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» LymeNet Flash » Questions and Discussion » Medical Questions » WHEN DOES A HERX OCCUR??

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Author Topic: WHEN DOES A HERX OCCUR??
kareamber
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I started taking my Cefuroxine last night 1000mg daily and so far so good. No side effects yet. I am curious when a herx from starting abx usually occurs?

Also if I don't herx, does that mean I don't have lyme?

Any help or input would be appreciated.

Thanks.

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IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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Wimenin
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Please do a search on herx topics and you'll see a ton of information.

Basically the herxheimer effect (herx) occurs when your body can't take the heavy toxin load that is created from killing off the lyme, or other bacteria, of fungus.

As they die off, they give off toxins and those toxins are flushed out of your system. If your body cant handle the load, flu like symptoms kick in as your body is then in crisis till it can recover and handle the load.

Just because you dont herx doesnt mean youre not killing bacteria. It could mean your body is handling the strain.

Just because you dont herx doesnt mean you dont have lyme either. Lyme is a clinical diagnosis and should be done by a qualified MD, preferably a LLMD.

However, most would agree that if you have been sick with lyme, and you take an antibiotic, you will likely have herx reactions. Some doctors will prescribe abx as a way to empiracally test whether or not you have lyme, because if you have lyme, you likely will have a reaction. If you have no reaction, the odds might be you dont...

Thats why its important to look at the symptoms and have a clinical diagnosis done by a qualified doctor, LLMD...

Good luck!

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kareamber
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But when does it normally happnen after starting abx? Days? Weeks?

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IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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sutherngrl
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Well I was off antibiotics for 3 months and just started back on them 2 weeks ago....2 weeks and 3 days to be exact. Today I feel like I am having a herxheimer reaction. I am so achy all over, just feel plain out sick.

There is no set time though to have a herxheimer. Everyone is different. I guess for some it could be a few days. First you have to take the antibiotics long enough to start to kill something. If your body can de-tox really well, you might not even have one.

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jtavares76
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I am into my 4th week of treatment and I was doing fairly well except for a few digestive issues up until a few days ago.

Since Sunday, I feel completely exhausted, headaches and neck pain have returned, mood swings, anxiety, and irritability are back with a vengance, and the body aches especially from the hips down are unbearable.

I think I may have even had a low grade temp last night. I figure this must be some type of herx and hopefully it will get better in a few days.

Good luck!
JT

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hope4sofia
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I think it's different with each med and each person.

I have reacted within 48 hours to each new med and in a different way each time. For me the reaction was fairly short - hours to a few days. On Artiminisin, I reacted that same night - same with Zithro.

That said, I don't Herx as bad as others on here. My Herxing comes and goes. I can't predict it yet as I have only been treating for about 6 weeks.

Fatigue is a big one for me. Headaches, and hip pain too. Facial pain. Other than that, the pain migrates and symptoms vary.

My dr said ANY reaction to the meds is a good sign. That means improvement or herx.

If you tested pos for Lyme then, I wouldn't worry about whether or not you have it. Just be happy you don't seem to herx too much. Of course, if you're like me, you might wonder if treatment is working right.

I didn't test positive (only had a few bands). So my reaction to meds concerns me a lot.

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Sofi

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KS
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For me, my herx decline started about a week into treatment and it was a clear worsening of symptoms. By week 3 of treatment I was sicker than I had ever been and thought for sure I was dying...ended up being hospitalized. This herx reaction for me was not even comparable to my worst days of this disease pre-treatment.

Definitely have improved since then (18 months of treatment...currently not treating)

My symptoms still flare. Some days or weeks are more tolerable/challenging than others but I don't believe these are truly herx reactions but instead the lifecycle of the disease (which we don't understand yet)

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kareamber
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I've only been taking abx for 24 hours...I didn't sleep very well last night and today I've had 3 episodes of excrutiating ear pain (right ear). I've always had intermittent ear pain, but this pain was worse.

I did test IgeneX IGG POS, but I still wonder if it is correct. A herx would solidify my dx and make me stop wondering I think.

It sound like it varies between people and that there isn't really a norm.

Thanks for the help.

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IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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bettyg
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HERXING REACTIONS ... understanding them!

http://flash.lymenet.org/ubb/ultimatebb.php?ubb=get_topic;f=1;t=041517

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JohnBurton
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Kareamber,

I assume you went to see Dr D? Avril my wife is on the same med and we too were very worried about whether she would Herx, perversely wanting her to feel bad as confirmation that ABX was doing something.

After about 1 1/2 weeks her existing symptoms started to flare and some old ones returned. The worse was a severe fatigue that she had when she had an "MS Relaps" about 4 years ago but has not had since to this degree.

I take that as a good sign. It is improving now (about 3 weeks in) but she has had no improvement in her other symptoms. DR D thought she would probably need to be on ABX for up to 2 years so I am not expecting immediate improvements.

Good luck and hope you herx!

Did you get any further tests done when you went to see him (I know you were asking about LTT etc)?

Regards
John

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kareamber
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I'm concerned cause before my lyme dx, I've been on abx for sinus infections. I honestly don't remember having any weird "reactions" to them that could be a herx.

The only thing I can think of was several months ago my ENT put me on Augmentin 875 for I believe 3 weeks and a few days into treatment my brain fog and dizziness got horrible!! I couldn't function it was so bad. It eased up after several days. Well I didn't finish the abx.

Maybe this was a herx? Do all abx cause herx? Or does it depend on the kind,dosage, and time taken?

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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pab
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I usually herx around day 4 of antbiotics and it usually lasts for a few days. My whole body will hurt.

After that initial herx, I would herx about every 4 weeks.

--------------------
Peggy

~ ~ Hope is a powerful medicine. ~ ~

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kimwg
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According to my LLMD

(1) Herxing is NOT caused by toxin release -- it is caused by the bacteria lysing (breaking up) in response to antibiotics; as a flood of antigens enter the bloodstream, the immune system "freaks out" and mounts an inflammatory response.

(2) Differentiating between a herx and side effects: medication side effects will usually be limited to one or two symptoms, while a herx will involve multiple symptoms, usually a WORSENING OF YOUR SUITE OF LYME DISEASE SYMPTOMS.

(3) The timing and degree of herxing and die-off reactions varies between patients, depending on bacterial load, bacterial form, time of infection, overall health level, and individual variation in immune system response.

I am, unfortunately, a mega-herxer. Every time I start a new antibiotic, I start herxing within one week. My symptoms always include worsening joint pain, increased fatigue, and increased cognitive difficulties. These symptoms usually last about 3 weeks for me and then abate, returning to a lesser degree every few weeks.

My doctor wants to place me on triple therapy (3 antibiotics at once, one for each form of the lyme bacterium). However, since I have had strong die-off reactions, he is letting me stay on the same 2 abx (ceftin and flagyl) for a couple of months before adding a third (biaxin), in the hope that one my body has healed somewhat, the next herx will not be as severe or knock me down as much.

When I started taking flagyl, I had such a severe reaction that I barely got out of bed, and when I did my joint pain was so bad that I was walking with a cane. However, this went away after a few weeks. Bear in mind that my doc says I have a strong reaction -- yours will hopefully be less severe and of lesser duration.

--------------------
Wildlife biologist working in tropics since 1997; tick bites in Nicaragua in March 2007, started getting sick May 2007; diagnosed with Lyme based on serological testing in Jan 2009; treatment starting Feb 2009. Wish me luck!

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kareamber
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Wow... day 3 and nothing...maybe a bit more pain, but nothing significant.

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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hope4sofia
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Don't worry yet, Kareamber. Are you easing on to your treatment (one abx at a time?) If so, that can lessen the herx.

I started on Doxy for 10 days before adding Zithro. I also started low dose Doxy for a few days. Initially, I felt fine. A little pain in hands and feet but wasn't sure if it was a herx. I think it took about a week before I got the headaches.

As I added meds and increased dosage I noticed more herx symptoms. Still, I don't seem to herx as badly as others.

Just trust the treatment for now and wait to see what your body does.

Try keeping a daily journal. Note your symptoms and improvements. This will help you track things better.

--------------------
Sofi

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kareamber
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hope4sofia,
I'm only taking one abx, Cefuroxine 1000mg daily. My LLMD only wanted to start me on one to begin with.

Maybe it's not strong enough? I have noticed an increase too in the pain in my hands, arms, and ankles,feet. But again nothing horrible... don't know if it's a herx, or just nothing...

It's hard to tell cause my symptoms off abx would flare anyways. I would have good and bad days. So even if I did herx, I may think it is just another bad day...

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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hope4sofia
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Exactly, that thought runs through my head too. That's why a journal might help you. You might notice patterns.

I have noticed an increase of symptoms after each med which makes me think herx not just bad days. But like I said, I went about a week of feeling ok when I first started.

I also wonder, since I've been sick so long, if we're going to accomplish much on oral meds. Dr thinks I probably have a lot of cystic lyme so Flagyl and IV meds will do more damage. I'm not on either yet, so may just be hitting the tip of the proverbial berg.

Maybe you're just not hitting it where it hurts yet.

--------------------
Sofi

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kareamber
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Speaking of Flagyl,
Back in March when I first noticed the frequent urination, my dr put me on Flagyl for possible Bacterial Vaginosis.

About three days into it I went to bed and out of nowhere got horrible anxiety, racing heart, nausea, sweats, and my skin looked all flushed.

Needless to say I quit taking the Flagyl as I thought it was a side effect.

But looking back, I think I've been on Flagyl years ago with no effects.

I'm wondering if it was a herx. It didn't last long though... just that night... so maybe not... but makes me wonder...

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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hope4sofia
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Could be. I herx like that on artiminisin for the first 24-48 hours. Did it when I first started and again when I upped the dosage.

Dr said the Flagyl will be better at hitting the cysts. Maybe that's why you reacted to it like you did.

--------------------
Sofi

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kareamber
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Ok.. well today I'm not feeling so hot. Maybe a herx, or flare? I don't now how to tell them apart.

I have some serious brain fog going on and I feel spaced out and kinda confused feeling. Also I'm feeling pretty achy too in feet, hands, and arms and feel nauseated. Just blah...

I had been feeling pretty well for like the past week, so I'm thinking this may be either a herx, a flare, or maybe side effects of the Ceftin?

Hmmm... I don't know..

--------------------
IgeneX IGG POS 30+ 31++++ 41++
IGM 30+ 31+++ 34IND 41IND 83-93IND
Quest NEG IGG 30 and 41 only

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hope4sofia
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I think side effects from the med would have shown up sooner. Sounds like a herx. Yeah!??!

--------------------
Sofi

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Hannemannn
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I herxed very quickly. During second day I had much

more pains and muscle twitching in legs.

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timaca
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kareamber~
I get a severe herx reaction to both antibiotics and antivirals. They have always occured starting between day 10 and day 14 (with the exception of this last one which started day 19).

I feel absolutely awful...death looks appealing and I cannot be vertical. I HAVE to be horizontal. There is no "gee I wonder if this is a herx". Nope. I know it is. I cannot function. I lie in a ball and whimper.

Best, Timaca

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