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2015 doi: 10.1016/j.ajpath.2015.10.002

Under normal conditions, cholesterol 7-hydroxylase (CYP7A1) initiates the classical pathway to produce the majority of primary BAs

Keremi, B., Lohinai, Z., Komora, P., Duhaj, S., Borsi, K., Jobbagy-Ovari, G., & Varga, G

That distinction matters clinically because it preserves the feedback loop that governs GH secretion, reducing the risk of the side effects associated with exogenous HGH administration at therapeutic doses