posted
its well documented that in the original example where Dr. Herxhiemer coined the phrase when treating syphilis patients with antibiotics the phenomenon lasted only a few days - 2 or 3 I think - and that was that. the mechanism was thought to be the release of bacterial lipopolysaccharides from the bacterias' cells as they are destroyed.
whereas plenty of us in the Lyme community seem to experience what we have come to call herx that last for weeks and even months (i have had them last for 12 weeks or more from taking herbs most people should be able to take as a healthy tonic! )
is it really credible that this is caused by bacterial die-off in sufficient quantity after 6 months of multiple antibiotics to make people extra sick?
what other mechanisms could be at work here?
for instance; could it simply be leaky gut + antibiotics lead to lots of lipopolysaccharides in the blood and therefore sickness symptoms?
or what other mechanisms have people theorized or come across
Posts: 245 | From UK | Registered: Feb 2020
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Bartenderbonnie
Frequent Contributor (1K+ posts)
Member # 49177
posted
Here is Dr H explaining Herx mechanisms in COVID-19 and Lyme, both which follow the same pathways, at the 11:00 minute mark on video;
posted
thanks for the link. worth a listen. he is a very passionate guy. I have both of his Lyme books also.
I don't doubt that ultimately the herx symptoms are caused by cytokines and raised inflammation.
but my question is what exactly is causing these cytokines to be so raised for so long - months rather than days of the original herxhiemer reactions.
It seems counter-intuitive that sufficient allergenic material can still be being produced by bacterial killing several months into multi-antibiotic regimes.
Think for example of the people here on disulfiram or Dapsone - where the herx reactions seem like they can go on for months.
this is a major barrier to effective treatment so i think it worth asking if there is actually another mechanism at play here.
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Phoiph
Frequent Contributor (1K+ posts)
Member # 41238
posted
Garz,
I agree with your assessment that an extended "Herx" may not really be a "Herx".
When I was ill, I was told for months that the decline I was experiencing on antibiotics and other treatments was a "Herx", when it was actually a continual downward spiral.
I believe the body can go into a "cytokine storm" mode, where the neuro-immune inflammatory response spins out of control and becomes self-perpetuating.
A trigger may be Lyme and coinfections, but whether it becomes chronic (and the cytokine storm ensues) may depend on the cumulative effect of many factors, including genetics, ability to detox, gut biome/health, past and present toxic exposures, brain insults, injuries, nutritional status, life stressors/trauma, etc.
In my opinion, automatically labeling an extended reaction a "Herx" can be a misleading and potentially dangerous thing, as it can lead people down a misguided treatment path for years.
Posts: 1883 | From Earth | Registered: Jul 2013
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thank you for your thoughts - yes, i agree that is certainly one of the possible mechanisms that are at play.
Horowitz writes about "Good herx" where patients have increased symptoms and then feel much better afterward - and "bad herx" - where patients simply to continue to feel bad or worse as the treatment protocol goes on.
in the former, he advocates continuing and in the latter, he advises a change in protocol.
this could indeed fit with your proposed mechanism - where those with a "bad herx" are experiencing an ongoing increase in inflammatory cytokines that are not slowing down.
in my own case I get herx like symptoms from antibiotics, probiotics, prebiotics, fiber but particularly from antimicrobial herbs and even some that are not supposed to be highly antimicrobial. Sometimes after long courses, I do feel better and seem to improve - but often seem to relapse. at others even after long courses I just continue to have herx like symptoms and no improvement so I seem to be somewhere in the middle of good herx / bad herx. this makes it frustrating given all the hard work and discomfort endured. and also difficult to know what to do for the best.
i suspect there are many people in the same position - that's why i am interested in a wider discussion of the topic
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Phoiph
Frequent Contributor (1K+ posts)
Member # 41238
posted
Garz,
I don't want to hijack your thread, so I will just suggest that you consider reading the Mild Hyperbaric thread in its entirety (49 pages):
There is discussion on your topic, and you can follow many people's journeys through this phase and getting their lives back.
I became well and med-free from 8 years of severe Neurolyme and coinfections with mHBOT when all else failed. Feel free to PM me.
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Phoiph
Frequent Contributor (1K+ posts)
Member # 41238
posted
quote:Originally posted by Garz: @Phioph
"...in my own case I get herx like symptoms from antibiotics, probiotics, prebiotics, fiber but particularly from antimicrobial herbs and even some that are not supposed to be highly antimicrobial..."
Consider that some of those substances may not be "antimicrobial" in and of themselves, but they may have an immune modulating effect (e.g., balancing the TH1/TH2 arms of the immune system). When the immune system function changes and begins to work on pathogens, it can feel like a "Herx".
As you experienced, however, the balancing act doesn't last, because it is a superficial reaction; there is not enough underlying healing of the immune system to retain the benefits at that point.
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There is discussion on your topic, and you can follow many people's journeys through this phase and getting their lives back.
I became well and med-free from 8 years of severe Neurolyme and coinfections with mHBOT when all else failed. Feel free to PM me.
thanks for the suggestion - I very much appreciate it. that topic has been on my list for a while as its something I know very little about - just couldn't face the 49 pages yet! oh well - every journey begins with just one step - and your message gives me that extra bit of motivation Posts: 245 | From UK | Registered: Feb 2020
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Cass A
Frequent Contributor (1K+ posts)
Member # 11134
posted
Garz,
I'm very glad that Phoiph wrote to you.
Personally, I have been on treatment plans that didn't really go anywhere for a year or more.
Also, it is important to understand that drugs, and even the actions of some herbs, are based in being poisons or toxic (at least to something). Sometimes that "something" can include your body!
A very few things have helped a lot.
I'm just starting with mHBOT now.
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