What’s a Herx? How do you know if you’re having one? And what do you do about it??

The Herxheimer reaction is also known as the Jarisch-Herxheimer reaction, the die-off reaction, or just ‘herx.’ The Herxheimer reaction is the reaction your body has to the Lyme bacteria as they die. When the Lyme (and co-infections) bacteria die, they release endotoxins. The body reacts to these endotoxins with inflammation from the immune system.

A Herxheimer reaction feels like a worsening of symptoms as opposed to feeling better immediately with treatment. Common symptoms associated with a herx are flu-like symptoms (fever, chills, body aches), headaches, digestive issues, nausea, and worsening of any other existing Lyme symptoms.

Typically, in healthy bodies, the immune system responds in a way that promotes healing by going after infections, but in the case of a herx, too many toxins are released and the immune system WAY overcompensates.

Think again of the dying bacteria as an egg smashed against a wall – each piece of the eggshell is an immune irritant. Since the egg has been smashed, the yolk and egg white are all over the wall now too. The yolk and white represent endotoxins in this metaphor. Endotoxins are inflammatory toxins. But they are different from the toxins most people think of.

The body responds differently to endotoxins than it does, for example, to toxins like alcohol or pesticides. Endotoxins are toxic to some degree, but mostly they get the immune system to respond with more inflammation, making it less focused on the actual infections, distracted and over-reactive.

Endotoxin driven inflammation is why many people that are treating their Lyme and co-infections first feel worse before they feel better. Endotoxins and microbial cell fragments are the cause of the Herxheimer reaction.

Why do some people herx and others do not:

Some people experience this Herxheimer reaction, where their symptoms get much worse before they get better, when they are treating the Lyme disease infection. Other people do not experience the Herxheimer reaction.

It comes down to genetics. Certain peoples’ immune systems are not equipped to handle the outcome of killing bacteria.

In this case, when a lot of Lyme bacteria are killed, the immune system is not able to recognize the pieces of the smashed egg, as we talked about in the metaphor earlier, so that these pieces can be removed. Instead, in these people, the immune system reacts with inflammation, making the outcome much worse for the person.

How to determine if you’re having a Herx:

A Herxheimer reaction is created when you’ve increased or changed your treatment protocol for Lyme disease and co-infections. But it can be really hard to tell if the difference between a herd, a flare-up, or other reasons for an increase in symptoms. Our guide may help you determine the cause of your increase in symptoms.

How to handle a Herxheimer reaction:

There’s a great rule to follow to minimize herxing: Pull it out, calm it down

  • ‘Pull it out’ refers to the detox support we recommend. Pull out the toxins that are causing the herx. Making sure you have regular bowel movements is really important for managing the Herxheimer reaction.
  • ‘Calm it down’…this refers to our tips to minimize inflammation and irritation which will help the symptoms of a herx.

Additional tips:

  • Make sure you are getting enough magnesium. Many people are deficient in magnesium and having adequate magnesium is important for having regular bowel movements.
  • Drink lots of water. Aim for light yellow to clear urine.
  • Supporting your lymphatic system will also help with herxing. See the section on Lymph for tips on how to move and support your lymphatic system. This will help reduce the symptoms of a herx by working toxins out of the body.
  • Decreasing inflammation will help mitigate a herx. These tips will help support your body while going through the Herxheimer reaction.
  • Alka seltzer gold, lemon water, and baking soda water all help reduce inflammation and support the body during a herx.
  • Herxheimer reactions can be very intense. If you’re not sure what to do, first contact your doctor, then review our guide for recommendations.