Cholestyramine, Lyme

Cholestyramine, Lyme

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.


  • Kristin
    - Jan 25, 2018
    Had to stop cholestyramine due to that intensification thing. It's been three weeks and still not improving. Does any one know how long this reaction could last? Help please.
  • Charleah
    - Oct 23, 2015
    I believe this is what is happening to me. I have gotten much worse since I have started taken it. I feel suicidal. Please help. 919-602-7854

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