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Q: My doctor prescribed Cholestyramine for me and though it has really helped clean up the toxins from my Lyme disease, my gut has a hard time handling it for more then a week or so. Can Cholestyramine be safely used part time, long enough to mop up the toxins and then quit for a few weeks to give the gut a rest?

A: Many people will use sorbitol and proton pump inhibitors to guard against CSM side effects. If your GI tract rally won't handle CSM, then a substitute of Welchol (2 tablets) for a dose of CSM makes sense. Many people like welchol since it is a pill, taken with food and it doesn't have the same side effect profile that CSM does. I wouldn't slow down your treatment by skipping all CSM for two weeks, as you could be exposed to additional sources of mold and not know it.

Ritch Shoemaker, MD
Pocomoke, Maryland