The Jarisch–Herxheimer reaction


Two dermatologists, an Australian by the name of Adolf Jarisch and a German by the name of Karl Herxheimer, are credited with the “Jarisch–Herxheimer,” or simply “Herxheimer” or “Herx,” reaction. The reaction was first described by Jarisch in 1895 and Herxheimer in 1902 when the men noticed an increase in symptoms after their patients began treatments for syphilis with either Salvarsan or mercury. Jarisch postulated that the reaction was caused by a toxin that was released from dying spirochetes, eventually finding its way into the bloodstream, which can then become very serious and “may result in irreversible organ damage!”

Unfortunately, my daughter, Kathleen, suffered a Herx reaction after she was diagnosed with Lyme disease and prescribed antibiotics … and it was excruciatingly heartbreaking to watch her suffer! At the time, I realized that the reaction may occur but I did not fully appreciate just how serious it could or would be. In fact, it is actually considered a good sign in the sense that it means the antibiotics are working to kill the bacteria; but if the symptoms become really bad, hospitalization may be required. For us, we were extremely lucky that the outcome for Kathleen was not more serious!

Kathleen survived the ordeal in good shape, but “herxing,” as it is commonly known, can prove to be a deadly serious event. There are a number of websites that tout various treatments for the condition, but the symptoms can vary from everything from common cold symptoms to nausea, diarrhea, vomiting and tinnitus (ringing in the ears). It can also result in anaphylaxis, which can be fatal if not properly treated.

The reaction is caused by the creation of inflammatory cytokines (TNF-alpha, IL-6, and IL-8) which are used by the body to promote healing. Toxins created by the dying bacteria need to be cleared from the body, but when they can’t be cleared fast enough from the blood stream an acid imbalance is created, which then impairs the enzymes needed to maintain a normal pH (balance of acidity to alkalinity). And the severity of the herx reaction will be dependent upon the number of spirochetes that die.  

The faster the body can clear the dead bacteria and the resulting toxin (a detoxifying process commonly known as “detox” to Lyme patients), the sooner the patient will feel better. And plenty of fluids will most certainly play a major role in helping the body rid itself of the toxins.


Good herx vs. bad herx

There are essentially two types of Herxheimer reactions: a “good” herx and a “bad” herx. In his book How Can I Get Better?: An Action Plan for Treating Resistant Lyme & Chronic Disease Dr. Richard Horowitz says that in the former patients will have a reduction of symptoms and begin feeling better after the flareup; whereas, in the latter, patients will see no reduction in symptoms and return to their prior baseline after the flareup.

So, a Herxheimer reaction can be either good or bad — or both. Regardless, it is important for patients, parents and caregivers to watch this reaction carefully, and not hesitate to seek immediate medical attention if the case appears to be serious.

Kathleen, thankfully, experienced a relatively brief period of suffering when she began herxing; but, for her — and for me and Mommy — the experience was very scary. It caused her to be very confused and disoriented, and I remember her crawling around on the bed in our master bedroom on all fours like a bewildered animal in a cage. It was so sad to watch, and the event will forever be burned into my memory. Fortunately, however, since that time we have been able to create many much better memories and, hopefully, we will be able to continue doing so.

Note: No content on this website should ever be used as a substitute for direct medical advice from a doctor or other qualified clinician.

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