Cholic acid

Cholic acid is a trihydroxy primary bile acid synthesised directly from cholesterol in the liver via the classic (neutral) bile acid synthesis pathway, conjugated to glycine or taurine before secretion into bile for lipid emulsification. As a salivary metabolite, cholic acid reflects hepatic cholesterol metabolism and bile acid synthesis capacity, with its ratio to secondary bile acids providing insight into gut microbiome composition and enterohepatic circulation dynamics. Disruptions in cholic acid metabolism are associated with hepatic stress, cholestasis, and altered gut microbiota composition relevant to elite athletic populations.