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Unlike the textbook JHR, which often lasts only 24 hours 1, Herx-like symptoms related to the treatment of gut dysbiosis or chronic low-grade bacterial, parasitic, or fungal infections may: Appear several days into treatment Last several days or even weeks Recur periodically, when treating infections that cycle between dormant and active phases This broader, experience-based perspective recognizes that not all Herx reactions follow the same predictable pattern, and many are milder but longer-lasting, especially when associated with gut pathogens

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DOI: 10.1196/annals.1405.001

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While not typically covered for general weight loss, some argue that short-term use in specific casessuch as preparing a patient for surgerymight be justified