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doi: 10.1016/j.yexmp.2014.09.006 226 ZhaoS.ZhangL.LianG.WangX.ZhangH.YaoX.et al

While this reaction was first found in individuals undergoing an antibiotic regime, other causes for a herx reaction include: Natural medicine regimens Dysbiosis- also known as an imbalance of the gut microbes Inflammation Detoxification process It is thought that this reaction is caused when bacteria dying off release toxins and cytokines