treatment part 3: herxing

Right now, even as I’m typing, my body is herxing. Every part of my face, scalp, and ears are burning… and It’s working its way down. I’m lightheaded, and the room is tilting back and forth. I would categorize this as a minor herx.

This isn’t a “type of treatment” kind of post. This is a “what to expect during treatment” kind of post. Essentially, here’s what happens: during the course of different treatments, you will have periods of intense Lyme and co-infection bacteria die-off. It will happen so rapidly that your body can’t filter out the dead bacteria quickly enough… resulting in an intense burst of symptoms. This process of quick die-off and intensified symptoms is referred to as herxing.

Herxing is your frenemy. Have you heard that term? “Frenemy” is a funny term for “best friend” and “enemy”… It’s wonderful to have die-off, because it means that your current treatment is working (friend… yay!). However, you feel even worse than your normal level of awful (enemy…boo!). This is one of the few times in your life, that you should be happy when you feel bad… Lean into the “friendship” feeling.


Herxing can bring out the “crazy” purple minion inside all of us. My best advice is to remember that herxing is a good thing. Ride it out. Keep your sense of humor.

For me, I’ve had many forms of herxing. By that, I mean that the duration, intensity, and what kinds of symptoms have varied. Here’s what I have noticed:

  • How I know: I know that I’m herxing because it’s like a rush of symptoms, much more than normal. It’s like those work-out bikes where you can select a random workout, and it’ll jump in one second from a level 1 intensity to a 6. That’s what herxing is like for me. It happens like a snap.
  • Kinds of symptoms: The symptoms associated with your herxes won’t always be the same. It seems to me that where the Lyme and co-infections have the strongest hold in your body directly correlates with what symptoms you’ll have while herxing. For instance, my lab tests show that Bartonella (a co-infection) is raging in my body currently. Bartonella is known for causing heart irregularities and problems in your brain. Not surprisingly, when I herx right now, my heart flutters, my blood pressure drops, and I have a lot of pain in my head. Not too long ago, Babesia was the co-infection rearing its ugly head, so I had herxes more related to Babesia symptoms. Make sense?
  • db6d464fcee21800440b5c90ea0fc446Intensity: My herxes have also ranged in intensity. With the minor herxes, I can still have a normal-ish conversation and people not know that I feel especially awful. With my most severe herx, I experienced intense air hunger (meaning I couldn’t breathe) and a host of other things. My doctor promptly sent me to the emergency room. If you’re ever uncomfortable with how much your’re herxing, you should definitely call your doctor / get yourself over to the ER.
  • How long: My herxes have lasted between 15 minutes and several days. It’s not a set formula. Don’t get too worked up about how long they last. It’s just good that it happens. Ride it out.
  • How to handle it: When I’m herxing, the best thing I can do is to rest. Don’t push it. Lean into the good die-off of bacteria. I eat especially healthy food, drink lots of water, eat salty foods (so that I retain the water I’m drinking), and cozy up on the couch with a movie(s).
  • P.S. (For my fellow female Lymies) Herxing tends to be elevated around the time of your monthly cycle. Oy vey… Just a heads up!

I highly recommend recording in your medical journal when you feel like you might be herxing, what symptoms you have, and how long it lasted. Talk to your doctor about all of it when you see them next. The goal for your treatment is to have tolerable herxing.

The full history and science behind herxing is fascinating. If you want to read more, check out Chronic Recovery Illness’s article.

Happy Herxing!

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