The Herxheimer Reaction

The Herxheimer Reaction is a short-term (from days to a few weeks) detoxification reaction in the body. As the body detoxifies, it is not uncommon to experience flu-like symptoms including headache, joint and muscle pain, body aches, sore throat, general malaise, sweating, chills, nausea or other symptoms.

This is a normal — and even healthy — reaction that indicates that parasites, fungus, viruses, bacteria or other pathogens are being effectively killed off. The biggest problem with the Herxheimer reaction is that people stop taking the supplement or medication that is causing the reaction, and thus discontinue the very treatment that is helping to make them better. Although the experience may not make you feel particularly good, the Herxheimer Reaction is actually a sign that healing is taking place.

What Is The Herxheimer Reaction?
The Herxheimer Reaction is an immune system reaction to the toxins (endotoxins) that are released when large amounts of pathogens are being killed off, and the body does not eliminate the toxins quickly enough. Simply stated, it is a reaction that occurs when the body is detoxifying and the released toxins either exacerbate the symptoms being treated or create their own symptoms. The important thing to note is that worsening symptoms do not indicate failure of the treatment in question; in fact, usually just the opposite.

A Rose By Any Other Name
Technically known as the Jarisch-Herxheimer Reaction, this syndrome goes by many names, including JHR, the Herxheimer Effect, the Herxheimer Response, a Herx Reaction, Herx or Herks. The most common terminology used is the Herxheimer Reaction. It is also often referred to as a healing crisis, a detox reaction, or die-off syndrome.

History
The phenomenon was first described by Adolf Jarisch (1860-1902) working in Vienna, Austria, and a few years later by Karl Herxheimer (1861-1942), working in Frankfort, Germany. Both doctors were dermatologists mainly treating syphilitic lesions of the skin. They noticed that in response to treatment, many patients developed not only fever, perspiration, night sweats, nausea and vomiting, but their skin lesions became larger and more inflamed before settling down and healing. Interestingly, they found that those who had the most extreme reactions healed the best and fastest. The patient might be ill for 2-3 days, but then their lesions resolved.

A Medical Example
The Herxheimer reaction is caused by the release of toxic chemicals (endotoxins) released from the cell walls of dying bacteria due to effective treatment. The Herxheimer Reaction is well recognized in medical circles and is certainly not confined to the world of natural medicine or supplements.

For example, a recent study report (Feb ’04) on the treatment of Sarcoidosis found that,

“. . . without exception, the improving patients are reporting periodic aggravation of their symptoms as an apparent direct response to the antibiotics. In other words, these patients say that their treatment makes them feel much worse before they experience symptom-relief.”

The abstract of the study goes on to say,

“This phenomenon is known as the Jarisch-Herxheimer Reaction (JHR) and is often referred to informally as Herx. JHR is believed to be caused when injured or dead bacteria release their endotoxins into blood and tissues faster than the body can comfortably handle it. . . . This provokes a sudden and exaggerated inflammatory response . . . . In Sarcoidosis patients, the Herxheimer reaction seems to be a valuable indication that an antibiotic is reaching its target.”

In the conclusion, the author states:

“In my work with Sarcoidosis patients, it is my experience that recovering MP patients understand and welcome the Herxheimer reactions even when they must endure temporary increased suffering. They accept it as the price that they must pay in order to get well and they even seem to find it gratifying to experience tangible evidence of bacterial elimination.“

The most common Herxheimer reactions are:

• Headache
• Flu-like symptoms
• Itch and rashes
• Flushes

Usually, the reaction lasts a few days. In more severe cases, reactions can last a week or more.

In most cases, the reaction tends to be mild and barely noticeable, but there are exceptions, particularly in cases of severe infection. Certain conditions, such as Multiple Sclerosis, Lyme Disease and other spirochetical illnesses can engender noticeable Herx Reactions as the disease-causing pathogens are killed off.

Herx reactions vary widely, depending on many factors, including the general health of the individual, the condition being treated, the degree of toxicity that exists in the body, and the support the body is provided in eliminating the toxins as rapidly as possible.

Clarification
The severity of the Herx reaction is often an indicator of just how much toxicity there was in the body to begin with and is an indicator of the effectiveness of the treatment. It is actually a sign that the body is restoring itself to good health.

Time Frames
There is differing data on the timing of a Herxheimer reaction. Some data indicates that it usually occurs between four and 24 hours from the onset of treatment. Others note that between Day 3 and Day 5 of a treatment program is often when the reaction is most noticeable. What appears to be most accurate is that reaction times — and indeed whether there will be any reaction at all — are strictly dependent on the individual being treated. Duration of the reaction also varies widely, from an hour or a few hours to days or even a week.

What To Do In The Event of a Herxheimer Reaction
If the reaction is mild enough that it can be borne without grave discomfort, the best approach is to continue treatment and assist the body in eliminating the toxins as quickly and as thoroughly as possible.

If the reaction is too severe, cutting back on the frequency of use can be very helpful in lessening symptoms but allowing the healing process to continue. Sometimes stopping for a day or so and then beginning again can allow for quick relief.
The best assistance for the body is drinking plenty of ReHydrate water
Other helpful suggestions include:

• Getting plenty of sunshine
• Minimizing exercise for the detox period
• Keeping the organs of elimination (the bowels, lungs, skin, kidneys, lymph) functioning properly
• Keeping the diet relatively pure during the detox period so that the body is not loaded with additional chemicals and toxins to eliminate while it is already working hard.

Adding lemon to the water, taking cold press olive oil first thing in the morning, taking sea salt baths and/ or steam baths and saunas, plus liver and elimination system supports can also be helpful, though any herbal supplements should be kept to a minimum and should be very mild and gentle in nature.

Conclusion
The most important advice in relation to the Herxheimer reaction is to “bear with the process”. The reaction is usually over within a few days and is well worth the cleansing and healing results. Plus, it is a sure sign that the treatment is doing its job and working to help restore the body to natural health!

Warning: Any serious symptoms such as cardiac irregularity; breathing difficulties; chest, lung or throat constriction; significant swelling; or other severe symptoms should be given immediate medical attention. These symptoms could be unrelated to treatment and could be caused by some other serious condition.