Written by Dr. Julie Moore, ND
A Herxheimer Reaction is a temporary worsening of symptoms following treatment for certain infections. Also know as a ‘Herx’ or a ‘Die-off’ reaction, it is caused by the release of endotoxins from bacteria that have been lysed by antibiotics or the immune system leading to additional inflammatory symptoms.
This includes but is not limited to patients undergoing treatment for chronic Lyme disease and it’s Co-Infections (Bartonella, Babesia, Erlichia, Anaplasmosis, Mycoplasma). Underlying most symptoms of people with chronic Lyme disease is chronic inflammation, when a sudden release of endotoxin flares this inflammation; the result is a worsening of existing symptoms.
The symptoms can be extremely debilitating and severe. For people experiencing this for the first time, it can be frightening and has lead to many late night trips to the hospital. Once people become familiar with their Herx symptoms, when to expect them, and how to manage them, it can actually be a welcome event as it signifies the treatment is working and progress is happening!
Herxheimer reactions have been known to occur at the onset of treatment, but can take anywhere from a few hours to several days to develop. Patients will often notice a cyclical nature with Herx flares happening every 2-4 weeks. This likely represents the life cycle of the bacteria, as most antibiotics are effective only as the bacteria is actively replicating. Any change in treatment plan such as switching antibiotics or herbs is also likely to elicit a Herx. Because of the sensitive nature of microorganisms, just about any change that causes stress to our bodies can affect them, such as a full moon, altitude change, or stressful event. Even exercise causes a Herx in Lyme patients, as the bacteria are sensitive to the increase in oxygen in the tissues. For that very reason, exercise is an important part of treatment, but only in the correct ‘dose’; enough to kill bacteria, but not too much that the Herx is unmanageable!
There are both preventive and immediate measures people can take when undergoing these treatments. The main goals are to quickly detoxify to assist the body’s removal of endotoxins, control inflammation, and settle a reactive immune system.
Preventatively, an integrative approach to managing Lyme and chronic infections is important. Using treatment protocols that not only kill the infection, but also consist of ongoing detoxification and inflammation support.
• Maintain an anti-inflammatory diet
• Constant detoxification support
• Managing gene mutations that lead to decreased detoxification and increased inflammation (MTHFR gene deficiency)
• A positive attitude (this can be the hardest but also the most important, as brain fog, pain, fatigue and depression are almost always present during a Herx)
Immediate treatments for Herx help to bind toxins, rapidly detoxify, and control histamine-release. Some people experience flu-like symptoms such as chills, fever, sweats, and allergic symptoms (especially in people who are prone) however these are not true allergies. The following is a list for acute management of a Herx, but many suggestions are great for anyone looking to increase detoxification pathways and control inflammation!
• Vitamin C
• Warm lemon water
• Baking soda bath (2-4 cups per bath)
• Filtered water (lots!)
• Castor Oil Packs
• Organic coffee enema
• Infra red sauna
• Bentonite or Psyllium