Psoriasis Cure Is Bile Flow, Bile Acids Eliminate Endotoxins
Those who have studied some research data about the bile acids know that there are a lot of unanswered questions about the acids produced and excreted by liver. Generally all bile acids are considered toxic for the body and even carcinogenic. However the best option seems to be the ursodeoxycholic acid (UDCA) also known as Ursodiol. This one can be prescribed by the doctor but is also available over-the-counter as the supplement.
Ursodeoxycholic acid is very popular in bodybuilders who take it for the liver protection when taking the anabolic steroids. So why there is so little data about ursodeoxycholic acid and psoriasis? Probably because official medicine doesn’t even think about the possible connection between the liver problems and psoriasis. And the connection is there for 100%. It is something that is known in underground science/medicine for more than 50 years.
Ursodeoxycholic acid is very effective in dissolving the cholesterol gallstones/liverstones and its very low toxicity allows its use for long periods of time without any serious negative effects.
Another bile acid used to treat psoriasis and also scientifically documented is dehydrocholic acid what is a synthetic bile acid prepared by oxidation of cholic acid. However its effects in the liver seem to be different from the natural bile acids. Dehydrocholic acid makes liver produce more bile by the process when dehydrocholic acid itself is metabolized in liver cells and excreted along with the bile acids. The natural bile acids seem to make the liver produce own bile acids without metabolizing the supplemental bile acids.
So from the scientific point of view we have 3 major choices if we want to try bile acids for psoriasis:
- ursodeoxycholic acid
- dehydrocholic acid
- ox bile (about 40% of capsule weight are bile acids)
As I already mentioned above the best option considering the safety and effectivity is ursodeoxycholic acid. Also it is well known for the doctors so they can prescribe it for you in many countries. The price is about 4 times more than ox bile (about 80 dollars vs 20 dollars per month) but it is surely worth it (not just for those who have gallstones or psoriasis) since it helps in many chronic diseases which are just the different versions of symptoms of the same underlying problems.
Dehydrocholic acid is not very popular so you will have to look for it since it is used in just a few supplements in some countries.
Ox bile is actually the cheapest from all those three bile acids since it is not one pure isolated acid but freeze-dried bile. The content of all bile acids in ox bile is about 40 % of dried bile powder weight.
There are many different studies that covered various effects of different bile acids on the body. The one and only fact that we can know for sure is that bile flow and bile acids are important for health. When we go further and want to research the effects of individual bile acids on the body we have to keep in mind that the current data are not so satisfying and conclusive.
Many of the research data are from the experiments with laboratory rats and not humans. Not just that rats biochemistry may be different in one or other particular area but rats have no gallbladder so we have one strong argument for considering major differences of metabolism and even importance of bile flow and acids in rats.
Restoring the normal bile flow (with adequate bile acids content in bile) is number one to cure the psoriasis.
Bile acids are toxic, but also for the pathogens
The bile acids are toxic – but also for the bacteria (which is the reason why they will cure small intestine bacterial overgrowth). The body must be in balance – the toxic bile acids are needed (but not too much or too little), essential vitamins are needed (but not too much or too little).
Overwhelmed liver is mostly from small intestine bacterial overgrowth = bacterial toxins (very toxic AMMONIA – NH3), endotoxins = damaged small intestine/leaky gut = undigested food molecules gets into a bloodstream, bacterial translocation from the intestine into the blood, bad digestion due to damaged microvilli.
Bacterial overgrowth (plus with bad species of bacteria) in the small intestine leads to more degraded conjugated bile acids (those acids dissolve the bacterial cell walls = cure of small intestine bacterial overgrowth) = absorption of deoxycholic acid and lithocholic acid (the amounts of these toxic bile acids would be very low if there was no bacterial overgrowth in small intestine). So even that small amount of bile acids that psoriatic’s liver can produce will be degraded in the small intestine (those bile acids become more toxic) before they are absorbed into the blood and go to the liver.
Bacteria degrade the conjugated bile acids (in conjugated form they are also called bile salts) by bacterial enzymes in order to make the bile acids weak (degraded bile acids are: deoxycholic acid, lithocholic acid) so they wouldn’t lyse/dissolve the bacteria cells so easily (bacterial cell walls consist of LIPOpolysaccharides – fat containing substances which are dissolved by the bile acids). The bacterial lipopolysaccharides are actually endotoxins = overwhelmed liver = toxic blood = inflammation = psoriasis.
In small intestine bacterial overgrowth – SIBO – the bacteria are constantly dying (endotoxins) and proliferating = chronic liver insufficiency (low bile acid synthesis and liver detoxification capabilities) = psoriasis.
Bile Acids Facts
Psoriasis is not the only one disease which can be improved with bile acids.
The effects of bile acids are well known in traditional Chinese medicine.
Remember that everything is about the balance. The point is to allow the liver to regenerate and not to supplement the bile acids forever (if you still have the gallbladder). There are the studies that concluded the carcinogenic effects some of the bile acids like – deoxycholic acid.
One of them is study in mice – the study concluded that 17 out of 18 deoxycholic acid (DOC) fed mice developed the tumors (10 of them was colon cancer) in 8 – 10 months. However the authors concluded that adding the antioxidant to the diet significantly reduced the tumor formation in DOC acid fed mice. But there is another fact yet – the mice was fed also with the significant amount (20 % of food content) of casein (protein) which the researchers and the authors of the book The China Study identified as a carcinogen if consumed at amounts of 20% of a diet. At concentrations of 5% in diet the casein didn’t cause the cancer.[168, 169] So it seems like it is still all just about the balance and importance of consuming the enough amounts of antioxidants.
In the other hand another study disproved that the deoxycholic acid (DOC) levels are higher in the colon cancer patients. However it could be so that after the colon cancer develop it weakens the body up to the point that the deoxycholic acid production is lower.
Another study concluded that the dietary fat-soluble vitamins A and D inhibit the bile acid synthesis. This process may be evolved as self-regulation of fat-soluble vitamin absorption since the bile acids are needed for the dietary fat-soluble vitamins assimilation.
Also the another carcinogenic bile acid – lithocholic acid (LCA) has interesting properties. It can bind to vitamin D receptor (VDR) what activates the lithocholic acid detoxification in the liver and intestine – self-regulated detoxification. The same detoxification path of lithocholic acid is activated also by the vitamin D. This fact may explain the protective effects of vitamin D against the colon cancer. The activated VDR receptor in the hepatocytes (liver cells) may play an important role in inhibition of bile acid synthesis to protect the liver during the cholestasis (low bile flow from the liver).
The colon carcinogenesis may be inhibited by several protective mechanisms of vitamin D: detoxification, raising the cell apoptosis sensitivity, or by inhibition of the proliferation of colon carcinoma cells.
LCA can also substitute the vitamin D in elevation of the serum calcium in vitamin D deficient rats. The researchers confirmed that the LCA can activate the genes in the kidneys of vitamin D deficient rats. So the LCA is able to circulate through the body and bind to the VDR receptors in the tissues.
VDR receptor mediates the most if not all vitamin D (1,25(OH)2D3) actions, so it is very important to have functional VDR receptors.[176, 193]
What are the bile acids?
Bile acids are strongly cytotoxic and their main functions are performed in the small intestine (digestion of fats and breaking down the bacterial cell walls and the toxins).
The conjugation of the bile acids is done in the liver – it improves the fat digestion properties of bile acids and restricts the absorption of the bile acids into the blood from the upper part of the small intestine. The glycine-conjugated bile acids are the most abundant of all bile acids – 70%. The taurine-conjugated bile acids represent about the 20% of produced bile acids.
The composition of bile acids in bile
Bile contains two major types of bile acids – conjugated and unconjugated. Here is the list of both.
Unconjugated bile acids
- cholic acid – trace amounts
- deoxycholic acid – trace amounts
- chenodeoxycholic acid – trace amounts
Conjugated bile acids
- glycocholic acid – 30%
- glycodeoxycholic acid – 15%
- glycochenodeoxycholic acid – 30%
- taurocholic acid – 10%
- taurodeoxycholic acid – 10%
- taurochenodeoxycholic acid – 5%
In the enterohepatic circulation (bile is used and reabsorbed many times), there is about the 4 grams of bile acids – the amount of bile acids is called – pool size. That means that the body should have about the 4 grams of bile acids for the right digestion and health. Those bile acids are part of the bile which is produced daily at amount about 250 ml – 1 000 ml.
Bile = water 85% + 15%(bile salts 75%, phospholipids 15%, cholesterol 10%).
How bile acids work?
The bile is released in bursts when activated by food rather than continually during the day. The enterohepatic circulation repeats about 4-8 times a day, so about the 16 – 32 grams of bile acids will flow through the small intestine daily.
About the 99% of all bile acids is in the enterohepatic circulation (liver->gallblader->small intestine->absorbed into the blood->liver). The systemic blood contains just the small amounts of bile acids.
The bile acids are reabsorbed in the terminal illeum (in the end part of the small intestine).
The only significant portion of the bile acids leak just through the stool (20% of a pool size = 800 mg; 100-150 mg of bile acids during each enterohepatic circulation process). However even this leakage is not meaningless, since it is supposed that the bile acids are in the stool in order to support the bowel movements (bile acids work as laxative).
Since the liver is able to synthesize about 3 grams of bile acids a day it can handle the production of 600 – 800 mg of bile acids a day (what is lost in the stool) without the problem.
The problem can pop up when we take some drugs which strongly inhibit the bile acid synthesis or when there is some problem with the bile acids reabsorbtion. It was confirmed in animal studies that the recirculation problems can be compensated by liver production up to 20% (normally about the 3% of pool size left the enterohepatic circulation through the stool). The more serious defects in enterohepatic circulation caused the progressive loss of bile acids pool to 1/5 of the normal pool size.
Those with the ileum resection will probably have very serious problems with the bile acids and enterohepatic circulation. In those people up to 90 % of bile acids is lost during one enterohepatic circulation, so it is impossible for the liver to
Also if the bile salts are not absorbed in the ileum then the leaking into the colon will cause diarrhea and even the colon cancer.
If the liver (as well as the intestinal peristalsis, stomach (acid) and pancreatic enzymes) is not working then the SIBO develops. If the small intestine is full of bacteria which degrade the conjugated bile salts then the fat digestion gets impaired. Also the low bile salts will be reabsorbed (because of the bacterial degradation of the conjugated bile acids – these are reabsorbed in the end part of the small intestine) and huge amounts of free bile acids gets absorbed into the blood which may be toxic. The bacteria metabolize the chenodeoxycholic acid to lithocholic acid which can cause colon cancer, gallstones and damage the liver.[180, 173]
The health is a balance – it is not something you can get once and stays forever.
Liver is unable to restart the bile acids production and regenerate itself since in people with SIBO (small intestine bacterial overgrowth) the all bile salts synthesized are degraded in the small intestine by overgrown bacteria. In the long-term the non-alcoholic fatty liver disease develops and it is almost impossible for the liver to regenerate without the supplements (bile acids) or long-term raw food diet.
That’s why it is important to supplement with the bile acids/salts supplement. Theoretically taking just about 20-40 capsules of 500 mg of bile acids (3 – 6 capsules of 500 mg per day during the 1- 2 weeks) will fill up the pool of the needed bile acids (4 grams). The bile acids will cure SIBO and the liver will start to work on its own.
Note: The dried bile in bile acid supplements contains usually about 40%-45% of bile acids. That means one 500 mg capsule of bile supplement = 200mg – 225 mg of bile acids/salts.
However in the beginning the bacteria in the small intestine will metabolize the supplemented (conjugated) bile acids so you will need more than just the 40 capsules to clear up all psoriasis and restart the liver.
Also the small intestine may be damaged up to the point where it can’t fully (re)absorb the bile acids so they will be leaking into the colon in higher amounts what can cause the diarrhea (and according to some studies the colon cancer).
The solution (if you would experience the diarrhea) is just lowering the dosage until you reach the tolerable level for you and your small intestine – so it will be able to absorb the supplemented bile acids from the intestinal lumen.
How much bile acids should I take?
Personally I would recommend to take 3 times a day one 500 mg capsule of bile acids for 3 months. Most people should see the effects in about 2 weeks taking even just one 500 mg capsule per day.
The gluten free diet may greatly improve the outcomes. The people unable to gain weight will probably gain weight and those who can’t loose weight despite trying will probably lose weight without any additional changes to their diet.
Supplementation with fat soluble nutrients
Since the bile acids are important for fat digestion and fat-soluble vitamin assimilation those who had psoriasis for years may have serious fat-soluble vitamins deficiencies.
Those who have high cholesterol or irregular bowel movements should eat the foods with the high fiber content since the fiber will soak up more bile acids, which act as a natural laxative in the colon (so the stool doesn’t stay there and dehydrates for a long time), as well as the cholesterol which makes about 1,5% of bile.
Where to Buy Dehydrocholic acid and How To Make it Works For Psoriasis
The most famous psoriasis study used dehydrocholic acid but on this blog the recommended supplement is ox bile. Why and What are the differences?
I link the Ox bile supplements on this blog just because they are more popular than dehydrocholic acid. Actually dehydrocholic acid supplements are for many people harder to buy since there is just a few producers worldwide that sell packaged tablets.
I do not know the real potency differences between ox bile (cholic acid, deoxycholic acid,…) and dehydrocholic acid (what is prepared synthetically from cholic acid) and there are surely differences in their effects on bile production and bile flow (contraction of gallbladder). Read my blog post that have been written earlier this year – Bile Acids, Endotoxins and Leaky Gut. I think that dehydrocholic acid works faster than Ox bile due its stronger choleretic effect when compared to cholic acid but there are very little data on this subject.
Also you have to keep in mind that in that study (Pathophysiology of psoriasis: coping endotoxins with bile acid therapy) people were continue using their prescription drugs (antihistamines and antibiotics) what could help the treatment. So the results during that study might appear sooner than if they were taking just bile acids alone but without the drugs the results are probably much more sustainable and process is safer.
As you might read on my blog or in PDF paper there was similar treatment of 3 patients in Japan with Ursodeoxycholic acid that resulted in slow disappearing of psoriasis starting after about 3 months if I remember right. So it is usual that the results will be visible after some months and therefore it is better not to assume that after 2 months you will be psoriasis free as those patients in that study. They get various tests for hidden chronic infections since they were treated by professional dermatologist and study was conducted by experienced researcher.
You can get a prescription for Ursodeoxycholic acid from your doctor in most countries. It helps with itchy skin (not just in psoriatics) caused by bad liver function so it might be worth to try it for a few months if doctor would be able and willing to prescribe it.
Do not forget to take omega 3, omega 6 and omega 9 fatty acids, B-complex, desiccated liver, whey protein (or maybe brewer’s yeast), zinc, magnesium, vitamin D3, K, E and A – at least these nutrients are critical and poorly absorbed when there is a low stomach acid and not proper bile acids/bile flow. Also some ionic multimineral is more than useful.
You know when somebody have very low/absolutely no stomach acid for months he will become so malnourished that the symptoms of old age (like 80-90 years person) develop in just a few months – slow thinking, fatigue, weak bones, Alzheimer like symptoms, low neurotransmitters like dopamine, muscle loss, wrinkles, etc… More than 80 years ago they treated psoriasis and various other chronic diseases by supplementing the stomach acid and brewer’s yeast – and it worked.
Also be sure to resolve dental infections – root canal is the biggest insanity ever. How any doctor let the dead tooth (rotting tooth) to stay in the mouth? Also the mercury fillings are extremely bad – cilantro helps to remove mercury from the body but it is very powerful so it must be done very slowly (and no mercury fillings should be present in the body at that time).
Where to buy dehydrocholic acid?
Here you can find brand names of dehydrocholic acid – http://www.drugs.com/international/dehydrocholic-acid.html
From Europe you can order these products that contain dehydrocholic acid as main ingredient:
- Poland: product 10 x 250 mg for 2,5 EUR – Raphacholin Forte
- Romania: product 20 x 250 mg for 2,5 EUR – Fiobilin
- Hungary: product 30 x 250 mg for 5 EUR – Bila-Git
You can find those products in european online pharmacies.
The purpose of supplementing the bile acids
The point is to dissolve biofilm (covering bacteria, fungus, parasites) through increase of bile flow in the intestines and also break down the endotoxins (bacterial dead bodies). Bile acids as well as many other choleretics (chemicals that support bile production) help to do that – dandelion, turmeric, artichoke, ox bile, dehydrocholic acid, ursodeoxycholic acid, etc…
Dehydrocholic acid is one of those choleretic chemicals. It is surely strong choleretic but I can not tell you how much compared to turmeric or ox bile containing cholic acid. There are some studies but as I already wrote on my blog it is hard to compare the data from various studies between each other.
The point is to make liver produce bile and release it into the intestine. It is not that supplement you take will clear up all that mess in the intestines. Supplemental bile acids (like dehydrocholic acid or ox bile) just make liver produce more bile and promote its release into the small intestine. That circulation will eventually clear the intestine and for that purpose dehydrocholic acid is one of the best. Problem with some supplements like Jarrow Bile Acids is that it contains very most of the bile acids in conjugated form – so they are less choleretic (that means less bile flow). Actually this supplement is promoted for fat digestion what is better performed with conjugated bile acids.
However conjugated bile acids undergo deconjugation in the intestines by bacteria so they will eventually end up deconjugated and are absorbed in the small intestine to the liver. However I could not find any complex research of various bile acids in humans so I can not tell you how big differences are between them.
Personally I think that dehydrocholic acid is better (in terms of choleretic effect) than Ox bile but if one don’t have it then I would say take Ox bile since they have the same effects on bile flow (even probably less strong so it may take longer to see the effects on psoriasis). With ursodeoxycholic acid it takes about 2-3 months to see progress and ursodeoxycholic acid is considered as the best for liver protection and repair – even bodybuilders on steroids use ursodeoxycholic acid for liver protection and in bodybuilding community it is considered as the best liver treatment. You can read more here – https://www.psoriasisdietplan.com/2014/07/stanozolol-winstrol-alleviates-the-rheumatoid-arthritis-symptoms/
Here is one of the best studies about the choleretic effect of cholic acid (found in huge quantities in ox bile) and dehydrocholic acid – http://www.ncbi.nlm.nih.gov/pubmed/5071398
Artichoke – Bile Flow Support for Vegan Psoriatics
A lot of people with psoriasis have problem taking the bile acids obtained from bovine. Maybe they are strictly vegans or just don’t like the idea of ingesting the freeze dried bile from animals. The nature has an option for them – Artichoke (Cynara scolymus).
Artichoke Leaf Extract Is more powerful than bile acids
The study on rats from 2002 concluded that artichoke leaf extract (ALE) has the similar effects as the dehydrocholic acid in terms of its choleretic activity. Orally administered ALE twice a day for 7 consecutive days significantly increased the bile acid concentration over the entire experiment. The highest dose that the researchers administered to rats was 400mg/kg of ALE and artichoke was much more potent in terms of bile acids production than reference – dehydrocholic acid. Researchers did not found any differences in cholesterol and phospholipid excretion.
I have always recommended Ox bile as bile flow support supplement since it is popular and easy to get but if the study proved that artichoke is superior even to dehydrocholic acid what is already way potent than cholic acid found in Ox bile it may be a great alternative. I had not found more scientific data about artichoke effects on bile flow that would be reliable enough to be compared with Ox bile or dehydrocholic acid but subjective reports from users show that artichoke is as good as bile acids. In Europe it was used by herbalists for a long time as a digestive aid and for liver repair.
Also keep in mind that “bile flow” and “bile acids production” are two different processes. Bile flow is affected by choleretic supplements (ox bile, dehydrocholic acid and artichoke) but bile acids production is the process in the liver that create bile acids from scratch and release them into the bile.
When taking Ox bile your liver besides processing (absorption and excretion in bile) the bile acids from capsule may create additional bile acids that will release in bile. However when taking artichoke, bile acids produced and released in bile are exclusively made by your liver since artichoke does not contain any bile acids itself.
The differences are also between synthetic dehydrocholic acid (manufactured by the oxidation of cholic acid) and bile acids found in Ox bile (cholic acid):
“Dehydrocholic acid makes liver produce more bile by the process when dehydrocholic acid itself is metabolized in liver cells and excreted along with the bile acids. The natural bile acids seem to make the liver produce own bile acids without metabolizing the supplemental bile acids.”
How much artichoke should I take?
As always I must say that everything is about the balance. Long-term overdosing on anything has detrimental and dangerous consequences.
Generally it is safe to take 2 capsules 3 times daily but everybody is different. Some people can get clearance of psoriasis taking 3 capsules daily and some might need more.
You can also make a tea from the capsules for better absorption of active ingredients and thus saving the money since you won’t need as much capsules.
You can read more about Artichoke effects here – http://www.lef.org/Protocols/Gastrointestinal/Digestive-Disorders/Page-05
Pancreatin Supplements Instead of Bile Acids Due To BSE Risk
Pancreatin (pancreatic enzymes) that comes from pigs is useless for the job that can be done just by the bile acids. However pancreatin is great for food digestion so it won’t stay undigested in the intestines being the feed for bacteria and molds.
I think that BSE is something that was created in the laboratories or maybe it is just a symptom of feeding the cattle with the grinded bones and other stuff from they predecessors killed in slaughterhouses, soy, corn, rapeseed/canola, hormones and antibiotics. And if BSE is contagious I think that contaminated with it can be everything that contains something from the bovine.
Officially there is no risk in BSE transmission through the milk products, but I don’t believe that – if it is something infectious it can be transferred by milk products in my opinion.
But those who are worried about the purity of ox bile supplements have the option to buy the synthetically prepared/altered bile acids:
- Ursodeoxycholic acid – this acid is approved (doctor can prescribe it) for treating the gallstones and it can cure psoriasis – www.ncbi.nlm.nih.gov/pubmed/17376209
- Sodium deoxycholate – sodium salt of deoxycholic acid
- Cholic acid
However those bile acids may still be made from the ox bile so there may be still a risk of contamination (if BSE is infectious in nature) if you are worried about that.
Bile acids like sodium deoxycholate or cholic acid are available on the internet but they are usually stated as for laboratory use so it is not recommended to use them internally even though laboratory chemicals from reputable suppliers are of very good quality. The best option is to get prescription form of ursodeoxycholic acid from the doctor if it is possible. Ursodeoxycholic acid is considered worldwide as the best liver treatment available.
I think actually that it is not so much about the type of the acid – cholic, deoxycholic, ursodeoxycholic, etc. but about the detergent properties of these acids on fat (cholesterol) as well as their choleretic effects (increase the volume of bile flow).
Realize that the bile canaliculi (tubes) in the liver that drain the bile (acids) are just 1 micrometer in width so they get stuck very easily when something is bad in the body (taking OTC or prescription drugs, stress->low stomach acid->SIBO and deficiencies, low fat diet, etc.) Then you may need to supplement the bile acids that will dissolve the cholesterol in those tubes in the liver that are actually 5 times smaller than the red blood cell – this is called congested liver.
Also keep in mind the importance of Vitamin K since it is the vitamin that plays a huge role in assimilation of calcium. If one is deficient in Vitamin K what most of use do then microscopic calcified “gallstones” can be formed in liver canaliculus so we end up with congested liver what will eventually result in chronic degenerative diseases like psoriasis.
Great supplement for the liver is the soy lecithin that helps to emulsify the fats so it can greatly help to clean the garbage from the liver and gallbladder.
That’s why it may go so fast (80% cure rate in 2 months according to the study about he bile acids and psoriasis) when you take bile acids. Liver will start to do its job usually immediately (if it is not physically damaged – cirhossis) but it may need the help by taking the bile acids which will dissolve that garbage. But keep in mind that if you have some serious deficiency – usually B complex vitamins (B6, folic acid and B12 deficiencies are very common but other B vitamins are as well important) and zinc (extremely common deficiency) the liver will have still very hard time to restart its function.
Bile acids vs cholestyramine or activated charcoal
Note: Activated charcoal is the choice when in need of adsorbent. I mention the cholestyramine just because its properties help prove the theory that toxins in the intestines cause psoriasis. Cholestyramine and activated charcoal adsorb the drugs so if you take some consult your case with the doctor. You can read more about it in my previous post – https://www.psoriasisdietplan.com/2014/03/cholestyramine-and-activated-charcoal-help-to-improve-psoriasis
Bile acids break down the endotoxins in the intestines to make them less toxic or non-toxic. Therefore the goal is to restore the proper bile flow. However there is another known way to reduce toxins in the gut – adsorption – in the intestines before they reach the bloodstream and liver. First of the popular adsorbents is the synthetic prescription drug – cholestyramine, second is popular also as home remedy – activated charcoal.
Cholestyramine was developed to lower the cholesterol and not to cure psoriasis. Cholestyramine binds to conjugated bile acids (it is the way how it indirectly reduces the cholesterol levels), but also to the bacterial endotoxins and other chemicals in the intestines. Its side effects include: tooth decay and tooth discoloration, low assimilation of fat-soluble vitamins, diarrhea, constipation, bad digestion of fats, etc. As you can see the diarrhea is usually from excess of bile acids in the colon and constipation from low bile acids in the colon, but still diarrhea and constipation can be caused by one drug.
I do not recommend taking cholestyramine for psoriasis since the relief stops and psoriasis starts to worsen again about one week after discontinuing the drug. Moreover the side effects may cause more damage than good overall.
Activated charcoal is in my opinion much better option however you will have to take about 10 grams per day in 2 or 3 divided doses so it is better to buy the powder not supplement in capsules (10 grams = 40 capsules). Activated charcoal can be very helpful during the first stages of healing the liver and restoring its functions since it significantly reduces the amount of toxins coming from the intestines.
1.) Saénz Rodriguez T, García Giménez D, de la Puerta Vázquez R. Choleretic activity and biliary elimination of lipids and bile acids induced by an artichoke leaf extract in rats. Phytomedicine. 2002 Dec;9(8):687-93.