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Starting abx - Herx v. allergic reaction v. ineffective

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So, we are starting DD's abx tx in a few days and I have been reading about herx reactions and trying to figure out what to expect.

 

I am still a bit unclear about how to tell the difference between a true herx reaction and what might be an allergic reaction to the meds.

 

Also, as she is really volatile right now, I'm a bit paranoid that her constant rollercoaster could be confused with herxing and really not be related at all, but mean that the abx is the wrong one.

 

Please, any thoughts?

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xerxing, if I understand it, may result in worsening of symptoms which should pass in a day or two. allergy should be more violent and would not be related to the same symptoms.

there is a third thing -- if this is a sulfur based abx and your kid does not process sulfur well (this is the case with us), abx will result in additional symptoms and worsening of some symptoms. when you stop the meds, this effect also disappears.

we know we don't process sulfur well because of our methylation gene mutations.

there can be also other ways in which abx can cause worsening, by promoting yeast, gut issues, etc.

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Hope this helps -

My son has been on a lot of medications and just had his first allergic reaction. He had hives all over his body (I thought it was chickenpox at first not ever having experienced it). I'm sure his behavior was somewhat worse also but nothing out of the norm - the reaction was totally skin based. Another thing to note- it ended up

being the Omnicef he is on (antibiotic) which he has been on for about 3 weeks - we had just started a new medicine and that was not the problem. I guess most antibiotics can cause an allergic reaction a while into taking them so even though everyone says "What have you changed lately" it could be something he has been on a while. My doctor knew right away. For me herxes have always been behavioral.

 

Melmix

DS8 PANDAS/PANS/Lyme

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From a pharmacological stand point, an allergic reaction is:

 

A mast cell is injured or irritated, it releases a variety of strong chemicals, including histamine, into the tissues and blood that promote allergic reactions. These chemicals are very irritating and cause itching, swelling, and fluid leaking from nearby cells. These allergic chemicals can cause muscle spasm and can lead to lung airway and throat tightening as is found in asthma and loss of voice.

 

http://www.emedicinehealth.com/script/main/art.asp?articlekey=2196

 

Also a rash/hives are common allergic reactions but those need not be present for the itching to be an allergic reaction.

 

Generally speaking, any other reaction is an not allergic reaction, but something else such as an intolerance to the abx (nausea, headaches, vomiting, mild diarrhea etc). Sometimes intolerances go away after a week or so, but contact your doc so they are aware of the issue. If you can tolerate the reaction, your doc may request you try to see if it goes away.

 

Also you may experience an adverse reaction which would vary depending on the antibiotic. Swelling/pain in the joints is not uncommon for fluoroquinolones. Sometimes a person may experience tremors as an adverse reaction. Severe diarrhea/gut pains with Clindamycin are also not uncommon. Each medication has a specific set of adverse reactions. Usually each abx will come with a paper handout that list most adverse reactions. Contact the doc immediately if you experience any listed adverse reactions. True adverse reactions are somewhat rare, but can lead to long term health complications if not handled immediately. You can pm me or ask on open forum if you are unclear about adverse reactions for a specific abx.

 

Or, the reaction may be a herxheimer reaction which for our kids usually includes worsening of existing symptoms directly related to the condition being treated ie: increased ocd, anxiety, tics, raging, etc..... Hexheimer reactions also usually resolve with time, but may require adjustments to the meds to lessen the reaction making the symptoms more tolerable.

 

No improvement at all after 2-3 weeks is a good reason to visit the idea that the abx may not be working for you. The doc may want to wait a bit longer however, as some kids take a bit longer to respond.

 

My kiddo started zovirax (anti-viral) on the 3rd of February and we are just now getting back to some "good days". Of course, things were a bit rough before we started anyway, then the herx took a while to settle down. I treated the symptoms of the herx (mostly items to reduce anxiety) and gave charcoal, and magnesium, for detox rather than reduce her dose since the symptoms were not intolerable for either of us.

Edited by mayzoo

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xerxing, if I understand it, may result in worsening of symptoms which should pass in a day or two. allergy should be more violent and would not be related to the same symptoms.

there is a third thing -- if this is a sulfur based abx and your kid does not process sulfur well (this is the case with us), abx will result in additional symptoms and worsening of some symptoms. when you stop the meds, this effect also disappears.

we know we don't process sulfur well because of our methylation gene mutations.

there can be also other ways in which abx can cause worsening, by promoting yeast, gut issues, etc.

Pr40 if you could respond I would appreciate it. Our son was recently diagnosed with G6pd (sulpha issue) He did great on Bactrim and artimisine for three months and then began a decline. We didn't know about the G6pd so we were adviced to give around the clock advil for inflammation(major prob for this condition). He got worse and soon became too weak and he never left the couch. We now know he has it. His blood level results came back at 46?? Don't know what that meant other than he was positive for it. Problem is that now he can barley handle anything. Super sensitive to all drugs most likely due to the Sulpher toxity. We have him on Rifampin 7.5ML every other day. That's 1/2 of 150 mg every other day. He herxes or falls apart for weeks if we go fast. I know Rifampin is not good pulsed and given singular treatment but he just falls apart and cant function no matter what detox we do. The 3 doc's we have take this lightly. They don't seem too concerned and I have to keep reminding them along the way he has it bc they will recommend things that are counter indicative to the condition. This has been a huge set back for us. If we give even a 1/4 amount of psych meds he reacts so we cant really add anything to treat his mental symptoms. Using CBC oil 40 drops a day and passion flower. Do you do low and slow on anti B as well?

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Thanks for all responses. We just started the abx about 1.5 hours ago, and so far, so good :) (trying not to sit and stare at her, waiting for something to happen - lol).

 

mayzoo, she is on clindamycin and rifampin. The insert for the drugs lists the adverse reactions you mention. The problem in my head, is that these same things (diarrhea, g/i stuff, etc.) are things I often see mentioned as a herx reaction. So, is it possible that the "adverse reaction", as the standard medical community sees it, is actually a herx reaction, from a different angle?

 

You mention charcoal -- wouldn't that carry the danger of absorbing some of the meds? Is there a specific time after dosing that you administer the charcoal?

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Thanks for all responses. We just started the abx about 1.5 hours ago, and so far, so good :) (trying not to sit and stare at her, waiting for something to happen - lol).

 

mayzoo, she is on clindamycin and rifampin. The insert for the drugs lists the adverse reactions you mention. The problem in my head, is that these same things (diarrhea, g/i stuff, etc.) are things I often see mentioned as a herx reaction. So, is it possible that the "adverse reaction", as the standard medical community sees it, is actually a herx reaction, from a different angle?

 

You mention charcoal -- wouldn't that carry the danger of absorbing some of the meds? Is there a specific time after dosing that you administer the charcoal?

 

Diarrhea as a herx, hmmmm, I am not sure about that, but of course my experience is limited.

 

Mild diarrhea (soft stools 1-2 times a day) is likely a short term intolerance. Violent, completely watery, excessive (more than 2-3 times a day), OR bloody diarrhea are an adverse reaction that absolutely needs to be reported to your doctor immediately. The Black Box warning for clindamycin is:

 

"Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.difficile."

http://www.drugs.com/pro/clindamycin-palmitate-hydrochloride-granules.html

Make sure you drink enough water/gaterade and that you are taking appropriate, and ample probiotcs (2 hours before or 2 hours after abx). Adding kefir, fermented vegetables, yogurt, prebiotics, etc is a very good idea to help lessen the likelihood of colitis or GI disturbances.

Charcoal needs to be taken 2 hours before or 2 hours after anything you want to absorb while in the stomach (herbs, any meds, etc..).

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Thanks. Yesterday I gave her 2 doses of her probiotics, but it's hard on school days, since we give her the abx right before school and her probiotic has to be mixed in water.

 

So far, no side effects at all, but we are still early in the game.

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From a pharmacological stand point, an allergic reaction is:

 

 

My kiddo started zovirax (anti-viral) on the 3rd of February and we are just now getting back to some "good days". Of course, things were a bit rough before we started anyway, then the herx took a while to settle down. I treated the symptoms of the herx (mostly items to reduce anxiety) and gave charcoal, and magnesium, for detox rather than reduce her dose since the symptoms were not intolerable for either of us.

 

Can you tell me what you used to reduce anxiety? We are currently tiering up with inositol which seems to be working but I'm thinking it's actually aggravating her ADHD and when I looked online, studies have shown it can make ADHD worse so I'm reluctant to continue with it much longer. Not sure what else to try as NAC irritates the stomach, and she has stomach issues as it is.

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