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Herxheimer/Immunopathology
Herxheimer: Jarisch Herxheimer reaction (JHR) is a transient clinical phenomenon that occurs in patients infected by spirochetes who undergo antibiotic treatment. The reaction occurs within 24 hours of antibiotic treatment of spirochete infections, including syphilis, leptospirosis, Lyme disease, and relapsing fever.
Immunopathology: Immunopathology is a branch of medicine that deals with immune responses associated with disease. It includes the study of the pathology of an organism, organ system, or disease with respect to the immune system, immunity, and immune responses.
I was watching Garrett Smith's weekly video (I think it was 9/10/21) and he mentioned that he didn't believe in Herxheimer. He believes that any increase in symptoms is simply caused by the increase in toxicity, either through cholestasis or external poisoning. While I do agree that cholestasis and poisoning can cause negative symptoms, I find it too simple of an approach in light of the evidence we have to the contrary.
His basic premise is that if something makes you feel worse, stop doing it. While this can be helpful to avoid feeling like crap too often or to too much of a degree, it leaves many confused on their state of illness. The dreaded symptom relapse is said to be mass dumping, which may be happening, but I feel it doesn't completely fit the evidence. Immunopathology is the other side of the coin.
We all know that when we get sick with a cold of flu, it is our immune systems pumping out these symptoms in order to clear pathogens. It is the response to these foreign materials that elicit the uncomfortable symptoms. If symptoms were a tried and true measure of toxicity, then steroids should be heralded as health promoters, as it makes you feel better. Yet, all they really do is suppress the immune response; an immune response that must happen one way of another, albeit at a comfortable pace.
Vitamin A toxicity is completely real and a huge factor in disease and disease progression. Vitamin A competes for Vitamin D receptors which are central to the innate immune response. Possibly, by reducing Vitamin A toxicity, the immune system starts to reactivate and has some spring cleaning to do. Dormant bacteria, viruses and other pathogens can finally be addressed. The retinoic acid corrupted tissues are now interacted with at a higher rate, leading to temporary worsening of symptoms. This may explain why months of reducing Vitamin A leads to increased immunopathology.
Fasting reduces symptoms. But when you return to a normal diet, the symptoms come back. I doubt that the body ran more effectively and cleared a bunch of toxicity during the fast just to return to the prior state within a few days. Fasting can actually be stressing on the liver and kidneys. What it more likely is that when the body went into starvation mode, immune function was reduced. High fat diets can also have a similar effect of reducing immune function. Adding carbs back increases symptoms and that freaks everyone out. But maybe the immune system runs better with carbs and is actually working on an issue, an issue that was put aside as the immune function tanked while being suppressed.
Pinning everything on cholestasis is like having a geocentric model of the solar system or the theory of phlogiston. Most factors fit into these models and thus it seems to make perfect sense. I find the relapse and "dumping" phenomenon the thorn in the side. If the body keeps the body safe by storing Vitamin A in the tissues, why does it mass dump after months of effective detox? Maybe a renewed immune system function provides a better approach.
When my flares occur, they come out of nowhere and leave out of nowhere. There is no slow retreat that would indicate slow gradual detox. They usually end in a bang. My symptoms are 10 fold worse around waking hours. The immune system runs hotter at night when we are resting. This indicates my symptoms are more immune related. Get the immune system running properly, decrease toxicity so future episodes are either much less severe or resolve all together. If you feel worse, it may just be the inevitable healing process. Modulate it as needed.
My symptoms are 10 fold worse around waking hours.
Maybe this is due to running out of glucose during sleep. Following glucose drop, the body recovers homeostasis via increasing the release of free fatty acids which are powerful antibiotics by themselves, hence additional immunopathology. At the same time glucose deprivation shuts down immune system both directly(by starving phagocytes of their main fuel) and indirectly(via increased fatty acids and ketones) so symptoms raise could be largely unproductive(i.e. useless stimulation of out-of-fuel/exhausted immune system with toxins leading to spinning unproductive inflammation).
Quote from rockarolla on September 26, 2021, 7:56 pmMy symptoms are 10 fold worse around waking hours.
Maybe this is due to running out of glucose during sleep. Following glucose drop, the body recovers homeostasis via increasing the release of free fatty acids which are powerful antibiotics by themselves, hence additional immunopathology. At the same time glucose deprivation shuts down immune system both directly(by starving phagocytes of their main fuel) and indirectly(via increased fatty acids and ketones) so symptoms raise could be largely unproductive(i.e. useless stimulation of out-of-fuel/exhausted immune system with toxins leading to spinning unproductive inflammation).
Lower cortisol around sleeping and waking hours has been proposed as a mechanism for more robust immune responses during the night. Cortisol increases through out the day and suppresses immune function compared to lower levels.
The past few days have been interesting
Felt like crap Friday night. Couldn't sleep, elevated heart rate and general delirium along with joint pain.
Saturday I woke up feeling pretty gone, mentally. Physically, I was better than Friday night. Once I fully awoke, I had the best day in months physically and mentally.
Sunday I woke up and I was sore all over my body. I've felt worse but it was definitely increased from the day before.
Not sure what to make of all this but I feel like I am making progress in general. Feeling normal was quite the treat.
Lol, I have all the same. I noticed that if I wake up in a crappy state, I will feel better during the day and vice versa 😐
I think that my liver throws out VA at certain moments and I get worse, but since my biological clock and hormones are knocked down, I can't predict this.
keep me posted)
I was watching Garrett Smith's latest Love Your Liver video on Youtube yesterday. I had to turn it off. It started to make little sense and convinced me that Garret is trying to square peg the whole Vitamin A paradigm.
Mid way through he talked about SSRIs. He has shown that Prosac can and has caused fatty liver. I concede that point. However, he links fatty liver/suppression of bile production to the symptom relief that Prosac causes. In other words, he believes SSRIs, and all symptoms relieving medications(?), work by suppressing bile "reflux" into the blood stream. Not that any pharma drug primarily acts and actually targets different receptors, but the overly simplistic approach that every symptom reducing effect seems to be written off as suppressing bile reflux or reducing bile production. If Prosac was primarily suppressing bile reflux, shouldn't almost any drug help? I can't get on board with that extreme notion.
According to Garret, symptom relief is either suppression of bile going into the blood stream or reaching health.
According to Garret, feeling bad is doing the wrong thing or doing the right thing too much or too quickly.
It's one big shit show that leaves everyone in the dark and confused.
He seems to really pimp out his services and constantly refers to it as "not a game" and that you basically need him or you are risking everything.
Where does the immune system come into play? Drugs, and many modalities, including diet, modulate the immune system. Many suppress immune function. This seems much more plausible than the suppression of reflux hypothesis (I do believe drugs have targeted receptors as well). Our immune systems are fighting real threats, and many times make us feel terrible. I feel it is inevitable. The model we should follow is a waxing and waning of symptoms phenomenon with a reduction in amplitude as time goes on.
I’ve told him that SSRIs do more than that. Not saying they are good for the liver, I’m sure they are not. However, that is not their primary mode of action. I’m sure of that.
Would it be possible that the effect on the bile is an indirect or unintended result of the treatment?
Where does the immune system come into play? Drugs, and many modalities, including diet, modulate the immune system. Many suppress immune function. This seems much more plausible than the suppression of reflux hypothesis (I do believe drugs have targeted receptors as well). Our immune systems are fighting real threats, and many times make us feel terrible. I feel it is inevitable. The model we should follow is a waxing and waning of symptoms phenomenon with a reduction in amplitude as time goes on.
All docs have an unhealthy attitude towards immune suppression drugs. 😀
Quote from Jenny on October 3, 2021, 12:32 pmI’ve told him that SSRIs do more than that. Not saying they are good for the liver, I’m sure they are not. However, that is not their primary mode of action. I’m sure of that.
SSRIs are a class of immunosuppressive drugs - basically a trade off between short term remission and long term relapse.