Coping with adverse die-off reactions

It is important to understand the difference between detox and die-off. I suggest you read my article on this topic. While some see die-off symptoms as a positive sign that their treatment protocol is effective in killing off pathogens, it is best to make sure these symptoms are well managed. The stress that the biotoxins place on the internal organs and immune system can slow down overall healing.

When experiencing severe die-off symptoms, there are a couple of important things one can do to counter the adverse effects:

  • Slow down treatment altogether
It is best to use a staggered approach when going on an elimination diet and to start the introduction of antimicrobials at a very low dosage and slowly building up the dosage.
  • Add nutrients and supplements to support detoxification
Nutrients such as molybdenum, vitamin C (1000 mg twice daily), vitamin E and A, extra magnesium (up to 800 mg or more daily) and/or a liver tonic is very effective. Molybdenum is particularly useful, since it not only help to break down the neurotoxin acetaldehyde into acetic acid, but it also supports sulfation for the conjugation of biotoxins that are generally high in phenolic compounds. Sulfur is also crucial to support the detoxification pathways, therefore increase sulfur-rich foods and take supplements such as optiMSM or Nat Sulph tissue salt no 11, ideally lactose-free. Be cautious though with sulfur when mercury levels are very high.  Amino acids (methionine, N-acetylcysteine, taurine and glycine) also plays a crucial role in detoxification, therefore make sure that protein intake is adequate and protein powders such as hydrolysed collagen and whey protein isolate might be beneficial to add to smoothies. Dandelion tea is also excellent for liver support. Green juices and plenty of vegetables in the diet will further ensure adequate antioxidant support.
  • Cut back on antimicrobial supplements
Most antimicrobials work by breaking down the walls of the pathogens, which then release the many toxins into the system. Reducing the antimicrobial dosage will cut down the amount of toxins released into the bloodstream. It is ideal not to stop taking the antimicrobial, but simply lowering the dosage until feeling better, after which you can slowly increase the dosage again.
  • Address parasites
Parasites love the liver and bile ducts, but also many of the other elimination organs. They block the elimination pathways, increasing biotoxin symptoms. It is important to address a possible parasitic infection, which is mostly underlying fungal and other infections and cause more severe die-off.  
  • Reduce the dosage of probiotics
Probiotics are less inclined to cause die-off and it is therefore best to start the protocol with introducing probiotics. They will repopulate the gut, crowd out the pathogens and boost the immune system. When die-off is experienced, temporarily reduce the dosage. This will be an indication that the pathogenic infestation is probably severe, but note that probiotics can also provoke a histamine reaction.
  • Binders and increase fibre
Activated charcoal, humic and fulvic acids, diatomaceous earth and zeolite are effective binders to bind and support elimination of biotoxins. It is also important to avoid constipation, thus a blocked plumbing system. Make sure there is adequate fibre (leafy greens, legumes and whole grains) in the diet and extra fibre in the form of modified citrus pectin and psyllium husks will also be effective. It is important to make sure stomach acidity is sufficient for proper digestion and healthy elimination.
  • Biofilm disrupters
For effective healing it is important to include biofilm disrupters in the protocol, but the introduction of these enzymes will also increase the release of biotoxins, dormant viruses, heavy metals and other toxins. Start at a low dosage and slowly increase.
  • Increase water intake
Make sure you are properly hydrated to flush out the toxins more effectively. A healthy person need 300 ml per 10 kg body weight for normal physiological function, but if you are toxic, the requirement might even be higher.
  • Rest, exercise and sunshine
Stress will weaken your immune system and reduce your body’s ability to fight pathogens, such as a fungal or viral infection. During an infection, more strain is placed on the detoxification processes, depleting more nutrients and increasing physiological and emotional stress and reduce one’s capacity to deal with stress – a viscous cycle indeed! Make sure to rest as much as possible and to be exposed to a healthy dose of sunshine daily. Don’t do strenuous exercise, but a brisk walk will help to stimulate the lymphatic system to eliminate cellular toxins.
  • Alternative detoxification methods
Treatments such as deep tissue massage, hot yoga, skin brushing, saunas, contrast showers and Epsom salt baths will also be helpful to aid the body in the elimination process by stimulating the circulatory and lymphatic systems. Coffee enemas and liver cleanses are great for liver and bile duct support.

Addressing specific die-off symptoms:


A very common symptom of any kind of detox. Make sure to be well hydrated and take extra vitamin C and magnesium. Binders such as activated charcoal can also work miracles, although it might lead to constipation in some, which should be avoided.


The increased load of toxins released during an antimicrobial protocol will deplete more nutrients leading to possible fatigue. Most people only regain vitality and energy after spending some time on the protocol. Adequate sleep (8 to 10 hours) is vital, not only to fight fatigue, but also to support the natural innate healing processes. Don’t do strenuous exercise, but it is important to remain active through stretching and light aerobic exercise, such as rebounding, brisk walking, Pilates etc. A good B-complex supplement and adequate protein intake will also help to combat fatigue.

Aches and pains

An aching body makes one feel even more miserable. An Epsom salt bath (4 cups Epsom salts in a hot bath and soak for 20 minutes with no soap) will soothe and relax sore muscles and joints through the action of sulfate (not so much the magnesium as generally believed). DMSO could also be rubbed into sore and inflamed muscles and joints for fast relief.

Skin rashes and itchiness

Our skin is also an important elimination organ and one might therefore experience rashes, dry skin, boils, hives, skin sores, flare ups of acne, eczema or psoriasis, or severe itching. Especially itching can be very debilitating. Dry skin brushing is a good way to stimulate the lymphatic system and slough off dead, toxin-containing skin. Use a soft, firm brush with natural bristles, and always brush from the extremities towards your heart. Skin brush once or twice daily, ideally before a shower. Coconut oil with some tea tree oil added is a great way to help heal skin rashes. Coconut oil and Epsom salt baths will soothe itchy skin and take extra molybdenum. While symptoms are severe, take 400 to 600 mcg molybdenum in divided dosages per day. Make your own Skin Rescue cream: mix coconut oil, almond oil and a few drops of tea tree oil. Tea tree oil is a potent antimicrobial and ozonated olive oil can work miracles for infected skin problems.

For skin breakouts make a home bentonite clay mask. Take 1 tsp bentonite clay (this helps draw toxins from your skin), ¼ tsp apple cider vinegar (for its astringent properties), 1 tsp raw Manuka honey (very healing, but also for texture), and 1-2 drops lavender oil (soothing to the skin). Mix everything together and add a little water to make the mask easy to spread. Apply to breakouts.  Let the mask dry, and after about 15 minutes, wash it off with warm water. Pat dry.

Emotional and neurological disorders

Biotoxins in general, but specifically parasitic infections like toxoplasma gondii, can be responsible for symptoms such as OCD, anxiety, depression, irritability, aggression or even schizophrenia. Additionally, certain neurological symptoms can flare during a die-off reaction due to increased levels of cytokines (particularly interleukins) released in response to the toxins.

EFT is a wonderful way to process emotional trauma. It is further important to optimally support methylation during die-off for healthy neurotransmitter balance. Make sure to be in the sun regularly and that vitamin D levels are not deficient. Vitamin D is not only a great mood booster, but it also support the immune system and detoxification.

It is important to elicit support from open-minded and supportive family and friends to relief emotional pressure and gaining objectivity about the healing process. It is also valuable to join a support group with similar conditions, such as on Facebook or forums.

Cravings and excessive hunger

Apart from being on an elimination restrictive diet during an antimicrobial protocol, which in itself will cause cravings and hunger, the higher demand on nutrients during die-off may cause cravings and excessive hunger. I prefer to recommend a less restrictive dietary protocol that is sustainable, balanced in nutrients and will prevent cravings and hunger. The main food culprits to avoid is refined sugar and yeast.  We need complex carbohydrates to act as prebiotic (food for probiotics) and supplying necessary fibre. Add many fresh vegetables to your diet and limited low-sugar fruit such as berries and green apples, as well as good quality fats. By adding more healthy fat, such as avocado or unrefined oils, will help to feel satiated. Avoid all processed food and enjoy only fresh wholefood produce.

To fight sugar cravings, enjoy a cup of peppermint or ginger tea and make sure chromium levels are adequate.

Phlegm, sore throat and blocked nose or sinuses

Mucous and phlegm are the body’s way of trapping and eliminating toxins and are usually the first sign of most infections. 

Oil pulling is a very good way of keeping the mouth free of pathogens. On an empty stomach, take 2 teaspoons (tsp) of organic extra-virgin coconut oil and swish it in your mouth (through your teeth) for 10 to 15 minutes and spit out. One can add Frankincense or lemon oil to your oil pulling for extra anti-microbial protection. Using a saline rinse, or Neti-Pot, to irrigate your sinuses is the best way to battle the stuffiness that occurs with die-off.

Gastro-intestinal tract symptoms:

The colon remains one of the major elimination organs for toxins and one can expect nausea, cramps, diarrhoea, bloatedness, constipation or other digestive issues during die-off.

Fresh ginger or pure aloe juice can be calming to the digestive system and will combat nausea. If you’re struggling with diarrhoea, activated charcoal can help bind the stools. Green juices and bone broths are also soothing and nourishing for an inflamed digestive tract. Make sure that stomach acidity is adequate, since hypochlorhydria will adversely affect digestion, elimination and nutrient status. Furthermore, a dysbiosis (imbalance of gut flora) is linked to hypochlorhydria. Iberogast from Flordis and slippery elm works miracles for cramps and typical IBS symptoms, while Siberian pine nut oil is very soothing for inflammation, such as sore throat and gastritis. To prevent constipation, take 1 to 2 tsp Epsom salts in water before bedtime or take vitamin C up to bowel tolerance levels.


Whenever the body is processing toxins, issues with sleep can arise. According to Traditional Chinese Medicine, there is a body clock which explains why certain times of day align with certain organs. For example, if you frequently wake up between 1:00 AM and 3:00 AM, it could be your liver that is affected, while waking between 5 and 7am could be the large intestines. You may also experience trouble falling asleep or staying asleep while you’re detoxing.

Try a castor oil pack before bed over the liver area, followed by a warm Epsom salt bath. This can give your body a boost in eliminating toxins before you climb into bed. Also, diffusing Cedarwood oil is a great option. Creating a completely dark room is also vital, as well as avoiding stimulating foods or any screen time for two hours before bed time.

Castor Oil Packs: Soak unbleached cotton flannel in organic, cold-pressed, hexane-free castor oil. Place it over your liver, cover in a thin towel, and apply heat.


It is important to realise that die-off reactions are not necessarily a sign that the protocol is succeeding. It may be an indication that pathogens are dying in large numbers, and an indicator of toxic overload. At this point, more toxins are being released than the body can adequately cope with and may be a sign the system’s elimination pathways (liver, kidneys, & bowels) are overburdened or blocked, as in constipation or liver congestion.

Remember, you are in control. Learn to manage your diet and antimicrobial dosages in such a way that the die-off symptoms stay bearable. It is important not to overwhelm the elimination organs in order to support effective healing.

Die-off reactions can cause you to doubt your progress, and may also be confused with other health challenges, such as lack of sleep. To improve your decision-making and ability to discern what is happening in your body, keep records of your dietary and supplement intake, other factors supporting or stressing you, and your responses to these variables.






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