Bile Acid Sequestrants
Common brand names: Cholestyramine (Questran), Colestipol, Colesevelam (WelChol)
Two nutrients listed against this medication. The most severe is marked critical.
At a glance
Neither of the two is marked well documented. Each row carries its own evidence level.
At a glance
- Fat-Soluble Vitamins (A, D, E, K)Critical · Moderate evidence
- Omega-3 (EPA+DHA)Mild · Mechanism only, no human trial
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Bile acid sequestrants bind bile acids needed for fat-soluble vitamin absorption. All four fat-soluble vitamins (A, D, E, K) are significantly impaired.
Common signs, Vitamin D deficiency, bone loss, immune impairment, Vitamin K deficiency (clotting issues), Vitamin E antioxidant depletion
West & Lloyd (Gut, 1975; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 1168607): long-term cholestyramine impaired intestinal absorption, including of fat-soluble nutrients, in children with familial hypercholesterolemia.
Fat-soluble vitamins are separated from cholestyramine by taking them 1–2 hours before or 4 hours after the dose. Studies used D3 plus K2, vitamin E (mixed tocopherols), and vitamin A (as retinol rather than beta-carotene).
Mechanism, Bile acid sequestrants bind bile acids and impair fat absorption broadly, and omega-3 fatty acids are fat-soluble. The general absorption effect is established; no human study has measured EPA or DHA status during sequestrant therapy, so the omega-3 step remains inference.
Common signs, Reduced cardiovascular protection, inflammatory burden increase
Bile-acid sequestrants impair fat absorption, which could reduce omega-3 uptake (mechanistic); no direct human omega-3 study exists.
Omega-3 supplements are separated from cholestyramine by at least 4 hours.
For your next appointment
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Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →