastrointestinal, including constipation, stomach pain, bloating, vomiting, heartburn, loss of appetite, indigestion, and upset stomach.[ii] Interestingly, these are considered "limited systemic side effects." Every one of these symptoms is indicative of poor absorption. Since you are what you absorb, poor absorption equals poor health. The impact of these drugs may not be experienced immediately but will eventually manifest in serious diseases of aging. It is actually a simple process. Our bodies are constantly being torn down and rebuilt. Diseases may be expressed as wear and tear exceeding repair and recovery. Nutrient absorption is critical to the repair and recovery process.

Bile acid sequestrants put you at a repair and recovery deficit.

[i] Lewis, Thomas J., and Clement L. Trempe. The end of Alzheimer’s: The brain and beyond. Academic Press, 2017. [ii] Lent-Schochet, Daniella, and Ishwarlal Jialal. "Antilipemic agent bile acid sequestrants." (2019). [i], August 10, 1997. [ii] Ravnskov, Uffe, and Kilmer S. McCully. "Vulnerable plaque formation from obstruction of vasa vasorum by homocysteinylated and oxidized lipoprotein aggregates complexed with microbial remnants and LDL autoantibodies." Annals of Clinical & Laboratory Science 39.1 (2009): 3-16. [iii] Koester W. Endarteritis and arteritis. Berl Klin Wochenschr. 1876;13:454–5.

[i], July 20, 2017.


Index & Upcoming (short) blogs on cholesterol and statins

Number 1: Cholesterol fun (true) facts - completed

Number 2: Is the actual cholesterol molecule important? c - completed

Number 3: What is an optimal TC value? Remember, no one knows their actual cholesterol molecule value. - completed

Number 4: Surprising fact about cholesterol as an antibiotic - completed

Number 5: TC simple math - dumb doctors - completed

Number 6: What is LDL really? - completed

Number 7: Statins - do they lower the cholesterol molecule? - completed

Number 8: What did we learn from the new "biologics" to lower "cholesterol" - completed

Number 9: Niacin and other "cholesterol" management treatments

Number 10: What did Natasha Campbell-McBride say about cholesterol/lipids?

Number 11: What is a QALY, and how does it relate to "cholesterol"?

Number 12: Idiot doctor from Johns Hopkins, Roger Blumenthal

Number 13: Who says statins do NOT extend life?


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