Jarisch-Herxheimer Reaction and Lyme Disease

Lyme disease is caused by the spirochete Borrelia burgdorferi, a corkscrew-shaped bacterium. Lyme disease is known as "The Great Imitator" because its symptoms are similar to those of many other diseases. Any organ in the body, including the brain and neurological system, muscles and joints, and the heart, might be affected. The spirochete bacterium that causes Lyme disease is transmitted by the bite of infected ticks. The disease is carried by the blacklegged tick (or deer tick, Ixodes scapularis).

Because Lyme disease and tick-borne infections are complicated disorders, therapy can be difficult. Symptoms may get worse before they get better while being treated for Lyme disease. This is because of a reaction known as the Jarisch-Herxheimer reaction, which usually occurs after starting antibiotic treatment for Lyme disease and other diseases caused by spirochete bacteria. The reaction usually occurs between 1 and 12 hours after the first antibiotic injection and can last anywhere from a few hours to a day. It usually goes away on its own or with symptomatic treatment, detoxification, and alternative home or lifestyle remedies. The intensity of the reaction determines the severity of inflammation.

Understanding the pathophysiology of the Jarisch-Herxheimer reaction

After starting antibiotic treatment for spirochetal illnesses, such as syphilis, Lyme disease, and tick-borne relapsing fever, you may experience the Jarisch-Herxheimer reaction, also known as "herxing" or "herxing." There is a temporary aggravation of Lyme disease symptoms that happens when the Lyme spirochete bacteria are wiped out by antibiotics, causing inflammation. These reactions produce cytokines (TNF-alpha, IL-6, and IL-8), which are a broad category of small proteins required in cell signaling. This cytokine release causes inflammatory symptoms such as fever, muscle and joint pain, headaches, cognitive impairment, and a general aggravation of the underlying Lyme symptomology.

Inflammatory cytokines and dying bacteria must be removed from the body to support healing. When the body is unable to quickly eliminate these poisons from the bloodstream, an acid imbalance is noted, impairing the enzymes required to maintain a normal pH (balance of acidity to alkalinity). The reaction will be stronger if more spirochetes die. People will feel better soon after eliminating the dead bacteria from their bodies. In patients with Lyme disease, this cleansing or detoxifying process is usually referred to as "detox."

Lyme herx normally starts 48-72 hours after starting antibiotics and can continue for weeks, unlike syphilis, which starts within hours and usually finishes within days.

The worst reaction for patients with chronic or late-stage Lyme disease occurs around the fourth week of treatment and is very similar to "serum sickness," wherein white blood cell loss (leucopenia) and a spike in liver enzymes occur. The reaction in the fourth week suggests that the disease is still present.

Conditions associated with the Jarisch-Herxheimer reaction

In addition to Lyme disease, the Jarisch-Herxheimer reaction is also seen in other spirochete bacterial infections, including syphilis, relapsing fever, and leptospirosis.

How do you differentiate between a herx and an adverse drug reaction?

It's crucial to understand the difference between a herx and an adverse drug reaction (ADR). The development of a Herxheimer response can indicate a spirochetal infection. If you're being treated for Lyme disease based on a clinical diagnosis, the herx may be an indication that you're killing the proper bacteria. Herxheimer’s reactions are usually pretty intense.

ADRs, on the other hand, can range from moderate to severe and are frequently misdiagnosed as a herx. Drug reactions appear to be more consistent with what is reported in the drug manufacturer's papers. Of course, with antimicrobials, you can have both at the same time.

Mild ADRs usually go away soon after the medicine has been stopped. A severe allergic reaction, known as anaphylaxis, causes the airways to swell up, get blocked, and can be fatal if not treated immediately.

It's usually a good idea to tell your doctor right away or visit the ER if you feel unusually ill and have difficulty breathing.

What are the types of the Jarisch-Herxheimer reactions?

When it comes to herx, there are two types: good herx and bad herx.

Following a good herx, the patient will see a reduction in symptoms and begin to feel better. In the case of a bad herx, the patient will return to their previous baseline after the flare, with no improvement in overall symptoms.

The Herxheimer reaction is a common side effect of late-stage or chronic Lyme disease treatment, but it’s crucial to manage it. A severe herx can be life-threatening in rare cases. If you’re having severe symptoms, I recommend heading to the nearest emergency room.

How does Jarisch-Herxheimer reaction present itself?

The reaction usually occurs between 1 and 12 hours after the first antibiotic injection and can last anywhere from a few hours to a day. Following therapy, it is no longer visible. The intensity of the reaction determines the severity of inflammation.

The Jarisch-Herxheimer reaction presents with the following signs and symptoms:

Malaise (body pain)
Fever
A flush from vasodilation
Tachycardia (increased heart rate)
Leukocytosis
Any existing skin lesions become more visible
Hypertension (increased blood pressure) or hypotension (reduction in blood pressure) due to vasodilation and decreasing peripheral resistance
Hyperventilation (rapid breathing)
A secondary rash that was not seen before treatment may appear
Rigidity
Headache
Anxiety

Some case reports indicate that the Jarisch-Herxheimer reaction can also include the following less common signs and symptoms:

Uterine contractions in pregnant women
Worsening kidney and liver function
Acute respiratory distress syndrome
Myocardial injury (heart damage)
Meningitis (inflammation of the brain)
Altered consciousness
Seizures
Strokes

Which tests are performed for identifying Jarisch-Herxheimer?

In most cases, no further investigation is necessary for Jarisch-Herxheimer. However, if an unanticipated reaction to antibiotic treatment develops, syphilis serological testing and other tests are required.

How is Jarisch-Herxheimer treated?

Prophylaxis and anti-inflammatory medications may be used to halt the progression of the reaction. As a supplementary treatment, oral aspirin or ibuprofen every 4 hours in a day, or steroid medication orally or intravenously, has been used. Steroids, on the other hand, are rarely beneficial. Patients must be continuously watched for potential consequences (collapse and shock), and IV fluids may be required to keep their blood pressure stable. If required, opioid analgesics (painkillers) may be prescribed to lessen the intensity of the reaction. Doctors can usually manage herx symptoms. So, if patients respond, the doctor can use a range of detox treatments to relieve any pain and other symptoms.

Common detox treatments that may be advised by doctors

The removal of toxins from the bloodstream is known as detoxification. Toxins are eliminated by the liver, kidneys, intestines, lungs, lymphatic system, and skin.

Detox IV homotoxicology

It is easier for your body to get rid of poisons when they are bonded together. This isn't something they do naturally. Your doctor can do this instead by using IV homotoxicology. Any negative symptoms, such as those associated with a herxheimer reaction, will fade away faster if the toxins are removed quickly.

Detoxification chelation

Heavy metal is in everyone's system. They're in our food, pharmaceuticals, and even our drinking water. Examples include zinc, copper, lead, mercury, and aluminum. Heavy metals promote inflammation in the body, causing difficulty in detoxing. If you have Lyme disease, the inflammation can be even more severe, making cleansing difficult.

As a result, your doctor can provide chelation to aid in the detoxification of your body and the alleviation of any symptoms associated with a herx response. The drug used in this procedure encircles the heavy metal poisons and causes them to deactivate. They leave your body through urine once they've become inactive.

Detoxification supplements

Therapeutic substances that aid in the detoxification process are available to Lyme specialists. Activated charcoal has two distinct advantages. It helps to relieve inflammation by acting as a relaxing supplement and binding to toxins, making it easier for them to leave the body. Your liver works tirelessly to cleanse your system. It could need all the help it can get. Glutathione is a vitamin that helps maintain the liver. It not only relieves the symptoms of a herx response but also provides additional benefits, such as improved sleep.

Lymphatic system drainage

Your muscles function every time you move your body. Your organs, tissues, and cells can do their job of eliminating toxins and waste from your body when your muscles are engaged.

Simple activities such as walking, stretching, and bending can help if there is no pain. Massage, which targets specific regions of the body to urge the body to aid in the detox process, is one way to drain your lymphatic system.

Alternative treatments for detoxification

There are several alternative therapies and home remedies that can help you avoid or reduce herx responses when detoxing.

The following methods of detoxification can help in the removal of toxins from the bloodstream. Toxins are eliminated by the liver, kidneys, intestines, lungs, lymphatic system, and skin. The following can assist in alkalinization, detoxification, inflammation reduction, and supplementation, improving the symptoms of the Jarisch-Herxheimer reaction:

1. Apple Cider Vinegar: Vinegar aids in the body's alkalization and pH balance repair. A glass of water with two teaspoons of apple cider vinegar can be drank. Using apple cider vinegar in the presence of a Candida fungal infection may trigger a herxheimer reaction rather than reducing it, so it should be avoided.

2. Activated Charcoal: Activated charcoal binds to the poisons that produce the herxheimer reaction and aids in detoxification by removing them. It can be ingested as needed or within a few hours of finishing a treatment. It's available as a pill, powder, or capsule. If you're taking any medications or supplements, proceed with caution and seek medical advice.

3. Alka Seltzer Gold: It assists in the alkalinization of body and removal of contaminants. As needed for herxing, two tablespoons of it can be mixed in lemon water as instructed on the carton. When coupled with lemon water, it alkalizes.

4. Dry Skin Brushing: Dry skin brushing stimulates the lymphatic system. A natural bristle brush might help to cleanse the pores. Before having an Epsom Salt Bath, this is normally done.

5. Lemon Water: Lemons aid in detoxification and the removal of toxins from the body. Squeeze two whole lemons into a cup of water and drink after 30 minutes.

6. Vitamin C: Vitamin C helps the body produce glutathione, which is a natural antioxidant.

7. Oil pulling is the practice of gently swishing coconut oil around in your mouth. Toxins and bacteria are drawn from your mouth's mucous membranes by the oil. Coconut oil has a high rate of absorption.

8. Light to moderate exercise: Muscle contractions stimulate the lymphatic system and increase perspiration, both of which aid in detoxification.

9. Infrared Saunas, biomats, and infrared mats: Infrared heat helps reduce pain while sweating off toxins. Saunas and mats with infrared technology are highly recommended. Avoid full-body saunas if you have heat intolerance, such as dysautonomia.

10. Epsom salt: Epsom salt aids in the detoxification process. In a warm bath, add two to four cups of Epsom salt (which can be blended with ginger or pink sea salt to increase sweating). Magnesium relaxes muscles, and sulfur produces bile, which transports toxins from the liver to the colon.

11. Foot Baths: There are many different types of special foot baths, and people's outcomes vary, but they use charged ions to help open detox pathways in the body by soaking your feet and removing toxins through the soles of your feet.

12. Bentonite Clay: It contains a high electrical negative charge that binds to the positive charge of toxins, allowing them to be eliminated from the skin and body. It can be used as a mask by mixing it with water and applying it to the face and armpits.

13. Glutathione: Glutathionine S-transferase (GST) production in the liver is increased. GST is a powerful enzyme that binds to toxins, metabolizes them, and removes them from the body. Use three tablespoons of organic ground coffee, combined with room temperature water, in an enema bag. This should be injected into the rectum. Before removing the coffee, wait for 5-15 minutes for it to settle in the intestines. If you leave the coffee for more than 15 minutes, it will be absorbed at a higher concentration than you want, which is potentially harmful. Always seek advice from a professional.

14. Increase fiber intake and hydration: Fiber and water help in detoxification. Every day, you must drink one-half of your optimal body weight in ounces (i.e., a 150-pound person should drink 75 ounces of water a day). This helps cleanse the kidneys and promotes regular bowel movements. To bind toxins in the intestines and induce regular bowel movements, three or more servings of fiber per day are required. Fiber is abundant in beans, lentils, and whole grains. Apples are also a good source.

15. Nutritional supplements: In many cases, good nutrition is insufficient to provide the vital nutrients required to maintain the detoxifying organs. A well-balanced multivitamin with mixed amino acids, taken on a regular basis, is the foundation of detoxification. In cells, N-acetyl cysteine and alpha lipoic acid are used to generate active glutathione (NAC). Glutathione is a powerful antioxidant generated by all cells and used by the liver to detoxify fat-soluble contaminants. Most oral glutathione supplements, unfortunately, are poorly absorbed. However, newer sources wrap glutathione in fats called phospholipids microscopically to improve absorption. Methylcobalamin is also a beneficial dietary supplement. Many over-the-counter nutritional supplements are not FDA approved and should not be consumed without first contacting a doctor.

16. Probiotics: Toxins are eliminated from the intestines by probiotics (good microorganisms). It is common for people with Lyme disease to have harmful bacteria in their intestines as a result of herbal or prescription treatments, as well as the stress of the disease. Re-establishing a healthy lining with high-quality probiotics can help with detoxification.

If the aforementioned treatments don't work and your symptoms are getting worse or you notice new ones, you should consult a doctor immediately.