The die off - The Herxheimer Reaction from daily probiotic use

Category: News
March 29, 2018
by BuyProbiotics
Feeling worse before feeling better

The Herxheimer Reaction is a short-term detoxification reaction in the body resulting from taking probiotics. As the body detoxifies and the bad bacteria die off, it is not uncommon to experience flu-like symptoms including headache, joint and muscle pain, body aches, sore throat, general malaise, sweating, chills, nausea or other symptoms.

This is a normal — and even healthy — reaction that indicates that parasites, fungus, viruses, bad bacteria or other pathogens are being effectively killed off. The rebalancing of good vs bad is over and the good has won. The biggest problem with the Herxheimer reaction is that people stop taking the probiotics that have been causing the reaction, and thus discontinue the very treatment that is helping to make them better. Although the experience may not make you feel particularly good, the Herxheimer Reaction is actually a sign that healing is taking place.

What Is The Herxheimer Reaction?

The Herxheimer Reaction is an immune system reaction to the toxins (endotoxins) that are released when large amounts of pathogens are being killed off, and the body does not eliminate the toxins quickly enough. Simply stated, it is a reaction that occurs when the body is detoxifying and the released toxins either exacerbate the symptoms being treated or create their own symptoms. The important thing to note is that worsening symptoms do not indicate failure of the treatment in question; in fact, usually just the opposite.  

Technically known as the Jarisch-Herxheimer Reaction, this syndrome goes by many names, including JHR, the Herxheimer Effect, the Herxheimer Response, Herx Reaction, Herx or Herks. The most common terminology used is the Herxheimer Reaction. It is also often referred to as a healing crisis, a detox reaction, or die-off syndrome.  


The phenomenon was first described by Adolf Jarisch (1860-1902) working in Vienna, Austria, and a few years later by Karl Herxheimer (1861-1942), working in Frankfort, Germany. Both doctors were dermatologists mainly treating syphilitic lesions of the skin. They noticed that in response to treatment, many patients developed not only fever, perspiration, night sweats, nausea and vomiting, but their skin lesions became larger and more inflamed before settling down and healing. Interestingly, they found that those who had the most extreme reactions healed the best and fastest. The patient might be ill for 2-3 days, but then their lesions resolved.  

The most common Herxheimer reactions for users of probiotics are:

  • Headache
  • Flu-like symptoms
  • Itch and rashes
  • Stomach aches
  • Diarrhoea

Usually, the reaction lasts a few days. In more severe cases, reactions can last a week or more. In most cases, the reaction tends to be mild and barely noticeable, but there are exceptions, particularly in cases of severe infection of Candida.

Herx reactions vary widely, depending on many factors, including the general health of the individual, the amount of probiotics being ingested, the degree of toxicity that exists in the body, and the support the body is provided in eliminating the toxins as rapidly as possible.

When will it happen?

For most people, this reaction usually comes several months after starting with probiotics. There is differing data on the timing of a Herxheimer reaction. Sometimes it happens much faster, between four and 24 hours from the onset of taking probiotics. Others note that between Day 3 and Day 5 of daily probiotic usage is often when the reaction is most noticeable. What appears to be most accurate is that reaction times — and indeed whether there will be any reaction at all — are strictly dependent on the individual being treated. Duration of the reaction also varies widely, from an hour or a few hours to days or even a week.

My own personal experience was around 3 months from drinking Milk Kefir daily. I noticed some flu like symptoms, I had a headache and felt a little strange. The experience only lasted 48 hours. I had been expecting it, and for me it was welcomed as a turning point in the road towards better health.

What To Do In The Event of a Herxheimer Reaction

If the reaction is mild enough that it can be borne without grave discomfort, the best approach is to continue treatment and assist the body in eliminating the toxins as quickly and as thoroughly as possible by the methods below.

If the reaction is too severe, cutting back on the dosage or frequency of use can be very helpful in lessening symptoms but allowing the healing process to continue. Sometimes stopping for a day or so and then beginning again at a lesser dosage can allow for quick relief. If your worried, please get in touch. We are not medical professionals, but have experience with the reaction.

The best assistance for the body is drinking plenty of water (2 litres a day is recommended).

Other helpful suggestions include:

  • Getting plenty of sunshine
  • Minimizing exercise for the detox period
  • Keeping the diet relatively pure during the detox period so that the body is not loaded with additional chemicals and toxins to eliminate while it is already working hard.
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