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Handling Herxheimer’s Reactions in Lyme Disease. Lymelighters Forum Raj Patel, MD 650-964-6700 www.DrRajPatel.net. Overview. History Definition Symptoms Clinical Implications Management Goal. Handling Herxheimer’s Reactions in Lyme Disease. 1. History
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Handling Herxheimer’s Reactions in Lyme Disease Lymelighters Forum Raj Patel, MD 650-964-6700 www.DrRajPatel.net Raj Patel, M.D.
Overview • History • Definition • Symptoms • Clinical Implications • Management • Goal Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 1. History • Adolf Jarisch and Karl Herxheimer at the turn of the century • Seen in syphilis patients treated with mercury • Commonly seen in spirochetal infections Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 2. Definition • Inflammatory immune response to endotoxins, cell wall antigens, and other cellular constituents • Elevations in cytokines, TNF, IL6, & IL8 • Toxin release exceeds clearance Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 3. Clinical Implications • Clinical indicator of treatment efficacy and presence of spirochete • Antibiotics vary in the intensity of herx they elicit Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 4. Symptoms • Headaches • Fevers • Myalgias • Arthralgias • Fatigue • Rashes • Nausea/vomiting/diarrhea • Behavioral changes • Others Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 5. Management • Mild: Water, Exercise/Lymph drainage, Homeopathic drainage remedies (oral) • Moderate: Charcoal, Clay, Cholestyramine, Dry skin brushing, Epsom salt/Baking soda baths, Ionic foot baths • Severe: Enemas/Colonics, Homeopathic drainage remedies (injectable), Glutathione, NSAIDS Raj Patel, M.D.
Handling Herxheimer’s Reactions in Lyme Disease • 6. Goal Effectively control the severity and length of Herxheimer’s reactions during the early stages of treating chronic infections Raj Patel, M.D.