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Seizures, hallucinations, extreme confusion, high fever, a very rapid heart rate, very high blood pressure, or inability to wake are not wait-and-see symptoms

A Herxheimer reaction, also known as the Jarisch-Herxheimer reaction (JHR), is a temporary inflammatory response that may develop shortly after antibiotic treatment begins for certain infections caused by spirochetes, including Lyme disease

Not everyone notices dramatic improvements, and a few people question whether some benefits might be partially placebo-driven

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These studies have largely focused on the epidermis, basement membrane, and accessary structures, including hair follicles and sebaceous glands