17 November 2012

Tips for Dealing with Herxheimer or Die-off Reactions


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Dealing With Yeast Die-Off (Herxheimer) Reactions
  
Yeast overgrowth can happen in response to improper diet, poor immunity, difficulties in digestion and antibiotic use. Poorly digested food can lead to putrefaction (rotting) and encourages the growth of organisms.  Antibiotic use destroys the normal balance of gut flora and leaves an open field for bad bacteria and fungi to move in.  Hormones and steroids can make this condition worse, too.  Most importantly, over-consumption of simple sugars & refined carbohydrates will feed the yeast.  If the immune system is weakened or there are not enough probiotic ("good" bacteria) to combat the yeast, then it begins to grow unchecked and cause symptoms, such as "leaky gut".

In this blog, I am addressing specific patients who are being treated for fungal dysbiosis (yeast overgrowth), who may experience a worsening of their condition after starting a program for yeast control. This may be very unsettling & discouraging if it is not understood.  It must be addressed effectively in order to avoid worsening symptoms. Here are some strategies to minimize the chances of suffering unnecessarily from a Herxheimer (die-off) reaction.

Common Symptoms of yeast die-off include:

Fatigue, brain fog, gastrointestinal distress such as nausea, gas, bloating, diarrhea or constipation, low grade fever, headache, sore throat, body itch, muscle and joint soreness or pain, flu-like symptoms. Other symptoms include: lethargy, intense sweet cravings, rashes, irritability, joint stuffiness, or muscle pain. In susceptible individuals with pre-existing neurological symptoms such as hyperactivity, irritability, tantrums, and difficulty concentrating, their symptoms may temporarily intensify.

Yeast die-off reactions are not necessarily a sign that yeast treatment is succeeding. It may be an indication that yeast cells are dying in large numbers, and an indicator of the body's toxic overload. At that point, more poisons are being released than the body can adequately cope with at one time and may be a sign the system's elimination pathways (liver, kidneys, & bowels) are overburdened or blocked (as in constipation or liver congestion)

If properly undertaken, treatment for yeast related health problems should not lead to severe yeast die-off reactions.  Patients with elevated heavy metal levels may more problems with “die-off” symptoms

Strategies to minimize discomfort & shorten duration of die-off reactions

·       Reduce the dose of anti-fungals: Some patients may have to stop altogether for a few days. Dr Jill will generally start doses slowly and increasing them over time to help you deal with the possible die-off symptoms
·       Enzymes: Adding enzymes with meals may improve the digestion of foods and limit putrefactive short chain fatty acids with enzymes.  Use pancreatic enzymes, NOT fungal or plant based enzymes.
·       Stay hydrated:  Dr Jill recommend 4-6 fluid ounces of warm water every forty-five minutes, throughout the day.  Mineral water may help, too!
·       Get your sleep:  It is imperative to rest when experiencing yeast die-off reactions – 8-10 hours per night is essential.
·       Neutralize toxins:  There are ways to neutralize fungal toxins. Dr. Jill may recommend molybdenum, biotin, pantethine or liver support to accomplish this.  Activated charcoal may also help.
·       Alkalinize:  You may buffer the toxins by taking alkalizing agents immediately upon experiencing die-off symptoms. Such products as AlkaSeltzer Gold. Drinking mineral water may also help.
·       Antioxidants:  Provide extra antioxidants to quench the oxidative reactions created by the toxins.  Dr Jilll may prescribe vitamin C, Vitamin E or A, alpha lipoic acid or N-acetylcysteine.
·       Sauna & baths:  If you have access to a sauna, begin slowly (15 minutes per session) scrub all skin surfaces with a stiff brush and shower immediately afterwards. Another helpful detox regimen is Epsom salt baths – use 3-4 cups in hot bath and soak for 20min every night.
·       Keep your bowels moving:  You must address any issues with bowel elimination if you have constipation – if you are not eliminating, you will reabsorb any die-off toxins being released! 

More remedies for constipation:
·       Use magnesium citrate 500-1000mg daily or until normal, soft bowel movements 1 or more X daily.  You may also add Ascorbic Acid 5-10grams daily to bowel tolerance.
·       Start every morning with a tall glass of warm water.  8 oz of coffee may also be helpful.
·       Try a few tablespoons of extra virgin olive oil, several times daily on an empty stomach.
·       Mix 2 TBSP of ground flax or chia seed into water & stir , let sit for 10minutes, stir & drink on an empty stomach.


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27 comments:

  1. I was having this last week and through the weekend, finding your blog and this article was timely. Magnesium did the trick for me - it was truely a blessing from God to get this information and I had sent for magnesium the week before all of this started, not because I was preparing - I just read about how great magnesium was for us. Just the first two tabs worked so well, that I doubled the recommended dose to 1,000 mg and I feel better than ever! I was having aches and pains before the Herxing started, but once it started I was in so much pain I could barely move and yet had to host my family from out of town for Christmas. Then I took the magnesium and it made the last day of their visit so much better. The magnesium worked immediately for me. Thanks so much for your help from afar Dr. Jill! God bless you!

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  2. Wonderful news, Kim! I hope you are feeling better soon... yes magnesium is simple, safe and profoundly effective!

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  3. Hey, great article and very beneficial. Ive recently carried out a couple of liver flushes (lime, garlic, ginger and olive oil) to help with my Psoriasis, which seems to have created an adverse effect than what I was hoping for.
    Im now very gassy, itchy, feels like i'm consitpated but actually having diarrhea and more Psoriasis on the skin.
    I did suspect a bacteria overgrowth (saliva test) and my naturopath believes this too...

    My question is... due to the large amounts of lemon juice and garlic i had for 5 consectutive days - could this trigger a die-off? Ive started taking HCL with pepsin in case its low stomach acid.

    Is there a connection between low stomach acid, liver flushing and die-off?

    hope to hear back :)

    Garry

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  4. Hi Garry,
    Thanks for your comments! Yes, it is possible you triggered a "herx" reaction. I generally do not recommend the liver flush you are describing, especially without knowing what is going on in the gut, liver and gallbladder. With psoriasis you very likely have underlying imbalances in microbes in the gut (http://doccarnahan.blogspot.com/2013/01/healthy-gut-healthy-you.html) I suggest finding a functional medicine doctor to order more extensive testing, like the comprehensive stool analysis to determine the extent of dysbiosis and a determine a treatment plan. Garlic is a potent herbal anti-microbial and may have triggered your symptoms.
    Take care
    Dr Jill

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  5. Hi, can you recommend or tell me how to find a good integrative medicine doctor in the western Chicago suburbs? thank you

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  6. You could try searching on www.functionalmedicine.org for physician in your area.

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  7. Leaky gut mom here. Trying to nurse 6 month old. So discouraged. Every time she nurses, she gets a reaction from my milk. I had an IgG test done and try to avoid those foods but I literally cannot eat anything except chicken and green beans. I have broken down in tears often because I am making baby uncomfortable but I don't know what to do. Tried probiotics (biokult). Dont notice a difference. Beyond discouraged. Trying to go to nutritional Dr but tests so expensive. $350 for first test. It will take me months to save that. I am in tears almost every day. Any words of encouragement would be appreciated. TIA.
    Discouraged Mom Keesha

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  8. Hi Keesha,
    I am so sorry to hear of your discouragement... I suggest staying away from the top allergens: gluten, dairy, egg, soy, corn, alcohol, sugar, and see how you do. You or your baby may have a problem with intestinal candida or abnormal bacteria so I do suggest a probiotic. I wish you the best in healing - I know this is not easy.
    warmly
    Dr Jill

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  9. Hi. I've been fighting candida for the past two years. I am currently not taking an anti fungal but am taking a strong probiotic morning and night w my meals (Symbion)... I'm doing a low carb diet and no sugar of any sorts. For the past two weeks I've been having this cramp like pain around my left breast which travels all around the breast, sometimes to my back and under my left arm pit. It comes and goes, sometimes more sometimes less intense. I've been to my primary doc and she does not think it's my heart. Also my acupuncturist today said it's definitely my stomach and my intestines. It is pretty painful but more so annoying and worrisome considering that it's around my heart. Is it gas from die off? Any suggestions on how to lessen the pain. I also belch and burp uncontrollably pretty much all day.

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  10. Hi Jana,
    I would not assume it's gas. You should find out what is causing the pain first before assuming it's benign. You PCP can order imaging or scope if necessary. Enteric coated peppermint is anti-spasmodic and ginger is good for nausea.
    warmly
    Dr Jill

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  11. Hi Dr. Jill, my 8 year old son has had tummy aches for the past five years. He has recently been diagnosed with GI inflammation via a scope and more recently with fructose intolerance because he was throwing up once a week. The GI specialist didn't think he had either one as I had to ask for these tests. I have him on the Makers diet currently and am planning on the GAPS diet if this doesn't work. He has been having die off symptoms frequently now as I put him on Culturelle. Should I discontinue the probiotics for now? He's also eating goat yogurt and some homemade sauerkraut juice with bone broth soup. Any precautions I need to take as he's already so skinny, and the due off is a real downer. I would appreciate any wisdom. We have not been able to get into a naturalpath docter yet, though I hear there is a test for a trigger food? Thank you. This is all quite overwhelming.

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  12. I meant to sign my name. Charissa

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  13. Hi Charissa,
    Have you tested for SIBO with lactulose breath test for methane and hydrogen? I would do this first as if he has SIBO he may not tolerate lactic-acid producing probiotics, like culturelle or fermented foods.
    warmly
    Dr Jill

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  14. I will check on that. Sounds the same as his fructose test but a different sugar? Any recommendations for doctors in Spokane? Thank you so much, and the Lord bless you.
    Charissa

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  15. Yes, many patients with fructose intolerance actually have SIBO and require treatment. You may try searching for a functional medicine trained doc at www.functionalmedicine.org.
    Best
    Dr Jill

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  16. Hi Dr. Jill,
    I think I may be experiencing some sort of die-off. I'm 40, just recently went gluten free, for 2 weeks now, because I have extreme wheat cravings and am overweight. For the past 3 days, I've had abdominal discomfort and joint aches. I woke up early this morning with extreme diarrhea, and those nasty burps. Ugh!
    I read your article and thought maybe taking my tri-salts and getting back on kefir would help. I've started walking, but wow, I hurt! How long will this last and is there anything else I could do? I live poor and out in the country near no natural type doctors.

    Thank you for your article and help!

    Lanny

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  17. Hi Lanny, one thing that may help is eating real food and avoiding processed "gluten-free" options like pasta, crackers, cookies, etc... Limit carbs and grains altogether and instead eat nuts, seeds, veggies and fruits. You might try mineral water, like San Pellegrino and epsom salt baths before bed.
    Warmly
    Dr Jill

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  18. Hi, I was on a strong probiotic with enzymes, take 4 capsules 2x a day for about a month, i became very lethargic and feel I might be experiencing die off, I am so exhausted and have brain fog. Being tested for everything. During a colonic cleans it revealed candida and mucus so they told me to take Natural Enzyme w/probiotic as follows: Provides a full complement of food enzymes—two sources of Lipase, Amylase, two sources of Protease, Glucoamylase, Lactase, Diastase, Hemicellulase, Cellulase, and Invertase—when enzyme-deficient food is consumed. †

    Please tell me of doubling up on the dosage could be cause die off. Apparently a typical dosage would have been 2 capsules 2 x, but they recommended 4 capsule 2x a day. Please advise.

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  19. Best to discuss this with your doctor....

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  20. Hi my name is Xavier from NC. I would like to take the time to tell you that I've been a beer drinker and cigarette smoker since the age of 13. I'm 38 now and decided it was time to do my first detox. For the past 2 weeks, I've been taking a teaspoon of black seed oil per day. My manuka honey came in about a week ago and I've been taking a teaspoon of the honey, along with the black seed oil, for a week now. About 3 days ago Ive begin to have mild fevers and my throat has been aching and I have muscle and head pain and today I've become very irritable, which is not like me. Since I've started the oil and honey, I've really been having a great deal of energy despite having pain in my throat, head and muscles. The last two nights I've suffered from chills and sweated in my sleep just a little and felt a little better after each sweat. What could I take to help with the pain in my throat and head that I could buy from the grocery store? Is this normal and how long will this last? I drink plenty of water and I still drink beer and smoke daily. I eat the same way I've done all my life, which is the typical American diet. Lol...Please help!!!

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  21. Hi Zay, I would never recommend attempting a detox plan if you are extremely toxic and have poor lifestyle habits. It is not safe without supervision of a doctor. Please discontinue and discuss with your doctor.

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  22. Hi Dr. Jill,
    I attempted treating what I sense is Candida (pain in the urinary tract that feels similar to UTI but tested negative, acne at age 41, and weight gain) via diet and took Oil of Oregano (food grade essential oil). The oil made my pain unbearable, and I had to stop taking it. I drank Pau d'Arco tea...no relief. I've increased exercise (walking 3 miles, 4 days/week and about 7 one day on the weekends) and dropped calories to 1300/day. Still gaining weight. After reading your blog, I've decided to try Candida Cleanse supplements by Purely Holistic (has enzymes and probiotics too) and add milk thistle to decrease Herheimer die off...and add to my regimen your suggestions for coping with die off. I'm also going to take a half-dose of the Candida Cleanse supplements. Have you ever heard of Candida causing urinary tract pain and inability to lose weight? Also getting my thyroid re-checked next week. For about a year it had been healing itself, getting faster, and my doctor was weening me off of Armour Thyroid. Perhaps I need to increase dosage. We'll see. Thanks for your blog! It gives me hope.

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  23. Hi Dr Jill,

    I started taking a probiotic about a month ago. Started out taking one capsule (2 billion live cells/capsule) for a week. Increased to two capsules the next week, then three. When taking three, I started feeling off--dizzy & headaches mostly. So after five days of taking three capsules, I skipped a day then went back down to two. Today was day 5 of being back on two capsules and I had a low blood sugar episode where I was shaky, sweaty and felt like I was going to faint. I ate a piece of dark chocolate with almond and the feeling subsided. From everything I'm reading, it seems like maybe my body isn't keeping up with the toxins being released. Worried about what an over abundance of toxins can do to me?? Planning to call my Dr but wondering if I should stop the probiotics altogether? How to manage these symptoms if I continue? Thank you!

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  24. Hello. I have a problem with my stomach after taking an antibiotics. I have a terrible bitter taste in my mouth whole day long,my tongue has a white cover,I feel nausea all the time almost and can not eat anything properly. The doctor prescripted probiotics to take twice a day two capsules. I just started today and I started only with one capsule. And I feel this very strange thing. I feel cold all over my body as if my blood is cold. I wear a lot of warm clothes and overheated the appartment but the cold comes from the inside. It's a very strange,scary feeling. I must say it seems to help to my stomach though even though I took only once and didn't continue because of this strange side effect. Do you think I shall continue taking it ?

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