General Protocol

The first step in our process is diagnosis. That involves the on-line test and then a visit to a participating care provider, who will examine you and determine what blood tests are needed. The different tests that may be required depend on your exposure history, your symptoms and your on-line test results. The labs are listed in under the 'Testing" menu. Please note that some of the samples must be sent to the laboratories listed or your results cannot be interpreted against our large database of other patients and our peer-reviewed data. It is a bit of extra work to use these other laboratories but it will speed your diagnostic and treatment process.

Steps of Treatment

Once a diagnosis has been made, the next step is to begin treatment. The very general steps are as follows (please note that each individual is different and their treatment protocol must be tailored to their needs. The following information is not intended as medical advice, but only as a general overview of what to expect during treatment.):

1. Begin cholestyramine (CSM) or Questran treatment. We have found that CSM powder works best. If Lyme is indicated, we consider treatment with Actos, since the mobilization of the Lyme biotoxin is especially hard to endure for many patients. Actos helps to prevent the cytokine storm and prevent TNF and MMP9 from increasing. Actos is not risk free, so with this, or any other information on this website, please consult your care provider.
2. Treat hormonal imbalances.
3. Treat underlying infections.  These include: multiply antibiotic resistant coagulase negative staphylococcus (MARCONS) which is very often present in the nasal cultures of biotoxin patients, re-activated viruses, yeast, Lyme (Bb) and co-infections, and mycoplasma.
4. Monitor progress with bloodwork and repeated follow-ups using on-line BIRS© tests.   

What is Cholestyramine (CSM) and How Does it Work?

Cholestyramine (Questran, Questran Light, Cholybar) is a bile acid sequestrant, which binds bile in the gastrointestinal tract to prevent its reabsorption. It increases removal of bile acids from body by forming insoluble complexes in intestine, which are then excreted in the feces. When bile acids are excreted, plasma cholesterol is converted to bile acid to normalize bile acid levels. The conversion of cholesterol lowers plasma cholesterol concentrations. Bile acid sequestrants are primarily used to treat hypercholesterolemia, but can also be used to treat the pruritus, or itching, that often occurs during liver failure due to the liver's inability to eliminate bile.

Ritchie Shoemaker, MD, pioneered the use of CSM for biotoxin removal. Although CSM is primary used to lower cholesterol levels, he petitioned the FDA for an exception for the use of CSM to treat patients exposed to biotoxins. The FDA determined that an exception was not required since dosing was similar to that for approved uses. Since then, CSM has rapidly gained acceptance among specialists treating biotoxin related illnesses.

The risks of using CSM are fairly low. Since the drug does not enter the bloodstream there is little chance for drug interactions. However, CSM must be taken several hours away from other medications or it may bind them as well. CSM will also bind 'good' fats and minerals so if extended therapy is indicated, supplementation should be considered.