Guest guest Posted December 10, 1999 Report Share Posted December 10, 1999 The Short Definition: Jarisch-Herxheimer reaction (“herxing”) is an exacerbation of symptoms in people with Lyme disease (also syphillis) upon taking antibiotics. It is thought to be due to the effects of toxins produced by the organism during it’s die-off and the resulting immune system response. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A Much More Detailed Explanation: from Lyme Disease 1991-patient /physician perspective Jarisch-Herxheimer Reaction H. Katzel, M.D. Dorland’s Illustrated medical Dictionary says this about the Jarisch-Herxheimer Reaction: “An increase is syphilitic symptoms after administration of antisyphillitic drugs.” Although it is an illustrated dictionary, there is no illustration next to the words. I wonder what they would put next to such a definition......I suppose if they were to illustrate the Jarisch-Herxheimer Reaction, they would have to put a patient with syphilis or, more recently, a Lyme borreliosis patient standing in fright with extremities extended and large circles radiating from his eyes. We’re talking about one terrible feeling person. From back in the 1960’s, Professor Harvey described the Herxheimer Reaction as an acute febrile reaction which may develope after treatment of late syphilis has begun. But Professor Harvey felt that this was a rare phenomena and such reactions were more common in patients with paresis, and he felt that they might be associated with a trasient increase in agitation and confusion as well as with fever and convulsions. His suggestion was that small doses of adrenal corticosteroids such as 20 mg. prednisone per day usually prevent or ameliorate the Herxheimer Reaction. Events similar to this Herxheimer type Reaction have been described in other disease states. I recently attended a medical conference where an experienced middle-aged man physician/pathologist descibed “crashing” and episodes of death after one dose of IV penicillin for children with meningoccoccemia. Whether the death of these children was due to acute, fulminating Waterhouse-Friderichsen syndrome or whether the deaths were due to a Herxheimer-type Reaction to one dose of penicillin is still unclear. The description of these events, which happened 40-50 years ago, is stilll vivid in the memories of these physicians. At times they were reluctant (but knew they had no choice) in giving the penicillin to these sick children who they knew would die if not treated and who might die from another cause with treatment. The Herxheimer-type Reaction is somewhat different in Lyme....Because Lyme is caused by a spirochete, much of what we learn and think about Lyme borreliosis comes from our experience with syphilis. In the early stages of killing the Lyme spirochete (Borrelia burgdorferi) with antibiotics this Hexheimer type Reaction can be found if looked for. Apparently it comes at different times. With I.V. antibiotics it may be noted within days of treatment; with oral antibiotics it may be noted within days to weeks of treatment. When these antibiotics begin to destroy the Lyme spirochete, a toxin is given off causing either direct reations or indirect actions through stimulation of the immune system. The symptoms can vary from systemic reactions such as a low blood pressure, fever,chills and hives, to more specific symptoms such as increase in joint pain, headaches, rash or in general, a reversal or worsening of the Lyme symptom complex. Jarisch-Hexheimer Reaction should be watched for when treating Lyme borreliosis patients, and the patient should be adequately warned about this phenomenom. Mistaking the Herxheimer reaction for an allergic reaction to antibiotics or serum sickness or some other catastrophe might lead to prematurely stopping the antibiotics on the part of the physician on non-compliance in taking the medications on the part of the patient. When starting antibiotics, one expects to feel better, not worse. But if warned that there may be a period where symptoms recur or flare up during this reaction , better compliance can be expected. Herxheimer reactions are at least ten times more common than true allergic reactions to antibiotics. Steroids are not recommended at this time for Herxheimer Reaction in Lyme patients. The best treatment is knowledge of the process so that panic attacks, anxiety and worry do not occur. Benadryl, which is an antihistamine, can be used to lessen the symptoms, and sometimes changing the dose and/or timing of the antibiotics is needed to make the reaction less symptomatic. So next time you start antibiotics, ask your physician whether or not you should expect a Herxheimer Reaction to occur. It may be a learning experience for both of you, I’m not aware of any deaths from Herxheimer Reaction in treating Lyme borreliosis. So give me a Herxheimer Reaction over an allergic reaction any time.” >From: Mama101@... > >Marta.. thank u... thats exactly how it feels... it`s not as bad today.. but >still there... am gonna see my nuero today... hopefully he will do something >What is Herxing? >Thanks again.. and also am very proud of all you that went to the protest.. >job well done. >God bless.. and may the new yr bring good health to all of us. >Bridie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2003 Report Share Posted February 4, 2003 Ann Thanks for the information. I know that I will have to go through worse times to get to better times, but it is still difficult. I got an appointment with a highly recommended LLMD for next Thursday. So, hopefully he will get me on the right track. How long were you and your husband sick for before you started treatment? 7 months sounds like a long time to be trying to get better. Are you feeling much better now? Again, thanks for answering my post and I wish you the best in getting well. Holly Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 24, 2003 Report Share Posted February 24, 2003 The Herxheimer (drug related flare) (toc) A general aggravation of symptoms is sometimes seen following onset of therapy and is more likely to occur if the disease is severe. This flare may be subjective (invisible) or objective (visible), or both, and may occur several hours or even up to two to four weeks after the medication is started. Those patients who test low in hematocrit and serum albumin levels and high globulin levels prior to treatment have the most intense flare on a given dosage of antibiotic. The Herxheimer flare is the first indication that the antibiotic is reaching its target, and therefore considered a good sign. When the severity of the arthritic condition begins to lessen, either from a spontaneous improvement or as a result of the continued treatment with carefully measured doses of antibiotic, a greater tolerance for the antibiotic is noticed and larger doses are tolerated without a return of the Herxheimer flare reaction. If however, the dose has been increased too rapidly at any time, the initial flare reaction may occur again. In the evaluation of these exacerbations, the physician must remain aware of the frequent disease flares from other causes, and he should attempt to differentiate from those which may be drug induced. " Differentiating between a Herxheimer, an RA flare and an allergic reaction to the drug " 1.)Laboratory tests can help differentiate between a worsening of disease (RA flare), a Herxheimer reaction to microbial toxins, and an allergic reaction to medication. 2.)WBC will elevate in a Herxheimer and lower in a flare. 3.)A Herxheimer will also exhibit a coincidental elevation of SED rate, gamma globulin and total globulin, and a fall in serum albumin and hematocrit. Patients who exhibit this flare reaction accompanied by anemia, depression of serum albumin, elevated total globulin and gamma globulin are probably reflecting a more intense reaction pattern to anti-L substances than in hematologically mild cases. 4.)A marked increase in eosinophils (for instance about 30%) is an indication of an allergic reaction to the drug. " Taken from protocol at rheumatic.org site* Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2004 Report Share Posted June 8, 2004 For anyone who has had a reaction > like this, how do you get through it and keep going? I stopped my abx that day and drank some rhat 'heavy' baking soda/water, Dr said this would help flush toxins. Then I started back on abx a few days later but at a MUCH lower dose, if you have to cut a tab, go ahead ( make sure this is ok with Dr or Pharm) My dose was 500mgs Zith, or 2 tabs, I started back up on 1/4 of one tab, still herxed , but at least I could function. Take care, heather Quote Link to comment Share on other sites More sharing options...
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