: J Clin Neurosci. 2002 Nov;9(6):689-90. Related Articles, Links

A case of neurosyphilis with a florid Jarisch-Herxheimer reaction.

Silberstein P, Lawrence R, Pryor D, Shnier R.

Department of Neurology, The St George Hospital, Gray Street, Kogarah NSW 2217, Australia. [email protected]

A 37 year old man with a 2 year history of progressive cognitive decline, unilateral tinnitus and deafness presented with complex partial seizures and a fever. On examination there was a sluggish right pupillary response but no other abnormal findings. Serum and CSF syphilis serology were both strongly positive. High dose intravenous penicillin therapy was complicated by a severe Jarisch-Herxheimer reaction (JHR) characterised by fever, obtundation, fluctuating upper motor neuron signs and complex visual and auditory hallucinations. These symptoms resolved over three days and the course of penicillin was completed. At discharge the patient's cognitive functioning was unchanged from the pretreatment state. He made gradual improvement over the following months but remains unable to live alone or work. Clinical, pathologic and radiologic findings of neurosyphilis are reviewed, as is the JHR, a self-limiting, systemic febrile response related to massive cytokine release that can occur in response to treatment of a number of bacterial infections. The similarities in pathophysiology of the JHR and the Septic Shock Syndrome are discussed, with particular reference to use of the JHR as a potential model for therapeutic agents in the treatment of septic shock. Copyright 2002 Published by Elsevier Science Ltd.

PMID: 12604286 [PubMed - indexed for MEDLINE]

 

Ellen, do you mean 20 g of Vitamin C a day ? Wow !! Anyone else doing this ?

I would like to hear more on treating the herx....obviously some sort of detox protocol ?
 

Just think about it - yes herxing is good -
you're killing bacteria - but that means the dying bacteria body's are giving off a toxin - I can't see overwhelming the body with toxin.

There is someone on this list, who in the past (and I can't remember who it is) kept saying her LLMD took a herx very seriously, and always had her back off till she felt OK.
I think this Dr. has the right idea.

I really think that if you can get in touch with your bodies enough, and familiar enough with your disease - you will KNOW the difference between a herx, a abx side effect,
and replicating Lyme.
What most of you all call "brain fog" is a reaction I get from the toxin relase when having a herx.

If you have a really heavy toxin load - I
can see it taking several weeks to clear the body and that's under optimum conditions..

I just think the Herx isn't being treated properly in Lyme.
I base this on my own treatment, and how the HERX **IS** treated in syphilis and Sarcoidosis.

How many of you take an anti-inflammatory when you're herxing?
Man - I did... and it helped ALOT.

Barb

Depending on symptoms, one may need anti-inflammatory, pain killers, psych meds in some..

I think the major way to treat it is detox..sauna, long HOT baths, lemon water for liver, lots of Milk Thistle..MSM and immune support vitamins.

But from our experience, as long as Doc is monitoring and Herx is at all tolerable, my son and my Herxing periods were always beneficial. We were advised by the specialists we see to stay on abx through them (in our case) and they have been beneficial. We were both better when we got through each one than we were before.

My son still has Herx's, but they are increasingly less severe (except when meds have been changed)..

But when he first went on treatment, he had a very severe symptom flare up. Doc J was made aware of every detail...and said he should stay on. That period took his infection load down considerably. Some MAJOR symptoms were cleared following that rough time.

BUT..that is not to say it isn't necessary to go off meds sometimes for some..I just don't think it is wise to do so for every Herx..as sometimes going off is more detremental and can increase the bacteria's potential for resistance.

I do think Herx's must be treated for symptoms, and toxins must be addressed during them.

Mo
 

Barb

 

I am rewriting this long reply after having it wiped out by some computer glitch.

Yes, I do mean 20 grams. I have been using such vitamin C "flushes" for 35 years, long before Linus Pauling. My first introduction came via Adele Davis (remember her?) She wrote about Dr. Fred Klemmer, chief of stff of Memorial Hospital in Reidsville, North Carolina, who had twenty five years of clinical research about vitamin C and published extenively in the 1950s. You will not find his research on the internet.

He successfully used extremely large doses (up to 100 grams per day) of vitamin C on many types of illness. He found that vitamin C enhanced the work of antibiotics as well as detoxifying the body. (taKk note, Crime)

I am going to post this now, then continue, lest I lose it again.

Ellen
 

Dr. C firmly states, "It was discovered that staying on antibiotics caused more troublethan good, if patients were havinga Herx. Borreliosis patients usually lose ground if they stay on antibiotics when Herxheimers hit."

Now that is not to say you won't have herxes, he is just saying once they start it (abx) is working and you should go off the abx for a break.

Seems with his experience, that the body can only fight so much at one time and taking a break actually speed up the recovery process rather than the opposite.

If I have the strength, I'll try and type more of the handout he gives his patients on this subject.

I will add this from his handout.

"Some of the saddest borreliosis patients I have are ones that did not take my advice, and stayed on anticiotics during a Jarisch-Herxheimer reaction. For months, they went downhill and downhill. When they finally quit antibiotics, they often stay worse. They do not get back to baseline, much less back to normal."

"Your brain will tell you that since the Herxheimer indicates the antibiotic is working, to stay on the. Please ignore your brain. Since 1988, with well over 600 borreliosis patients, I assure you, going off antibiotics is the better part of valor. We do not need any heros or heroines. Thoughness in not needed. "No pain, no gain" DOES NOT apply to Jarisch-Herxheimer reactions!

The normal healthy body needs only a few hundred milligrams of vitamin C per day; the rest is excreted in the urine. This amount is mostly used (with calcium) to produce connective tissue and collagen. But if any toxins are present, whether bacteria or their byproducts, viruses, heavy metals, poisons, medication byproducts, whatever - viamin C will combine with them and is destroyed in the process.

When there is a heavy load of such toxins, especially over a long period of time, massive doses of vitamin C must be taken before any is available to do its normal work. In one study that I read at the time, 15 grams a day were given to otherwise healthy people on tranquilizers before any showed up in the urine.

When you have detoxified the bacteria and their byproducts, and all the byproducts of your medications, your tissues will return to saturation with vitamin C. Then, of course, you back off on the amount. To me, herxing is evidence that you still have toxins.

Doctor Klemmer continued his arthritic patients with ten grams a day indefinitely, with good results and no ill effects.

Assuming that you are already following a mostly good diet, let me suggest that adding more vitamin C will not hurt and may help. If you think I am suggesting too much, why not try the amount you are comfortable with and see if it helps? You can increase if it does, and stop if it doesn't.

Wish I could give you more information here, but I am working from memory - that and the fact that this regimen has worked for me in even my dimmest hours.

Hope it helps someone - let me know.
Ellen

 

I find this question about what to do when herxing gets bad very interesting. I have a LLMD who strongly encourages pushing through herxes and not pulsing, or taking a break or anything. He also doesn't "monitor" symptoms. Although this may be helpful for many, it has caused me lots of problems.

I've posted before about a very negative reaction to rocephin (unsure how much was herxing plus my gut and gall bladder reacted badly). I kept taking it, and boy did that backfire.

I got so out of it that I went from working again to bedridden again for months. It took me two months to keep any food down after stopping antibiotics and now I am just beginning omnicef with a plan to add other antibiotics slowly. I think I'm having my first real big "herx" vs. flare-ups like I used to get. All of my neurological symptoms are so bad that I'm bedridden, shaking, often in so much pain and tears that I can't stand it. And this is just one antibiotic in an effort to get back on them. It's only been 13 days.

My intuition tells me to take a short break for some relief and to let me body catch up with what's happening to it. I hear what many of you are saying that when herxing gets so bad, take a break. What exactly is the length of time for a break? What are your doctors recommending? I fear taking too much time off and relapsing again and starting over again like I am now. Yet, this feels like "too much." I think a lot is being attacked all at once after being off of the antibiotics for two months. Do your docs think 2-3 days? I may be close to the end of a big herx, so I'm tempted to continue, but being bed-ridden and needing help to take care of me durng the day is feeling like just too much to take!

Any thoughts are greatly appreciated!

Joanie
 

I also follow Dr. C's protocol, and it does enable the body to recoup. Tough...because I'd just love to hurry this abx tx in the hopes to get all these buggies out of my system, but it doesn't work that way.

Which brings us back to, "the turtle wins the race." So true...so true...we have to listen to our bodies.

lifeline
 

It depends on how you feel....12 hours, 24 hours, 48 hours.72 hours.

Each individual has there threshold.

Trout
 

Look, herxheimer airlines.

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Lyme Disease Help & Support
www.wildcondor.com
 

Many thanks,

Joanie
 

"The stuff kicks ass, it really makes you herx, but suck it up and grin and bear it, take the full dose and be patient. It works awesome. I remember when I took it I could feel the herx start about an hour after I took the pills, it was that strong. Make sure you are on a good combination of other antibiotics while you are taking it and take protective care of your stomach. Stay the course, be tough!"

Isn't that the opposite of what you posted above on another post? I'm confused.
 

Often I have not finished herxing on one drug combo and then I am taken off and put on another. This has not served me well. I'm going to go easier on my treatments.

Ellen--thanks for the vit C info. I was taking 3 grams and dropped down to half that. Maybe I'll see what a little more does.

I have never had a herzheimer.
But I also never took any antibiotic, remedy or vitamin supplement that was not muscle tested with ART (Autonomic Response Testing)
on me before I swallowed or was infused. Every drug, every vitamin, every herb, every essential oil was tested. All my nutrient deficiencies were found in this manner - i.e. more Omega 3 or more Omega 9. All the important nutrients and minerals that are not in balance or inadequate (sometimes overloaded) in Lymies.

Keep learning!

I am totally well today - and all my organs are fully functional. I feel better than I ever did before Lyme hit me with full force several years ago.

What you say makes sense. Each of us is uniquely different, and what works for one may not work for others.

I have heard of Autonomic Response Testing before, and found it intriguing. Certainly at a deep level, our bodies know what is needed, and will guide us. ART seems to be a way of taking that depth reading. I am curious whether one can learn to do it for oneself. I know that meditation often helps me bring the deep knowledge to the surface.

Ellen

Here's one:

Vitamin C Reduces Antibiotic Resistance

Vitamin C supplements decrease antibiotic resistance and broaden the activity of antibiotics, to which bacteria are commonly resistant. Vitamin C supplementation is an easy way to increase the potency of antibiotics.

For example, large doses of vitamin C was shown to enhance the activity of penicillin against many bacteria that would otherwise be antibiotic resistant, as well as reduce allergic reactions to antibiotics.

Vitamin C also decreases the amount of antibiotics needed to kill bacteria.

Dr. C told me to really up my doses of Vit. C substantially to a mega dose level. That makes sense to me.
 

If your magnesium level is low or if the bacteria are depleting it, you cannot form the antibiodies necessary to neutralize the toxins.

Magnesium appears to improve the functioning of both the cellular and the antibody-mediated immune defense. The levels of antibodies (immunoglobulins) decrease in experimental animals (mice, rats and hamster) by up to 60% when the supply of magnesium is significant reduced. This decrease is greatest for IgG, but the levels of IgA, IgM and IgE also fall. The reason for this fall in immunoglobulin production may be due to an inability on the part of the B-lymphocytes to develop into antibody-producing plasma cells. It may be that magnesium has other immunological properties which are mediated through hormone-like substances, in the reactions between antibodies and macrophages, for example. The defense system, which is regulated by the T-lymphocytes, requires both magnesium and calcium. The T-lymphocytes are transformed into natural "killer-cells", amongst other things, which are able to attack cancer cells. There is a direct correlation between magnesium deficiencies in rats and reduced immune defense against allergic reactions and cancers, in particular leukaemia and lymphomas. http://www.1stvitality.co.uk/az/magnesium/

"T-cells: move through blood vessels and mature in the thymus gland. Some T-cells kill pathogens while others regulate other cell function.B-cells: mature in red bone marrow. B-cells are stimulated by helper cells to make antibodies (antibodies are proteins that destroy or neutralize pathogens)."

"The organism has still other ways and means of defending itself. At the time of bacterial infection, certain germ-killing substances are developed in the blood serum. Science has named these defensive proteins alexins. It has also been found that the phagocyte and tissue cells in the neighborhood of the area of irritation produce antipoisons or natural antitoxins, which neutralize the bacterial poisons and kill the microorganisms of disease." http://www.soilandhealth.org/02/0201hyglibcat/020123lindlahr/020123ch8.html

Now...here's the "biggie"...Toxoids are toxins that are treated so as to destroy its toxicity, but still capable of inducing the formation of antibiodies.

What the heck am I saying, you ask? This is where our immunizations come into play. Most of our vaccines are made by adding mercury or aluminum. These positive charged metals...not needed or wanted by the human body... are what is used to make a vaccine from a toxin (scientists use the diphtheria toxin...add some aluminum to make part one of the DPT shots...we all HAD to have). Darn, darn double darn.

Magnesium chelates (removes) many metals. Malic acid chelates aluminum. Selenium chelates mercury.

Support Mother Nature with as NATURAL substances as possible to restore the delicate, delicate balance.

More later, I have a house guest.

 

Lots of sagacity in this thread on herxing and attending the herx.

As most of us have had, I've had severe herxes and agree that there is a time to back down, not continue w/ abx while herxing, and to medically attend the herx.
I felt like I had a U.S. military "Daisy Cutter" going off in my head. A "4th of July cytokine storm" in the brain.

Many accounts of deaths from herxes in the lyme literature.

On Vit C.:
This should be re-considered, at least in the massive doses suggested.

In lyme at least, many dietary supps. have the paradoxical effect of worsening symptoms.

Unfortunately, Vit. C, at least when taken in oral form results in an increased production of the natural neurotoxin called Quinolinic acid, leading to demyelinizaton(white-matter degradation)

For accounts of certain vitamins and minerals and their effects in lyme disease, please see writings of Tom Grier http://www.lymealliance.org

dq

[This message has been edited by DiffyQue (edited 11 February 2004).]
 

When they get home, tell them to "work out". Latest (news) is exercise helps. No
*^%#...oxyhemaglobin = neg. charge.

The neg. charges (this includes the acids) PROTECT us, but too many are NOT good. (Heat and frequency too...but another story.) Balance...gotta restore the balance...and NOT throw it off in ANY other direction!!! Small doses, spaced. SLOWLY, SLOWLY.
 

Kuwait, Iraq etc. are loaded w/ uranium ammunition rounds.
I heard approx. a hundred hours of material and interviews of soldiers by Gary Null and other experts who covered the vaccine, and uranium issues.
In case anyone has loved ones who were in the Gulf War, and other military actions, theres lots of material on, and more leads to these topics at this site: http://www.garynull.com

quote:

---

Originally posted by Marnie:
Hey DQ...sort of explains Gulf War syndrome, doesn't it? Make those brave men work out..."get in shape". Don't give them enough serious good nutrition/supplements to compensate for the extreme work-outs, usually in the heat. Shoot them with a ton of vaccines. (Depress their immune further.) Ship them off to another country where they are probably exposed to a "new-for-them" bug. Add uranium to the tip of the bombs so they think they have uranium - radiation poisoning (strong neg. charge).(See the news re: Gulf War British victims)

When they get home, tell them to "work out". Latest (news) is exercise helps. No
*^%#...oxyhemaglobin = neg. charge.

The neg. charges (this includes the acids) PROTECT us, but too many are NOT good. (Heat and frequency too...but another story.) Balance...gotta restore the balance...and NOT throw it off in ANY other direction!!! Small doses, spaced. SLOWLY, SLOWLY.

---

[This message has been edited by DiffyQue (edited 23 June 2003).]
 

Thought I would revive this excellent thread.

I very much agree take it slowly, the turtle wins the race!

Be kind to ourselves.

I am just recovering from a herx from Samento and am going to take as long as I need to before resuming and then pulse. I've learnt a very hard lesson.

I used to think no pain no gain and even got out my old Nietzche books! It's machismo gone mad!

Let's listen to our feminine sides and get out our Jung books instead!

Life isn't a straight line, its a long sensuous detour. As the Toaism says it wandering along the way!

I 'll better stop before I get too poetic!

Healing thoughts,

Wallace
 

My question is this: When certain physicians say to go off meds for a couple of days or take more VItamin C to detox WHAT SPECIFIC herx symptoms do their patients feel to warrant this decision?? Problems breathing, severe pain, major fatigue? What is the threshold?

My symptoms when herxing are severe fatigue and weakness that lasts for a few hours each day. I drink TONS of water and try to drink lemon water, green tea, etc. Would this warrant going off the meds for me and for others like me?

Looking forward to more discussion on this and plan to ask my LLMD about it today in our phone consultation. (she does phone consultations to monitor progess each week).

Thanks,
cristine
 

From experience, and the deaths from herxes that I read about and inferred in, and from the literature, a herx needs to be taken seriously; else heart attack, burst aneurysm, or creation of an aneurysm in brain, aorta, etc. More brain and other organ system damage than one already has. One can "blow-out" an organ or part/section/area of an organ.

The next time I undergo i.v. abx, or an oral abx(s) that induce a herx, you better believe that I will have on hand one or more things to quell the herx to a level I think I can handle, if not quell it all together.

To-date, no posts from the hereafter informing us.

dq

[This message has been edited by DiffyQue (edited 11 February 2004).]
 

When I was first diagnosed and put on rocephin, the herx put me in the hospital for 3 days...
 

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Carole
Soon-to-be-Grandmother to #4!
 

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Carole
Soon-to-be-Grandmother to #4!
 

quote:

---

Originally posted by cristine04:
My question is this: When certain physicians say to go off meds for a couple of days or take more VItamin C to detox WHAT SPECIFIC herx symptoms do their patients feel to warrant this decision?? Problems breathing, severe pain, major fatigue? What is the threshold?

My symptoms when herxing are severe fatigue and weakness that lasts for a few hours each day.

---

Christine,
Usually, taking a break from abx is done when the symptoms become intolerable rather than merely inconvenient or uncomfortable.

Our daughter's first Herx caused fever (102.7) and a preceptious drop in WBCs. Fever over 100.5 means stop the IV abx, we were told. WBCs below 3, ditto. However, the WBCs come back up rather quickly, so IV abx can usually be resumed after about a week, give or take a couple of days, depending on the WBC count.

Another sign would be a bad cough that threatens to progress into an active bronchial infection. That means don't push it. Stop and let the body clear the dead and dying "keets" and clean up all the toxic debris so that the immune system can restore its balance again.

Other reasons to pause might be for a severely debilitated person who has been completely housebound and plastered on the couch 24/7. They need a "sanity break" from the abx just so that they don't get too frustrated and discouraged and think that the therapy is failing. One or two days off each week helps their immune systems to resume a more nearly normal level of homeostasis, which can be beneficial.

For persons who are still able to function and who are not totally disabled by LD, then pausing the abx might not be necessary at all -- unless once in a great while just to try to take stock of where one is without them.

Bb is a slow-growing organism, so it's considered to be safe to pause the abx for a couple of days without creating abx resistance -- or at least according to current medical thinking, that is.

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Carole
Soon-to-be-Grandmother to #4!
 

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Carole
Soon-to-be-Grandmother to #4!
 

I STILL dont see folks having the same herx symptoms as me though. That worries me.

I am sooooo dizzy again today and been off all meds for 6 1/2 days now.

is the mepron/zith herx different than plain ABX herx?

very informative thread, thanks, Trails

 

Karen