Treating High Cholesterol With Bile Acid Sequestrants

Learn about the pros and cons of taking this class of drugs to lower cholesterol levels

Most people are familiar with the cholesterol-lowering statin drugs. And they should be—they’re the number one most often prescribed medication. But there’s also another way to pharmaceutically lower cholesterol: Bile acid sequestrants.

Bile acid sequestrants work in the digestive tract to impede the absorption of cholesterol. Commonly prescribed bile acid sequestrants include Questran (cholestyramine), Colestid (colestipol), and Welchol (colesevelam).

While these drugs are quite good at removing cholesterol from your body, they are not very choosy about what else they block from your system. Bile acid sequestrants also interfere with the absorption of:

• Oral medicines, including cardiac drugs such as Digoxin, beta-blockers such as Lopressor or Inderal, and diuretics such as Lasix
• Fat-soluble vitamins A, D, E, and K
• Calcium (and also promote calcium excretion)
• Iron
• Folic acid

Blocking the absorption of all these important vitamins and minerals may create nutrient deficiencies that can lead to such health problems as immune system dysfunction, osteoporosis, and anemia.

My Bottom Line for Prescribing Bile Acid Sequestrants

If you are taking a bile acid sequestrant, you at the very least need to have your blood levels checked regularly for the nutrients listed above, so as to guard against any deficiencies and keep on top of any extra supplementation of these precious nutrients that may be needed. But ultimately, I believe cholesterol-reducing lifestyle adjustments are just as effective at lowering cholesterol levels and far healthier. See the dietary changes, nutritional supplements, and exercise strategies I recommend to bring down your cholesterol levels without medication.

More Dr. Sinatra Advice on Healthy Cholesterol Levels

What numbers indicate high cholesterol? Get my recommendations on what constitutes healthy cholesterol levels.

Considering a statin for your high cholesterol? Learn about the pros and cons of statin drugs.

Who should take a statin? Discover which people will benefit the most from taking a statin drug.