Die-off / Herxheimer symptoms after starting Phage Complete

Are you feeling achy, have a headache, maybe some flu-like symptoms after starting Phage Complete?

Congratulations! Most likely you are suffering from a “Jarisch–Herxheimer reaction” (or Herxheimer Reaction, or Herx for short), also known as “die off”. This is caused by gram-negative, endotoxin (LPS usually) releasing, bacteria dying! This is a well known condition in medicine, and can also be seen after antibiotics. For very severe diseases (e.g. sepsis) a Herxheimer Reaction can be dangerous, for chronic gut issues, with bacteria dying at a moderate pace, it is not. This type of bacteria has to die in order for you to feel better and balance your microbiome.

Symptoms (usually mild) can include:

• Body aches
• Muscle pain
• Head ache
• Migraine (if prone)
• Nausea
• Flu like symptoms
• Low grade fever
• Thirst
• Bloating
• Diarrhea
• Constipation  ⇒
• Body itch
• Hair loss
• Worsening of existing anxiety and/or depression

These symptoms are temporary, and generally dissipate in 2-4 days.  If you had a lot of bad bacteria (now dead bacteria!) you may continue to feel a bit achy for a week, but you will most likely improvements after 2-4 days.

Bacteria, of course, die all the time, but at slower rates. LPS producing bacteria can make you feel a little bad day to day (e.g. brain fog); when they die in mass, you feel a lot worse. It sort of overwhelms your body’s ability to quickly detox them.  The problem is everyone is different in the amount of toxins produced and their ability to detoxify them. So there is no one phage/probiotic dosage that works best for everyone.

Because you still need to “do life”, and not just lie in bed all day, you’ll need to adjust your dosage.  You don’t want to just get through this, you want to control the die-off as to only experience low to low/moderate levels. If you were taking 2 capsules per day, take 1 capsule for a week instead, then try 2 after that (remember, it isn’t the probiotic making you ill, it is the dying bacteria. Once most of the LPS bacteria are dead adding more probiotic won’t cause more die off). If, after a couple of days, that doesn’t help try 1 capsule every other day for a week, then 1 capsule per day, then after another week ramp up to 2 capsules per day (divided, 1 in the morning, 1 in the evening).  You can also break open a capsule and take 1/2 per day if you wish (rather than one every other day), even a 1/4 if necessary. So if you start with one and experience a lot of die off, skip the next day and then start with half a capsule per day. It is also fine to start with 1/4 capsule per day and work your way up, this is especially recommended for children, elderly or if being at your best (what ever that is) is critical.

Here are some more things that can help:

• Drink plenty of water. Try not to drink anything that can possibly dehydrate you for the first week (e.g. alcohol, coffee, soda).
• New research indicates that LPS molecules are absorbed through the small intestine better if there is fat present, especially a saturated fat. We don’t want that; what we want is for the LPS produced in the gut to simply pass through with the stool. Therefore, if you experience die-off, including additional histamine symptoms, with Phage Complete start taking it away from food (especially high fat foods). Perhaps right before bed, or even during the night if you routinely get up. Taking it on an empty stomach is perfectly fine.
• Studies have shown the MCT oil can be protective against LPS (PubMed ID#PMC1522134 as well as this study). While corn oil (a PUFA) and saturated fats may worsen LPS induced symptoms such as inflammation and leaky gut.
• Take a Milk Thistle supplement to help support the liver and kidneys.
• Berberine – Taking a berberine supplement can suppresses the LPS-induced inflammation. This can   help eliminate  most of the symptoms and damage caused by LPS in gut.   ⇒
• Active Charcoal supplements can help mop up LPS endotoxins. But don’t take them for more than 2-3 weeks without a break as they can interfere with mineral absorption as well, so only take if you are getting die off symptoms,   ⇒  ⇒
• Due to studies showing high arsenic and lead levels, I would not recommend bentonite clay ⇒
• Get more sleep. Remember that detoxifying LPS molecules from gram-negative bacteria is a normal function of the body. It is when your body can’t keep up that you get symptoms; sleep helps our bodies function better and greatly improves detoxification of LPS.
• Epsom salt bath – it seems to help some people, but not others. It doesn’t hurt and it feels great.
• Mild exercise helps, a brisk walk is great. Don’t over do it while experiencing die off. Anything inflammatory isn’t not a good idea.
• As outlined above, take a one day break and/or reduce the dose.

Don’t worry if you do not get a Herxheimer Reaction, you are still killing unwanted bacteria and improving your microbiome. Not everyone experiences die off, in fact less than half of the people do. They can still be greatly improving their microbiome (fewer undesirable bacteria, more beneficial bacteria), but if they have gram-negative LPS endotoxin coated bacteria dying, they are able to keep up with the detoxing. Younger people generally handle detoxifying more efficiently than older people. You are also still helping to rebuild your microbiome, and that is always a good thing.

You can read a lot more on lipopolysaccharides (LPS) endotoxins in Chapter 12 of The Gut Health Protocol.

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