In this article, I wanted to provide a basic overview of cholesterol regulation in the body. I share such articles with my heart health coaching clients whenever necessary. How the body regulates cholesterol is relevant to choose the right method of controlling cholesterol levels.
Cholesterol is quite essential. The following key players regulate cholesterol in the body:
- cells lining the intestine
- intestinal bacteria
The food we eat has some form of cholesterol which becomes absorbable after manipulation by intestinal bacteria and pancreatic enzymes.
Cholesterol can enter the bloodstream also through the bile system. Whether you still have a gallbladder or not, your liver will produce cholesterol pumped into the intestines.
Cholesterol Absorption Varies
Some individuals are hypoabsorbers of cholesterol. No matter how much high cholesterol foods they consume, their intestinal cells don’t take up much of it.
Others are hyperabsorbers of cholesterol; even the lightest meals can have every bit of its cholesterol extracted and pumped into the bloodstream.
Cholesterol Regulation and Treatment Options
For my hypoabsorber clients, I am less concerned about their dietary cholesterol intake. Their cholesterol production in the liver would be a more important factor.
The hyperabsorbers will benefit a lot from a particular dietary change. Sometimes it helps to cut back on saturated fats, but eating times and gut bacteria are also important criteria.
Dietary change? Statin therapy? Ezetimibe? Evolocumab?
To answer that, I need more information about the person. A generic cholesterol test won’t always tell us the whole story.
The Liver’s Cholesterol Production
How cholesterol is regulated in the body has a lot to do with the liver. This fleshy organ on the right upper quadrant of the abdomen produces LDL, HDL, and VLDL particles.
Statin drugs decrease the production of cholesterol molecules in the liver.
The liver also has LDL receptors and absorbs cholesterol.
From fatty liver to elevation of liver enzymes to problems with the gallbladder, it’s important to consider the health of this organ when assessing my clients.
The Role of Gut Flora and How Cholesterol is Regulated
Some bacteria in the gut convert free cholesterol molecules into a stanol chemical that intestinal cells cannot absorb.
We could call these beneficial bacteria. They can help slow down the absorption of cholesterol for certain individuals.
Ezetimibe is a medication that works similarly, blocking the absorption of free cholesterol molecules.