A herx reaction is an abbreviation for a Jarisch-Herxheimer reaction which is named after the two people who discovered this process. In summary, it is an inflammatory response which produces cytokines due to the interaction of the immune system with microorganisms and their toxins as a result of killing these organisms with antibiotics or natural products. Whew! What a mouthful! Quite simply, they are “die-off” reactions. If you have Lyme disease, you will often have a herx reaction with treatment.
The symptoms can be quite diverse, such as headache, fatigue, pain, fever, brain fog, rashes, depression and anxiety. You can have one symptom or many symptoms. You may have experienced that symptom in the past or it may be new to you. The herx may last a few minutes, a few days, or a few weeks, and occasionally even longer. Herxes can also be very serious and even life-threatening. Each person is unique in their response to herxing.
Most ILADS physicians - including Dr. Richey - believe that the risks of chronic infections far outweigh the risks of herxing.
Nevertheless, herxing should be and can be minimized
by weaning up slowing on killing products (medication and/or natural products) in order to produce less cytokines and by using adequate amounts of detoxification
products in order to eliminate the cytokines responsible for the herxing. You do not have to - nor should you - suffer through significant herxing. Herxes can be managed to minimize discomfort.
Specifically, she will suggest that you start on a sufficient amount of detoxification products to make sure that your detox pathways are wide open so that cytokines can be easily eliminated. Then, she will ask you to slowly wean up your killing product (antibiotic and/or natural product) as tolerated. If you herx too much, she will slow your killing even more and/or increase your detoxing. If you herx a lot, she will most likely stop your killing for awhile while continuing to detox. Then, she will add back your killing when you can better handle it. Eventually, you will learn to be your own best doctor!
During this process, it is important that you do not add any other killing products on your own. If you choose not to detox simultaneously, then you need to wean up on your killing products even more slowly and healing will take even longer.
Yes, it may seem complicated, but Dr. Richey will explain everything in much more detail during your first appointment, and she will help you through the process during your treatment.
If you are a patient and if you are having problems with herxing, then please contact Dr. Richey for assistance. Let her know everything that you are taking including how much and how often so that she can provide you with specific recommendations.
Management of the herx reaction is highly individualized, and Dr. Richey will guide you every step of the way.