17 November 2012

Tips for Dealing with Herxheimer or Die-off Reactions


Photo courtesy of www.freedigitalphotos.com


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.


Want more great content like this?  Sign up for my FREE Newsletter here!

42 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!

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

    ReplyDelete
  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

    ReplyDelete
  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

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

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

    ReplyDelete
  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

    ReplyDelete
  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

    ReplyDelete
  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.

    ReplyDelete
  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

    ReplyDelete
  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.

    ReplyDelete
  12. I meant to sign my name. Charissa

    ReplyDelete
  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

    ReplyDelete
  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

    ReplyDelete
  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

    ReplyDelete
  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

    ReplyDelete
  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

    ReplyDelete
  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.

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

    ReplyDelete
  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!!!

    ReplyDelete
  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.

    ReplyDelete
  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.

    ReplyDelete
  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!

    ReplyDelete
  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 ?

    ReplyDelete
  25. Probiotics are beneficial for just about everyone. They’re particularly suitable for the individuals that feel digestive distress and the ones that suffer from a compromised immune response.

    ReplyDelete
  26. I think I'm having a die off affect from probiotics. Since taking probiotics pb8 14 billion I have been awfully sick.

    Lightheaded/dizzy
    Headaches constantly
    Fatigued/tired
    Brain fog
    Flu like

    I have completely stopped probiotics and started taking milk thistle and molybdenum. my boss is not to happy since I got sick because my job is performance based and I'm barely keeping up.

    After stopping probiotics will I return to normal or am I now supposed to do special diets? All I want is to feel normal again.

    This sucks and I will not touch another probiotics again ever. I may not have been healthy before but I have never in my life felt so sick to where I might lose my job.

    How long does it take for probiotics s to clear from your system.

    ReplyDelete
  27. It sounds like something deeper is going on... probiotics do not seed the gut, they modulate the immune system.

    ReplyDelete
    Replies
    1. Jill, I also notice cold every time I take probiotic. This is even before the doctor gave me a medicine to kill the yeast or candida in my body. Also I gave my nephew a probiotic, he also feel cold.

      Delete
  28. Probiotics rank as one of the promising options. There’s some evidence that probiotics could be used as a form of prevention. In addition, the good bacteria may also reduce the risk of cancer reoccurrence.

    ReplyDelete
  29. Any tips for extreme bloating due to die off. I'm really small but my stomach bloats really bad randomly. I cut out everything I only eqt fish and veggies but I'm starting to get discouraged. Any advice anyone? I take enzymes, probiotics, oxy cleanse and drink water with Bragg's daily but the bloating is really bad. Please help.

    ReplyDelete
  30. Probiotics are safe for kids but are they beneficial? Researchers haven’t done an awful lot of work when it comes to identifying the health benefits that little ones can experience from probiotic supplementation. Still, a couple of clinical studies provide positive results.

    In a 2005 study, researchers worked with 200 infants. The babies were given probiotics over the course of 12 weeks. On the average, kids that were given a probiotic supplement suffered from diarrhea much less frequently than the babies that were given a placebo.

    ReplyDelete
  31. Hi Dr. Jill, love your blog. I'm having what appears to be uncomfortable die off from a garden of life green powder. I'm confused in theory wouldn't probiotics crowd out the bad bacteria and help this die off? Should I cut down on probiotics or take more?

    thank you!

    ReplyDelete
    Replies
    1. This could be a reaction or due to underlying issues, like SIBO or SIFO. I would not continue on that product until you've addressed the underlying issue.

      Delete
  32. Hi Dr. Jill. My biggest die off symptom seems to be major agitation! I have been taking candicid forte by Ortho molecular. I have been taking it as directed along with oil of oregano, olive leaf, syntol AMD and candi-zyme. My biggest symptoms seem to be agitation, bloating and weight gain even though I'm on the candida diet and eat very little. I do suffer from anxiety and medication tends to keep it at bay. This type of agitation feels different and my poor boyfriend is reaping the effects of the agitation. Just wondering if you think these symptoms are from die off? I started the diet and was fine, it was when I started the supplements that the symptoms occurred.

    ReplyDelete
  33. Go slowly and take your dose down if necessary .... it may last a few weeks or longer

    ReplyDelete
  34. I've candida overgrowth on my tongue, two weeks ago, after I took antibiotics for throat infection,at the starting I experienced alot of symtoms, anxiety attacks in night, trouble breathing, excessive saliva, salivary glands on cheeks were swollen, fatigue, nausea,acidreflux,with time I got better, bt from last two days evry symtoms returning, I've simple meal, no spicy,sweet,no fruits, I'm having alot of ginger and lemon water, I went to see many doctors, no body cares to evn notice the yeast growth, often says I'm making things up, I get extremely frustrated to this,my nose is blocked and difficult to catch breath sometimes, is it a die off reation? How many days its gonna last? It can b dangerous? I'm having itchy skin, nd fever nd sweaing also, plz doctor help me, I'm not able to handle this, I get this feeling I'm goin to die. Save me plz..i need to be understood...
    Priya 24yr, india

    ReplyDelete
    Replies
    1. Hi Priya, please talk to your doctor about treatment and testing. If you do indeed have candida, treatment can teke 4-6 months

      Delete
  35. Hi Dr Jill. I have been on the anti candida diet for at least 2 weeks, then started pro biotics about 2.5 weeks ago. I experienced bloating, which has now gone, then diarrhea, and now nausea every day around mid to late afternoon. About 1.5 weeks into probiotics I added anti fungals, caprylic acid, oregano and horopito. The probiotics are Optibacs for women, 2.6 billion bacteria. The side effects are not life ruining and usually pass after an hour - i am also taking milk thistle and in the past few days activated charcoal. Should I reduce my probiotics or stop anti fungals for a bit - I am not sure if there are any lower dose of probiotics however? The side effects started before I started the anti fungals.

    ReplyDelete
  36. Dear Dr. Jill,

    I had Food poisoning in January 2017. and then i had severe watery diarrhea. in feb 2017, i began to feel dehydration and lost 6 kg weight. and muscle spasm. i did all the blood test and stool test all came out normal. i continue to feel dehydration, and muscle spasm. i tested for blood and stool every month, march, april , may, and finally in june 2017, it came out samonella group c2. during this time i was in immense pain, specially in lower back, upper hip bone, left wrist and left foot. so then doctor prescribed me suprax 400 mg twice daily for 5 days, then probiotics for 10 days.

    But i still feel dehydration, chronic fatigue, and reactive arthritis.

    so right now i am on probiotics, and last dosage of drug was on 24th june. so am i dealing with Herxheimer or Die-off Reactions ? and when it will get over.

    my problem was Gastroenteritis Salmonella Group c2. and i suffered a lot from this disease, a lot of pain, and weakness.

    Please guide me now what shall i do, so that i don't feel dehydration again. i wake up with high blood pressure in the morning due to dehydration, and then i immediately rush to drink water. then my blood pressure goes down.

    Regards,
    Sharfu

    ReplyDelete