Cholesterol is normally dissolved and kept in solution as a flowing liquid when there are adequate amounts of essential fatty acids. The melting point of solid cholesterol is 300 degrees F. When lecithin is present, such as in the biliary system, the melting point of cholesterol falls to 180 degrees F, but it is still insoluble without the addition of bile salts. The chemical structure of lecithin and the electrical charges it carries give it powerful detergent action. It is able to emulsify oils and hold them in solution. Lecithin is an important constituent of bile. Lecithin is derived from soybeans or egg yolk, is composed of the B vitamin choline, linoleic acid and inositol. Lecithin enables fats, like cholesterol to be dispersed in water and removed from the body. When the essential fatty acids linoleic and linolenic are present in sufficient quantity, the melting point of cholesterol falls to 32 degrees, which is below normal body temperature. These fatty acids are found in some vegetable oils particularly flaxseed oil, also called linseed oil.

There is a separate debate about whether soya lecithin has the same action as egg lecithin.

Lecithin, cholesterol and bile salts comprise the three major constituents of bile. Its function is to keep the bile in a liquid form so that gall stones will not form. Cholesterol and bile salts are in a delicate balance in bile and an absolute or relative increase of one over the other tends to result in stone formation. The detergent action of lecithin can prevent this stone formation.

Cholesterol Gallstones form when the cholesterol concentration in the bile exceeds the ability of the bile to hold it in soluble form. This occurs either by an increase in cholesterol secretion by the liver or a decrease in bile salts or phospholipids through a decrease in synthesis or interruption of the enterohepatic circulation (circulation of bile). The result is crystals that grow into gallstones. Bile cholesterol comes from three main sources:

• Synthesis in the hepatocytes cells of the liver from acetate
• Low-density lipoproteins that carry cholesterol from other cells in the body. Most cells except the brain can produce cholesterol.
• Chylomicrons that transport dietary and recycled cholesterol from the intestines to the liver.

The main source of cholesterol is the synthesis by the liver. The cholesterol saturation index is determined by the ratio of the measured concentration of bile salts and phospholipids compared to the concentration of cholesterol. If this ratio is greater than 1, bile is saturated with respect to cholesterol, thus producing the environment for the precipitation of cholesterol to form globules. A decrease in bile salts can increase the cholesterol saturation index without an increase in cholesterol concentration. Once the globules are present, they aggregate together in the supersaturated bile and crystallization occurs, resulting in cholesterol monohydrate crystals that can agglomerate to form macroscopic gallstones. These globules can accumulate anywhere in the biliary system leading to liver or intrahepatic stones and duct stones. However, the highest concentration of the environment that favours cholesterol gallstone formation is of course the gallbladder.


If unusual concentrations of the three chemical cause the bile solution to become imbalance then there are three types of solid particles that can form in the bile. These are crystals, micelles and vesicles a scientific word for clumps. A micelle is an aggregate of surfactant (wetting agent) molecules dispersed in a liquid colloid or simply put globules. A vesicle is a type of film like a blister or plastic bubble containing bile substances.

Bile has the potential to make a wide variety of different types of stones in the liver, ducts or gallbladder. Bile falling within normal concentrations may under certain condition form gall stones, Eg if the bile isn't replenished regularly or the gallbladder doesn't contract properly among other things.

Experiments in a laboratory have demonstrated that bile from people without Gallstones takes about 15 days to form the nucleus of a gallstone. Bile of people with cholesterol gallstones, which, usually already contains cholesterol crystals has a nucleation time of about 3 days. Nucleation of cholesterol occurs far more rapidly from gallbladder bile of people with cholesterol Gallstones than from hepatic bile in the same person, even when hepatic bile samples are supersaturated with cholesterol. The addition of even small amounts of gallbladder bile to the hepatic bile samples causes rapid nucleation. These observations have led to the isolation of proteins in the gallbladder that promote or retard the nucleation of cholesterol crystals. At least five proteins have been identified as nucleation promoters, in addition to gallbladder mucoprotein.

During the normal inter-digestive period the gallbladder partially contracts, thus potentially evacuating any small crystals that might have formed. This cleansing function of the gallbladder should in theory prevent bile stasis and prevent crystals from growing into stones. However, interruption in the normal biliary cycles can lead to the formation of cholesterol gallstones. This condition is sometimes called biliary stasis or gallbladder stasis. Stasis means the state in which the normal flow of a body stops.

Cholesterol re-absorption in the intestines can be blocked with an essential fatty acid "alpha-olefin maleic acid". This may be way of expelling excess bile, mainly cholesterol, and facilitating the biliary equivalent of an oil change but the evidence is not sufficiently robust at this point in time.

Maleic acid should not be confused with malic acid or malonic acid, both of which are different types of dicarboxylic acids.

Telman