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It Hurts So Good: The Jarisch-Herxheimer Reaction

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"The Scream" by artist Edvard Munch.Credit: Christopher Macsurak's Flickr stream

“The Scream” by artist Edvard Munch.
Credit: Christopher Macsurak’s Flickr stream

Sometimes during my recovery, I want to scream. But I tell myself to hang on. Because with Lyme, you often have to feel worse to get better. Welcome to the Jarisch-Herxheimer Reaction, or “herxing.”

Today, for instance, my chest is tight and burning, and there’s an uncomfortable sensation like ice water running through my veins. I feel ill all over, like you do when you have the flu or a high fever.

There’s more: Joints in my left foot throb, along with both knees and hips. My legs and arms are on fire with a burning pain deep in the tissue, as is my digestive tract. Add in weak muscles and low energy, and you can see why I’m on the sofa.

My mind might as well be underwater, my thinking is so muffled and remote. (As you may have guessed, it’s actually taking me several days to write this post). Chills crawl over my lower back and hips.

On the worst days, I don’t feel up to reading or watching a movie or visiting with a friend by phone. All I want to do is lie here. I’m good with that. Here’s why.

First described by Viennese dermatologists Adolph Jarisch (1895) and Karl Herxheimer (1902), the Jarisch-Herxheimer Reaction refers to an increase in symptoms like chills, fever, and pain early on during treatment for certain illnesses.

These doctors observed the reaction in syphilis patients; later doctors saw it in patients with other illnesses, including Lyme. With Lyme, it may be caused by toxins released as the bacteria die off.

The name is a mouthful, so most people call it herxing. Here’s the good part: The reaction confirms infection, very helpful for diagnosis especially since Lyme testing is unreliable. It means the medication is working.

Case in point: my first herx.

A primary care doctor had prescribed a couple of weeks of antibiotics for possible Lyme following a tick bite, bull’s-eye rash, pain and fatigue. When I suddenly got worse after starting the antibiotics and could not get out of bed, I called her to report my rapid downhill slide.

She told me that my body simply wasn’t tolerating the medication. She said she’d just gotten my Lyme test back and it was negative, so to stop taking the antibiotics—I didn’t need them.

I know now that she didn’t understand that Lyme tests can’t be relied on. And she didn’t realize I was herxing.

The Lyme kept thriving, launching me on a lengthy battle to find a Lyme literate doctor and get on the right path.

On antibiotics I cope as best I can until I get to the other side. I’ve had herxes last a few days or a few weeks, depending on where I am in my treatment and which medications I’m starting.

Lyme literate doctors may adjust treatment depending on the severity of the reaction, and suggest steps to take at home to get a little more comfortable. (By the way, see this interesting blog post by a Lyme doctor about babesia and herxing). 

Blogger Lymechick offers a video on detoxingMy acupuncturist recommended drinking plenty of filtered water with fresh-squeezed lemon juice. I also soak in Epsom salt baths, which for me lessens the flu-like feeling dramatically. My microwavable heating pad is my best friend.

Getting through a herx is no small feat. But when the heightened pain and other symptoms lessen as the herx winds down, I know I’m that much closer to getting rid of infection and getting back to good health.



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