How can I tell if Lyme treatment is working?

[Ephedra]

Sorry if I have already asked this before, but is a herx reaction a required part of getting better?  What if I don't have one or can't identify it??  Does that exclude Lyme as a possibility?  How do I know for sure treatment is working?
I've been on a few different oral antibiotics at this point and I can't say I could pinpoint anything much out of the ordinary with any of them.  

I know it most likely varies but on average, how strong is a herxheimer reaction on oral antibiotics?  Could perhaps the herx not be strong enough for me to notice?  

Thanks!

[Ephedra]

Thanks!

I have been having some on and off nausea but I just attributed that to the typical side effects of antibiotics.  I'm so exhausted, I can't even put it into words.      

I should be getting my results back soon on that genetic test, hopefully they're not too hard to interpret.
  

[mojogal]

I know its the rifampin because one day I took 300 in the morning and 300 at night and it was much better.

I am having a lot of pain and nausea. I don't detox well from the mutated MTHFR gene so mine could be much worse than your herx.

I use to be on Zithromax and rifampin but Zithromax came out with a warning on irregular heartbeats. Since my dad died at 53 from a heart attack, my LLMD switched me to bactrum. A bad day for you could be your herxing.

[Ephedra]

Can I ask what sort of herx reaction you are having?  I'm on 600 mgs /1 time a day in addition to Zithromax and I cannot really tell a herx from a typical bad day.  Maybe it's the tindamax that's causing your herx though.

[mojogal]

I am herxing right now on Rifampin. At first I was taking the 600mg/2 but now I switched to 600 MG at once which made me herx so my LLMD said to stay on this for Bart's. I also take bactrum. The researcher Dr Eva Sapi wrote an article that she thinks tindamax is a wonder drug for cyst busting so I have been taking that too.

[JackieCalifornia]

"I even thought about taking a whopping dose of Flagyl to see what would happen"

Ummm, I wouldn't do that.  Stick straight to the dosing schedule and timing, so that you can accurately report to your doc what results you had.  Taking too much of a good thing ... well, it can mess up the treatment plan and also be potentially dangerous.  Just go by the label.

[Ephedra]

Thanks for all the great responses!

I think my Dr is reliant on some sort of herx.  Like you did Jackie, I feel so bad that it would be hard to feel much worse.  But I guess if I really pay attention, I do feel a little worse.  Then again, I think my Dr is going by the textbook definition of a herx (if there is one).  That being that herxes only last a few days and I'm hearing otherwise, everywhere that they can last quite a while.  

Being on treatment for Bart now for a few weeks, I think I'm more fatigued and I didn't think that was possible.  I can hardly get out of bed now, but I wasn't really sure if this could have meaning as I was already really tired to begin with.  Could it be a side effect of Rifampin maybe?  I didn't look it up to see.  

I want to have an obvious herx so I will have some confirmation.  I even thought about taking a whopping dose of Flagyl to see what would happen but even if I did have some sort of reaction, whats to say it wouldn't have been a direct result of the high dosed medication.  

I just don't like the idea of long term antibiotics, when I don't even know for sure!    

[mojogal]

Since I know I have the mutated MTHFR gene which makes herxes worse, if I don't herx, I change my meds. Now I am asking myself if I am crazy because I am herxing so badly its awful.

My old Bart's meds weren't working, I wasn't getting better, and I didn't herx.
So in my case, I hope its related.

[Ricobord]

I think not herxing would be great.  Maybe it means your body is really good at processing and disposing of toxins?  

I've herxed with all 3 of my infections, Lyme, Bart, & Babesia. The worst herxes have been with Babesia.  I literally got sicker for nearly 8 months once we started treating it.  

I've had no perceptible Lyme herxes on orals, only on Bicillin and Rocephin.  I've concluded the orals for Lyme don't help me much, if at all. I've only shown improvement on the Bicillin & Rocephin.  But then I had an entrenched neuro infection.

I was surprised at my symptom flare up on treating my Bart relapse last month, as when we first treated it in the beginning, I didn't notice any symptom flare up/herx.  Those symptoms really settled down about 3 weeks into Rifampin.

The question is if you're getting better.  If not, you might need IV or shots. Some do, many don't.

[honeybee72]

Hi
I was diagnosed with lyme and bart
I never herx and can go onto full dose meds straight away and still no herx
I always wondered this too
And have asked this too on other lyme sites and have many people tell me they don't herx either

[JackieCalifornia]

That's a good question --

From what people have said here and elsewhere over the five or so years since I was diagnosed with Lyme, it seems that Herxing varies widely from person to person, just like Lyme symptoms vary from person to person.

I know someone who had virtually no Herxes, with a smooth path through the treatment and no problems at all.

I don't recall having any particular Herxes either, but I felt so lousy that it would have been hard to feel worse.  I seemed to get better gradually without any dramatic events.

Like everything else connected with Lyme, tho, it seems to be different for everyone for a whole lot of reasons -- which co-infections, what meds, how the individual tolerates the die-off..