The path to healing is not always smooth. In some cases, especially when the treatment is designed to clear toxins and infections, you might feel worse before you feel better.
You might be wondering if your symptom aggravation is normal or if you are having an allergic reaction. The information below will help you figure out the best next steps if you are noticing that you feel worse since starting treatment.
There are three main reasons why a person might react negatively to treatment:
They are experiencing a die-off reaction
They are experiencing an allergic reaction or intolerance
No matter what, if you are experiencing an aggravation for whatever reason, my top recommendation is to stop your treatment and book a call for further advice.
If you have started multiple treatments at the same time, my top recommendation is to stop your treatment (all), wait until symptoms return to baseline, and then re-start your treatments one at a time, allowing at least 7 days between each new supplement or medication so you can identify any aggravations. It may be that just one single agent is bothering you. This strategy should help identify the culprit.
In many cases, a few adjustments to the treatment can improve treatment tolerance and allow you to complete the treatment much more comfortably.
Reason #1: Die-off
Die-off (also known as a Herxheimer reaction) is a temporary worsening of symptoms due to the release of toxins from dying microbes (bacteria, yeast, parasites). This often occurs when starting antimicrobials, biofilm disruptors, or gut-healing supplements. Typical Onset: 12–72 hours after starting the supplement (may be delayed depending on microbial load and detox capacity)
Duration: A few days to a week, though some symptoms can last longer if supportive strategies are not used.
Dose-dependent (higher doses often cause worse symptoms)
Often improves with detox support (binders, hydration, rest, epsom salt baths)
Feels like a "flare" of chronic symptoms
Reason #2: Allergic reaction or intolerance
An allergic reaction is an immune response (IgE-mediated in true allergies, non-IgE in intolerances/sensitivities) to a compound in the supplement—often a reaction to the active ingredient, fillers, or contaminants.
Typical Onset: Within minutes to a few hours of ingestion (often very quick and obvious symptoms)
Duration: Until the supplement is out of the system; symptoms may recur with every exposure.
Common Symptoms:
Itching, hives, rashes (especially sudden and widespread)
Swelling of lips, tongue, face, or throat
Difficulty breathing or wheezing
Sneezing, runny nose, watery eyes
Stomach cramps, nausea*, vomiting, or diarrhea
Fast heart rate or dizziness
Anaphylaxis (life-threatening and requires emergency care)
Key Features:
Sudden and reproducible on repeat exposure
Often independent of dose (even a small amount can cause reaction)
Does not respond to detox strategies
May require antihistamines or stopping the supplement immediately
*A note on nausea
Nausea is an interesting symptom that can occur for many reasons:
Taking a medication/supplement on empty stomach
Die-off response
Allergic or intolerance response
Sensitive stomach
For this reason, if nausea is a primary aggravation symptom, my first recommendation is to make sure you always take the medicine with a meal. If this doesn't help, try reducing the dose (amount) and frequency. If this doesn't help, and if nausea continues to occur after every dose, it may be an allergic reaction or intolerance.
What to do in an aggravation
It is sometimes difficult to tell if an aggravation is due to die-off or an allergic reaction or intolerance. If you're unsure,follow these steps:
stop the new supplement(s) and/or medication(s) and observe. Wait until symptoms return to baseline
reintroduce supplements and/or medications one at a timeat a lower dose. E.g., If you started with 3 capsules by mouth daily, reintroduce with a much smaller dose, like just 1 capsule every 2 days.
If this lower/less frequent dose strategy continues to cause the same aggravation, book a call for further guidance.
If this lower/less frequent dose strategy is better tolerated but still causes some disruption, consider adding detox support strategies as outlined below and notice if this helps.
If adding detox strategies helps, gradually increase dose back up to the recommended dose.
Repeat these steps with each new supplement/medication you add, making careful observation of your response. Many people will fully be able to take all supplements and medications if they simply take a more gradual approach to adding them in.
Final tip: If the treatment you are using is targeting toxins or infections, die-off is more likely.
Another final tip: You do not need to figure this out on your own. Please book a call with me for advice on what to do next if you're unsure.
How to manage die-off symptoms:
The following strategies can all be used to support someone experiencing die-off symptoms due to an infections or toxins treatment protocol:
1) Reduce dose and/or frequency You can decide how best to reduce your dose or frequency. This will depend on the dose/frequency you were originally prescribed.
Option 1: reduce dose:
E.g, If you were prescribed 3 capsules daily, reduce dose to just 1 capsule daily for now
Option 2: reduce frequency:
E.g, If you were advised to take 1 capsule daily, take 1 capsule every 2 or 3 days for now
2) Hydration + Electrolytes Making sure you are hydrated is essential to ensure your kidneys and lymphatic system can effectively flush out toxins.
How:
Water: At least 2–3 litres per day
Electrolytes: Consider adding a pinch of sea salt or use products like LMNT, Ester-C, Organika electrolytes, Nuun, or coconut water.
3) Add Binders Binders help trap and eliminate toxins in the gut before they’re reabsorbed. * *Note: Even binders can aggravate a person when toxic load is severe (e.g. mold illness) Always take binders at least 1 hour before or 2 hours after medications or supplements.
Dose: Depends on the type of fibre. Flax/chia = 1-3 tablespoons daily. Psyllium: 5-10 grams 1-3 times a day. Guar gum/acacia gum: 5 grams 1-3 times. Whichever fibre you use, take with at least a full glass of water.
Activated charcoal
Dose:500–1,000 mg once or twice daily with water, away from food and medications. **May cause stools to appear black
Bentonite clay (liquid option preferred)
Dose: 1/8 tsp - 1 tbsp diluted in a glass of water, 1-2 times a day
Chlorella (broken cell wall):
Dose: 1–3 g daily, with food.
Modified Citrus Pectin:
Dose: 5 g, 1–2 times per day with water.
4) Support Liver Detox Pathways Liver is key in helping your body eliminate die-off byproducts. If liver support makes you feel worse, this is a strong clue that you have a heavy burden of toxins. In this case, take lower doses less frequently at first.
N-Acetyl Cysteine (NAC):
Dose: 600–900 mg once or twice daily with food
Note: Supports glutathione production (key detox molecule)
Milk Thistle (Silymarin):
Dose: 150–300 mg standardized extract, 1–2 times per day