by Dr. Bill Rawls
Posted 9/23/19

We’ve all been there: One moment you’re following a treatment protocol and all seems fine, the next you’re hit by a barrage of symptoms. Is it a Herxheimer reaction? Is it a Lyme flare-up? Trying to solve the puzzle of what caused a setback can be overwhelming. Join Dr. Bills Rawls as he explains how to distinguish between a Herxheimer reaction and a Lyme flare-up, and how to keep your recovery moving in a forward direction. Learn more about Dr. Rawls’ journey to recovery from chronic Lyme disease here.

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Video Transcript

Question: What’s the difference between a Herxheimer reaction and a Lyme flare-up?

Hello, Dr. Rawls here. So, what’s the difference between a Herxheimer reaction and a flare-up?

We’ve all struggled with this. You’re doing well, things are getting better, and then suddenly everything isn’t getting better. And there’s always that fear of, “Gosh, am I going back into that misery again? That deep dark hole that I’m never going to crawl out of?” It is important to really distinguish between the two.

Technically, a Herxheimer reaction is bacteria breaking down in the body. So you introduce some kind of new therapy, an herbal antibiotic, whatever it might be. Bacteria are killed off, and that floods your system with particles of bacteria. That can initiate an immune response, or generate inflammation in the body, and really make you feel terrible. It accentuates all the problems that you’re having: joint pain, fatigue, everything feels miserable.

Whereas a flare-up is, you’re not getting there. You’re not controlling the microbes, and microbes are actually flourishing more in your body. So they’re driving all of your symptoms harder.

A flare-up can seem the same as herxing, because when the microbes are driving the immune system harder, they’re generating inflammation throughout the body. So on either side, it’s inflammation. It can feel exactly the same, and sometimes it’s hard to distinguish between the two.

Generally, the tip-off is if you’ve started something new. You’re starting a brand new therapy, and your symptoms intensify right after that therapy is initiated — that’s a Herxheimer reaction. You’re starting to do a number on the microbes. You’re starting to kill them off, and therefore you have a reaction to that.

So what you do with that is basically back off the therapy a little bit, or add some anti-inflammatories in. One of the best ones that I know of is CBD oil from hemp, because that controls or moderates that inflammatory reaction and makes you more comfortable. And sometimes that can help you keep going with the antimicrobial herbs, or whatever you are doing to treat the illness. You can control it with the CBD.

Other inflammatory herbs like turmeric are really nice for that, also. They also work for a relapse, but in a relapse or a flare-up, there are things that are affecting the immune system in a way that is allowing the microbes to thrive, so they’re driving the inflammation harder.

Maybe you’ve been on that particular therapy — antibiotics, herbs, or whatever — for a long time. And the microbes are starting to develop a tolerance to it. That can happen with herbs, too. It doesn’t happen as much with herbs as antibiotics, because herbs contain hundreds or even thousands of chemicals that affect the microbes, but it can.

There are other factors, too. And I found out what was happening most of the time. There were other factors entering in my life that were affecting my immune system, or preventing it from working properly. That could be food sensitivities, like I was eating the wrong foods. It can be new stress. It can be not sleeping well or traveling.

So go down that list of what I call system disruptors: food, toxins, stress, activity level, and make sure it’s not something on the list that’s affecting your immune system.

If all of that checks off, if all those boxes check off as good, then you look toward the therapy. If you’re using herbs, it may be time to shuffle the herbs around. Or what I found worked the very best was adding on other herbs to it. I’ve been taking herbs for about 10 years, so I do tend to shuffle herbs about every six months to a year, and rotate new ones in, and rotate some out.

So I’m always hitting the microbes from a different direction. Even now, you know, keeping my microbiome in balance, I do that. So I think those are some important things that you can do to distinguish between a Herxheimer and a Lyme flare-up, and really keep your recovery going in a forward motion.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.