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Cholestyramine dosing schedule...?

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Posted 4/1/2021 8:33 PM (GMT 0)
I'm digging around trying to find the best approach to taking cholestyramine 3x a day. I usually eat two meals a day, and there are 2 times/day that I need to take supplements/meds etc. I'm trying to figure out the best approach to scheduling all this in regards to the cholestyramine interfering with the other meds/supplements.

Depending on where you read, you are supposed to wait up to several hours BEFORE AND AFTER cholestyramine before taking other meds. That could be tough to do 3x per day.

Anybody have good, specific timing/scheduling ideas on this? I'm going to be taking cholestyramine for the foreseeable future, so I'm wanting to make it the most feasible and effective as possible. Thoughts?
Posted 4/1/2021 8:37 PM (GMT 0)
2x a day should be fine also - esp if you are only eating 2x a day

if it were me i think i would take all my supplements etc with meals - and the cholestyramine in between

edit -

thinking about its mode of action - CSM is a bile sequestrant - its purpose it to absorb the bile acids along with the toxins that have been dissolved/conjugated with them - to prevent it being re-absorbed into the blood stream and sent back to the liver as is otherwise the norm. The bile gets re-absorbed mainly in the small intestine - which is a pretty long thin tube with the contents in constant motion from where the bile duct dumps bile in - to the colon where it slows down and no further absorption take place.

with this in mind - logic would suggest that the CSM needs to be in the same section of tube( small intestine) at the same time as the bile in order to work - and it would follow that the CSM therefore needs to be taken with the food - or close to it - in order to do that.

Perhaps the prescription is to take it just before in order for there to be enough time for the CSM powder to disperse / absorb water etc ?

bile is produced continuously but stored in the gall bladder until you eat a meal with some fat in it ( sensed by a small sensory organ protruding into the small intestine just after the opening of the valve in the stomach) which then triggers the gall bladder to contract ( typically around 7g of fat per meal is sufficient though more will perhaps lead to greater secretion) and inject the required amount of bile. Hence fat with meals is needed to ensure bile is secreted.

so with this in mind i think i should reverse the above comment and instead take it with meals - and supplements, medications etc away from the CSM

Post Edited (Garzie) : 4/7/2021 4:02:18 AM (GMT-6)

Posted 4/1/2021 11:08 PM (GMT 0)
I just got done taking it for about 4 months. I would wake up early 6am and take my abx then supplements a little later. Then about 10am take my first dose. Noonish probiotics, then magnesium an hour or so latter, I've read that should be taking away from other meds too. 5pm abx again then an hour later supplements, then around 9-10pm CSM again. I did try 3 doses a day for awhile but I was waking up in the middle of the night to take a dose then which was a big pain.
Posted 4/2/2021 1:24 AM (GMT 0)
I found Shoemaker’s paper on CSM online here. https://www.survivingmold.com/docs/csm_fact_sheet.pdf

I have heard others were told to take it much differently. However, since it is a bile sequestrant, then in order to effectively bind the toxins as they are released in the bile, the timing in relation to food seems pretty important. I don’t see it mentioned here, but my CIRS doc told me to eat fat with the meals. I think fat helps stimulate bile production.
Posted 4/6/2021 3:33 AM (GMT 0)
Thanks for the info, folks! I'm still working on it, and apparently I need to because I'm pretty sure I've been herxing for a few days now....
Posted 4/6/2021 2:17 PM (GMT 0)
Hmmm. That says something, since you tolerated it fine before. Did you start low and slow before and have no herxing?

I started what I ignorantly thought was low and slow and had a horrible intensification reaction. Shoemaker said that he found that occurred in people with Lyme or MARCONS.

At the time, my MARCONS test had come back negative. My Labcorp WB for Lyme, was positive for band 41 and something else non-Lyme. The doctor had told me it was negative. By this time, I had been doing some reading and thinking on my own and had been sick with a mystery illness with bizarre symptoms that defied doctors’ understanding and had come and gone randomly since 2009 (this was 2016).

I knew from what I had read on surviving mold that Shoemaker said that about the horrible intensification reactions with CSM, and I started asking questions about Lyme. Then the doctor said I could test with Igenix, so I did. Had more bands but still not a positive. Did have band 39 Indeterminate (Lyme band). Then the doctor finally told me that a negative test didn’t mean no Lyme.

I pressed further and tested with DNA Connexions and was positive for Lyme and Ehrlichia. Doctor said it didn’t mean active infection but agreed to trial treatment with abx. At first she was going to give me Doxy and then changed her mind and gave me Minoxycline. After 7 days, my symptoms were increasing but not as bad as what CSM did. She told me to stop. I stopped and had a cytokine storm that took 4 months to recover from. That doctor didn’t know what to do with me except take my money and spin me around in circles. I finally left her and started Buhner’s herbal protocols.
—————-
EDIT:
Sorry I am so longwinded! I wanted to add that I don’t think Shoemaker understood enough about Lyme and coinfections. I suspect the patients he was successful with had pretty much straight mold problems. I think that’s why Ackerley and many others broke away and formed ISEAI. They found that following his rigid protocol was not working for a lot of patients, especially really sensitive ones.

I also think many of them were NOT rigidly following the protocol. For one, it is very difficult. It is also very cost prohibitive for patients to constantly be testing at every step and re-exposure, etc.

Post Edited (WalkingbyFaith) : 4/6/2021 8:34:29 AM (GMT-6)

Posted 4/11/2021 4:21 PM (GMT 0)
Hi All,

Thanks again for the thoughtful replies! And I am also absolutely guilty of being long-winded too !!

It's been so long that I don't even remember if I herxed the first time I started CSM. FWIW, this time around the herxing has gone away after 2-3 days, which is a relief. I started off with, and am continuing with the 3 doses/day. I guess what I'm interested in now is investigating if I need to do an additional form of detoxing to fully cover my bases with the detox I'm hoping to find if there is another strong, "no BS" form of detoxing to add to my regimen. In the past I've generally found that most herbals and similar attempts at detoxing never seemed impactful enough to make any noticeable difference. I hear Neil Nathan's book on toxins etc. is very good - I need to take a look. So far I've been reading Sherry Rogers' "Detox or Die" for that general info.

From my past experiences, the next most powerful detox method I'm aware of is infrared sauna. I may dig my old homemade one out and put that back into the regular mix...... BTW, my inexpensive and easy homemade "regular" infrared sauna works GREAT for sweating it all out. I would sweat out about 8 pounds of water weight every time I did a full session (!!) But you have to do it carefully - electrolytes before, during and after, tons of hydration, etc.) Message me if you'd like plans/instructions for that.

As many of us have learned the hard way, the "what could it hurt?" justification for trying all sorts of "fringy"?? treatments frequently costs a lot of time money, time and heartache but gets you very little overall progress. I've also found that even most "LLMDs" goof around with a lot of secondary symptoms and their often lengthy treatments, resulting in similarly poor results....

From my general understanding of the Shoemaker approach, I understand the comments about his slightly dated approach to lyme/mold. Ackerley's approach seems more current, and is constantly being refined. Again, she was THE ONE who finally helped me get healthy the first time (after 7 years of constant other attempts), so I'm a firm believer in her and as I mentioned, I am really trying to get my new doc to closely follow Ackerley's more recent specific plan for me. Happily, she seems very amenable to this plan!! To be fair, though, I'm just getting started with this new doctor so it is too soon for me to be "recommending" them... but I certainly have experiences with most of the LLMDs here in Atlanta - most of them not good.

Specifically Regarding the CSM: I have another idea....

I've been wondering that since I usually have a long stretch during the day without meals or the need to take supplements, meds, etc., that maybe I could try the following:
During the middle of the day, take a dose of CSM, wait an hour and then take another dose. Would this be adequate time between the two doses, and would they still both likely be effective? This would make it easier to get multiple doses in per day hopefully without interacting/interfering with meds/supplements. Ackerley's recommendation is at least 3 and possibly 4 doses per day....

What do you folks think?

Post Edited (Spaceboy30000) : 4/11/2021 10:47:08 AM (GMT-6)

Posted 4/12/2021 5:49 PM (GMT 0)
Spaceboy what about setting an alarm in the middle of the night to take a dose?
Posted 4/13/2021 2:17 PM (GMT 0)
Thanks for the idea. I am sort of an insomniac, and waking up in the middle of every night would be problematic. What I am trying to do for the present is to take two doses with an hour or so in-between them in the middle of the day, a few hours past breakfast. I generally skip lunch anyway, so I have the time there. I eat dinner at a normal time, and then a few hours later get another dose in before I go to sleep. Hopefully this will work for now....
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