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Formation

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Primary bile acids are those made in the liver. They are reliant on a steroid backbone derived from cholesterol. Cholesterol may be obtained:

  • directly from the blood
  • indirectly from acetate

Cholesterol is converted by the enzyme 7-alpha-hydroxylase into 7-alpha-hydroxycholesterol. The latter compound undergoes slight further modification to form the two key primary bile acids:

  • chenodeoxycholic acid
  • cholic acid

Secondary bile acids are formed by the action of gut bacteria on the primary bile acids. They include:

  • deoxycholic acid
  • lithocholic acid

Bile salts are formed from the bile acids by conjugation with taurine and glycine in the liver.


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