The Jarisch-Herxheimer Reaction
With many diseases, the most difficult part of the struggle is the diagnostic phase. In those instances, once you and your doctor have discovered what the mystery illness is, it's a simple matter of taking the proper medication and you will begin to recover. However, when it comes to Chronic Lyme Disease (as well as some other long-term illnesses, the most known being cancer), the treatment can be nearly as harsh as the disease itself.
What Is "Herxing?"
Cancer patients must deal with the grueling effects of chemotherapy. Chronic Lyme patients have to deal with the Jarisch-Herxheimer Reaction from antibiotics. The reaction is named after Adolf Jarisch and Karl Herxheimer who published descriptions of the reaction in 1895 and 1902, respectively (Rull).
For short, it's often referred to as "the JHR," "herxing," or "a herx." Not all patients will herx, it depends on the level of infection and the type of treatment, among other factors, but it's something to be aware of before beginning treatment. If not expecting it, a herx can be a terrifying and incredibly disorienting experience.
It takes place in response to antibiotic treatment with several conditions, including Lyme Disease. Other illnesses that are known to have associated herx reactions include rheumatoid arthritis, tuberculosis ("Herxheimer..."), syphillis, relapsing fever (Rull), and Candida--also known as systemic yeast infection ("A Body..."). Still, it is most common with Lyme Disease.
Herxing occurs when dead or dying bacteria release large amounts of toxins into blood and tissues at an alarming rate. "This provokes a sudden and exaggerated inflammatory response" ("Herxheimer..."). Essentially, the body is attempting to eliminate the released toxins much faster than it is able to ("A Body...").
The bacteria can also drill into the white blood cells and live inside. Killing these particular bacteria also results in the death of the host cell. The immune system releases the massive inflammatory response, and this will "cause a rise in symptoms in the area in which the bacteria are being killed" ("Herxheimer..."). What this means is that if the bacteria in your knee are being killed off, your herx is likely to include swelling in your knee. Bacteria dying in the brain can be associated with a rise in neurological symptoms.
A white blood cell as it goes through apoptosis, which is the scientific
term for "explode in a massive ball of excruciating pain and confusion."
The more pervasive the infection, the more severe herxes are likely to be. "Chronically ill patients are carrying a heavy load of intracellular pathogens... infection has been growing, unhindered, for most of a patient's life" ("Herxheimer...").
How To Recognize a Herx
Unfortunately, recognizing a herx is not always easy. A rise in symptoms can mean any number of things. Sometimes it's due to chemical exposure, allergies, medication side effects, or things that formerly seemed trivial like temperature change, weather, or even the phase of the moon. Herxes can even be symptoms you've never experienced before.
The truth is, the best way to figure out what is and isn't a herx is to keep a good, detailed Lyme journal. Keep track of which symptoms get bad and when, and journal what's going on in your environment. Herxes don't always happen instantaneously. They can occur hours, days or even a couple weeks later. When beginning a new medication, you want to pay close attention to your symptoms for a while.
"The most common symptoms reported include increased fatigue, joint or muscle pain, skin rashes, photosensitivity, irritability, paresthesia, dizziness, sleep disturbances, asthenia, muscle cramps, night sweats, hypertension, hypotension, headaches (especially migraines) and swollen glands. Also reported are heavy perspiration, metallic taste in mouth, chills, nausea, bloating, constipation or diarrhea, low grade fever, heart palpitations, tachycardia, facial palsy, tinnitus, mental confusion, uncoordinated movement, pruritus, bone pain, flu-like syndrome, conjunctivitis and throat swelling" ("Herxheimer...").
How To Manage Herxes
Though some people will never herx during their treatment, for the majority of us, it's an unavoidable and upredictable part of the process. On the other hand, there are steps that can be taken to help manage the severity of these reactions. First and foremost, your doctor will select your medications and dosages carefully to make sure you are at a level your body can handle.
You can also talk to your doctor about a medication known as Benicar, which many doctors celebrate as a fantastic way to control the reaction ("Herxheimer..."). I myself have no personal experience with this.
The things that you can do on your own time to help prevent herxing include basic things like avoiding unnecessary stress, resting as much as you can, and minimizing chemicals in your environment. The last of these includes the quality of your food and water as well as your air. Also try to keep a positive outlook, because both the bacteria and the herxes can mess with your thoughts and emotions ("Herxheimer...").
Also when you're herxing, remember to detox, detox, detox! While there are medications your doctor can prescribe to assist your detoxing functions, this is usually something you're responsible for doing at home. Most importantly, always keep hydrated. Drinking lots of water helps to flush toxins out faster ("A Body..."). Putting a bit of lemon juice in your water can also expedite this process, especially in the liver.
Preparation of a Detox Bath
Epsom salt detox baths are also an amazing way to pull toxins out of the body ("A Body..."). Personally, I swear by them. A word of warning: they can increase the herx reaction at the beginning of the bath, this is followed by a period of exhaustion, but it has always brought relief in my past experience, when done correctly.
Massage is also highly recommended, when the pressure is not painful ("A Body..."). Deep tissue massage especially can help to break up any toxins that have solidified inside the muscles. This is a big part of what forms the "knots." Exercise helps in a similar way, as well by promoting sweating, which will also flush out toxins.
Some people will also use enemas or colonics ("A Body..."). Most commonly, I've heard of people using coffee enemas. Though I have not tried them myself, people who have say they feel rejuvenated and their energy is restored
In rare cases, herx reactions can require medical treatment, and in the most extreme situations, they can prove to be fatal. While the vast majority of the time it's best to just push through, if the pain is greater than you can handle, get in touch with your doctor as soon as possible to be on the safe side and avoid permanent damage.
"A Body in Recovery." Well-Being Oasis. Well-Being-Oasis.com, n.d. Web. 24 April. 2012.
"Herxheimer Reaction." Chronic Illness Recovery Counsel Liason Education. Chronic Illness Recovery, Inc., n.d. Web. 24 April. 2012.
Rull, Gurvinder. "Jarisch-Herxheimer Reaction." Patient.co.uk. EMIS, 1 February 2011. Web. 24 Feb. 2012.