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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Does Valtrex cause Herxheimer reaction?

I have tried antivirals off and on over the past three years, always feeling hellish when I try them. I don't know why it is, but Dr. Bonilla at the Stanford CFS clinic said it is common for patients to feel worse. So I am starting again, taking a 5th of a tablet a day. We'll see what happens.
Did the negative effects go away quickly every time you stopped?
Frank1001, I don’t know if this will help you or not since it seems like there are so many different pathways for ME/CFS. When I was first diagnosed with ME/CFS I was started on Valtrex, monolaurin and transfer factors. That was 14 years ago, and at the time I was pretty much bedbound I experienced a ton of dieoff symptoms, and from reading on the forum, I tried activated charcoal. At the time I was on 1 g twice a day of Valtrex and the activated charcoal was two capsules twice a day, and really did seem to help. I pushed through and kept taking the Valtex because at the time I didn’t know about the pulsing or completely stopping it. That was 14 years ago after my second or third year on the Valtrex my kidney function levels were starting to get bad, and they recommended I come off the Valtrex, at that point, I was mostly homebound, but not bedbound and was able to go help take care of my elderly parents 1 to 3 hours a day, and the rest of the time we spent on the couch or in bed. My big focus for the next few years why is my stomach and trying to address any issues going on there. Once I got the stomach issues under control, I seem to be fairly steady at about 40% of my pre-illness and was also able to tell when a big crash would be coming as I would break out with cold sores on my lips and around my nose. My integrated medicine doctor had me go back on the Valtrex, 50mg twice a day for a couple of weeks.
Then Covid hit, and everyone needed to get the vaccine. For some reason and I can’t tell you why, my belief is because my stomach issues were under control, the vaccine helped me. Right after being vaccinated I had a huge crash and was pretty much couch or bedbound again and back on Valtrex for herpes breakouts. But after a couple weeks I could feel my body responding and I was fighting off the inflammation. My problem is it doesn’t last, so I’ve gotten the subsequent vaccines and they seem to work the same way and allowing my body to fight off the inflammation for a couple of months.
Right now at this time I am at about 60% to 70% of my pre-illness condition. The only symptoms I still have of ME/CFS is the fatigue, except if I overdo it and experience a crash I’ll briefly have a week or two of all the other symptoms, PEM, unable to concentrate, muscle aches, muscle weakness, etc. I haven’t stopped taking the lower dose of valtrex because at this point, I think it’s keeping the inflammation at a constant and do not want to go back to where I was in the beginning .
I can only tell you how much I think Valtrex has helped me and wish you the best with it. I hope it works for you and that you can stick it out until the dieoff isn’t as bad and making you as sick as it has been. I can’t even tell you that it was the valtrex and the vaccines that have helped me, I can only guess by my symptoms and partial return of some good health. Best wishes and prayers it helps you.