High cholesterol is not a disease per se, but an indication of a problem somewhere in the body. Increase in cholesterol can be an indicator of chronic infection, chronic inflammation, ischemia (insufficient oxygen), poor nutritional state, or just a recent injury.
Cholesterol is a main constituent of protective cell envelopes called cell membranes. Any injury to a cell will cause the cell envelope to break down and their content to spill out. That excess cholesterol is normally removed by the liver. The liver uses cholesterol to make bile, which is then stored in the gallbladder and if this process is interfered with you can end up with high cholesterol.
Bile deficiency caused by the liver
Healthy liver is a major cholesterol manager. It is the liver that decides how much cholesterol is produced and how much it is excreted. There is no simple test that checks for liver ability to produce bile. The only thing you can do is to see if excess cholesterol is actually being excreted through digestion or not. If you have high blood cholesterol you want to see that this excess is being passed for excretion. For the liver to excrete cholesterol it first has to use it to make bile.
Do you make enough bile?
One simple glance over your poop can tell you more than a list of elaborate blood tests ordered by your doctor. If your stool is completely devoid of color or shy away from brown most of the time you may suspect bile deficiency from under-active liver.
Bile contains bilirubin, a pigment left over by red blood cell degradation. Bile is the very substance that gives stool its yellowish-brownish color. So if you see no color, you should think no bile. That’s that simple.
Bile deficiency caused by gallbladder
What if your stool is sometimes pale, sometimes normal? In that case liver may have nothing to do with it and you need to look at the gallbladder instead. Gallbladder does not decide on bile production, but on bile release. If gallbladder has stones blocking its exit, suffers from inflammation that narrows exit passages or simply goes into a spasm, you may expect that stored bile would not be released and stool will be pale.
Gallbladder problem may only be temporary. The stone may reposition, inflammation may subside and spasm may go away. At times when gallbladder is working fine and liver produces enough bile your stool will have normal brownish color. If you see that your stool alternates between pale and normal, suspect gallbladder problem rather than insufficient production of bile and chronic bile deficiency.
Can lack of bile cause diarrhea?
Since bile is necessary to digest fats, lack of bile can cause several problems related to fat digestion. One of them is diarrhea from accumulation of undigested fat in the stool. In that case you can also see oily droplets in the toilet which may be accompanied with a foul smell. Pale stool and oily droplets are give-away signs of definite bile deficiency either due to liver or gallbladder problems.
High cholesterol caused by gallbladder?
If liver cannot use cholesterol to produce bile, or gallbladder cannot release the bile you may experience cholesterol back up in the blood and cholesterol numbers may go up. In case of pale or grey-looking stools, suspect liver and gallbladder as potential culprits behind your high cholesterol numbers.
However, with normal-color stools suggesting that bile production and release is adequate, investigate your dietary habits instead. There is a good chance your diet is lacking dietary fiber.
Dietary fibre decides whether the bile will be excreted or recycled. With sufficient dietary fibre, bile and by extension cholesterol will be excreted by the bowels, rather than put back into circulation. Diets with low soluble fibre intake are a much more common cause behind high cholesterol than any gallbladder problem. Start there. How many beans and carrots did you have today?