Let me start by saying that Herx reactions are real. If you read the product monograph for certain antibiotics (e.g. cefuroxime), you will see that the Jarisch Herxheimer reaction is a recognized medical condition. They can happen when infections from spirochete bacteria are treated with antibiotics (many antibiotics have some effectiveness against spirochetes).
On the other hand, patients may simply be reacting badly to a treatment. People with chronic illnesses happen to respond badly to many treatments and medications. Antibiotics in particular have one of the highest rates of the patient reporting negative experiences. In the graph below, see the 4th and 5th columns which reports mild worsening and significant worsening. Very few treatments have patients reporting negative experiences at such high rates.
Unfortunately there aren’t too many patients who report positive experiences from antibiotics, so their risk/reward is one of the worst among all of the treatments out there.
Herx symptoms
body aches, fevers, rashes, nausea and vomiting, and flushing, along with other symptoms. The symptoms usually begin 2 hours from the administration of the antibiotic and resolve within 24 hours.
Herx or not?
Because Lyme and spirochete infections have been around for a long time, we do have an idea about what treatments work and have the potential for causing a Herx reaction.
- Natural: Monolaurin, oil of oregano, essential oils (e.g. Biocidin), ?bee sting venom?, etc.
- Pharma: Antibiotics, methylene blue, HCQ, etc.
- Other: HBOT
If you consistently have a negative reaction to most of these treatments, then consider the possibility that you may have an underlying spirochete infection.
Testing for Lyme
Unfortunately, the tests for Lyme are terrible with very high rates of false negatives (and sometimes false positives depending on the test). If your infection is really out of control and ends up in the blood, then the standard 2-step test for Lyme will pick it up. There are other arguably better tests that can detect Lyme in the blood. However, in practice, many people are debilitated by infections in places other than their blood (e.g. in the brain, inside tissue, etc.). So unless you test positive, you don’t really know if you have an infection or not.
You can try Lyme treatments to see if you respond to them. That may be the best “test” for chronic Lyme.
Doctors can have bad incentives
Unfortunately, a lot of doctors will tell you that you test positive for whatever it is that they specialize in treating (e.g. microclots, Lyme / tick-borne diseases, long haul, etc.).
They may order tests with very high false positive rates such as:
- Non-standard Lyme tests from vendors who don’t publish the specificity and sensitivity rate of their tests. Basically they don’t even make any claims regarding the false positive and false negative rate of their test.
- GPCR auto-antibody tests from CellTrend
- Cytokine panels
If they do that, then the patient will test positive a lot of the time and they will try to convince the patient to get on their treatment plan.
The bottom line
I suspect that most Herx reactions actually aren’t Herx reactions. It’s just a bad doctor who doesn’t want to admit that some patients are being harmed by treatment. Unfortunately that may be harmful medicine if the doctor convinces the patient to keep going with treatment and to ‘tough it out’.
However, don’t rule out the possibility that you may actually have an underlying spirochete infection. Look at your symptoms and response to antibacterial treatments (especially the ones used heavily for Lyme treatment).