The Jarisch Herxheimer Reaction (herx) is a detoxification reaction in the body typically experienced after someone has started antibiotic therapy for Lyme and tick borne diseases (and other spirochetal diseases). It is quite common and is known to be very miserable in some cases.

A "herx" typically involves a worsening of symptoms (and possibly new ones appearing) that can last hours, days or weeks (sometimes longer) after beginning treatment. Prolonged reactions can cause damage to organs and tissues in the body.

Sometimes a "herx" can be mild and barely noticeable; other times it can be intense and even life-threatening. Some patients have died as a result of this reaction.

Each person can respond differently when the toxins hit their system. Depression is a common symptom that appears or intensifies during a "herx", as well as body aches, fever, chills and more.

Please contact your health care provider if you are experiencing harsh or non-abating symptoms.

On the pages in this section are some detox methods and tips from Lyme treating professionals that may help reduce the 'miserable' you feel when herxing.

The GOOD NEWS- If properly addressed it will get better!

Scientific Studies & Abstracts- dated from 2003- 2017

Mental Health Issues- JHR (Jarisch-Herxheimer Reactions) Can Cause or Worsen Mental & Emotional Symptoms

Herxheimer Reactions- "...over prolonged periods of time may cause tissue damage from the excessive release of endotoxins and cytokines." [Dr. Susan Marra]

Herxheimer- Severe & Intense Reactions- "We have treated a number of individuals whose Herxheimer experience is so intense and prolonged that continued treatment is virtually impossible." [Dr. Jemsek]

Treating A Herxheimer- Dr. Richard Horowitz

There Is No Place For Heroes In This Disease- When a herx is too much, pulling back on the therapeutic throttle is often appropriate. Herxes can be terribly damaging. [Dr. Fishman]

Cerebral Edema- "severe CNS symptoms, such as incapacitating headache".. "in 2-3% of our treated cases, we have had to resort to one or more therapeutic lumbar punctures to provide relief by lowering intracranial pressure." [Dr. Jemsek]

Duration of JH Symptoms- "These symptoms may persist for days or weeks and often become a major management concern as our patient may suffer considerably in the process of treatment." [Dr. Jemsek]

Reducing Acute JH Symptoms- Herxheimer Reducing Recipe [Dr. Horowitz]

CD 57- May go down during JH reactions. [Dr. Stricker]

Slowing Down Reaction- Some agents will slow the inflammatory reaction such as: Willow Bark, Omega-3, zinc (many are zinc deficient), turmeric, ginger, licorice root. Many of these quiet down NFK-ß. Probiotics help dampen the cytokine response in the gut. His favorite is 87 Vitamin D3. [Dr. Fishman]

Herx Reaction- Lyme treatment may actually increase the activity of XMRV. [Dr. Joe Brewer]

Pulsing Treatment- LLMD’s (Lyme literate medical doctor’s) who are aware of JH often like to treat those affected in pulses. [Dr. Joe Brewer]

Heart Related Symptoms- chronically low blood pressure, causing the heart to overcompensate by beating faster-resulting in palpitations (tachycardia). Due to the poor cerebral blood flow, fatigue, dizziness, poor concentration problems and nearly or actually passing out are common symptoms. [Dr. Horowitz]

Adjusting Doses- Can adjust dose to patient tolerance to minimize Herx responses. [Dr. Anderson]

Parsley- may be used at 10 drops every ten minutes for one to two hours for detoxification or herxheimer symptoms. [Dr. Horowitz]

Treating the JH Flare Reaction- full length article [Dr. Stuart Weg]

Byron White- some have severe herxes but overall benefits. [Dr. Horowitz]

Dosing & Timing- start on only one new medication per week. I space out the timing of new medications so that if patients have a negative reaction to a medication, then they will know right away which one it is. I also do this so that they won’t “Herx” too much. [Dr. Nicola McFadzean]

Timing of New Medications- some people don’t “Herx” until three or four days after taking a medication, which means that their Herxheimer reactions may not yet be well cleared after a week. If this happens, then I wait until they are over the worst of their Herxheimer, before starting them on a new medication. [Dr. Nicola McFadzean]

Hyperbaric Chamber- Jarisch-Herxheimer reaction was expected to appear in all subjects if destruction of the spirochetes took place. [Rapid Recovery Hyperbarics]

Glutathione & Herx- use IV glutathione as a potent antioxidant and to support liver detoxification [Dr. Ross]

Comment JHR- symptoms, treatment and more [LymeNet]

Jemsek- “...look at the fact that we need to do appropriate therapy and understand the toxicity of therapy, and we must we take advantage of the life cycles of these organisms, so we don’t treat every single day. We treat with combinations… multiple therapy, but with pulsing."

Experienced Diver Meets Mr. Herxheimer- "I urged him to come back to my office to be tested for tick-borne diseases, since what he was experiencing sounded for all the world like an oxygen-prompted Jarisch-Herxheimer [cytokine] excessive immune system reaction to a kill-off of toxic spirochetes—the bacterial cause of Lyme disease." [Dr. Virginia T. Sherr]

Treating the Herx Reaction

See the new Treating Lyme & Tick Borne Diseases website. Look under the headings "Herxheimer Reactions" and "Herxheimer Reaction Treatment".

Last Updated- April 2019

Lucy Barnes