Two main theories have been proposed to explain the lipid-lowering effect of psyllium. First, psyllium sequesters bile salts during passage through the intestinal > 2007 Elsevier Australia

lumen and second, It physically disrupts the Intraluminal formation of micelles, thereby reducing the absorption of cholesterol and re-absorption of bile salts. In both cases, bound bile acids are moved to the terminal ileum and colon, thereby interrupting the enterohepatic circulation so that more cholesterol is converted into newly produced bile acids. Reduced cholesterol biosynthesis results in upregulation of LDL receptors and enhanced uptake of LDL-cholesterol. Overall, the combined effects result in decreased serum LDL-cholesterol and total cholesterol (Rodriguez-Moran et al

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