Are there problems with Lyme patients taking cholestyramine?
In 1999 I was surprised to see that Lyme patients (as opposed to mold, dinoflagellates or cyanobacteria patients), experienced the marked worsening of their clinical status when they started cholestyramine. This reaction, one that I called intensification to separate it from a Herxheimer reaction, occurred commonly at dose 6-10 of cholestyramine or day 2/day 3 of treatment.
An investigation into the cause of this intensification lead to development of the Actos and the Omega 3 protocols for pretreatment to block excessive release of TH1 inflammatory responses. These responses primarily are related to proinflammatory cytokines and are best measured by MMP-9. With pretreatment, the intensification reaction can be blocked and cholestyramine can be tolerated in Lyme patients much as it is in other inflammatory conditions.
The intensification reaction will lead to a fall in scores on Column E and a rise in MMP9.