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» LymeNet Flash » Questions and Discussion » Medical Questions » Triple Therapy and Cholestrid/Welchol

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Author Topic: Triple Therapy and Cholestrid/Welchol
Kat1777
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After seeing some immediate results with Doxy and then plateauing, my lyme doc has decided to switch me over to triple therapy for the summer.

He says this combo won't make me as sensitive to the sun (although that wasn't a huge problem for me on Doxy anyway). I'd like to know others' thoughts on this combination and what side effects I should be on the lookout for.

Zithromax (once per day), Plaquenil (twice per day) and Minocycline (once per day).

He's also going to try me on Cholestrid (I think that's how it's spelled), the generic tablet form of Welchol. He's warned me about constipation.

How likely and bad is that side effect? I'm debating whether to wait on filling that script.

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TF
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You will definitely have constipation with the Welchol. For some, this side effect is unbearable.

If it were me, I would take laxatives right along side of the Welchol.

My husband (doesn't have lyme) was given Welchol pills by his doc to lower cholesterol. He took 2 pills and the next day he was furious! He never suffers from constipation, but Welchol stopped him up badly. He refused to take any more of the pills. (My husband never has a problem with constipation. So, this was unbearable to him.)

This is typical. One lady posted on LymeNet that she ended up in the hospital due to this side effect.

You see, you get bloating along with that--your intestines are blowing up like a balloon. Just recently a lady posted about how ill her hubby became with one day of taking Welchol. So, be sure to take laxatives along with it.

"Cholestyramine should be taken two to four times daily, and Welchol is prescribed at three pills twice daily.

While the latter is obviously much simpler to use, it is less effective than cholestyramine. The main side effects are bloating and constipation, best handled with increased fluid intake and gentle laxatives." (page 13 of Burrascano Guidelines)

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Kat1777
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I don't think I'm going to fill the script then. (Although I'll wait and see if there are any other positive experiences before I make the final call.)

He wants me to take three tabs a day. So I'll be stuck with a bottle of 90 pills if it's too much for me. It's a generic, at least, but still money down the drain.

And I'm not one for adding another pill to the mix to counteract another one. He says it will help with the brain fog. It would have to produce some pretty spectacular results in that regard for me to tolerate unbearable constipation.

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treeinatree
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Here's a positive vote for CST or Welchol. I haven't taken Welchol, just cholestyramine. LLMD warned me it can cause gas, bloating, constipation. My GI is fairly sensitive but it did none of those things to me. (I took one dose per day instead of two because of timing).

As was suggested in the presentation "Shoemaker for Dummies" at this year's ILADS conf, I started VERY slow. One dose of 1/8 teaspoon and up from there.

For a few days there was...not constipation, but delayed urge to stool by a few hours each day.

On the best days on CSM, after bm I would feel fabulous, like I had just gotten rid of something terrible. It was quite strange!
I am taking a break while I narrow down the cause of a different side effect, but I really like it.

Tree

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TF
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These meds pull toxins (poisons) out of your system. So, they can do great things.

Why not find out the price of the generic. Then, just take lots of magnesium along with the pills. (Actually, you can't take meds or supplements at the same time as the Welchol because it will just suck them up and take them out of your system. So, you take the magnesium a few hours before or after the Welchol.)

You can also ask what it would cost if you just bought 30 or 10 pills right now. That could be your test.

I would start with one pill per day for a few days until you figure out how much mag you need to take to stay comfortable.

The doc must think your brain fog is from toxins, so I would definitely give this med a try if I were you.

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RC1
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That is a really good protocol, I've done it, still do it actually, plus a few other things. Welchol gives me no trouble at all. It's awesome for binding the toxins.
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Lymetoo
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It was just as bad as the CSM for me. Awful.

--------------------
--Lymetutu--
Opinions, not medical advice!

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Kat1777
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Okay, so that's two positives and two negatives. You all aren't helping me very much. [confused]

These are tablets if I understand correctly, not capsules. So that means I can split them and start REALLY slow, right?

I've done some online research and seen some things that make me sort of want to try them. Plus, only about 10% of people in one large study listed constipation as a side effect.

I've got plenty of Vitamin C and Magnesium to help if necessary. What's a few more pills? [loco]

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OtterJ
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KAT, Welcol and cholestyramine are used as binders. Although I am not taking any, they bind the toxins released by the dying bugs. I know a woman in my support group who uses apple pectin. Some here have taken a type of clay. You may need these so you don't herx badly. I also can't imagine not being sun sensitive on minocyline. I would err on the side of caution before I knew what effect the sun had on you.
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TF
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Here is a recent relevant post for you to read:

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/124367#000001

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RC1
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Just start it slow. A dose of Welchol is three pills, I would just do one for a week or so then add another go another week, then the last one.

If you get constipated just use Metamucil. It's really worth doing, just make sure you space your abx and supplements far enough away so that it doesn't bind to them.

I was only able to fit in one dose a day of Welchol or CSM, I've done both, because of the time needed in-between meds.
It still works better than anything else even if you do only one dose.

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treeinatree
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Just know that they work by a different process than other binders, so may be able to get things you couldn't get out any other way. If you have had 23andme or Shoemaker genetic tests you can know more about whether they are especially indicated for you. Or you can just try it out [Smile]

The key is to start very slow and ramp up. Since it is not abx, there is no harm in doing that.

Tree

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RC1
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Dr. S says he gives it to people whether they have the bad detox genes or not...he's the expert in this stuff, it was his discovery.
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