Dear Stephen,
I have been taking knotweed, stephania and smilax for eight months, while also adding a lot of supportive vitamins/minerals, garlic, oregon grape, and some Nutramedix tinctures per Cowden’s protocol. In the last two months or so I have also been doing oxygen therapy per my doctor, and also did a course of artemisinin over the summer, which led to a period of general improvement.

In any case I have been under a lot of stress (work, small toddler at home) while ramping up knotweed in the last month (up to 3 3x/day) and I have been having stronger and stronger die-off—the oxygen seems to do that as well—to the point where I felt extremely toxic all the time and was having big emotional effects (panic/depression) and having trouble functioning. I went to an osteopath last week who I see periodically (he is not overly lyme-educated but very good and knowledgable) and he said my body was very toxic and that he recommended stopping all supplements/treatments for a while and focusing on detoxing—fasting and acupuncture are his suggestions.

I have stopped the herbs and oxygen for a couple of days and the acute die-off feelings and depression/anxiety got better, but now I am trying to sort out symptoms of the illness from what may be toxic overload—hard to distinguish. You have written here that you do not feel it’s good to stop the protocol, but what might one do under such circumstances? I feel I have been slowly improving over the past few months but lately it’s become hard to tell that because of the big die-off. I have read that herxing too much is not necessarily helpful even if it is a sign of die-off. I think I will reintroduce the therapies slowly, but I am trying to balance between the die-off and trying to heal and living my life.