CHOLESTYRAMINE (CSM)
Updated: 6 days ago
I haven't used CSM in my mold treatment for a while, but I tolerated it fine. I used remedies to keep things moving while I was on it. I took CSM in the morning and my other binders in the afternoon.
Cholestyramine (CSM) is a prescription binder that comes up a lot for mold and biotoxin illness. Here is what my trusted mold doctors share about it, so you can talk with your doctor about whether it is right for you.
A quick-view graphic with the key points is at the bottom of this post.
The supplements recommended by Rise Above Lyme are listed at the bottom of this post for easy shopping.
WHAT CSM IS
- A prescription powder you mix into a drink.
- Dr. Marty Ross calls it the strongest binder, and he often starts with it to see if binder treatment will help.
- He explains it binds fat-soluble toxins.
WHICH MOLD TOXINS IT HELPS WITH
- Dr. Neil Nathan finds CSM is best for ochratoxin, and not a good binder for many other mold toxins.
- Dr. Ross lists it as a top binder for ochratoxin, and one of several helpers for trichothecenes.
- Other binders are matched to other toxins. See the full chart in my Binders post:
NOT EVERYONE TOLERATES IT
- Dr. Jill Carnahan shares that only about 20% of her patients tolerate high doses, so she rarely uses it.
- Dr. Nathan has shared that very sensitive people may only handle tiny amounts, spaced days apart, at first.
- Dr. Ross starts low and slowly increases week by week.
WELCHOL, THE OTHER PRESCRIPTION BINDER
- Dr. Nathan and Dr. Jill Crista list Welchol alongside CSM for ochratoxin.
- Dr. Nathan has shared that he prefers Welchol over CSM.
HOW TO TAKE IT
- Dr. Ross suggests taking medicines and supplements at least 30 minutes before CSM, or 2 hours after it.
- He says you can eat anytime, but about 30 minutes after CSM is ideal.
- Dr. Ross also uses curcumin, starting a week before binders, to help calm inflammation. Learn more here:
KEEP THINGS MOVING
- Binders can be constipating. Dr. Jill Crista says no binders if you're backed up.
- Dr. Nathan uses magnesium and vitamin C to help with constipation from binders.
- My Lyme literate naturopathic doctor had me take constipation remedies right along with my binders.
- More ideas are here:
PLEASE BE CAREFUL
- CSM is a prescription. Talk with your doctor about whether it is right for you.
- Binders can also bind nutrients, so ask your doctor about timing with your medicines and other supplements.
HOW TO BUY AT 25% OFF
CSM and Welchol are prescriptions from your doctor. The products below are for keeping things moving and for Dr. Ross's curcumin tip. Anyone can get 25% off when signed up under the Rise Above Lyme Fullscript discount:
Magnesium (Citrate) by Pure Encapsulations:
Buffered Vitamin C Capsules by Allergy Research Group:
Kiwi Kleanse by Priority One (chewable):
Theracurmin HP by Integrative Therapeutics (curcumin):
RELATED POSTS
Binders:
Detox Solutions:
Constipation Solutions:
Turmeric / Curcumin:
ALL MOLD AND CIRS POSTS
Mold Directory:
Mold (education):
Mold - Possible Solutions:
Steps to Overcome Mold:
Mold and Lyme Treatment Order:
CIRS and Related Mold Issues:
Find a Mold Literate Doctor:
EC3 Micro Balance for Mold:
Binders:
MMP-9:
NeuroQuant MRI:
SOURCES
Dr. Neil Nathan, Two Perspectives, One Mission: Advancing the Conversation on Mold Illness and CIRS (2026)
Dr. Marty Ross, Mold Toxin Illness in Tick-Borne Diseases (updated 2026)
Dr. Neil Nathan with Dr. Jill Carnahan, Toxic Mold Revisited: Mold and the Highly Sensitive Patient (2026)
Dr. Neil Nathan and Dr. Jill Crista, A Comprehensive and Practical Review of Mold Toxicity (2021)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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