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Symptoms of A Herxheimer Reaction There are a range of symptoms that you can experience during a Herxheimer reaction, such as: Flu-like symptoms Fever Chills Aches and pains Nausea and vomiting Headache Anxiety Brain fog Low blood pressure High heart rate Skin lesions, or if they are already skin lesions, a worsening of them Flushing Originally, this reaction was thought to peak at eight hours after an antibiotic or natural medicine regimen and then clear within 24 to 36 hours