Candida or Herxheimer reaction?

Hello.

I started Bartonella treatment again after 1 week break.

After 3-4 days on Rifampicin 300 mg some of my symptoms started to get better - very bad, throbbing headache and tinnitius - and that dissapeared after 4 days on Rifampicin.

On day 5 I generally started to feel bit better, and my general well-being went from 2/10 to about 4-5/10.

Unfortunately, on Sunday (2 days later) I waked up feeling much worse, with new physical symptoms.

First of all, there were physical symptoms that I haven’t had for several months - very weak, huge daytime sleepiness / fatigue (I haven't had this for a very long time), feeling heavy legs and shuffling, very tired and completely lack of physical strenght.

In addition, strong itching of the skin, coating on the tongue, flatulence and the feeling of "collapsed" throat.

I was also recently staying with a family that smokes and I couldn't stand the smoke from cigarettes, so I don't know if that means anything.

For a few days I also had huge, probably the biggest memory problems since the beginning of treatment - I can forget about something I was thinking about 2 seconds ago, e.g. when approaching the fridge.

The rest of the neurological symptoms have gotten worse and I generally feel much much worse and much more sluggish somewhere in the 1-2/10 range.

I had similar symptoms with Candida in the past (and big problems like extreme headache and diziness) and my previous LLMD reccomended to go off antibiotics for a month and focus on killing Candida - that was in May 22’

I contacted my new LLMD today, and he said that it looks more like Herxheimer reaction to him, as I introduced new antibiotic (Azithromicin).

I asked about Candida as I had big issues with it in the past, and in his opinion it’s not likely as I’m taking antifungals just in case.

However the dosages are small, so I’m wondering if it’s enough.

Those physical symptoms are mostly caused either to Candida or Herx.

What I take currently:

Rifampicin - since 10 days, currently 450 mg

Azithromicin every 2nd day - 500 mg since 4 days

Fluconazole 100 mg - 2 times a week

My diet is very very strict (candida prevention) so that’s not the cause.

What you think - it’s Candida or Herx?

I have definitely noticed this when herxing, although from Lyme rather than Bart. I will get an itchy skin rash that smells moldy. I've found that atovaquone is effective in treating it (I couldn't tolerate fluconazole due to kidney and adrenal issues).

I don't understand why it happens though. Is this just an opportunistic infection that flares up when my immune system is busy fighting something else, or does the mold actually hide in the borrelia biofilm?

it sounds like herx reactions to me - esp as it seemed to come on after adding a second or third antibiotic