You did a gut microbiome test and you discovered that you have some harmful bacteria, parasites, or fungi that need killing, right?  

OK.  Good.

Now you need to know what you should expect when these uninvited guests die, so that you aren’t caught with your pants down.  

Here’s the 411 on die-off…

The Herxheimer Reaction

Generally, when bacteria, fungi, and parasites die, they release inflammatory endotoxins (their weapons of defense) and proteins into your body.  This can cause unexpected symptoms in what is called the Herxheimer reaction or the Jarisch-Herxheimer Reaction (JHR).

In the late 1800s, Austrian dermatologist Adolf Jarisch noticed an increase in skin lesions in a patient after starting antibiotic treatment for syphilis. A few years later, a similar reaction was reported by German dermatologist Karl Herxheimer.  

No telling why Herxheimer gets the credit now, I mean, most people call this phenomenon the Herxheimer reaction or simply Herx.  Poor Jarisch, he was robbed.

We Want Them to Die

When you’re treating overgrown organisms, whether that’s with herbal treatment, antibiotics, anti-fungals, or anti-parasitics, the goal is for those suckers to die.

Remember, when they die, they release their inflammatory toxins, right, so if a bunch of these organisms die all at once, you could be left with a buttload of toxins hanging out in your body (this is the Herxheimer reaction!).  This puts a lot of stress on your liver, kidneys, and gut to clear that junk out of there.  

If your gut detox pathway isn’t working at 100% (that’s one of the markers on our gut microbiome test so we can see exactly how your detox pathway is functioning!), then that’s a big UH-OH for you.

Here’s why… 

If your gut treatment is working well and a bunch of harmful organisms are dying, and your detox pathway works at full capacity, then typically your body is able to clear toxins as they are released.  In this scenario, you may notice zero Herxheimer symptoms because your body can clear the toxins as they are being released.  No problem.

But, if your detox pathway is a bit sluggish or if you have significant overgrowth that dies all at one time, then you might feel like utter garbage when organisms begin dying.

Potential Symptoms

As organisms die and that inflammatory response occurs, you might experience flu-like symptoms such as: 

• Chills
• Fatigue
• Muscle aches
• Brain fog
• Headaches
• Potentially fevers
• Exacerbation of GI symptoms (bloating, constipation, diarrhea, gas, etc.)
• Irritability or moodiness
• Nausea
• Joint pain
• Skin issues

Fun times.

So, it’s possible to experience these kinds of symptoms when on a treatment designed to control harmful overgrowth and rebalance your gut microbiome.  However, make sure you keep a tab on how long the symptoms last; they should be short-lived.

When Die-Off Is Not Normal

If you think you are experiencing “die off” symptoms that last for a long time, chances are there is something else going on with your treatment plan.  It could be a reaction to something in one of your herbal treatment supplements or something else that needs to be addressed.

Reach out to me if you’re a patient or another healthcare practitioner if your symptoms persist, since die off symptoms should generally only last 3 – 7 days.

This is where people tend to get tripped up; it’s easy to think that you’re dealing with “die off,” when in reality it’s possible that the treatment protocol just isn’t right for you and you may tolerate something else much better.  

That said, any time you are altering your gut microbiome significantly, whether that be through probiotics, prebiotics, antibiotics, diet, you name it – you may experience less severe symptoms that last a longer than a few days (still only a couple weeks, typically), and this is within the realm of normal.  

So, no worries if you have a low-grade headache for longer than 7 days, but it should not be anything of significance.

If your symptoms are intense (like the die off symptoms listed above) or you have less severe symptoms that last longer than a couple weeks, it’s a good idea to reach out to a healthcare practitioner to discuss a potential new treatment.

What Can You Do?

In the meantime, to limit those symptoms there are a few things you can do to make things a bit easier on yourself.   And note that we are all individuals, and each of us will manage this die-off a bit differently.  

Some people will breeze right through it while others will struggle.  If you’re in riding the struggle bus, the options listed here might just come in handy.

Don’t Feed Them

First and foremost, if you’re killing off harmful organisms, especially H. pylori, Klebsiella, Pseudomonas, or Candida, pay attention to what you’re eating.  Refined carbs and sugar can directly feed the same species that you’re trying to kill, so limiting or completely avoiding the foods that help them thrive can be super helpful.

Foods that promote growth of harmful organisms include:

• Sugar including honey, refined sugar, coconut sugar, maple syrup
• Baked goods such as cake, cookies, pie, donuts
• Pasta, rice, tortillas, bread, or any other high carb, low fiber substitutes
• Snacks like potato chips, tortilla chips, etc.
• High-sugar fruit like banana and mango
• Processed foods

Stay Hydrated

Drink plenty of pure, filtered water so that you keep your digestive system zipping right along.

Nobody wants to be constipated.

Water also is necessary for your kidneys to function optimally.  Your kidneys do an amazing job of cleansing and ridding your body of toxins as long as your intake of fluids is adequate, and that means it’s time to drink up when you’re treating harmful organisms.  

Get Your Zzzz’s

A good night’s sleep may literally clear the mind!

In studies with mice, researchers showed for the first time that the space between brain cells may increase during sleep, allowing the brain to flush out toxins that build up while we’re awake.

And guess what?!

They found that our nighttime waste clearance system works best when people sleep on their side, particularly the right side.  

Although scientists haven’t yet tested this in humans, they do speculate that side sleepers will have similar advantage with regard to the removal of toxic waste products in people as well. 

Sauna Bathing

Various studies have shown that saunas can effectively and efficiently help the body remove toxins, including drugs, alcohol, and pharmaceutical medications.

As your heart rate speeds up, a process called lipolysis occurs, and that starts to release toxins from fat cells into your bloodstream.

At the same time, the heat of the sauna makes you sweat profusely, thus opening your skin’s pores. Some of these toxins are flushed out through the pores along with sweat.

Vigorous exercise or living in a sweaty climate can have the same detox benefits, as can hopping in a super hot bath.  Add some scented epsom salts for a truly relaxing experience.

Eat Your Antioxidants

Antioxidants play a crucial role in supporting our body’s natural detoxification processes by neutralizing free radicals that can damage our cells. 

Foods that contain high levels of antioxidants include:

• legumes
• fruit, especially berries
• cranberries, special call-out for their high polyphenol content
• veggies
• pecans and other tree nuts
• dark leafy greens
  
• chocolate
• coffee
• black and green tea
• red wine – read all about why I recommend red wine here

Support Your Detox System

One of my favorite tools for supporting detox pathways, besides a good sweat session,  is a super antioxidant called acetyl-glutathione. Glutathione is one of your body’s most powerful detoxifiers, and can help your body process and eliminate toxins. 

Activated charcoal can also be a game-changer when it comes to helping to clear toxins from the body.

Charcoal works like magnets to attract positively charged elements such as the toxic byproducts released during die-off. These byproducts bind to the outside of the activated charcoal and get trapped in its tiny little pores. Once trapped, the charcoal effectively carries these harmful byproducts out of your body so they don’t get reabsorbed.

Supplementing with glutathione and/or using an activated charcoal product can help your body more easily manage symptoms of die-off by clearing toxins more quickly.

Think you have some harmful organisms to kill off, but you’re not sure which ones?  It’s super easy to test your gut microbiome to find out exactly what’s causing your issues!  Contact EverVital Nutrition for a FREE gut assessment and let’s figure it out!