Understanding Die-Off and Herx Reactions with Steven Wright

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It’s easy to get sidelined in your healing process and think you’re having a particular detox reaction, die-off, or herx response that is actually something else. Or perhaps there’s an underlying trigger that you’re not quite seeing that’s holding you back.

So as we usher in 2023, I’ve brought my friend Steven Wright of the Healthy Gut Company back on the show to talk about die-off and detoxification, what it is and what it isn’t, and how you can best support yourself through this process, especially if you are working with a practitioner.

For years, Steven Wright struggled with a wide variety of severe digestive problems, which led him to create the SCD Lifestyle, and now the Healthy Gut Company.

In this episode, we discuss:

  • What an actual die-off or herxheimer reaction is and how long it should last
  • How food sensitivities are often misconstrued as a die-off reaction
  • Why keeping a food mood journal is an important part of the healing process
  • How trauma, emotions, and your environment impact your gut microbiome
  • How supportive therapies such as digestive enzymes, HCL, and postbiotics can minimize symptoms
  • Expert tips on learning how to listen to your body’s cues for more effective healing

Listen to the podcast here:

Within the below transcript, the bolded text is Samantha Gilbert and the regular text is Steven Wright.

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Understanding Die-Off and Herx Reactions

It’s easy to get sidelined in your healing process and think you’re having a particular detox reaction, die-off, or herx response that is actually something else. Or perhaps there’s an underlying trigger that you’re not quite seeing that’s holding you back.

For example, over a year ago, I worked with a young woman from New York that came to me with significant challenges in the areas of digestion, OCD, anxiety and depression. She was on a very limited vegan diet of ultra-processed foods, and was convinced she had mast cell activation disorder. Right off the bat, I knew she had a lot of inflammation in her gut, and her diet was a big part of the problem. Initial testing revealed extremely high thyroid antibodies, elevated liver enzymes, overloaded metals, high homocysteine, and several nutrient deficiencies.

I created a treatment plan for her that removed all the processed foods she was eating along with important nutrients that support gut healing. She made amazing progress and shared with me that her mood, energy and digestion were greatly improved. However, at our next appointment, she reported that her hair was falling out, and that she was greatly fatigued. Testing revealed her antibodies and liver enzymes had increased again. I asked how the diet was going, and she confessed that she added back all the processed foods she had been eating, because she “thought it would be okay since I was feeling so much better.”

I explained that you can’t out supplement a poor diet and encouraged her to go back to the dietary plan I created for her. Ultra processed foods are well known to be an underlying cause of non-alcoholic fatty liver disease and contribute to Hashimoto’s disease. Well, instead of doing that, she became quite obsessed that the vitamins A, D, and K I recommended gave her a fat-soluble vitamin overdose, and this is why her energy was low and her hair was falling out, which couldn’t be further from the truth.

This is a great example of falling prey to the Google rabbit hole of misinformation. Just because you read something online that has your set of symptoms, doesn’t mean that’s the cause. Which is why working with a skilled practitioner is important. You know the saying, we can lead a horse to water but we can’t make them drink.

Welcome back to the show. Steven, it’s great to see you.

Thanks for having me, Samantha.

I’m really excited for this conversation because we’re seeing an interesting trend regarding detox and die-off or Herxheimer reaction. And it seems like there’s a lot of confusion about what this is, with many people attributing symptoms they are experiencing with die-off that really aren’t die-off. So I wanted to bring you back on the show to help clear some things up, give people clarity, and so on. So let’s dive into what is die-off or what we often call a Herxheimer reaction.

What Does Die-off Mean in Medical Terms?

So I think that we should go by the actual medical definition, which is where the body’s detoxification organs, specifically the kidneys and the liver, are overrun by toxins, by nutrients, by something, usually toxins of some type. And that overrunning of the normal detoxification pathways causes a symptomology that’s usually more like a flu or cold feeling. This would be chills, fever, brain fog, headaches, sometimes some rashes, definitely muscle aches, sometimes increased mucus production, and oftentimes GI issues and an uptick in loose stools or something like that.

This is really important to me. I think it is to you too, because that is a very specific body process that’s been overrun and a very specific set of symptoms that are the cause of that, or because of that, and people are running around talking about die-off this, and die-off that. And they’re doing themselves a massive disservice to their healing journey, to their meaning making in the world, to their health providers, and to their family members.

And especially if they’re sharing in Facebook communities, or any community on the internet, if you’re not using these terms appropriately, you’re doing yourself a massive disservice, and you’re doing the world a massive disservice. And so if we can clean up our language and clean up our understanding of the body and of healing, you’re actually going to get what you want faster, which will probably result in better health.

I’m so glad you said that. So important. Herxheimer has been around a long time, it was actually named after two Austrian doctors. Herxheimer, as I recall, was a dermatologist, correct me if I’m wrong there. And then as you shared, it is a reaction to endotoxin-like products released by the death of harmful organisms within the body during antibiotic treatment. That was basically the original synopsis of their work. And that’s very different from what we’re often seeing. So let’s dive into what actually causes die-off.

In case people are like, “I don’t know if I want to listen to this podcast”, let’s just start by saying my goal today is to piss everybody off who listens to this podcast by pointing out areas in which you might be misinterpreting signals from your body. And if you continue on this misinterpretation pathway that you’re on, you’re going to choose potentially the wrong next steps for yourself, costing yourself more money and more time.

And like I said, confuse your health care providers and confuse your community members who are trying to support you. And so making meaning and understanding the signals your body is giving you based on what you’re giving it, meaning your environment, your food, or supplements or drugs, whatever. This is really critical to ever making it out of a chronic health condition. Like if you’re going to ever make it out of the hole, to the point where you don’t identify as, “I’m an autoimmune, this, I’m a GI problem.” No, I’m just a human who has a few weak links. But I have a pretty awesome life. Like if you ever want to crawl out of that hole and stop identifying with these issues and go back to regular life, you’re gonna have to get really good at understanding your body and interpreting its signals back to you in ways that move you forward and help you manage it.

How to Interpret the Signals Your Body is Giving You

I’m so glad you said that. Can we talk about signals now? And what are some things you’re seeing that people are correlating with this concept? That may not be entirely accurate?

Signals to me are any sort of change in your day-to-day symptomatology. It could be increases in energy or decreases in energy, increases in cognitive capacity, decreases in a better Bristol stool chart number. Let’s say you’re normally like soft serve ice cream. And now you’re less clumpy or less chunky. Or maybe you’re more like a rabbit pellets. And now you’re more like a Snickers bar. “Oh, normally after dinner, I feel sluggish, I didn’t feel sluggish today, I’m feeling a little extra sexy today.”

These are all little signs and signals and awareness that we can have as humans, and we can write them down. Because we have terrible memories. Everybody has a terrible memory, you can look at data on how Abraham Lincoln was shot in a really, really small theater, and there were 300 people there. And none of the 300 people have the same written account with the Secret Service about what happened. And so our memories are terrible. So if we write these things down, and you do that over and over again, you’ll start to understand your natural rhythms.

And if you’re a woman, you’re probably already way better at this than most men in my experience. But you also have an added variable that makes your sensitivity even more complex, which is your cycle. So once we start to overlay our cycle and remember things like, “Oh, God, I’m so emotional today, like, oh, wow, I’m three days out from when I’m supposed to start.” And you can look back in a calendar or an app or in a journal and be like, “oh, right, I get headaches, and loose stools the week prior to my cycle or during it or whatever.” You can overlay that with “I had that big project that was due or the kids’ school got let out or I went home to visit my family.” You can overlay that data, you can start to understand that these signals are typically more correlated contextually with bigger events in our lives than just I had broccoli today or I’m having die off from the paleo diet or the carnivore diet, or the SCD diet that I’ve been doing, and I’m somehow doing something wrong.

So these signals come in all different manners, they can be signals of positivity, like you want more of them, you know, better sex drive, better health, better skin, better GI, or they could be on the negative side, like, worse GI, worse sex drive, worse brain health, all those things, achy joints, but the trend is really what we want to be aware of. Because we are highly complex creatures with highly complex environments. And the interaction between the environment and ourselves is how we experience these signals. 

And so just recording one day of positive or one day of negative is a really crappy data point, it’s really not going to do much if you’re basing your next dietary decision, or your next prescription drug, or your next supplement on just one or two data points. That is a terrible decision making process. We should be observing trend lines over months. And that correlated with what’s happening in our broader lives is really where you get amazing rich data sets. And you can make really wise decisions, especially if you have a third-party involved like a health provider or psychologist, somebody who can be like, “Wait a second, I think you’re lying to yourself, or you’re lying to me.” You’re like, “Oh, I forgot to check my journal.” You’re right, I did. It’s not the non-GMO chicken that I accidentally got exposed to at a work party, it turned out to be chicken, it just wasn’t that high of quality. It was about the end of the pay cycle. And I always get nervous, am I going to get paid on time?

Understanding Die-Off and Herx Reactions: tracking your body’s cues is an important aspect of healing.

I’m so glad we’re segwaying into this area of listening to what your body’s telling you rather than what an article on the internet says. And also data tracking. And it’s wonderful because it’s free. But we don’t think about that, we think I need to do this test and that test. And you know, I’ll be the first to say that testing can be so incredibly important and helpful in the healing process, especially if you’re working with a practitioner. But a lot of these things you can do on your own. For example, when I’m working with someone new, I always give them a food mood poop journal. And I ask them for at least two weeks, can you please write it down? How does food make you feel? What comes up for you? What’s your mood? They get a Bristol stool chart handout. And it’s just something that is really simple and easy that they can do to, like you said, get some wonderful data about how they’re interacting with their environment, what they’re eating, what their stress level is.

I’m glad you brought up menstrual cycles for all of us, ladies, because I agree with you, we tend to track those things more and correlate symptoms more with that time of the month. I’m so glad that we’re starting off in this way. Because I always want people to be empowered on my show, and you’ve been on a couple of times before and you always share so many pearls of wisdom. I think as we all collectively move forward in the world that’s ever evolving and changing, coming back to who we are and getting really intimate with ourselves, I think is such a wonderful key starting place.

With that being said, Steven, I’m curious, you mentioned a couple, but I kind of wanted to just go deeper in terms of things that people can react to that they maybe don’t realize they react to. It could be like you said it could be starting a new diet, like a paleo diet. It could be lifestyle events or changes. And it could be exposure to things. Can you share a bit more with us about that?

Die-off and Environmental Toxins

There’s a number of categories and maybe we should go through each category. That would be wonderful. Okay, so the environment is one of the easiest ones to test. There’s hundreds and hundreds of 1000s of people in various mold Facebook groups who are all convinced they have mold issues, and some of them frankly, very much do. And there’s lots of under-diagnosed people with sensitivity. So I’m not minimizing anyone’s sensitivities. I’m just trying to challenge everyone to think better because I feel like what you and I were chatting about and one of the reasons to have this podcast was it feels like people are getting dumber. Maybe they’re just fed up with trying to make meaning because meaning is so hard to make of this. There’s so many signals out there. Which one is the true truth for them? So maybe it’s that people are just burned out and you know, I’m not trying to call everybody dumb.

Oh, I know you’re not, but I see your point. Yes, I think people are just fatigued and tired of everything.

So it’s easy to say something like this one thing is the answer. With mold or other environmental toxins, you might have a small leak of carbon monoxide in your house or something like that that could be the trigger, these things happen. This is part of being in a Western culture, one of the best things to do is go to a hotel. And I know hotels get a bad rap by the super mold sensitive folks, but go to your in-laws or go to a hotel for four days or so and see what happens. Because a lot of people never realize that they’re reacting to their home. And maybe it could be the plants in your house, it could be the plants in your yard, there’s all kinds of things you could react to, even personal care products. When you go to a hotel you’re usually using something different, maybe even your travel products are different than your home products, or the hotel stuff, but just leaving and going on a trip, even in your town, to a new place. All the mold testing back in the early 2000s, that’s what the best integrative practitioners used to tell people to do. 

Just go check into a local hotel that’s medium quality or above. And stay there for a week and tell me how you feel. Because back in 2010, they didn’t have the kind of testing they have now. So I would say that’s one of the best things to do from an environmental standpoint. Notice when you go to an office, if you go to an office, a lot of people don’t go to offices anymore. But some offices clearly have water leaks all over the place. So when you’re entering and exiting buildings, when you go out of town for a little while, notice these things. Hopefully you’ll hear this podcast and a year from now you’ll be like, “Oh, I’m going back home to see so and so I’m going to try that thing.” That’s when you should try to do these things unless you’re really in a bad place. And you’re like, I have to figure this out, then you go stay at a hotel for a week, if you can.

I just want to interject one thing, you’re reminding me, Steven, of a client that I had a few years back that I was working with who had terrible psoriasis, covering most of her body. She also struggled with a lot of really severe brain fog, fatigue, high anxiety, panic attacks, things like that. And we made some good progress in the beginning, but not enough for it to be significant. And I finally said, “Well, what is your home like? What does it smell like?” Tell me about that. And she started to describe some things that had occurred, some water damage, some other things that had occurred in the home.

And I love the idea of staying with a friend or an in-law, because that’s what I suggested that she do. And she went and stayed with her in-laws. And guess what, with all the nutrients and everything and the diet that she had switched to after we started working together, her skin completely cleared up and her brain fog and the anxiety was greatly minimized. I’ll never forget the last session we had, she’s like, “this is amazing, I just had no idea I didn’t even realize that it was our home that we were living in.” And just simply staying with my in-laws for a couple of months was a treatment in and of itself. 

So I’m so glad that you brought that up to really think about our environment and what we’re exposed to. And I know nobody likes to write things down anymore. But I think it’s a nice brain exercise to get into the habit of carrying around a little pocket, like a three by five journal. And I have several of these and I always have one in my handbag, I have them around the house. Because I think it’s healthy and a good exercise to be off of screens. And to get into the practice of journaling, actually writing and getting thoughts out of your brain and down onto paper and sharing with your journal, what you’re experiencing and what you’re noticing. So this is really profound. Keep going. What else?

Well, I think another really confusing one, they’ll probably get more confusing as we go here, but the environment one was just easier to start with. But food is a very confusing one. And I’m gonna go ahead and say 99.9% of all food reactions are not a die-off reaction. Like it’s just not even possible. Based on the definition we gave at the beginning of the show. If you react to food, whether you’re adding it in or taking it out like 99.9% chances are probably not unless you went from a full Western diet full of sugar, like a sugar-a-holic, to a straight up paleo or a fasting seven day water fast. 

Maybe then, because the die-off in the small intestine overwhelms the internal capacity of clearance but rare, very rare. That doesn’t make the symptoms of food issues any less debilitating or painful or annoying. It’s just that if we can reclassify them it can give you clues about what your body is actually needing to handle food. I’ll go to scenarios and then maybe you have some other ones that you can throw out there or share from your experience. But one I find all the time is FODMAP reintroduction.

That’s a big one, yes.

Die-off and Food Intolerance

People are now very aware that carbohydrates and certain types of vegetables can be really hard for an inflamed, messed up gut to break down, they take them out whether through a low FODMAP diet or a little carbohydrate, or an SCD or something like this. But then they want to add them back in because, hey, there’s nothing inherently wrong with starches, or with garlic, or onions or broccoli, or whatever. But some of these foods can be debilitating to folks, and when they try to add them in, it becomes very frustrating, especially once you get really clean and you start to become very aware, you’re like, “now I’m reacting to everything.” Well, likely you were reacting to everything before you just had so much build up that you couldn’t really figure it out. So there’s a few mistakes that happen when reintroducing foods. One is that people go too fast. They’ll be like, “Oh, it’s time to reintroduce onions.” And they make a dish that’s full of onions.

Understanding Die-Off and Herx Reactions: digestive enzymes can help reduce symptoms.

I miss these babies, I’m gonna add a lot to this dish because they’re delicious.

Die-off, Digestive Enzymes and the Gut Microbiome

But the truth is, your body has certain enzymes that it needs to break down these foods. And your microbiome has certain bacterial populations that eat the various specific molecules in these foods, and if overwhelmed, causes its own issues. And so I have a three day food introduction rule where it’s like, start with a quarter cup or less, and then double that every three days so that you’re getting exposure every day for three days. You’re giving your microbiome and your pancreas and your brush border time to ramp up enzyme production, the microbiome has time to bloom and respond to this new thing it hasn’t seen in like eight months, or however long, it’s been eight weeks. And that seems to really help people with their reintroductions.

And then if you’re still struggling with that it’s not die-off. It’s just that whatever is required for digestion of that food, you don’t currently possess the capacity. And that can often look like not enough digestive enzymes. And you need to use something like our Holozymes or some other product or not enough stomach acid, and you need to support that, or maybe your mucous membranes are just totally shot and you’re having histamine reactions to normal everyday things. And you need to use Tributyrin-X or something like that to rebuild those pathways. And that’s really important, because if you keep thinking it’s die-off, you might keep thinking like,” Oh, I need to get some herbals or I might need to go down the SIBO path” when the truth is, you might not at all, you might need to be building rather than tearing down. And so I think that’s a really common area of struggle for folks.

I’m so glad that you said that. Quite a few things were coming into my mind as you were sharing, and one thing I do my best to help everyone with is patience. I know, we want everything now and yesterday, and it’s hard to be in pain, I have so much empathy for what people are going through. And you and I both know, the healing process does require patience, and the ability to, again, just notate what you’re noticing and back off accordingly. So it’s always nuanced, right?

I was just thinking about the brush border enzymes and finding that having that support, while going through this process, can also be really, really beneficial. That’s why I love your products and I get such great results with my clients. So when that extra support is added in, that can help modulate some of what we’re talking about. But gosh, I’m thinking of so many clients that I’ve walked through this same scenario with where sometimes we just have to go a little bit slower, pull back a little bit more and allow the GI tract time in that healing process, not add in antimicrobials too soon. And it’s amazing how just the act of being a little bit patient can help shift things.

And then I’ve had many clients where they weren’t able to handle FODMAPs. And without doing any major overhaul, we were able to slowly add them in, we just needed to shift the diet in a different way from what they were eating. Because let’s be honest, a lot of the foods that people are still eating are, even though they are marketed as healthy, and we’ve talked about this on previous shows, it’s just marketing. They’re still very inflammatory so there’s high inflammatory responses going on in the body. And it’s kind of like a chart where it’s constantly going up and down, and we’re trying to lower the inflammation and bring in the good stuff. And the body and the brain are going, “Okay, I like this, but I need some time to assimilate, I need some time to upgrade.” It’s like putting new software on your computer. And it’s just a process that takes time. So I really appreciate that. That’s one of the important points that you’re sharing with us today.

I love the software analogy. I think it’s so true. I don’t want to bring myself back to eggs after I go on a tangent here, but this idea that you can trace back one issue with one, let’s say, the FODMAP things like it’s just a broccoli thing, or it’s just an onion thing or something that’s like, is virtually impossible, like the complex interplay between your immune system and your gut and your microbiome, and everything that’s going on in your body. And then if you’re suddenly flooded with nutrients that haven’t been there, like phytonutrients, from a certain class of vegetable that hasn’t seen the idea that that doesn’t go somewhere in the body, and then upregulate certain genes and down regulate other genes, that is literally what’s happening.

Die-off and Fraudulent Studies

And so this idea that we can just trace it back and say, “Oh, well, it’s one thing that fails in alternative medicine and in mainstream medicine.” I mentioned before we started here, there’s two papers this week, one out of England, showing that there is zero link between serotonin and depression, like the foundational research that has been relied upon for over a couple of decades now. There is no correlation between serotonin levels and depression. That doesn’t mean that certain people don’t benefit from certain antidepressant drugs, because they do. But it’s probably in some crazy complex way that we can’t trace back.

And then the same thing happened with amyloid beta plaques this week, and Alzheimer’s. It turns out that the leading paper, the leading scientists fraudulently published data, which happened with Ancel Keys and fat, it happened with the Women’s Health Initiative, and estrogen and breast cancer. And so it’s happening in regular peer reviewed Western medicine. Don’t think it’s not happening in your Facebook group. Don’t think it’s not happening in integrative medicine and functional medicine, because it is like these are cognitive biases that we have as humans. And so we have to guard against this, we have to think better than this.

Understanding Die-Off and Herx Reactions: increasing your zone of tolerance can help with the healing process.

I’m so glad that you said that. Because that’s what we’ve been saying for the last couple of years. When we talk about the conventional system. It’s always been there. But it’s really come to the forefront over the last couple of years, how fraudulent so many of our esteemed medical journals really are, and who owns them. And I think it’s important that we make this a part of the conversation. I’m not saying that all studies are fraudulent, or are designed to benefit Big Pharma. I’m not saying that at all. There are some really great peer reviewed journals. And I know you’re not saying that either. But I love that you said that, because I think it needs to be out in the open. And I think we need to not be afraid to be honest and talk about it.

I agree. And I think what’s important about each one of those topics was a large group of people or certain powerful people saying it’s this one thing that is your cause and your problem. And that happens with mold, that happens with Lyme, that happens with GI issues, that happens with everything on the integrative side. And it happens in conventional medicine. So I encourage people to tune their brain to whenever anybody, both conventional or non-conventional, says “I know the secret. I know the one reason why you feel the way you do.” They’re pretty much fooling you. Life is too complex.

Oh, it is. And we are so complex, incredibly complex. And in fact, a big part of my work over the years has been there’s never one root cause. We’ve been trained to think that, especially in the functional and holistic alternative space. We’ve been trained to believe that there’s one root cause, so once we figure that out, “Oh, I’m cured. I’m great. I’m good to go.” That is never, ever the case. And I just want to reiterate what you shared, because, again, we’re complex beings, with so many layers.

And the layers are not always physical, the layers are often spiritual. The layers are often on an emotional level. We are complex in all these different levels of who we are and layers of who we are. So I really want people to just remember and understand that even though we’re headed into this, I’m just going to say it, Transhumanist agenda, we’re human beings. We’re not robots. Let’s remember that.

Die-off and Listening to Your Body’s Cues

I appreciate you sharing that because it is so true. If there’s one other food thing, and then I want to pick up your emotional spiritual path, you just laid down there. So this is just fresh in my mind, because this literally just happened a month ago. I have a friend and he’s extremely bright, like top in his field, he runs groups that people in our industry beg to be a part of. And he’s having some GI issues. And everybody’s failed to work with him so far. And these are New York Times bestsellers, and other people that we know. And I tell them about the new products we have. And I’m like, “Cool, man, I’ll put you on a protocol and see if we can get these loose stools fixed, and the bloating.” And we start ramping up the dosages of HCL Guard, of Holozymes, and Tributyrin-X.

So we’re at a low dose, then a regular dose. Now we’re at a high dose and I’m like, “How are you doing?” And he’s like, “Well, things are slightly better.” But there’s a few things he refuses to do. He refuses to keep a journal, because I think the way his brain works, it slows him down. And he’s a high functioning type A personality. And so because of that, I actually believe he saw benefit, but he had no way to actually classify how much better he was getting. But it was clear to him that he was not good yet, and something was off. And so then it was clearly low FODMAP because he had tried that a few years ago. And he eats a pretty solid diet already. So then he hired a chef to make him the most ideal low FODMAP diet ever.

So now he’s using our full stack of Healthy Gut products. And he’s got a chef making him the best low FODMAP diet ever, and still having bloating, loose stools. So now he’s convinced that he’s a lost cause and our products aren’t that good. And I was at breakfast with them. And he always ordered these eggs poached, and he was like, “this is the healthiest way to eat them.” I was like, okay, it was probably I guess, based on some advanced glycation end products. Maybe that’s true. Cool. But I noticed that he had eggs every time we hung out. And so I was like, “Hey, why don’t you quit eggs.” So he quits eggs. At the same time he quits our supplements and then picks up a whole stack of other supplements from a different gut health company. And now, what’s fascinating is that his symptoms are shrinking. His loose stools are going away. But he has no clue if it was the eggs or if it’s the products from the other company. I’m pretty confident it was the eggs.

Yes, for sure. It was the eggs. I was just going to say, I can really relate to that scenario. I can’t even begin to tell you how many times I’ve come across individuals that won’t keep a journal, they say it’s too much trouble, even though it’s simply writing something down the minute you notice, or it comes into your mind, like two seconds. I love eggs, they are kind of a perfect food, but definitely not for everyone. In fact, the people that I work with, I almost always leave them out initially, just so we can get a baseline. And then when we start adding things in one at a time, like you shared earlier, because that’s the best way to reintroduce something, then you get a really good understanding of whether this person can actually tolerate these proteins or not. 

Because there’s other things going on with eggs. But I’m so glad that you shared this because I think that if I’m being quite frank and honest, this is a frustration for a lot of practitioners. Because we have no control group so to speak, right? We have no way of really understanding and knowing which one it was, but just knowing again, how inflammatory eggs can be. I definitely go in that direction. But anyway, please carry on.

Well, there’s that but I think there’s another takeaway here. Both for practitioners as well as clients and patients, which is that if you can use or follow a group of people using a specific brand, and their specific dosages, they will know when you’re at a small dose, a medium dose or a high dose. And if your problem is supposed to be helped by that product, and you’re not getting the benefit at a high dose, that is an amazing signal. Actually, that is wonderful news to you. Because it tells you that you should stop digging in this direction, or going in this direction and pause and figure out what else could be causing this or contributing. Because if you’ve already pushed, let’s say you have loose stools, and you’re taking like six to nine Tributyrin-X a day and four Holozymes with every meal, and you’re still having loose stools, that is an amazing signal that something else is happening.

It’s in your environment, it is the eggs in your diet, it is maybe an abusive relationship you’re in. So there are really cool takeaways other than everybody should probably try no eggs for a week or two, which is knowing if you’re going in a certain direction, there’s something called the law of diminishing returns. As well as if you have practitioner knowledge with specific brands and specific compounds, you develop an encyclopedia of expected results. And when the results deviate from the expectation that tells you really important data about your next step with that signal.

Understanding Die-Off and Herx Reactions: is it die-off or a food intolerance such as eggs that are know to cross-react with gluten?

Yes, it’s really important. And that’s where this again, to bring it back to the discernment of getting really in tune with your body, collecting information as it comes up, taking two seconds to write something down is really critical. So thank you for that. Just kind of as a natural flow of our conversation, bringing up the spiritual, the emotional bodies that encompass who we are as human beings. You mentioned abusive relationships. So many people struggle with that. So many people have lost their jobs and are really struggling financially. I mean, the stress of so many different scenarios that people are in and how that impacts our physiology. Can you speak into that a bit?

Is it Die-off or Stress and Trauma?

Yeah, I mean, it’s 100% true, and it’s 100% real. And the idea that thoughts become things is 100% true. You can feel that infatuation when in love with a human and you know that you feel buzzy and light and everything’s more colorful. Like that is just a thought, though, that’s just a feeling. But you’re creating that chemistry in your body in relation to your environment, in this case, another human. So everything is possible in this realm. And it’s very true and very serious. So if let’s say you’re on an amazing diet, and by amazing diet, I mean, you’re like 95%, adherent to a paleo or some sort of low anti-inflammatory whole foods diet. And let’s say you have a pretty solid supplement protocol, you’ve done some basic testing, and you’re still struggling with your RA or your psoriasis or your GI stuff, this is a really good sign that your steps and the things you need to remove that’s holding you back is not in any of those directions, because of the law of diminishing returns, you can try a bigger elimination diet, a better supplement program, you know, $1,000 a month worth of pills, and probably get marginally better. 

But if you find out that it’s some trauma from your past, or an abusive boss, or just the fact that you don’t feel safe financially, and you need to take a little bit of time and just handle that, that is going to give you much more bang for your buck and help you so much more physically than continuing to obsess over whether you’ve had too much FODMAP today, and that’s the cause of the bloating or the cause of the loose stools. And my personal story to that is actually on the opposite end. So I got to the point where I spent hundreds of thousands of dollars. I could call up anybody. I could call Chris Kresser, I could call Dan Kalish. I could call up anybody and get a test and a consultation. I now had a business where I could write off expenses, which helps when you’re trying to spend a lot of money on your health. And I was disillusioned with nutrition and functional medicine and supplements and drugs because I was like the answer is not here because I keep getting this intermittent, visceral hypersensitivity, which is basically increased pain in the abdomen due to IBS related issues.

It can feel like knives stabbing you in the gut. It’s really intense. And I would just get this intermittently. And you know, there goes a couple of hours of my life. I can’t focus, I can’t do anything. I’m not a good human. Don’t talk to me during that time period. And pain relievers don’t do much for that. And I was like, “How did I get this far?” How did I read this many books, this many scientific journals, I did this many courses, I’ve worked with people, I’ve helped people worse off than me, but I can’t get better at what is going on. So I walked away, and walked into my emotional baggage and my spiritual baggage that I had not dealt with, because I was too scientific and too much of an engineer.

And lo and behold, for me, it took assisted psychedelic therapy, both ketamine, and psilocybin, and MDMA. But I can point to very specific contextual journeys, one on one, with a guided professional, where I relive certain experiences in my life and process them with the psychedelic assisted compounds. And I can literally feel my gut and my abdomen and everything loosen. And I literally do not have the same pains or the same kinds of things. Since then, it’s literally 50% gone in one afternoon. And I’m not saying that’s easy peasy. In fact, every single one of those journeys would not be what people would call pleasure, it was a lot of work. And there was a lot of integration that took place after that.

But this idea that there’s things that are actually stored inside of our body or tension that is related to things that have happened in our past, is profound. It could be something else much simpler. But for me, this was a huge piece of my integration and my last healing to the point where I became way more resilient in my health and way more just okay with being in a human body that sometimes is a little farty and a little mucousy. And just a little gross, you know, because I think that’s where I got rid of so much of the random pains, and the random things are the things that held me in a box where I couldn’t eat this, and I couldn’t eat that to the point where I just recognize like, “Oh, there is no Pinnacle here.” Sometimes you’re just a little farty, or sometimes you just got a little too much mucus and that’s okay.

I appreciate your story. I believe the first time I had you on the show, which we’ll link to in the show notes, we talked about your journey in more detail. I can relate to your journey because I had a lot of abuse and trauma in my childhood. And it took me many, many years to work through that and to find the right people to work through that with. To be quite frank, and some people made it worse, if I’m being honest, professionals that actually made it worse, and probably shouldn’t have been in their fields.

But for me, that whole spiritual journey and understanding, why is this happening to me? Why do I have to go through this or when you have a scenario where it’s kind of the same situation over and over, maybe the same type of individual comes into your life over and over, and you’re thinking, “Okay, I thought I learned this lesson, it’s time to move on.” And it was huge for me after clearing up my own biochemistry and gut infections and all that stuff, but to then be able to use that as a springboard because I was feeling better because I had some legitimate biochemical issues and infections that having that clarity allowed me then to work on the spiritual and the emotional.

Now, that’s not the case for everyone. Sometimes it’s the other way around. I find that most people, when they work on the physical, it does help propel them, give them more energy to look at those things that are painful, because I don’t think any one of us will go through this life unscathed. I mean, we just don’t, we’re going to have things that come up and happen. I think, just in general, there’s going to be some form of abuse, whether it’s covert, or whether it’s very much, you know, in your face. And this is such a big part of, or rather impacts, our physiology.

And I always want to encourage people to remember that I know it’s difficult, because we don’t see, it’s not tangible like food on a plate. I know this is good for me, I know this meal is going to make me feel good. But you know, I just got into a shouting match with my spouse. And that’s also playing in the background, too. So again, I’m glad we’re going down this road. Is there anything else you want to add in that regard? Or can we maybe look at another category that people aren’t thinking about?

I think you said something very important that I want to highlight which is, for a long time, it really bothered me to realize that I could go to a chiropractor and they could literally touch my feet and affect my head and then I could go to a psychologist who touched my mind in a way, and it would affect my feet. I was like, I don’t understand how both of these could be true, at the same time, this is crazy. Why I bring that up is because of what you just said there, which is that some people, I think, naturally lean more towards maybe being aware, and they already are into yoga and meditation and go see a therapist. If they want a different experience in their health, or if they’re frustrated with what’s happening, they should probably go more towards the physical, looking at their bones or their organs, or they should get some functional medicine testing.

And then those people who are really stuck on the functional medicine testing and spent thousands of dollars over there and tried like five different diets or 50 diets, they should really stop, put that down and go pick up the meditation and the yoga and the therapy and go over there because the most likely breakthrough for someone is not in the place you’ve already been going.

Otherwise, you would have experienced it already, because it would have been easy, like low hanging fruit or an easy win, and it hasn’t been. And then to your point, I don’t know which school of thought or psychology this is from, I did not come up with it but there’s this idea of a zone of tolerance. And when a human is in their zone of tolerance, they’re not too high, meaning like anxious, and maybe angry, or emotions that are high energy or too low, meaning more like depression, fatigue, and we don’t eat things like that, when you’re in your zone of tolerance, you’re very much responsible for what’s happening.

Die-off and Zone of Tolerance

And I think one of the goals I have for myself and I hope other people can become aware of, is to increase my zone of tolerance. And we can increase our zone of tolerance by adjusting the physicalness. Like if you’re in so much pain in your joints in what you see in the mirror, because your skin is all blistered off. Or if you literally know that if I eat this breakfast, which I’m so hungry for, I’m probably going to have diarrhea, and then I can’t be in that pain. That means your zone of tolerance is really, really narrow. And so there’s physical things you can do with nutrients and doctors and things like that to increase your physical zone of tolerance that allows you to have a better mental zone, where you can take on an angry spouse in a different way or a child who’s misbehaving in a different way. Or you don’t even care that someone cuts you off in traffic this morning.

If my tolerance is too small due to physical issues, that is going to make it really hard for you to make mental, emotional, and spiritual breakthroughs. So I want to acknowledge those folks who are just in constant pain. Zen Buddhism is kind of like this, where they literally want you in so much pain that you actually break through into a new experience of pain. But that is a very hard road to walk. And I think there’s a lot more people out there who can get relief in the physical realm and then be transferred over to the mental, emotional, spiritual realm than those who are in so much physical pain that they have a spiritual breakthrough.

First, I love this phrase zone of tolerance, and understanding what your specific zone of tolerance is, and how you can utilize that to manage chaos, because that’s kind of what we’re talking about here. Whether it’s traffic chaos, or stress, or family or work environment or what have you. I think that’s a really important gauge. So I’m glad you walked us through that. One of the things that I read on your website, and I think you’ve shared this before, but you can have a reaction from the inflammation in your body, getting to the point at which it starts to affect you in a really significant way. So for example, and I’m kind of leading us into another category unless you want to add something else, Steven, we have those clients and patients where they come to us and they feel pretty good. And they go through life and maybe they’re in midlife and they’ve been doing fine. And they’re like, I’m so active, I’m a runner, and I lift weights, and I do all these things. And in my job, I have a lot of responsibility. I manage a lot of people, and then all of a sudden they just hit a wall.

And you know, for lack of a better word, kind of fall apart. And I feel like that’s its own little subcategory of what we’re talking about because we started off with die-off and people getting really confused about what that really means. And now we’re kind of segwaying into these other things and trying to help people understand that there are myriad reasons for why you might be having a reaction and I think, just that inflammation alone and not realizing maybe that it’s there because we’re so busy with our lives. That’s a big one in and of itself. Would you agree with that?

Yes, I might even describe it in another way. And I think one of the reasons for this podcast is that people need to hear the same message from different people at different times in their lives. But they also need to see, I sort of think about it like rotating a diamond. If you look at a diamond, it’s beautiful on all sides, but each time you rotate it, you see a different lens or a different prism. And so I would introduce this idea of systemic versus local effects. And so I think it’s really easy to get focused on local effects. And local effects are like, the FODMAP thing or the egg thing, like, I eat this today, I feel bad, it’s probably this or I introduced this product, it’s not working, or it is working. These are very local effects. But we failed to really grasp, systemic long term trends.

And so if, for instance, your entire community is just covered in wildfire smoke right now, that is a systemic effect that you cannot get away from. And over time, that’s going to raise the inflammation in your body, especially if you’re maybe poor at clearing that due to some genetic or epigenetic weaknesses. Maybe the water in your community is slightly tainted with something, this is a systemic effect that is affecting everyone, but you happen to be affected by it a little bit more. Another systemic effect that people really fail to consider how impactful it is, is aging. It’s really tough to talk about in a Western culture, but like our testes, or ovaries, our gut cells are literally dying out, our stem cells, our brain cells, as we pass 35, it’s not really uphill, it’s kind of downhill with our accumulation of DNA damage and everything. And so I think a lot of people can be going through life. And like you said, being very healthy, being very active, not really identifying with having health challenges. And then one day wake up in a world of hurt and pain.

And I think these things tend to clump around certain systemic issues, including age buckets, like 40, and 50, and 60, they tend to clump around events in society, like changes in public policy, or if you cannot escape something that’s happening in your community, maybe you’re very afraid, like the whole community is afraid because of, I don’t know, a shooter or terrorist or the new political party, like these are systemic things that build upon people’s psychology that they have a hard time registering, and then one day, you can just build up enough inflammation, because you’re getting a little bit here, a little bit there. And then the systemic pressure is rising, such that people do hit a wall. And, you know, that’s enough for their level of capacity.

Understanding Die-Off and Herx Reactions: a postbiotic can support the gut and modulate reactivity.

I liked the way you worded that, and again, bringing in how there can be a collective influence as well. And we’ve seen that a lot in the last couple of years. And I want to honor that, because I think, as a whole all over the world, we’re all experiencing the same thing. In certain areas, little pockets are obviously going to be a different experience than others. But we’re all collectively in this thing together. And it’s interesting how those, again, bringing it back to that whole physical, and how the body is like, I just can’t take any more, I need rest, or I need something else, I need a change, I need a different direction. So I really appreciate you speaking into it that way.

Die-off is Associated with an Herbal or Antibiotic Killing Program

Die-off is typically associated with things like an herbal killing program, or an antibiotic killing program, antifungal or anti parasitic, like some sort of killing program. If you’re not on a killing program of some type, it’s very unlikely that you’re experiencing true die-off. Now some people can have some intense detox reactions from maybe mold or some sort of protocol. And so if you’re feeling like you’re one of those individuals who is not having a good detox experience, there’s some very simple things you can do. You can increase your amino acids. Glycine and cysteine are very important for glutathione creation. They’re also just amino acids in general that can be burned through quite a bit in a detoxification program.

And so getting a really broad spectrum amino acid supplement, and taking that can be very helpful. Taking some extra glutathione or milk thistle or something like that. Taking systemic enzyme therapy. If you’re worried, and think it’s a kidney or liver, sluggishness or incapacity, try some of those products. They’re not usually all that expensive. And for some people, they really are a big difference maker, but for the other interactions, and if you try those products, and you still experience the same signals, then I think we’ve got to loop back to the beginning of this podcast and listen to it again. What meaning are you making from the signals? And what meaning do you make based on where you’re viewing it, you can make it mean something if you’re just looking local, but if you fail to recognize the systemic perspective of what’s happening in your life, then it can take on a totally different meaning.

I’m glad you said that because we were starting off with this trend we’re seeing, that everything seems to be die-off, when it’s not. And what really is die-off? Yes, I’m working with a lot of botanicals when they’re appropriate. And that’s creating a change, a physiological change in bacteria, yeast, etc. And that person can go into what we call a herx reaction. But we always want to make sure that we’re mitigating any negative experience as much as possible, not that it doesn’t happen. And when it does happen, it doesn’t mean that it’s a bad thing. It just means that your body is evolving and going through change sloughing off what it doesn’t need, when it’s not a specific die-off reaction as you shared.

Again, it’s part of our our human evolution of going through different things that happen and come up in our lives, whether it is a new medication that you’ve added in or a new supplement, or a food or a shift in that sense, or, again, you’re just going through something that is really traumatic, and your body is responding accordingly and needing to work through that. So I just really appreciate that we’re able to have this conversation today. Is there anything else you’d like to add, Steven?

How Long Does a Herx Reaction Last?

I think one other little nuance that maybe helps one person, maybe more is my experience of true herx stuff is that it’s typically over in about a week or less? Is that your experience as well?

Yes, definitely. I shouldn’t be three months long. If it’s three months long, something else is going on. As you shared earlier, absolutely, that’s been my experience.

Back when I had a clinic, and we did consulting, if we put someone on an anti something program, anti bug program with some killing agents, they would often be on that for like four to eight weeks, depending on the bug and the person and everything. They could experience a herx. In the first introduction in the first week in which we would have the dosages that would typically go away, and then we were able to go back up to the full dosage the week after, we would just extend the program a week. But this idea that if you introduce a killing program, and you’re on week three, or four or five, and you’re still feeling like junk, that is not a herx in my book. And that is a signal that something else is off, and you need to ask for more help from whoever you took this program from.

Yes, good point. I’m glad you brought that up, too, because I think there’s also confusion. And this is a whole other show. But I’ll just say this briefly, antibiotics are more of a one trick pony kind of scenario. They’re really effective at killing bacteria, but they don’t do much else and cause yeast to proliferate. And overall, I think they can be really poisonous, antimicrobials work a bit differently. Even something like oil of oregano, which is an antimicrobial, but it’s also antifungal, antiviral, it has a lot of different properties to it. So it’s getting in there and it’s doing a little bit more than just addressing the SIBO, if that’s the only thing that was prevalent with testing.

If someone’s really sensitive, I’ll just maybe start them off with one thing, rather than three different things. Oftentimes, I’ll do a combo approach, or even a triple type of approach, depending on, again, sensitivity level, and so forth. But if you’re getting into different types of bacteria, like methane producers, and so forth, then we have to be careful with things that are garlic derivatives. Because those can be really difficult for people to tolerate. So there’s nuance there. And then probiotics. We’ve talked about probiotics in the past, but I don’t think we’ve done a show specifically on probiotics. So maybe that’s something we can explore in the future. But typically, it shouldn’t be this forever and ongoing. If that is the case, then I would be concerned that something else is amiss.

Well, it sounds like we got our next few shows already lined up.

Yes, definitely. I always love talking with you. So as always, Steven, you’re amazing. And I really appreciate you and all that you do to share your knowledge with us and the world. And I’m really appreciative of your time and thank you for coming back on the show today.

Yes, thank you, Samantha. I really enjoy our conversations as well. I hope that we pissed enough people off in a good way to think a little bit more critically about not only Western medicine but integrative medicine and Facebook groups and influencers. So hopefully this helped people and I appreciate you just hosting a show like this, because I think it’s actually super important.

It is important, isn’t it? I appreciate you saying that. We’re all human and we all make mistakes. We all deserve grace. We don’t get a lot of that these days. But I just want to remind everyone to have grace for your neighbor. Think about forgiveness, rather than just getting angry and saying something that maybe you’ll regret later. So, thank you again, Steven.

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