Too many times I see clients unnecessarily suffering from what is called the Jarisch-Herxheimer Reaction (or “Herx”).
What is a Herxheimer Reaction?
Traditionally it was defined as a negative, transient reaction to antibiotic usage in tick-borne or syphilitic illnesses. A person could react with skin rashes, fevers, flu-like symptoms, headaches, muscle pain, and even (very rarely) death. This usually occurs within 24-36 hours of taking the antibiotic.
More recently, the term “herx” has really been broadened into any negative reaction to killing off “bad bugs” – Can be pathogens, yeast/Candida, SIBO, etc. Many people now refer to it as “die-off” symptoms.
When “bugs” are killed their cell wall collapses and they release an endotoxin into the bloodstream, gut or wherever they die. If antibiotics (even herbal) are given rapidly and in high doses one is much more prone to the Herx reaction. The remnants of dead/dying microbes create the release of inflammatory cytokines causing this cascade of negative reactions. While the body is attempting to remove these toxins, the load is just too much for some and they react – some horribly and miserably. Symptoms can be those mentioned above or digestive like bloating, diarrhea, abdominal pain, etc.
Let’s break this down more.
The whole idea is to get rid of the “bad bugs”. If the routes of elimination aren’t open properly (kidneys, liver, digestive system and skin) or we are killing too fast for the body to handle (OR BOTH) then we are bound to face some problems!
Many think a Herx reaction is not only necessary but a good thing! That it’s a sign that the bacteria are dying and you have less of them to deal with. I understand that thought process but is a Herx Reaction necessary? Can it be avoided?
Let’s think this through! As practitioners wouldn’t it first make sense to remind ourselves that there is the possibility of a Herx Reaction? To think through a treatment plan and contemplate this as a potential outcome of the treatment plan is important vs. just making a client unnecessarily suffer through it by good too hard and/or too fast. Common sense, right?
I have a ton of clients come to me with worry about having a negative reaction to a treatment plan due to “die-off” they have experienced with other practitioners.
What I always say – if you have “die-off” symptoms then we aren’t doing something right! You don’t NEED to have “die-off” symptoms. A proper protocol and working slow and steady usually does the trick!
Once again, our goal to rid the body of these “bad bugs” but what we have to remember is that simply killing the bad bugs doesn’t stop the problem long-term. If they got into the system once, they can do it again.
Too many doctors focus on “killing”. Yes, that’s important however you don’t ALWAYS need to directly kill the bad bugs with antibiotics (herbal or pHARMa).
A BETTER FOCUS: Instead of the focus on “killing the bad guys” what I do is focus on building up the “good guys” and they in turn take care of the bad guys – in other words they do their job!
Here’s an analogy for you with regards to something like SIBO (Small Intestinal Bacterial Overgrowth): SIBO is really a bunch of opportunists taking advantage of a lack of good guys to keep them out. It’s like leaving your front door open and posting a sign out by the street for all those walking by that says “PARTY! COME ON IN – FREE FOOD IN HERE!”. So, those walking by decide to come on into your home and into your kitchen and start eating your food. It’s a party, right?!?!
These aren’t “bad guys”, but they are taking away your resources as they eat your food and leave their garbage all over your kitchen and prevent your access to your own refrigerator and food. Now you aren’t thriving because you aren’t able to eat your own food and your kitchen is a trashy mess!
You can spend your energy and time kicking out the opportunists in your kitchen making a mess but unless you close your front door and take down the sign they will continue to come back.
Now back to the gut…the SIBO bugs are there because your gut microbiome isn’t strong enough to keep them out. Simply focusing on “killing” these bugs doesn’t solve things long term. But rebuilding your gut microbiome creates an army against any type of invader and keeps your resources for you. Many people with SIBO have a “die-off” experience and can be quite miserable – their doctors are focusing on just killing the bugs. Years ago, I switched to rebuilding the army that closes the door and keeps the opportunists out of the gut and have had rare Herx reactions and much better long-term results.
Why do some people “Herx” while others do not?
There are a few simple answers to this one and each treatment plan MUST address these:
- Their main routes of elimination are not properly open.
- Their endotoxin burden is already high.
- They have high gut histamine.
To view each individual as exactly that – an individual – is the key here. To review labs and approach a treatment plan as a brand-new process regardless of the findings because each person is different. To me there is no such thing as a specific treatment plan for “XYZ” because no two people are alike in how they present with “XYZ”.
We need to truly get back to individualized and personalized medicine.
We need to step back and think about things in a commonsense manner.
We need to focus on long-term goals and know that this can take time.
You come with your own unique history and presentation. Everyone needs a constant reminder that we cannot rush through healing – even the practitioner!
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