Herx without fever? Flare up? Hypoglycemia?

I forgot to mention I started Cryptolepis 4 days ago and resumed NAC a week ago. I took 7drops yesterday morning and 6 in the evening.

It’s important for me to know if it’s a herx or flare because I have to decide if I’m starting Mepron tomorrow.

Quin, thanks for the info, I didn’t know herxing could effect blood sugar. That’s interesting what you’re saying about the Cryptolepis because since posting I’ve eaten and drank juice and my blood sugar is still the same as when I got up (86ml/dl and I’ve checked it every 15 minutes). I’ll have to talk to my doctor about wether to stop it or not as she wanted me to keep on it to help mitigate the Mepron herx and increase Mepron’s efficacy.

My fasting blood sugar is always 80-83. That’s in normal range. I believe hypoglycemia is below 70. Did a doctor diagnose you with hypoglycemia, or were you thinking that’s what it is based on symptoms?

I was also thinking MCAS, like saraeli said.

saraeli,
Thanks for the response, that does kind of resonate with me, I’ll definitely have to look into it. Do you if there is any real way to tell whether it’s MCAS or herx without testing?

I’m glad to hear not all herxes have fevers because I was really starting to get concerned.

Girlie,
Thanks for the response, that makes me feel a lot better to know a herx doesn’t mandate a fever.

Quin,
That’s good to know, my doctor mentioned I might be low on B12 but I forgot about it with everything that’s going on.

Claritin might ease symptoms of MCAS especially if they are respiratory, and some do find it helpful. If you can't avoid triggers, though, it might not make much of a difference. (Like if you took a Claritin, then you might feel a bit better, but still would not react well to kombucha.) Each mast cell stabilizer might affect you differently, so it's best to try a few types until you find a good combination for you.

Other antihistamines and mast cell stabilizers to try, instead or in addition:
Low-histamine diet (for some, this is crucial, myself included. No herbs or meds are going to help if I am jacking up my histamine levels from within!)
Curcumin
Quercetin
Bromelain
H1 blockers (like Claritin)
H2 blockers (like Pepsid)
Stinging nettles (great as a tea)
DAO
D-Hist
ketotifen (Rx)
cromolyn sodium (Rx)

And avoiding triggers until your flare has passed. Limbic system retraining programs like DNRS and Gupta also can rewire the parts of your brain that are activating mast cells inappropriately.

In case it's helpful, here are some triggers to keep in mind:
Stress, overstimulation
Heat, sweating, saunas
Cold, shivering
Showers
Abrasive fabrics
Cardio exercise
Allergens (pollen, poison ivy, etc.)
Fragrances
Environmental toxins (cleaning products, body products, etc.)
Herxing, injuries, viruses
High-histamine supplements (some probiotic strains, lion's mane mushroom, etc.)
High-histamine foods (alcohol, anything fermented, anything aged, leftovers, citrus, tomato, vinegar, etc.)
Mold exposure

Some people can tolerate some triggers sometimes, but then reach a tipping point. Like you might be fine most of the year, but have MCAS symptoms when it's ragweed season and hot, for example. For a while I was tolerating some fermented foods well in moderation, after not eating them for years, but then I had an unrelated intestinal disturbance that caused irritation in my system and led me to react again. Usually a low-histamine diet, quercetin, and curcumin are enough to keep me feeling fine with regard to MCAS, but triggers added up until it flared, and I needed a few doses of cromolyn sodium to calm the symptoms.

I was diagnosed clinically (by someone with experience treating MCAS, based on signs and symptoms). During flares I have had elevated eosinophils show up on CBCs, but my LLMD felt like further testing wasn't warranted because my symptoms are so directly related to eating high-histamine foods, and therefore pretty obvious. There's some controversy about the tryptase and histamine tests for MCAS because they require precise triggering and timing to come out positive.

Zyrtec has been working well for me. I went to a dermatologist a couple weeks ago, and she recommended cutting the pill in half and taking half in the morning and half at night. That’s been good for me.

i think it was a Claritin derivative called desloratadine used in the study - claritin was much weaker.

no telling what the effects might be in people - and some are of course very sensitive to any medication or herb - having herx like reactions to even 1 drop of tincture for example -

as Quin mentions - even the effect of the stronger desloratidine were weak against borrelia - in the in-vitro study the doses for the much stronger desloratadine were huge for the measured anti-borrelia effects - many many times that achieved in people with anti-histamine oral use ( from memory maybe 50x normal therapeutic antihistamine dose?).

i also took deloratatine at normal antihistamine doses for 3 months in combination with Doxy - as that's what the study implied might be most effective ( desloratadine appeared to disrupt the borrelias ability to evade antibiotics in vitro by preventing it from forming cystic or persister cells properly) and its a very safe drug in normal doses - i did this starting a few days before the doxy.

i noticed no herx from the desloratadine alone and only mild improvement after around 3 months on the combination

*Update on what I figured out*
It's been a a while since I started this post, but I wanted to follow up with some of what I figured out in the hopes that it might help someone else out. The short and sweet of it is that I had chronic mold exposure (in: outlet next to the head of my bed, A/C, shower, under faucet I drank out of, in fridge water, pantry) and a Herx / Die off from Candida in my gut, combined with anti-biotic resistant chronic strep, Histamine issues / MCAS, and maybe Lyme, Bart, Babesia on top of it all.
As far as the Candida die off goes, I figured out that that is what it was only after months and months of thinking and trying to find answers. My theory was that when I went more than a couple hours without eating the Candida would begin to die off, and that it was in fact the toxins it was releasing that were causing my ill feelings that paralleled many of the symptoms of hypoglycemia. I tested this theory by fasting and taking a binder when I got symptomatic. After 3 hours the anxiety, sweats, shakes, weakness, and hot feelings came on, but I stuck with my plan and drank some bentonite clay as my binder of choice. After 45 minutes, I started to feel better and within two hours I was feeling good without any weakness or anxiety. To be quite honest I was feeling on top of the world because up until then I had thought I was going to be stuck with the knowledge that a few hours without eating was all it would take to knock me out, and my fear was that those symptoms would get worse and worse until... (you get the picture). I am planning on making a post outlining how I was able to differentiate the symptoms of candida and strep, but I don't recommend fasting and taking a binder like I did until you are sure it is not related to hormones, blood sugar, or another illness and you have talked with your LLMD.

For the Strep, it was only recently that I realized I had likely been battling strep on and off ever since I was diagnosed with Lyme. My LLMD always wrote off the high strep markers when we would test, because she believed that the anti-biotics I was on would kill the strep, and that since the throat swabs always would come back negative, it must mean that it was a previous infection which I no longer had.
It is a long story, but it turns out that the form of Strep I have does not seem to respond to: Amoxicillin, Augmentin, Azithromycin, Cephalexin, Clarythromycin, Cephdinir, Minocycline, or Doxycycline and does not return positive on swabs. For Augmentin and Cephalexin, they both worked within 48 hours the first time I took them, and I instantly felt better than I had in months, but on the second go around they were less effective, and by the third I couldn't tell a difference and had to switch to something else. Moral of the story there is that you can have strep that only shows up in Igg blood serum tests and not throat swabs, and is resistant to the antibiotics that "should work". I ended up getting a Bi-cillin shot this last time and am scheduled to get tonsils removed in less than a week. Also if you have chronic strep, Streptococcus salivarius K12 pro-biotic has been shown to be 80-90% effective at preventing recurrent infection (the NOW Foods pro-biotic tastes quite good in my opinion).

As far as MCAS goes, I started taking Low Dose Naltrexone, and that helped A LOT. Before starting it I had symptoms of POTS and would start sweating, get a rapid hear rate (140), and get extremely anxious if I sat in an upright positions for more than an hour. Standing up would make these symptoms disappear within a couple minutes. It also helped me to decrease my heat intolerance, and once I treated strep I was feeling better every day (until I got covid and then strep again, and now I am back to where I was nearly three months ago).

In regards to mold, I took the Great Plains Mycotoxins profile, and that is what alerted me to the mold issues.

So don't give up if you're reading this! And don't be afraid to think out of the box, it might not require Ozone IV therapy, a Rife machine, Christals, or no wifi, it's entirely possible that there really is a simple explanation that does have effective treatment, and you might not have found it yet. That seems like it is going to be true for me at least after 7 years of thinking it was an untreatable mysterious ailment. It was probably mostly Mold, Candida, and Strep (probably what let the Lyme in on top of it).

My weapons of choice: Chlorella, Bentonite Clay, Liposomal Glutathione, Ox Bile, Lumbrokinase, Low Dose Naltrexone, Mirra-Lax, Magnesium, Anti-Histamines

well done on finding a way forward - everyone here knows how challenging this is

for info
we had another member who developed lyme like symptoms and tested positive for lyme, babesia and bartonella only after an episode of strep throat.

his condition was resistant to most forms of lyme treatment - the more potent bartonella focussed treatments would trigger severe arrhythmias

he was later diagnosed with rheumatic fever ( a condition where a particular type of strep bacteria can damage the heart )

its interesting to hear of another case where step seems to be playing a role

some LLMD's like Dr J believe chronic lyme is really a "soup" of different infections, spirochetes, more conventional bacteria, fungal infections and parasites like Babesia, all cohabiting inside the host in biofilms and disrupting the hosts immune system to keep them sick.

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for general info
i have positive serology for lyme and bartonella confirmed by direct microscopy of blood smears - but i rarely have signs of fever when experiencing herx like reactions - unless they are very severe - so maybe only once or twice in all the years i have been treating

ref the desloratadine and claritin - in the single study that found an effect on borreilia - desloratadine was found to have stronger anti-spirochaetal effects than loratadine(Claritin) - but these were only found in the lab at concentrations of around 50x those achieved in humans with normal doses of these drugs.

I was really surprised at how much herxing I got from claritin. While desloratadine alone is not enough to kill borrelia at normal doses, in combination with antibiotics it is much more effective.

As has been mentioned, the herx does not always cause a fever. I would get sweating, increased heart rate, adrenal stress, and polyuria.