The Healing Crisis
AKA: Jarisch-Herxheimer Reaction (JHR), Jarisch- Herxheimer (J-H) , The Herxheimer Reaction, The Herxheimer Effect, Lucio's Phenomena, The Healing Crisis, The "die-off”, Herx, The Cleansing Reaction, The Detox Reaction
“You have to get worse, before you get better”
Post remedial massage clients report periodic aggravation of their symptoms as an apparent direct response to their remedial massage treatment. In other words, these clients say that their treatment makes them feel much worse before they experience they feel better.
This phenomenon is known as the Jarisch-Herxheimer Reaction (JHR). JHR is believed to be caused when injured or dead bacteria release their endotoxins into blood and tissues faster than the body can comfortably handle it (1,2). This provokes a sudden and exaggerated inflammatory response and is associated with the systemic appearance of cytokines.
Cytokines are a category of signalling proteins and glycoproteins, which, like hormones and neurotransmitters, are used extensively in cellular communication. While hormones are secreted from specific organs to the blood and neurotransmitters are related to neural activity, the cytokines are a more diverse class of compounds in terms of origin and purpose.
They are produced by a wide variety of haematopoietic and non-haematopoietic cell types and can have effects on both nearby cells or throughout the organism, sometimes strongly dependent on the presence of other chemicals. The cytokine family consists mainly of smaller, water-soluble proteins and glycoproteins. “The JHR is an elegant model of the human cytokine cascade in events resembling sepsis…” (3).
JHR is your body's reaction to the release, mobilisation and over abundance of dead or dying bacteria, fungus, cell particles, antigens, yeast and viruses as a result of your treatment. This reaction is NOT COUNTERPRODUCTIVE or a COUNTER ACTION of the process. It is your body telling you to flush it more quickly.
The more toxic one's body is, the more severe the detoxification, or healing crisis. When the body tries to eliminate toxins at a faster rate than it actually can manage, you may actually feel worse and therefore conclude that the treatment is not working.
It is characterized by a temporary increase in symptoms during the cleansing or detoxification process which may be mild or severe. But these reactions are instead signs that the treatment is working and that your body is going through the process of cleaning itself of impurities, toxins and imbalances.
Such reactions are temporary and can occur immediately or within several days of a remedial massage. Symptoms usually pass within one to three days but on very rare occasions can last several weeks. In any case, a cleansing & purifying process is underway, and stored wastes are in a free-flowing state. The healing crisis is the result of every body-system, in concert, working to eliminate waste products through all elimination channels and set the stage for regeneration.
JHR has shown an increase in inflammatory cytokines during the period of exacerbation, including tumour necrosis factor alpha, interleukin-6 and interleukin-8 (4,5)
Endotoxins, not to be confused with enterotoxin, are potentially toxic, natural compounds found inside pathogens such as bacteria. Classically, an "endotoxin" is a toxin, which unlike an "exotoxin", is not secreted in soluble form by live bacteria, but is a structural component in the bacteria which is released mainly when bacteria are lysed, which refers to the death of a cell by breaking of the cellular membrane.
The good news is that the JHR is thought to indicate that the treatment is indeed working and that following each worsening may bring about more improvement. However the lack of JHR should not cause anxiety if symptoms are improving. The more bacteria present and the stronger the symptoms and reaction.
Two common sources are a remedial massage following a period, possibly long term, of decreased the blood flow, which allows the toxins to accumulate and the other a period of increased the die off of parasites.
Other factors which may increase the probability of JHR are;
• Anxiety, fear and worry
• Hormonal imbalances
• Enzymes, pancreatin, bromelain, etc.
• Clotting agents, heavy foods
• Chronic illnesses
• High doses of vitamins
• Excessive exercise
• Fatigue, tiredness, exhaustion
• Exposure to cold temperatures
• Air pollution
The healing crisis will usually bring about past conditions in whatever order the body is capable of handling at that time. People often forget the diseases or injuries they have had in the past, but are usually reminded during the crisis.
There are a wide variety of reactions that may manifest during a healing crisis, the most common ones include:
• Fatigue or restlessness
• Arthritic flair up
• Frequent urination and/or urinary tract discharges
• Skin eruptions, including: boils, hives, and rashes
• Headaches or migraines
• Ringing in the ears
• Mental dullness and disorientation
• Cold or flu-like symptoms
• Swollen glands
• Constipation, diarrhoea, or bloating
• Myalgia increased joint or muscle pain
• Elevated heart rate
• Chills, cold extremities
• Itching, scratching
• Unusual perspiration
• Fever (usually low grade) and/or chills
• Hypotension (low blood pressure)
• Sinus congestion
• Itching, hives and rash (sometimes assumed to be an allergic reaction)
• Emotions swings: anger, despair, sadness, fear, anxiety etc.
• Suppressed memories arise
Easing Your Way through the Healing Crisis:
Drink plenty of water, juices and herbal teas to flush the body of toxins. If you find water unpleasant then add favour to it, such as sliced lemons or cordial. Some professionals recommend distilled water as the best. Drink from 2 to 4 litres per day. This will help flush the toxins out of your system and speed along the detoxification.
If you are feeling fatigued, or sleepy, your body is talking to you and telling you to rest. Be kind to yourself and get the rest that you need and sleep.
Symptoms frequently disappear immediately after a good bowel movement.
Depending on your lifestyle and in which modalities you follow solutions vary. It is logical to conclude that improving the blood flow to clear the toxins faster and/or neutralizing the toxins will reduce symptoms;
Ask your doctor or pharmacist about;
Flavanoids (widens blood vessels)
Blood thinning supplements
Enemas, Colemas, Colonics
Ask your Wellness Consultants about;
Enemas, Colemas, Colonics
Aerobic oxygen supplementation
Olive Oil Extract
Liver/gall bladder cleanses
Infrared Hot House treatment
Encourage perspiration and excretion by;
Drinking plenty of water, favoured if you dislike the taste
Spit out any phlegm
Blow your nose rather than sniffing
Relaxation techniques, such as yoga and meditation
The trusted advice of Russell McMillan, DDS, DPH, who wrote the Arthritis Trust of America in 1994 with his personal remedy for the JHR maybe the most pleasant of all treatments. "I take a saltz bath which consists of adding 1 cup salt, 1 cup soda, 1 cup Epsom salts, 1 cup aloe vera, to a hot bath which I remain in and keep hot for about 1½ hours, all the while consuming about 2 quarts (4 litres) of warm water. Evidently the perspiration and osmotic pressure removes the causative toxins. I find it quite helpful."