posted
Doc took me off biaxin for 5 days because of diareaha, since restarting monday tummy ok but I hurt everywhere, my muscles hurt all over my body and joints in hands are stiff and achey. Feel real shakky and weak. Just scarred cuz I get tested every other month for kidney and liver enzymes, always been normal, but I let my mind get the best of me and wonder if they were up if that would make me feel this way? Do you think this is a herx and how long can one last?
Yikespanic in a panic Posts: 33 | From OH | Registered: Feb 2006
| IP: Logged |
TheCrimeOfLyme
Frequent Contributor (1K+ posts)
Member # 4019
posted
Im no doctor, but it COULD be a herx. It depends on alot of individual factors for how long a herx lasts. Some people herx a few days, some a few weeks and some just herx their arse off all the time.
The easiest way to figure out what is going on with yoru body is to buy some cheap journals. I bought 5 at the dollar store for 5 bucks
and EVERY single day, write in there what you took ( medicine and supplements)
the date
how you feel including ALL symptoms
and do this EVERY day. It took me three solid months ( and I never missed a day writing in there)
to pick out my herxes. SOME people DO herx on a cycle ( I do, I herx every 28 days pretty much on the nose)
and you MAY be able to find a cycle. ( if you are a female, you may notice a HUGE increase in symptoms around your period too due to the drop in hormones and elevation of others that DO affect some bacteria)
Keep watching and writing down if possible, a journal. It will help you so much and you can refer back to it at a later date if you need to know what antibiotic took care of the pain,etc.
I hope this helps.
-------------------- You want your life back? Take it. Posts: 3169 | From Greensburg, Pennsylvania | Registered: Jun 2003
| IP: Logged |
posted
Here is some information from an LLMD regarding the HERX. I have found much of this info to be true, though the ideas regarding the yeast thing I personally know very little about. One should only take the smallest dose of medicine that produces a herx(provided that the dose is in the normal antimicrobial range - assume that to be a given)
Jarisch-Herxheimer Reactions
These reactions were discovered by Dr. Jarisch and Dr. Herxheimer, and result from taking antibiotics. The reaction is that symptoms get worse. As antibiotics kill germs, the germs (such as bacteria) die and they release their toxins. Symptoms are caused by toxins. So, the Jarisch-Herxheimer reaction is thought to be due to significant amounts of toxin, causing symptoms.
An example of toxins causing symptoms would be Strep throat. The reason your throat hurts is due to toxins from the Streptococci bacteria. Likewise, the flu makes you achy and feel lousy, due to toxins from the virus.
Syphilis, relapsing fever, and Babesiosis are other infections that call for antibiotics which cause Jarisch-Herxheimer reactions. Why these reactions are not seen with all infections is unknown.
Borreliosis (Lyme disease) is highly associated with Jarisch-Herxheimer reactions. Most of my patients with Borreliosis have these reactions. Since different species of Borrelia cause the clinical pattern of symptoms associated with Lyme disease, then Borreliosis is a more accurate term. This is an infection. Old Lyme is a town in Connecticut. So I use the name Borreliosis, not Lyme disease.
Jarisch-Herxheimer reactions are often called Herxheimers for short. Or even Herx is used to avoid the tongue twister that arises from the full name!
Bacterial load is a concept about how much bacteria is present in the patient's body. More bacteria means a higher load. Herxheimer reactions should be worse if the load of bacteria is greater.
If a patient has 10 billion Borrelia burgdorferi (one of the bacteria that causes Borreliosis), and an antibiotic killed 5 percent, the Herx would be worse than if the patient had 60 thousand bacteria and 5 percent were killed. These numbers are arbitrary, and just used to make a point.
The worse the Jarisch-Herxheimer reaction, the better the antibiotic is working! If more bacteria die, more toxin is released at their death. Greater toxin levels make the symptoms worse. Again, worsening symptoms while on antibiotics, is what the Herxheimer reaction is.
Bacterial load may explain why some patients have a worse Herx than others. In general, as Borreliosis patients get better and better, their Herxheimer reactions get milder and milder. As the antibiotics slowly chip away at the "iceberg" of Borrelia burgdorferi, it gets smaller and smaller. Smaller amounts (loads) of bacteria mean milder Herx reactions should occur.
Patterns often occur with Jarisch-Herxheimer reactions. Most commonly, if there is a pattern, it is every 4 weeks. In some patients it is so predictable, they may almost set their calendar by it. The shortest pattern I have seen is every 7 days, and the longest is every 6 weeks.
Not all Borreliosis patients have Herxheimers, and some that do have no pattern. If a Herx occurs, it is highly significant. Clinically, this tells us that we are on the right track. It is just as significant as improvement in symptoms from taking antibiotics, if not more so. The Herxheimer is very helpful in making the clinical diagnosis to support a laboratory diagnosis (test result).
In 1988, if my Borreliosis patients had a Jarisch-Herxheimer reaction, I changed their antibiotic. Later it was realized that the reaction was because the antibiotic was working. So patients were told to try to stay on antibiotics during the Herxheimer.
It was then discovered that staying on antibiotics caused more trouble than good, if patients were having a Herx. Borreliosis patients usually lose ground if they stay on antibiotics when Herxheimers hit.
Some of the saddest Borreliosis patients I have are ones that did not take my advice, and stayed on antibiotics 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 them. 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 heroes or heroines. Toughness is not needed. "No pain, no gain" does not apply to Jarisch-Herxheimer reactions!
Questions often arise. Patients want to know what to do if the Herxheimer is mild. Worsening of symptoms may be due to the variation associated with Borreliosis. One of the classic features of Lyme Borreliosis is change. Patients have good days and bad days, good and bad weeks or seasons, and good and bad hours. So, what do you do with a mild Herxheimer?
Experience has taught me to tell patients to go off antibiotics if there is any question about whether or not a Herx is occurring. In an article I have, researchers took 10 1/2 months before they could see the Borrelia burgdorferi growing in the test tube. This is an incredibly slow growing bacteria! So, if you go off antibiotics to get over a Herx, you are not losing ground like you would with Strep or Staph infections. These bacteria grow very fast, unlike Borrelia burgdorferi.
Going off antibiotics for a Herxheimer, usually results in symptom improvement by 3 days, and definitely 6 days. This is true, until you use Flagyl (Metronidazole), or Mepron with Zithromax. These antibiotics tend to cause very severe Herxheimers, and often take longer than 3 to 6 days for the symptoms to get better.
This is a two-edged sword. The worse the Herxheimer, the better the antibiotics are working. So Flagyl or Mepron with Zithromax, is also associated with much better clinical improvement. The key is to start with low doses of these antibiotics, and increase the doses slowly.
Some Borreliosis patients have required about a month to come out of a Herx caused by Flagyl or Mepron with Zithromax. It is important to get off these antibiotics at the first sign of a Jarisch-Herxheimer reaction. Prolonged recovery times from Herxheimers are usually seen with high doses, or patients that tried to tough it out and stay on antibiotics as their symptoms worsened.
In general, Herxheimer reactions are a worsening of previously existing Borreliosis symptoms. But I have learned that a worsening of new symptoms may also be due to a Herx. So, I advise patients that a worsening of existing, past, or new symptoms is a strong indication to go off antibiotics until they feel better.
Two other reactions need to be distinguished from Jarisch-Herxheimer reactions. These are drug side effects and allergic reactions.
Drug side effects from antibiotics are usually gastrointestinal. Nausea, vomiting, heartburn, gas, diarrhea, bloating, irritable bowel syndrome (spastic colon), intestinal cramps, and constipation are examples. Borreliosis may cause abdominal pain. But most patients have a pretty good idea if the pain is a gastrointestinal drug side effect, versus a Herx.
Allergic reactions are associated with itchy red rashes (drug exanthems), hives (whelps, urticaria), tightness in the throat, and difficulty breathing or shortness of breath. Borreliosis may cause hives.
The skin is one of the target organs of Borrelia burgdorferi. So a great variety of rashes are seen in Borreliosis patients. Again, most patients are able to distinguish an allergic reaction from a Herxheimer. A lot of patients, who think they are allergic to antibiotics, actually experienced a Herxheimer. A history of multiple antibiotic "allergies", is a clue to look for possible Borreliosis.
Steroids, such as Prednisone or Medrol, are best avoided if possible. They suppress the immune system and promote yeast growth. But if the Jarisch-Herxheimer reaction is severe enough, steroids may be needed. Some patients even have to be hospitalized, due to the Herxheimer! Usually, going off the antibiotics is all that is required for the worsening of symptoms to resolve. Drinking extra water and rest are helpful.
Some patients with Borreliosis Herx on the first day they take an antibiotic. Or the reaction may occur months later. With Flagyl or Mepron with Zithromax, patterns are not as common, like is seen with other antibiotics. My success rate in helping Borreliosis patients has sky-rocketed since I started using Flagyl or Mepron with Zithromax. Since Flagyl and Mepron may both cause severe Herxheimers, it would be best in general to not take these together. Patients who have, responded nicely, but very low doses were needed, until the Herxheimer reaction severity was determined.
Borreliosis, like Syphilis, may mimic or imitate virtually any disease, and cause virtually any symptom. So, a Jarisch-Herxheimer reaction may be a worsening of virtually any symptom. But it is more likely to be the symptoms that are typically experienced by Borreliosis patients.
On the Lyme Borreliosis questionnaire, there are about 100 symptoms. This is not an all inclusive list. The classic triad of Borreliosis symptoms is fatigue (tired, exhausted), musculoskeletal pain (joints, muscles, back, neck, headache), and cognitive changes (memory loss, decreased mental concentration, trouble remembering what you read, disorientation, getting lost, depression). So, a Herxheimer usually includes a worsening of these classic symptoms in the triad.
Sometimes a Herx is a worsening of all symptoms. Or one or some symptoms may worsen, while other are unchanged.
Musculoskeletal pain, or neurogenic (generated by the nerves) pain may require strong pain medicine. More pain from a Herx does not justify using more pain medicine to stay on antibiotics. Patients lose more ground than they gain if they stay on antibiotics during a Herxheimer. Masking or hiding worse pain with drugs is a huge mistake.
Sometimes after going off antibiotics, patients get a mixed picture. The symptoms that became worse while on antibiotics may start to get better. But other Borreliosis symptoms that did not change during the Herx, may start to get worse. In this case, try going back on antibiotics. A lower dose may be needed, or pulse therapy.
An example of pulse therapy would be to take a "sliver" of a Flagyl pill every 4 days. I had a patient that got better using this regimen.
Since Flagyl or Mepron with Zithromax may cause severe Herxheimers, most patients do better with low doses. The message I hear over and over from my patients, is that a low dose taken slowly works better for most people.
The dose that results in the patient getting slowly better and, if they have a Herx, it is a mild one, is the correct dose. This is a "fairy tale" infection. Believe me, the turtles win the race, not the rabbits!
Everybody wants to be normal and healthy yesterday, but you did not get sick in a day. Almost all Borreliosis patients get better. I cannot guarantee anything to anybody. But focus on the good and positive. I am a huge believer in the mind and body connection. Keep telling your brain that you are in the majority that gets better.
The goal is for all Borreliosis patients to get healthy, and be able to fire me. I want everyone to go on with their lives, and be normal! Many people joke that normal for them is an unknown.
One of the keys to getting well, is finding the correct antibiotic. If an antibiotic works, it usually causes Herxheimers. So, another key to getting well, is learning to maneuver around the Herx obstacle course! Please read these guidelines more than once. If you have a question, the answer is probably in the guidelines. This will save you a phone call. But if you are unsure, please call.
Virtually everything written here about Borreliosis Herxheimer reactions also applies to Babesiosis. Babesia microti is a protozoa. It is not a bacteria, virus, fungus, or yeast. Other examples of protozoal infections would be malaria and giardia. Because protozoa are different types of germs, the usual Borreliosis antibiotics do not work.
Most Borreliosis patients also have Babesiosis. As malaria is spread by mosquitoes, Babesiosis is spread by ticks. Blood is involved in both. Babesia microti likes to live in red blood cells, like malaria.
The symptoms of Babesiosis are the same as Borreliosis, except that Babesiosis causes more sweats and fever. So, Babesiosis is just as big of a deal as Borreliosis, if not bigger. My success rate in helping Borreliosis patients dramatically improved when I started searching for and treating Babesiosis also!
Babesiosis also is associated with Jarisch-Herxheimer reactions. Regardless of whether you have Lyme Borreliosis or Babesiosis or both, all of the Herxheimer guidelines apply. Some patients tell me that they are able to distinguish which symptoms are from which infection. Regardless, just follow the rules. Coloring outside the lines is best left to artists!
About 1992 I had a patient ask me to treat her for intestinal yeast. Like most medical doctors I would not listen to her. Intestinal yeast is not taught in medical schools or residencies. But she kept begging me, so I gave her a prescription for Nystatin pills, to kill yeast.
She got dramatically better with the Nystatin, and also by changing her diet with adding good bacteria back into her system. This was my first eye-opening experience that there was another world out there, besides traditional orthodox main-stream Western medicine. The number one risk factor for intestinal yeast is antibiotics. The other 3 are steroids, birth control pills, and pregnancy. Since the number one risk factor is antibiotics, and that is the treatment for Borreliosis, I started treating my hundreds and hundreds of Borreliosis patients with the yeast protocol. The patients got dramatically better! This forever changed my professional life. Once your eyes have been opened to the fact that some alternative treatments have merit, others are worth consideration.
The real issue with yeast is the immune system. I have two files full of articles showing that yeast suppresses the immune system. If you have a chronic Borrelia burgdorferi infection, the last thing you want is a suppressed immune system. Babesiosis and Ehrlichiosis are also chronic persistent infections, spread by ticks.
An article in the New England Journal of Medicine concluded that intestinal yeast was not a real issue. But they did not change the diet. I could have told the researchers before they started the experiment that the patients would not get better.
Three things have to be done. The yeast has to be killed, usually with Nystatin or Diflucan. Diet changes, including avoiding sugar and fructose (the sugar in fruit), along with sometimes avoiding other carbohydrates, is the second component. And lastly the good bacteria, such as Lactobacillus acidophilus and Bifidobacterium bifidus need to be taken. The good bacteria are called probiotics.
Scientists like to change just one variable in an experiment. If you use Nystatin or a placebo pill that looks like Nystatin, that would be scientifically ideal. But 3 things have to be done. So it is a less than perfect research model. In the real world of day-to-day medical practice, intestinal yeast is absolutely huge.
The yeast questionnaire is included in my Family Practice intake questionnaire. It is amazing how much is seen in a typical practice, that is due to intestinal yeast. Irritable bowel syndrome (spastic colon), premenstrual syndrome (PMS), migraine headache, hypoglycemia (low blood sugar), allergies, and chronic fatigue are just some of the diseases that may resolve with the yeast treatment protocol.
A lot of overlap exists between the symptoms of intestinal yeast and Borreliosis, or Babesiosis. Likewise, the symptoms of adrenal dysfunction and low metabolism are similar. Many Borreliosis patients have hormone imbalance.
An overlap of symptoms is not the issue. The key in treating Borreliosis patients, is to see how many of these other disorders are "straws" breaking the camel's back of your health. The more stones I may turn over, the better my chances are of helping you. Each added arrow in my quiver enhances success. In any disease, it is always better to treat the underlying causes, as opposed to throwing medicine at the symptoms.
When I first meet a new patient for an evaluation for possible Borreliosis, I do not treat for intestinal yeast, or other diseases. It is critical to treat one new thing at a time. For instance, if I start a patient on Tetracycline for Borreliosis and Nystatin for yeast, and the symptoms change, I will not know which one caused the differences.
The number one priority is to try to establish whether or not a patient has Lyme Borreliosis. Once the clinical and/or laboratory diagnosis is made, then it is reasonable to add the yeast protocol.
After patients are on the yeast protocol, and are also on antibiotics for Borreliosis, Babesiosis, Ehrlichiosis, or whatever infection, they need to continue the Nystatin with diet changes and taking probiotics (the good bacteria). Even if it is 10 years later, antibiotics must be accompanied by the yeast protocol, to avoid immune suppression and yeast symptoms.
When yeast die in the intestines from Nystatin, symptoms may result. It is like a Jarisch-Herxheimer reaction. Some yeast experts, like William Crook, MD, call it a die off reaction. Some call it detoxifying, detoxing, or a detox reaction. But it is the same mechanism of toxin release, as in a Jarisch-Herxheimer reaction.
If the protocol on the yeast handout is followed, this die-off reaction from yeast is usually not an issue. But virtually all patients cheat, and when they do, they cheat themselves. When patients eat sugar, their symptoms often get worse. So I do not have to fuss. It is better to be a cheerleader, and encourage patients.
Patients often ask about whether to take Nystatin or Diflucan when they are off of their Borreliosis antibiotics due to a Jarisch-Herxheimer reaction. One expert recommends 40 days of the yeast protocol after stopping any antibiotic. Since I am not aware of any scientific proof to support that, it would be reasonable to stay on Nystatin while off antibiotics for Borreliosis. But if you want to go off Nystatin or Diflucan, it would be acceptable. After you restart antibiotics though, jump back on the yeast protocol bandwagon.
In summary, the key to getting well is finding the correct antibiotic, going off antibiotics during Jarisch-Herxheimer reactions, treating intestinal yeast, and looking for other facets to the illness. The most common of these other facets, are co-infection, low metabolism, adrenal dysfunction, and hormone imbalance. Almost everybody gets better. Focus on the good and positive. If so inclined, pray. Try to keep a since of humor. Realize you are not alone. There are hundreds of Borreliosis patients just like you. And almost all of them are getting better.
Posts: 559 | From Cary, NC | Registered: May 2006
| IP: Logged |
5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Again I am not a doctor either but I can herx MANY days after stopping an ABX.
some things that help me are stepping up my detox methods and cranking up the pro-biotics.
For all overbody and muscle aches the thing that helps me is a warm soak in epson salts. Not too hot this can make the herx worse. Just warm enogh to break a slight sweat.
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
| IP: Logged |
Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
Are you getting any treatment for the pain and stiffness? There is no reason to suffer through a herx without medications to help reduce the pain.
If this continues beyond a few days, then I would suggest you talk to your LLMD abut pain treatment. You may need to see somebody who specializes in pain, because a lot of LLMDs don't really know pain management or are scared of prescribing pain meds on top of longterm abx.
Everybody has different pain meds that work the best. What helps control my pain is:
Flexeril, a muscle relaxer, for my muscle stiffness and pain. Taking it every night helps more than just when needed.
Plaquenil helps reduce stiffness and pain in my hands. This is often prescried with Biaxin, because it helps it penetrate the body. But it also reduces arthritic symptoms in people with RA and Lupus.
Vicodin I take when I still feel pain. It helps everything but my nerve pain.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
![[confused]](graemlins/confused.gif)
Printer-friendly view of this topic