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Die-off, also called the Herxheimer reaction or “healing crisis,” occurs when harmful microorganisms (bacteria, yeast, parasites) in your gut are killed faster than your body can eliminate them.
When you make dietary changes—especially eliminating sugars and processed foods that feed pathogenic bacteria and yeast like Candida—these organisms die and release toxins as they break down. Your liver and elimination systems can become temporarily overwhelmed trying to clear these toxins.
Common die-off symptoms include:
∙ Fatigue and brain fog
∙ Headaches
∙ Digestive upset (bloating, gas, diarrhea or constipation)
∙ Skin breakouts or rashes
∙ Flu-like feelings (muscle aches, joint pain)
∙ Mood changes and irritability
Why it happens with dietary changes:
When you shift from a high-sugar, high-carb diet to one focused on whole foods and vegetables, you’re literally starving the pathogenic organisms that have been thriving on sugar. As they die en masse, the sudden release of endotoxins (particularly lipopolysaccharides from bacterial cell walls) triggers an inflammatory response.
Managing die-off:
The key is going slowly with dietary changes—this is one reason the GAPS protocol you use includes that gradual introduction phase.
Other strategies include:
∙ Staying well-hydrated
∙ Supporting detoxification pathways (adequate sleep, gentle movement)
∙ Using binders like activated charcoal or bentonite clay
∙ Slowing the pace of dietary changes if symptoms are severe
∙ Ensuring bowel movements are regular
Die-off is actually a positive sign that the dietary intervention is working—you’re shifting your gut microbiome toward health. Symptoms typically peak within the first week or two and gradually resolve as your body clears the toxins and beneficial bacteria repopulate.