“You’ll feel worse before you feel better.”
7 words no one wants to hear!
But when you’re removing harmful things from your body, a herxheimer / die-off reaction is often accepted as an inevitable consequence.
And yet, it doesn’t have to be.
We’ve learned die-off can be dramatically minimized with detox methods safe for even sensitive people and children.
From miserable to well-managed
My daughter was diagnosed with Lyme disease this year. Killing bacteria (or yeast or parasites) produces a lot of toxins and at first, we were not managing the die-off well enough. She felt nothing short of miserable some days. It was terrible to see and I knew there had to be a better way.
When we became very serious about managing die-off with the below protocols, she started to feel remarkably better. At times, not even affected by the serious bug killing we’re doing. The difference has been dramatic!
To determine the best methods, we tried quite a few combinations. There are a lot of articles written on detox! Some strategies didn’t help as much as others and some ideas we’ve put our own twists on to make them more natural or more effective. We hope sharing what we’ve learned may help you too.
We will present the information in two categories:
- Minimizing die-off reactions
- Speeding removal of the toxins
Both should be started together for relief from symptoms any time large amounts of metabolic by-products are being released.
Please note: This post is about reducing die-off caused by an inability to eliminate dead organisms & toxins quickly enough.
The reaction to a supplement that isn’t designed to kill pathogens could be something other than die-off. Please see this article to learn more about what is and is not ‘die-off.’
Strategies to minimize die-off reactions
In this first category are methods useful to help you feel better! They don’t necessarily remove the toxins, but they counteract their effects and keep you from feeling lousy until they’re eliminated.
Homemade Herx Water
The dead bugs can create a very acidic environment, so a common method of buffering die-off is taking alkalizing agents such as AlkaSeltzer Gold.
The issue is that ASG contains the added ingredients: citric acid (actually increases acidosis), mannitol (an artificial sweetener) and potassium bicarbonate (can contribute to adrenal exhaustion).
We’ve found greater success with the simple ingredients: Baking Soda (sodium bicarbonate), Ginger Root and Fennel (both help calm acidosis).
The combination is safe and effective. You may even know baking soda, ginger and fennel as the main ingredients in Gripe water. They can be taken as supplements (in capsules) or mixed in a drink.
We find it works most quickly if dissolved in a few ounces of water, followed by additional plain water.
With any method, drinking a full glass of water and taking it away from meals and medicines is ideal.
You can also use just the baking soda alone or just the herbs alone. On days with less die-off, or if giving it closer to a meal, we skip the baking soda.
Baking soda dosage (1 tablet ASG = 1/4 tsp):
- Over 2 years old: 1/16 – 1/8 tsp
- Age 6-12: 1/4 – 1/2 tsp
- Over 12 & adults: 1/2 – 1 tsp
*Note: If you do need the extra potassium from AlkaSeltzer Gold, there are alternative, clean products containing the same active ingredients, sodium + potassium bicarbonates: Klaire Bi-carb, Seeking Health – Neutralize
Recommended to Read: Risks For Potassium Bicarbonate
Acid Reducing Food, Drink, & Enzymes
Taking digestive enzymes with meals can also be beneficial. They improve the digestion of foods and limit putrefactive short chain fatty acids. We prefer pancreatic enzymes with papaya such as Solaray Pancreatin or Pure Encapsulations Pancreatic Enzyme.
* We avoid all fungal derived enzymes. “Making Sense of Digestive Enzymes” includes a helpful chart of enzyme sources on page 5.
For water, we use high pH / alkaline water. Some recommend not to drink it with meals but we haven’t found it to cause any digestive issues. Much more information on water is in this article: Why Drink Alkaline Water When the Stomach is ACID?
Apple Cider Vinegar is another common remedy to reduce acidity, but it’s also a potent antifungal, which can lead to more die-off, so we don’t use it unless yeast is an issue.
* If reducing acid with any of these methods make you feel worse, please see the ammonia section below.
Cytokines are proteins that regulate the nature, intensity and duration of the immune response from our cells. Their release alerts our cells to fight with increased inflammation.
When the immune system begins to fight the dead organisms and toxins (that are released from the killing), a cytokine flare results.
Calming the dramatic increase in inflammation is critical to addressing die-off / herxheimer reactions. [R]
In our toolbox we primarily use:
- Cytokine suppress: ECGC (green tea) + Mung bean, (1/2cap 3x/day) see: Turn off the cytokine switch
- Resveratrol (100mg 3x/ day) see: Japanese Knotwood Root
We use both supplements on an empty stomach along with vitamin E (gamma), vitamin C (Acerola cherry), and NAC (see below).
Other supplements we also use to inhibit inflammatory cytokines and are especially important with neural pain and anxiety:
- Chinese skullcap (Baical skullcap) [R] (200mg 3x/day)
- N-acetyl cysteine (NAC) [R] (200 mg 3x/day)
- Greater Celandine tincture [R] – 9+ drops/day
- Kudzo Root tincture [R] – 9+ drops/ day, relieves headaches
- Motherwort tincture [R] – 9+ drops/day improves sleep
*All dosages given are for my 75 lb. daughter. Please adjust accordingly and consult a physician with any concerns.
When bacteria, yeast or parasites die, they can release ammonia. Ammonia is extremely toxic to your body and tends to accumulate in our organs. In the brain, it causes distressing brain fog and sometimes laughing which can be mistaken as yeast (I’ve made that mistake before!)
Ammonia has a high pH and complicates treatments for acidity. It must be under control before you can properly treat high acid levels and if you feel worse when reducing acid, it could indicate high ammonia. [R]
To control ammonia we use:
- Binders – Activated charcoal & Pectasol to eliminate it from the body (see below) – these both have truly been critical for her
- Citrulline and Yucca – 300 mg with protein meals can mop up extra ammonia
- Pteridin-4 (Bh4) – 1.25mg to clean up ammonia and generate nitric oxide to protect the heart and brain
For more on the above and a complete list of options please see: Ammonia toxicity and treatment options.
Foods that are high in arginine / protein, sulfur and glutamate should be avoided until ammonia issues are resolved.
When everything feels like too much and emotions are high, adrenal fatigue is always the culprit in our house. Toxin overload can significantly stress the adrenals so supporting them at this time is critical to feeling better.
To support the adrenals we use:
- Adrenal Cortex Extract – Thorne (3 caps/day) & Biomax drops, as needed per symptoms
- Ashwaghanda – 200mg 3x/day, especially helps with stress induced sleeping issues
- Vitamin B5 – 100mg/day, enhances adrenal function
Please also see: Herbal Options for Managing Adrenal Fatigue for many other options.
If needed and possible, backing off from constant killing of bugs can give the body a chance to catch up with the elimination.
We’re currently dosing antimicrobials for 5 days on and 2 days off. Depending on the type of bacteria you’re dealing with and how far into treatment you are, this method may help you also.
Reducing doses or stopping for a few days when killing yeast and parasites can also be done as needed.
Strategies to quicken toxin removal
In this second category are approaches we use to take out the trash. The best part is, none of them argue about who’s job it is and they all pitch in!
When used effectively, these protocols minimize the amount you need to rely on the first category.
Binders grab antigens and eliminate them indefinitely so they’re not reabsorbed. They are a cornerstone of any detox program.
We used to be afraid of using them, but they have made a huge difference and I haven’t seen any bad effects, only very noticeable improvement.
They must be taken a minimum of 1 hour away from food and other supplements, because they will bind anything they come in contact with.
Consider adding magnesium if any constipation occurs (it hasn’t for us).
*Note: While effective for others, we do not use chlorella, cilantro, or parsley because of concerns about heavy metal contaminants and redistribution.
Supplements to support the detoxifying organs
- Burber-Pinella detox – NutraMedix created it to reduce brain fog, stop herx, cleanse liver, kidneys, lymph system, brain and blood. (3 drops as needed, and added to herx water)
- Dandelion Root – helps detox both the liver and kidneys and neutralize endotoxins (200 mg, 3x/day)
- Milk thistle – an important maintenance supplement to protect the liver & help phase 1 detoxifying (300mg, 3x/day)
- Burdock Root – promotes blood detoxification and strengthens lymph system (300 mg / day)
- N-acetyl cysteine (NAC) – helps reduce brain inflammation & replenish glutathione (200 mg 3x/day with cytokine supplements)
- Lipisomal Glutathione – supports liver phase 2 detoxifying (250 mg)
- Molybdenum – helps liver expel die off toxins, especially good for yeast die-off and can reduce sulfites / sulfur (250 mcg/day)
*Did you know? You can fill capsules with any combination you need, including liquids. And, if you need an extra hand, but don’t have a capsule machine, we find a scissors works great!
The MTHFR gene is sometimes called ‘the detox gene’ because if you have mutations, your body generates less glutathione – which is critical for detoxifying.
Supplementing with methylcobalamin (vitamin B12), vitamin B2, vitamin B6 and 5-MTHF (methylfolate) is generally advised and there are many other supplements that can help people with these common gene variants improve detoxification.
Please see, What you need to know about genetics and detox (It’s all about methylation!) for more information.
The lymphatic system is responsible for removing toxins from our cells and sending them out of our body, it’s our circulatory system’s waste removal plant.
Optimal performance is critical!
- Red Root – helps drain the lymph system (we add 2-3 drops to Herx water)
- Burbur, Pinella, and Burdock (see above)
- Ginger – boosts and cleanses the lymphs
See, The best herbs to cleanse the Lymphatic system for these and additional options.
“By doing lymphatic drainage massage correctly, we can stimulate the opening of the initial lymphatic and increase the volume of lymph flow by as much as 20 times.” – See this article for more about why it’s instrumental for toxin removal.
A professional lymphatic drainage massage is great, but if that’s not practical there are many techniques you can perform at home, even on yourself, that you can learn on YouTube.
Some examples are: Lymphatic Drainage Massage Therapy Demonstration, Full Body
Massage by Heather offers several detailed instructional videos you can perform on yourself or someone else.
One key thing I’ve learned is that you must use a very gentle touch, only the pressure it takes to slide a coin across a table, otherwise you will collapse the lymphatic system and the massage will be ineffective.
While it doesn’t work for the face or throat, we find that a massage tool like this one can help keep a soft touch on the body.
The proper pressure is explained and demonstrated with videos in: Lymph drainage techniques.
My daughter loves dry brushing! It clears the pores allowing toxins to leave and also stimulates the lymphatic system. We do it just before a shower.
Detox baths & foot baths
Eliminating toxins by soaking has never been more on-trend, so you may have a favorite type and method. If you have an ionic foot bath, you’re probably using that.
Our favorite traditional foot bath is the black detox recipe:
- Activated charcoal (1-2 capsules)
- Ginger root (1-2 capsules)
- Epsom salt (1/4 cup)
- Baking soda (2 tablespoons)
Note: Using oil with charcoal baths is not advised because it will stick to you for days!
Castor oil packs
Castor oil packs are used to improve lymphatic circulation, reduce inflammation and also boost liver detoxification. For maximum benefit the oil should be placed over the abdomen / liver for 45 minutes to 1 hour with an added source of moderate heat to stimulate lymph and liver function. This video teaches how to make a castor oil pack.
Exercise to your tolerance level is a great way to get the blood flowing, lymphs working, and also eliminate toxins through perspiration. My daughter especially loves yoga, dancing, and bouncing on a rebounder.
Note: While many people use saunas and other Far Infared treatments, deep heat can activate viruses and also aggravate Lyme / worsen symptoms in some people. She seems to one of those people, so we don’t use them.
Stay hydrated and keep your bowels moving
Increasing water intake is of utmost importance for detoxification. It should probably have been listed first it’s so critical, but we also assume everyone knows this one!
In addition to eliminating toxins through urine, it’s critical to make sure any constipation issues are resolved. If stools are not regular, the body will reabsorb die-off toxins, causing even greater symptoms and the need to start over again.
Catch some Zzzzzz’s
When you need your body to perform at peak condition, especially under the added stress of removing toxins, it’s imperative to rest as much as possible. Like the increased water consumption, this is one tip we all know, but sometimes forget until we crash and wonder what went wrong?!
Our Daily Detox Schedule
How do we fit it all in? It’s not always easy, but we do our best. Here’s an ideal day:
- Wake up: Pectasol (if time allows)
- 30 min later: Cytokine and Lymphatic supplements & Herx water
- Lymph drainage massage
- Breakfast: w/ supplements & killing agents
- Mid-morning: Cytokine and Lymphatic supplements & Herx water
- Noon: Lunch w/ supplements
- Early afternoon: Cytokine and Lymphatic supplements & Herx water (if needed)
- 3:00 Snack + supplements
- 4:30 Binders (1 cap each GI Detox + Pectasol)
- Dinner: 6:00 w/supplements + foot bath
- 7:00 Dry brushing before shower
- Bedtime: snack, nighttime supplements and antimicrobials
- Brief lymph drainage massage in bed
This post was long! I’ll briefly wrap it up by saying, you can find an overwhelming amount of information about detoxing and die-off in books and on the internet. So many options, that for a child or a person with a sensitive system, it can be daunting to know what’s safe.
From the vast amount of choices, we’ve narrowed down what works best for us. Our experience has shown these protocols to be both safe and effective.
As a group, they’ve remarkably helped give Caroline relief from herxheimer reactions and feel amazing again. We hope they will help you too!
Update: As the post has circulated, some have asked how to best test for / treat Lyme.
TESTING: The test we used was from DNA Connexions. A positive test indicates the presence of DNA from Lyme and/or other co-infectors in the urine. It’s finally a reliable test that makes older, often inconclusive lyme tests practically obsolete.
TREATMENT: Because my daughter is not yet in remission, I don’t know that I’m qualified to answer, however I can share our current list of antimicrobials and antibiotics we’re using for Lyme, Bartonella and Ehrlichia and some of the best resources I’ve found.
Herbs (pulsed and rotated): Houttuynia, Sida Acuta, Alchornea Cordifolia, Isatis, Berberine, Neem, Grapefruit Seed Extract, Cat’s Claw, Gou Teng, Artemisia, Mimosa Pudica & Usnea
Antibiotics (pulsed and rotated, 3 at a time): Rifampin, Doxycycline, Flagyl / Tindamax, Cefdinir, Biaxin
It’s commonly held by Lyme Literate MD’s that supporting the body, with recommendations in this detox post (as well as enhancing the immune system and maintaining healthy nutrition) is as important as the antimicrobial agents chosen. So it’s critical to remember to not begin killing microbes without the proper support to detox. If you do, the herxheimer symptoms may be unmanageable and the toxins can be re-absorbed.
Reference links for 3 (of the many) protocols for fighting Lyme
- Buhner herbs: Buhner Healing Lyme & Success with Buhner
- Antibiotics: A Lyme Disease Antibiotic Guide
- Cowden: The Cowden Support Program
LLMD’s can help you select the best treatment tailored to your needs, often also addressing parasites as part of an overall Lyme elimination program.
To purchase: Buhner herbs in tincture or capsules are available from several retailers on Amazon. You can find them individually or in combination with others by searching the herb name(s).
Cowden herbs are available at Nutramedix.
In addition to Buhner and Cowden’s à la carte herbal protocols, the most commonly used Herbal Blends that LLMD’s use are from: Beyond Balance, Byron White, Researched Nutritionals, and RestorMedicine. Links direct you to lyme specific products.
I found it helpful to compare and contrast the herbs used by Buhner, Cowden and the ingredients in each of the above linked blends to determine which single herbs we would use and introduced them one at a time, instead of purchasing blends.
After researching and selecting herbs that sounded most beneficial, I began 1 drop per day, and within a day or so added another herb at 1 drop per day. From there, I increased them to 2 drops per day and continued increasing slowly until reaching the recommended amount.
The reason for low-dosing them all together instead of reaching a full dose of one at a time is because they are synergistic and enhance the actions of each other.
I have also found these to be extremely beneficial sources of information:
- Advanced Topics in Lyme Disease free pdf from Joseph J. Burrascano Jr., M.D.
- New Paradigms in Lyme Disease Treatment: 10 Top Doctors Reveal Healing Strategies That Work book by Connie Strasheim
- Healing Lyme AND Healing Lyme Disease Coinfections books by Stephen Buhner
- Lyme Disease Treatment Guidelines outline from The Treat Lyme Book by Dr. Marty Ross
I wish you all the best health and healing on your journey!
For more information on testing, lyme induced autism & PANS, and treatment options please see the Lyme Disease guide at our Facebook Group
For additional blog posts by Rebecca Ferguson – Regarding Caroline • click here