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Cholesterol Balance Test
 Take a look at the brochure!
The Cholesterol Balance, Cholesterol Balance Test is the second of Boston Heart Lab’s unique tests also not available from any other laboratory.
This test will tell you whether your body makes (produces) a lot of cholesterol from scratch, or if it takes up (absorbs) cholesterol from your small intestine after a meal (this cholesterol comes both from food and from bile). Different drugs affect these processes differently. Treatment with drugs can be tailored to production orabsorption.
Cholesterol production
To measure how much cholesterol is being made, Boston Heart Lab measures lathosterol and desmosterol. If you have a lot of those two markers, you overproduce cholesterol. If you have high levels of beta-sitosterol, campesterol, and cholestanol, you absorb too much cholesterol.
Statins
How you produce or absorb cholesterol matters, particularly when it comes to medication. The most common drugs used to lower your cholesterol are statin drugs such as Crestor, Lipitor, Mevacor, Pravachol and Zocor. Statins work in your liver by preventing new cholesterol from being made. To compensate for less cholesterol being made, the liver begins to take up more LDL from the blood. This is how statins reduce cholesterol levels in blood. The less LDL cholesterol you have in your blood, the less atherosclerosis may develop.
Dependent on the amount (the dose) and type of statin, you can lower your LDL cholesterol 20-62 %. Normally one begins treatment on a low dose. If the LDL is not reduced to the desired level, a physician usually doubles the dose. Doubling the dose does not lead to a doubling of the LDL reduction. Instead, one doubling of the dose only reduces the LDL about 6 %. Doctors commonly refer to this ratio as the rule of 6.
As you lower cholesterol production in the liver, your body may to try to compensate by taking up more cholesterol from the intestine. The various statins have different effects on this. Some cause more compensation, others less. Knowing whether or not you produce a lot of cholesterol will help your doctor chose the right dose and the right statin from the beginning.
Cholesterol uptake
Some people do not produce a lot of cholesterol. They take up more from the intestine. These so called "hyper absorbers" smay not benefit from statin treatment as much as other people. Instead, to reduce cholesterol levels in these patients, another type of drug is needed.
The drugs that prevent cholesterol from being taken up are called “cholesterol absorption inhibitors” (CAI) and bile acid binding resins. They may be very effective. The two most common drugs are Ezetimibe (Zetia in the US, Ezetrol elsewhere, which is a CAI) and Colesevelam (Welchol, a resin). These drugs lower cholesterol 15-20 % in most cases. Ezetimibe is often used in combination with a statin because it has the same LDL lowering effect as doubling the dose of a stain three times. Ezetimibe can reduce LDL cholesterol up to 70% in some patients. Those patients are likely hyper absorbers. The sterol balance test will identify what kind you are.
The more cholesterol is absorbed, the bigger the effect of a drug that blocks cholesterol uptake.
Boston Heart Lab’s Cholesterol Balance Test can help you determine whether you make or take up cholesterol, and whether a statin, or a cholesterol absorption blocker , or a combination of both, will be most effective in getting your LDL to goal!
The Cholesterol Balance Test will help you choose the most effective therapy.
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