Healing Crisis Explained: Symptoms, Causes and How to Manage Them
It's not unusual for people to feel unwell shortly after starting a detox plan or having complementary therapies. You might think this is the exact opposite of what's meant to happen, but there's a reason for this and it’s not always a bad thing.
Understanding the Healing Crisis
This experience is often referred to as a healing crisis. As therapies such as massage, reflexology, herbs or detox programs stimulate the body, toxins and cellular waste are released into circulation. The immune system and detox pathways may become temporarily overwhelmed, leading to uncomfortable symptoms.
Two common reasons this happens are:
The immune system is unprepared – systemic circulation leads to flare-ups in other parts of the body that now come into contact with the toxins.
The detox pathways aren’t prepared – our elimination pathways (liver, kidneys, bowel, skin) are not able to get rid of the toxins faster than they can accumulate.
Healing crisis vs Herx reaction
The healing crisis is a term that’s often used interchangeably with the Jarisch-Herxheimer effect (shortened to the Herx effect) but the two are different.
The Herx effect refers specifically to a phenomenon that was observed in patients treated with antibiotics at the turn of the 20th century. A healing crisis, on the other hand, can occur after various types of detoxification or holistic modalities, not just antibiotics.
The Herx reaction is a natural, sudden and temporary response from the body to the waste, endotoxins and pro-inflammatory cytokines from destructed bacteria, fungi or parasites (1). The body’s immune cells detect these and this triggers a cascade of inflammatory responses.
The reaction was first described by Dermatologists, Adolf Jarisch and Karl Herxheimer. They observed that after giving patients antibiotic treatment for syphilis, some of them experienced temporary worsening of symptoms (starting within 2 hours of taking the antibiotics and resolving within 24 hours).
Symptoms
Common symptoms seen both in a healing crisis and a Herx reaction include:
Fever and chills
Muscle pain
Headaches
Nausea or vomiting
Digestive changes (bloating, constipation, diarrhoea)
Skin rashes, flushing or swelling
Brain fog, fatigue or poor coordination
The reason the symptoms are so vague or non-specific is because when the medication, herbs or other treatment disrupt and damage large amounts of pathogens, it stimulates the release of inflammatory messengers all over.
This is also why broad-spectrum antibiotics produce more widespread and undesirable side effects as they are less targeted.
How to manage a healing crisis
Mild symptoms generally settle by themselves within a few days without any intervention needed. Still, you can support your body in several ways:
Rest
Get sufficient rest and try not to strain the body. We often forget that most of our healing happens when we are asleep. Sleep is when our cells regenerate and detoxify so we can support this cleansing process and our immunity by prioritising it.
The liver, in particular seems to suffer with poor sleep (2, 3, 4, 5) but is a key player in our detoxification processes. Additionally, the brain literally cleans itself while we sleep, using it’s very own waste clearance system known as the glymphatic system (6, 7, 8, 9) which helps us feel less groggy. Lastly, sleep is crucial for our immune system to function at its best (10, 11, 12, 13).
Nourishment
Ensure sufficient nutrients that support the immune system through fresh food. Choosing home-cooked food gives us oversight of the ingredients that go into the meals and research shows that home-made meals are often more nutritious (14). Including a variety of vegetables will enhance our intake of vital vitamins for our immunity too such as vitamin C.
How we prepare our meals can also support the extraction of nutrients. Cooked meals, using spices will increase the antioxidant content as well as improve absorption of nutrients (15). Compared to raw meals, cooked meals are also easier to digest which might be more helpful at a time when we are feeling fragile.
Try to minimise foods and drink at this time that can add to inflammation in the body and brain. Highly-processed foods may be convenient, but could end up exacerbating any symptoms as they contain ingredients which drive up inflammation. Excess sugar can do the same as well as dampen our immune system’s response (16, 17, 18) at a time when we really need its support. And alcohol is a known toxin so it would make sense to avoid this when we are already at risk of experiencing a higher level of toxins in circulation.
Sunlight exposure
Exposure to natural sunlight can boost our immune system. Our immune cells walk a fine line when it comes to sunlight exposure. Too little sunshine and our innate immune cells are reduced while our adaptive immune system can become over-reactive (leading to autoimmune diseases such as type 1 diabetes, rheumatoid arthritis, Crohn’s diseases, lupus). One recent study showed that light exposure increases the antibacterial activity of a type of innate immune cell called neutrophils (19).
Safe exposure to sunlight also helps us reap the benefits of vitamin D and its supportive role in our immune function. Vitamin D supports our immune system in many ways. One way is by increasing the number of pattern recognition receptors on immune cells so that they can better identify invaders (20), and another way is by lowering the amount of inflammatory messengers released by immune cells (20).
Support elimination
We can help move toxins out of our system by drinking plenty of water and minimising drinks that burden the liver such as alcohol and coffee.
Fibre is another essential component in our health toolbox. We often think of fibre as the thing that helps to keep us regular with bowel movements, but it’s so much more! This star ingredient feeds our good gut bacteria (21, 22, 23, 24, 25), slows down the release of glucose in our body (26), and binds toxins to throw them out of our system (27, 28, 29).
Gentle approach
To minimise reactions, it’s better to approach any detox plan gently so that it doesn't stir up pathogens too aggressively. Often, quick-fix detoxes and cleanses might sound tempting but can feel hardcore and do not have the lasting impact that developing long-term consistent change can have. By maintaining a gentle but consistent approach, our organs are able to process waste in a manageable way and reduce the instance of reactions.
Stopping and starting treatments can also impact the process and create further reactions because of the yo-yo restarting and disruption of the toxins that now have nowhere to go because we have not followed through with the plan to allow for elimination.
Speak with a practitioner
It’s always useful to consult with a practitioner, before, during and after a treatment for clarity and reassurance. This is an opportunity to be made aware of possible side effects, flag up any unexpected reactions and get guidance on managing these symptoms.
A practitioner can:
Help you understand if your symptoms are a natural part of the healing process or if they require further assessment.
Suggest modifications to your treatment to ease discomfort.
Provide emotional support and coping strategies during a time that can feel challenging.
When to seek medical help:
Not every reaction should be dismissed as a harmless healing crisis. Seek urgent medical attention if you or someone under your care experience the following:
Swollen lips/tongue/throat
Difficulty breathing
Mottled skin
Increased heart rate
These could indicate an allergic reaction, an underlying infection, or another serious condition. Similarly, vulnerable groups – children, pregnant women, elderly and immunocompromised individuals – should consult a doctor more promptly.
The bigger picture
A healing crisis can feel like a setback or failure but it's important to remember that healing is rarely a straight line. With the right support, patience and gentle consistency, working through these early stage challenges can lead to meaningful improvements in our health.
References:
1. Wood & Sbar (2025) Jarisch-Herheimer Reaction. StatPearls
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