Herxing theories

So I've read that herxing means the meds/herbals are working and we should detox more or take a few days off and then continue.

I've also read that healing does not mean herxing and hurting.

Based on personal experiences, what do people think?

When I am herxing bad, I feel like a couple weeks later I am better than before the herx. A 2 steps back, 3 steps forward sort of pattern.

Thoughts?

I'm aligned with your thinking. Especially given your personal experience I'd say in your case the herxing is part of the healing process. You just never want the herx to go to redzone level or spiral out of control into a tsunami of endless continuous herxing. If you feel you make progress after herxes then that is a very good sign.

It may be a bit different case by case, depending on individual genetics (especially immune system genetics) and particular pathogen stew of the patients. Some people don't really herx. Others, like me, herx like heck. If I'm not careful they can get out of control and can be harmful (ie burn me out, make me feel like I'm going insane, spiral into continuous blackhole death herx). That's why I have to find ways to pace myself with treatments and always detox as best as I can. For my situation I think some level of herxing is inevitable, this whole process is like chipping away at a mountain but I eventually see gradual improvements after effective meds that make me herx. But it is a long process.

But also maybe both points are right. I do think going after the pathogens is important component, but you can also promote healing by therapies that boost immune system, try to tackle other angles other than the pathogens like metals, stress, adrenals, etc. So not all healing has to involve herxing. But for many of us I think herxing is part of the program, you just have to find ways to make it manageable.

So much of this is trial and error. I think you've figured out how things work for your situation and that is huge! There is still a lot we don't know about the exact mechanics of herxing (from what I've heard). Would be nice to have some more research on that to really get the nuts and bolts on the biochem, we basically have to go off anecdotal experiences and figure out patterns and strategies from that information. I think it is likely a combo of toxin release from pathogens getting nailed, body systems trying to process this toxin overload, and immune system getting riled up picking up all that pathogen debris and sending the system into high alert. That's my general intuition and understanding of this phenomenon.

I wouldn't pulse the herbs...just lower the doses maybe.

It can take a few days (or longer) after stopping the antibiotics for the symptoms to alleviate.

What it comes down to is that herxing is a good sign because it means it's working, but it's also damaging to the body. So you want to minimize it. Take smaller doses if you have to. Or push through it if you want. Just know that herxing is inflammation and inflammation is damage. Maybe it'll all heal and it doesn't matter. Some would rather rush it. But ideally, we can minimize risk by minimizing exposure to it

I personally don't recommend that. Ideally, unless youre intentionally pulsing, you want a constant stream of antibiotic in your system other wise you might end up treading water or worse leaving opportunities for pathogen adaptation. Better to lower the dose than lower the frequency. This is one of my many reasons i prefer herbs over abx. I can cut the dose into as tiny of a piece as i want. If you're making progress after every herx it might not be a big deal though. Sounds like your body is able to heal it. Just don't overwhelm yourself. As long as you feel it's helping i think that's the most important thing

Psilociraptor said...
I personally don't recommend that. Ideally, unless youre intentionally pulsing, you want a constant stream of antibiotic in your system other wise you might end up treading water or worse leaving opportunities for pathogen adaptation. Better to lower the dose than lower the frequency. This is one of my many reasons i prefer herbs over abx. I can cut the dose into as tiny of a piece as i want. If you're making progress after every herx it might not be a big deal though. Sounds like your body is able to heal it. Just don't overwhelm yourself. As long as you feel it's helping i think that's the most important thing

Pulsing is an accepted, tried and true way to treat lyme and co's.

One of the best and very experienced Lyme Docs only pulses...and gets good results.
But, he does prescribe full doses of the abx.

So happy to hear that Kat1000! well it is a lot of trial and error, finding what you can handle, what detox works and helps in your case. Some people don't herx as much, others it is brutal. We just have to find our pacing and whatever methods can help us manage the treatments. And I'm so happy to hear that you have such a great relationship and partnership with your doctor, that is ideal!!!

I think your attitude is right on (at least it mirrors my own). I feel herxing in my case is inevitable, I just have to make sure it doesn't get to the point where it launches me to outerspace. So long as I can keep it relatively corralled I'm cool.

Kat,
Thanks for starting this thread. Everyone's responses on this are so good.

It's great that you notice improvements after a herx - 2 back and 3 forward. I know when I've gotten better or busy and skimped on the epsom baths, it def caught up with me. The fact that you're wondering if you're herxing too much means you probably are. You'll just have to decide what action to take.

Inflammation is inflammation like others said, and it calls on the immune system's attention, which means its attention is then distracted to some extent from killing pathogens, IMO.

Sebreg's first response on this thread is sooo thorough and reflects my thoughts precisely.

I've often wrestled with understanding what is really happening in the body and wish there was more scientific facts known instead of a bunch of theories.

From what I sense of people's comments about what they call herxing, it's really just a worsening of some or all of their symptoms. I personally believe that can be caused by 3 separate things or any combination of these:

1) bacteria or other pathogens dying and releasing endotoxins
2) cytokines released by the immune system, whether that immune response is normal and healthy or whether it's abnormal and out of control
3) other toxins in the body such as mycotoxins, heavy metals, accumulated environmental toxins, etc, that are somehow affected by the treatment or by the immune system's response to the treatment

Personally, I sometimes believe I can tell which type it is by how it feels. My herxes tend to last longer than most, usually 1-2 weeks. The longest was 2 months. I never know how something will affect me, so I've learned to start low and go slow. Sometimes I herx right away, sometimes a week or more later.

I think it's because I went undiagnosed for years and likely have a stew of pathogens and environmental toxins. I also have a genetic predisposition to biotoxins. I'm sure it will take me a few years to get mine all unraveled.

i don't believe that herxing is what we believe it's now. besides the first week when you start IV antibiotics or something like mino, and gives you something that will send you to the ER. now THAT is herxing. When on mino 300mg a day, i called the ambulance at some point i thought i will die, i had 130 pulse and felt im going to suffocate, my head was pounding, half of face going numb and severe photofobia...

the night before i had psychological reactions, started crying uncontrollably (i am NOT the crying type, i did not cry or even close even when i found out i have lyme, so i had no reason to cry when i was going better during treatment!), nevertheless i was crying

that is herxing!

What we experience later i do not believe are herxes, they are some sort of autoimmune reactions started by the bacteria when it sheds coating. when lyme bacteria turns from a worm form to a spherical form it changes antigen, meaning some of the proteins in its coat change, probably the old coat gets thrown away, the immune system goes nuts after these and provokes an immune response. It's not only me who thinks this is true

lymemd.blogspot.com/2017/08/autoimmune-encephalitis-and-lyme.html

and i saw other famous LLMD, either Dr. H or P, saying the same thing.

If you think about it, how many bacteria can u really have inside you, how much herxing can u really do. There are people here on forum that are herxing "for years". That is NOT possible.

Post Edited (mpost) : 9/15/2017 10:10:09 AM (GMT-6)

Yeah Mpost you bring up good points. There really are only so many pathogens in the body, so it could be that the immune system is picking up a bit of pathogen debris due to therapeutic challenge and then gets sent into some massive red alert overdrive. Almost like a glitch in the immune system, but while I think immune system genetics plays a role I bet pathogens might also be skewing the immune system response as well, amplifying certain things and undercutting other aspects.

The thing is, my guess is that herxing is not a monolithic entity, I think it is likely a multitude of things with high variation based on particular pathogens and immune system make-ups. Some people have major issues with the detox pathways as well, so this exacerbates the situation or backs up the clog creating amplified herx responses even if not much pathogen is being derailed.

All I know is I've never been able to get around what I consider herxheimer responses. Effective meds bring out this response and it is slow and grinding but it is after those therapeutics that drive those responses that I eventually see improvements in my symptoms. I think it is because of my immune system and the particular pathogens I'm dealing with, coupled with genetics that may present issues in how my body detoxes. Also, no one can say the exact concentration of pathogen that resides in my system, I'm dealing with some form of bartonella/BLO and it is super responsive to therapeutic challenges. It could very well be there is a high pathogen load and that it affects the whole vascular system plus various other organs and tissues. The vascular system encompasses a hell of a lot of surface area so there is plenty of room for large amounts of pathogen colonization I think. I also think that the length and severity of my illness also plays a role in these treatment challenges and herxes.

Plus, as I've gotten further into treatment these herx responses have become less and less of an issue, I'm guessing this is due to the fact that there is less and less pathogen load. Earlier on in my treatment journey I could barely manage one small dose of monotherapy, I can manage much more aggressive therapeutic combinations now. This leads me to believe that the pathogen response to medication was the driving force behind my "herx" responses, whether they turbocharged immune storms or die off or whatever (I think it was combos of these things). As the pathogens get whacked over time they produce less and less "herx" response for me, probably because there is less pathogen there to respond the potential for severe herxing gets diminished.

Unfortunately no one can say exactly for sure. There just doesn't seem to be enough hard evidence or science on this phenomenon, and whenever there will be I think it is going to show us that there is high variance and multiple reasons for how and why this phenomenon presents, and presents differently on a case by case basis.

Btw Mpost thanks for that link to the LymeMD post. That is interesting how he parses things. I'm going to keep reading up on that, he might be on to something.

Post Edited (sebreg) : 9/14/2017 3:26:15 PM (GMT-6)

mpost said...
yes 1000Daisies is correct, so after a REAL herx, you feel MUCH MUCH better than before. and u feel as if u stepped out of some sort of dungeon of hell. people that come to this forum and chat all day about how they are herxing, with all respect, when i was herxing i was not able to read anything or i was worrying for my life, very little time to pay my respects to healingwell friends... now that's a herx.

dr neil spector talks about his first Ceftriaxone dose for lyme, i pinned the video exactly when he starts talking about it (took me 15 mins to find it, you owe me one gluten free beer ;) )
/youtu.be/MVmPAK-4Kfs?t=1903

When my herx subsides, I don't feel much much better than before the herx. Of course I feel better than I was while herxing though.

My symptoms are slowly dropping off one by one and no improvement happens immediately after a herx.

Herxing symptoms can be lessened with effective detoxing.

Girlie said...

When my herx subsides, I don't feel much much better than before the herx. Of course I feel better than I was while herxing though.

i did feel a huge different with the worst herxes i had. i was MUCH better than before the herx. so that is why im saying these flares i see in us on a weekly basis seem to be autoimmune induced and less herx.

We all like to think they are herxes because that means we are getting better

But it makes no sense. How much herxing can one feel over the years....

The articles you shared Girle are awesome, ill make sure to read them all. Thanks !!

In the treatment of relapsing fever (Borrelia recurrentis), antimicrobials are the drugs of choice.

However, following antimicrobial treatment, patients may develop a Jarisch-Herxheimer (JH) reaction, which can be severe, especially in louse-borne relapsing fever, when patients' host defenses may be otherwise compromised.

This reaction has been reported to occur in 50% of patients with tick-borne relapsing fever.

The JH reaction produces apprehension, diaphoresis, fever, tachycardia, and tachypnea with an initial pressor response followed rapidly by hypotension.

The JH reaction can be fatal.

------------------------------
http://www.academia.edu/29956740/Jarisch-Herxheimer_reaction_in_Lyme_borreliosis_treated_with_Josamycin

Another article showing severity of some Herxheimer reactions with Borrelia recurrentis.
Again, it says it is so severe that it can be fatal.