Mycotoxins can cause oxidative stress. Oxidative stress is an intracellular imbalance that occurs in chronic disease where reactive oxygen species are not readily removed and detoxified into more inert compounds in the body. This results in cellular dysfunction leading to disease. The production of free radicals and peroxides are chemicals that cause intracellular organelle damage and prevent normal cellular function. Mycotoxin exposure significantly increases oxidative stress and therefore reduces glutathione. When glutathione is low, disease ensues.

However, glutathione can be replenished by an oral paste or liquid very effectively. When glutathione levels return to normal, proper cellular function ensues and often disease-causing symptoms diminish substantially. For more details please ask Dr. Marra for more details on how mycotoxins can cause oxidative stress in your next appointment.

Mycotoxins and mold are metabolites of fungal organisms that are toxic to the human body and exposure can be present in both food and air. Two food-borne mycotoxins are Aflatoxin and Ochratoxin. Aflatoxin is produced by many species of Aspergillus fungi and can be found in soil, peanut butter, olive oil, and some cosmetics. Ochratoxin is also produced by Aspergillus species and can be found in cereal, coffee, and wine. It too has disease-causing effects on the body and has a half-life of 35 days.

In September 2012, Dr. Dennis Hooper, director of Realtime Laboratories in Carrollton, Texas, presented information on the new technology available to investigate mycotoxins and mold exposure in patients. He has developed a urine PCR test for identifying mycotoxins, which are known causative agents in many chronic diseases and probably complicate healing from Lyme disease.

Additionally, Trichothecenes are airborne mycotoxins produced by several molds but most notably, Stachybotrys, otherwise known as “black mold.” Stachybotrys is a mold that arises from damp conditions and water leakage in homes. These toxins can produce significant irritation to the mucosal lining of the lungs, GI tract, bladder, and brain causing chronic illness. Patients exposed to Trichothecenes often report having severe headaches and brain fog which lessen when they change to a mold-free environment.

However, mycotoxins can get trapped in the body by adhering to fat cells or entering cells (especially adipocytes) causing oxidative stress. Oxidative stress for prolonged periods of time depletes intracellular glutathione and interferes with the cell’s ability to self-repair.

The Jarisch-Herxheimer reaction was originally noted in 1895 by Dr. Jarisch who worked with Syphyllis (a spirochete) patients.  In the 21st century, we observe Herxheimer reactions in tick-borne illnesses such as Lyme Disease, also caused by a spirochete.  A Herxheimer reaction (Herx) typically occurs hours to days after antimicrobial administration and is thought to be the result of endotoxins released into the bloodstream by dying spirochetes.  The body’s immune system then responds to the endotoxins and the concurrent release of cytokines (i.e., tumor necrosis factor, interleukin 6, and interleukin 8) which are chemical messenger molecules of the immune system producing exaggerated symptoms lasting 3 days up to several weeks.

Dr. Marra doses antibiotics specifically for the individual patient so that the Herxheimer reaction on a scale of 1-10, is about a 5.  This is her own technique, and she feels that severe Herxheimer reactions over prolonged periods of time may cause tissue damage from the excessive release of endotoxins and cytokines.  Tissues become friable as the result of chronic inflammation, not unlike what happens when a sponge is repeatedly used and the surface area becomes frayed.  Dr. Marra is not convinced that this kind of tissue damage is reversible which is why she chooses to take the route of treatment that she does.  However, many other physicians choose to treat more aggressively and seem to have good results. This is simply her own treatment preference.

The general description of a Herxheimer reaction is a temporary increase in symptoms but may also include the development of completely new symptoms.  More specifically, the most common complaints of a Herx reaction are increased joint and muscle pain, headaches, chills, night sweats, fever (usually low grade), extreme fatigue, and brain fog or lack of mental clarity, drop in blood pressure, hives, or a rash of some sort.  Worth noting here is that a rash or hives can sometimes be mistaken for an allergic reaction.  It is up to the treating physician to determine this, but with close, experienced observation and the use of Benadryl, Alka Seltzer Gold, Quercitin, warm lemon water and vitamin C (see Herx management), unnecessary premature cessation of antibiotics may be prevented.  In more severe cases of Herxheimer reactions, a reduction in the antibiotic dosage or cessation of the antimicrobials may be required.

The timing of a Herx reaction is very individualistic and can occur within days to weeks after the onset of antibiotic treatment.  In some patients, a Herxheimer reaction occurs only once or twice, or not at all throughout treatment.  It is clear however, that as you move through the treatment and the spirochetal load becomes decreased, the Herx reactions become less and less severe.  Herxheimer reactions can also occur in cycles (usually 4 week cycles) and may be affected by the lunar cycle.  This is anecdotal but it is an interesting observation in some people.

About 70-80% of people undergoing Lyme Disease treatment with antibiotics experience some sort of Herxheimer reaction.  It is thought by a number of physicians and scientists that these people have difficulty in detoxification processes, and that perhaps there may be a defect in one of the detox pathways in the liver.  This may be genetic, environmental or a combination of both.  But without question, maintaining an alkaline diet and an  “alkaline bioterrain” helps lessen the effects of a Herx reaction.  The 20% of patients who do not experience a Herx reaction should not feel like they are getting nowhere by taking antibiotics.  Discussion of this issue should be left to the patient and their treating physician.

Check out our page about alkalizing foods.