What is a “herx” and why are they so feared in the Lyme community?

A Jarisch-Herxheimer reaction, shortened to “herx” as slang,  is a predictable and temporary “flare-up” or worsening of symptoms caused by the die-off of spirochete bacteria.   This condition was discovered and named after the German dermatologist, Karl Herxheimer (1844-1947). The condition was originally observed in syphilis patients.

Although both diseases come from a Spirochete bacteria, their structure is quite different.

Dorlands Medical Dictionary refers to the Herxheimer reaction as  “…a transient, short-term, immunological reaction commonly seen following antibiotic treatment of early and later stage [infectious] diseases which [may be] manifested by fever, chills, headache, myalgias (muscle pain), and exacerbations of cutaneous lesions. The reaction has been attributed to liberation of endotoxins-like substances or of antigens (a substance which causes an immune reaction) from the killed or dying micro-organisms.”

Unlike Syphilis, Lyme will cause multiple Herxheimer reactions determined by the effectiveness of the treatment and the life cycle of the Borrelia bacteria.

This recurring flare up is physically and emotionally devastating – especially for those who have very chronic and/or severe cases of chronic Lyme disease.

Some have a reaction within days of effective treatment; while for others, it may take longer.   Generally, the longer it takes for a reaction to occur after beginning treatment, the more disseminated the disease is.

These brutal flare-ups can last between two days and two weeks, but there are some who report much longer reactions when treating their disease aggressively (some will try several therapies at the same time with the hope of attacking the disease more effectively).

“You have to get worse, before you can get better!” is a grim consolatory phrase passed back and forth in chat rooms and community forums amongst sufferers.  But the roller-coaster of pain often threatens recovering patients to greater depression and in some cases it feels like a full relapse.

Regardless of the intensity of one herx over another herx, for a “recovering” patient who is slowly recovering and who wrestles  daily with a diminished amount of energy, grasping for the extra energy to deal with both physical and emotional symptoms can be overwhelming, and in fact has caused numerous suicides.

“It’s just so hard to deal with worsening symptoms after months or years of illness.” complains one long-time Lyme patient.

The good news is that science clearly shows “herxing” means that treatment is working.  The dying spirochetes emit a neurotoxin that floods the body from every active location, and over-stimulate the already weakened immune system.  So in general, the greater the bacteria-load, the greater the reaction will be.  For the very ill patient, the reactions can be fatal, but for most it is a grueling aspect of recovery.

How to cope?

Many Lyme-literate doctors recommend “Smilax”, an herb that effectively binds the neurotoxins, and passes them out of the body (see below). Epsom salt baths are also soothing; although very hot baths will also aggravate symptoms, as the spirochetes are threatened by heat. (More about the pros and cons of hot baths to come.)

Basically, anything you can do to help your body detoxify will help:

• drinking plenty of water
• far infared sauna
• organic coffee enemas
• smilax
• takava foot patches

Emotional support is critical as well.  Stress that can be handled one day might be completely overwhelming during a herx.  The best way that I have found to deal with “herxes” is to be prepared.

Prepare mentally for them to come as the bacteria dies – which is good.  And then when they come – try to stop as much activity as possible and do whatever it takes to get the maximum amount of sleep which will also aid your body as it struggles to eliminate the neurotoxins.

For more information read “What is a Herxheimer Reaction?” by Donna Herrell, The Director of Lyme Alliance, Inc.