Die off is the GAPS boogeyman. It is the dreaded unknown and cause of great concern from most clients I work with. Understandably so. But what is die off? Die off, also known as a Herxheimer reaction, is when pathogenic bacteria, fungi, protozoa (and the like) are eliminated quickly from the body. As these things die, toxic substances are released and make the host (you!) feel really lousy. Sounds fun, huh? Not fun, but 100% necessary to the healing journey and I’ll tell you why.
When my son, Raleigh, began the GAPS diet back in 2017 (age 4) I was terribly afraid of die off. I didn’t understand it and I feared it. He went swiftly into his first die off within the first 24 hours. It took him a handful of days to fully come out of it but when he did I felt I could wrap my head around what die off might look like for his journey. I still had a lot of learning to do.
The only way out is through.
The only way to change the environment of the gut is to go through die off. We are a society of quick fixes, but unfortunately it takes time to change the environment of the gut and heal chronic illness. Die off, as scary as it may be, is a necessary evil.
We want die off to feel like a slow burn. What I mean by that is we want die off to feel like a cold coming on. When a cold is coming on you feel sluggish, low energy and just not great overall, but you can still do things and function. We want die off to feel like this so that the body has the ability to rid itself of toxins. When you are going through die off the body is working hard at dumping the toxins that the pathogenic bacteria are releasing. If we are very burdened by this, if the die off feels more like a flu than a cold, the body may not be able to get rid of the toxins as it intends and the toxins end up being redistributed in the body. So we aim for a a slow-and-steady-wins-the-race type of die off to avoid toxin redistribution.
How do we do that?
Fermented foods play a pivotal role in the GAPS diet. Fermented foods are full of beneficial bacteria that help change the environment of the gut. We should be consuming fermented foods with every meal since our gut needs beneficial (good) bacterial strains to help keep the pathogenic (bad) strains at bay.
Dr. Natasha recommends working up to 1/4-1/2 cup of lacto-fermented vegetables a day and 1/2-1 cup of 24-hour fermented dairy a day. But we can’t just start with these amounts, we must start with a much smaller amount and slowly work up to these amounts. This is how we keep die off from becoming too overwhelming for the body.
Everyone’s starting point with their fermented foods/brines will be different. It is best to err on the side of caution and begin with a very small amount like 1/2 tsp daily. If this amount is too much for the body we back up to 1/4 tsp daily or, for some, all the way back to a drop. This is an individual process and everyone will be a bit different. This is a great area to bring in the help of a coach or practitioner if you feel yourself struggling to navigate die off.
What will die off look like and how long will it last?
Die off will present in an increase of your typical symptoms. If eczema is your typical symptom it will worsen during die off. If your issues are more brain related: headache, brain fog, etc, these will worsen during die off.
Each die off will likely be a bit different but you will see some trademark similarities develop as you continue to increase the fermented foods. I have seen die off last as short as 2-3 days and as long as 8-10 days. Die off should look like a rise and fall in symptoms. There should be a clear indicator (by worsening symptoms) that you have entered into a new die off, and a clear indicator (by an improvement in symptoms) that you have come out of the die off.
When you have come out of die off, this is when you increase your ferments by a small increment. For example: if you were consuming 1 tsp sauerkraut juice through the die off, when you come out of it you would increase to 2 tsp and wait for the next die off to happen. You proceed this way until you reach the desired daily amounts.
Supporting the body in die off
Supporting the body in die off is extremely important. We want to help the body get rid of as many toxins as possible during this time. Some of my favorite things to do are detox baths, dry brushing and juicing. Spending time in the sun, without sunscreen, and barefoot is also very beneficial. Talking walks and other light kinds of exercise that you feel are tolerable can also be really beneficial.
Staying positive is really important as well. The mind is so powerful. Remember, the only way out is through. And you will get through this. Give it time.
The only way out is through! The only way out is through! The only way out is through! What I repeat over and over to myself as I smear more coconut oil on the lizard like skin on my neck and face.