The Jarisch-Herxheimer Reaction, or herx reaction for short, is a reaction to endotoxins released by the death of harmful organisms within the body. The release of these endotoxins occurs much faster than your body can remove them. This reaction was first discovered by Adolf Jarisch of Austria in 1895 and a few years later confirmed by Karl Herxheimer of Germany. Both were dermatologists, and the two both observed reactions in treating syphilis patients with mercury.
They both noticed that when the mercury was used to kill off the syphilis bacteria, the bacteria’s death triggered a release of these endotoxins in which contaminated the patients blood and tissues. This reaction to the toxins caused patients to have worse or different symptoms than to begin with, and they would feel worse. The patients would still feel sick until the toxins were released from their bodies. Syphilis was later treated with penicillin, and the same reactions occurred.
It was first thought that the herx reaction was from syphilis alone, but now more diseases, such as Lyme (also a spirochete bacteria) have been proven to have the same reaction.
That is why when a Lyme patient says that you get worse before you get better, this is what they mean by that. It is hard for people to believe it, however, as I have explained it dozens upon dozens of times to people who see myself getting worse, it is NOT the antibiotics that are causing my symptoms to worsen, it is the die-off and the toxins in my body. Not only do we get the pleasure of being sick, we get to get even sicker before we get better… yayyyy!
Some other diseases that can carry a herx reaction are Bartonella, Q fever, Leptospirosis, Babesia, and Rheumatic diseases. If you have any other tick-borne infections, you can be in for a real treat!
Sometimes it can take a day, or even weeks to experience this phenomenon. Some don’t experience them at all. For myself personally, depending on the medication, can definitely experience a herx reaction in less than a full day.
Symptoms can range in a multitude of ways. Sometimes it is flu-like symptoms and worse pain issues, sometimes your symptoms are exacerbated, and sometimes new symptoms can arise that you hadn’t had before. It can be difficult to distinguish if you are having a herx reaction or a symptom flare. An easy way to distinguish this is to know that Lyme disease progresses very slowly. If you all of a sudden have a very new symptom that you didn’t two days ago, and it only lasts for a day or two, you are likely experiencing a herx.
It is also good to know if you are having a DRUG ALLERGY or a herx reaction. Also can be confusing. Two good ways to tell are your EOS% on your bloodwork… greater than 30% is probably an allergic reaction. Herx reactions can also tend to linger for weeks and weeks, while a reaction generally subsides after a few hours. Herx reactions can also cause rashes. If the rash shows up immediately, likely an allergy. A few days down the road, more likely a herx.
Interesting information for you ladies out there, I was recommended to go on birth control, to quit ovulation as symptoms tend to flare or herx reactions can become worse when you are ovulating. That seemed very true for me as my symptoms always tended to flare right after my time of the month. I also had very painful periods, and had a lot of ovarian cysts, which is common among women with Lyme, and birth control helps shrink them. I went with the depo provera shot, which works out since I get a shot once every 3 months. All the while preventing pregnancy! Probably the last thing on my mind for getting the birth control shot these days… LOL
There is a lot of controversy as to if it is a good thing or a bad thing to have a herx reaction. Some doctors feel Lyme patients should not have any herxing. However, without herxing, you might not be having an aggressive enough treatment to be killing the bacteria. Some people don’t always have the same herx reactions or intensities as everyone else though. You are also more likely to have worse herx reactions if you have had the disease for much longer. You are going to have more bacteria to die-off if you have been sick for 20 years versus 6 months.
The good news is, it is a scientifically proven fact you know a treatment is working if you are experiencing a herx reaction. It is very important to know there is a BALANCE. You should NEVER be having severe herx reactions. This can in fact be far more damaging than good.
Always better to ask your doctor about this one. I was always too afraid to complain until either Dave or my parents made me, and have definitely suffered way more than necessary. Every single time I finally sent an e-mail, I would usually get some sort of a “that’s not good!” and we changed game plans. Like I said, don’t be afraid to ask! A good doctor should be willing to help you along the way with any questions or concerns.
Dr J believes that herx reactions are a good way to indicate improvement and to see how a treatment is working. As I have mentioned before, his protocols are all pulse therapy. He wants to see how you are doing off of the antibiotics. If you relapse, it is a sign you are not ready to stop treatment. If you fail to have a herx reaction during treatment (his protocol is pretty aggressive), it is an even better sign as there is less to die-off! Makes sense.
Sometimes antibiotic dosages need to be altered because the herx reaction is too great. There are many tools to help ease some of the herxing such as aspirin, Benadryl, hot baths, minimizing stress as much as possible, getting enough rest and sleep, eating a well balanced diet, and drinking plenty of fluids.
The most important thing you can do is to detox. Your body is flooded with toxicity, and you need to rid yourself of the dead bacteria. I do the lactated ringer IVs on most of my off antibiotic days to help, but I know not everyone can do that. If you are on IV and do not to lactated ringers, I would strongly recommend you suggesting them to your doctor. Epsom salt soaks, lymph drainage massages, green tea, lemon water, Burbur drops, etc. are all great ways to detox.
Hope this helped some!
Have a good day! Just another manic Monday 😉
http://mylyme.org, https://chronicillnessrecovery.org/index.php?option=com_content&view=article&id=161,mdjunction.com,roadback.org, http://en.wikipedia.org/wiki/Jarisch-Herxheimer_reaction, lemonandlyme.com, http://biovedawellness.com/2010/02/the-herxheimer-reaction-feeling-worse-before-feeling-better/, http://www.jemsekspecialty.com photo courtesy http://www.tiredoflyme.com/the-herxing-zombie.html#.UjaIsxYTt1M