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Quercetin in Lyme disease by Marty Ross MD image.

About Quercetin

Quercetin is an herbal medicine that may

  • decrease pain,
  • limit and improve Herxheimer die-off reactions,
  • stabilize mast cell activation, 
  • improve bladder inflammation and irritation in interstitial cystitis, and
  • decrease allergic reactions.

Anti-inflammatory and Antioxidant

Through a variety of mechanisms laboratory experiments show quercetin lowers inflammatory cytokines and prostaglandins. Cytokines are made by the immune system in response to chronic infections and the killing of Lyme germs. Cytokines treat infections by turning on various white blood cells, but also cause pain, achiness, fatigue, hormonal dysregulation, and poor sleep. In chronic Lyme and associated diseases the immune system makes too many cytokines. In a sense, Lyme disease is a syndrome of cytokine dysregulation and excess. In some ways it is a misnomer to say someone has Lyme disease symptoms. In fact, what they really have are excess cytokine symptoms and other symptoms of organ or tissue injury.

A Herxheimer Die-off reaction is the result of a cytokine flare (increased cytokine production by the immune system) in response to antibiotics killing germs. In a Herxheimer die-off reaction, Lyme symptoms worsen significantly when antimicrobials are started or changed.

Pharmaceutical medicine does not have effective anti-cytokine agents that are safe to use in chronic Lyme and associated diseases. Steroids can lower but suppress the immune system making it hard to treat the Lyme infection. Others like Remicaide also suppress the immune system in harmful ways.

Regarding inflammatory prostaglandins, there are pharmaceutical treatments like ibuprofen and aspirin. However these medicines do not lower cytokines. They also injure the lining of the stomach which can lead to stomach pain and even bleeding. Ibuprofen, naprosyn, or aspirin in Lyme disease may help but quercetin and other herbal anti-inflammatories seem to work better instead. Based on my observations, quercetin is as effective at lowering pain from prostaglandins, but it does not carry any of the risks and therefore is a better medicine.

Interstitial cystitis is a condition with symptoms similar to bladder infections. Lyme and/or bartonella coinfections cause inflammation of the bladder lining. This leads to increase urination urges, frequency of urination and sometimes burning with urination.

Allergy Medicine and Mast Cells

Quercetin also helps patients who have allergies or Mast Cell Activation Syndrome that worsens their illness. Many people with Lyme disease have food or environmental allergies that hurt their health. Quercetin may limit allergies in two ways. First it can stablize immune system cells that make and release histamines. With quercetin certain immune system cells do not release histamines when they are provoked by environmental allergens like plant pollens and dust mites or by foods. Quercetin also may decrease inflammation in allergies by decreasing leukotriene inflammation chemicals made in allergies. For more information read Mast Cell Activation Syndrome & Lyme.

Method of Action for Pain, Herxheimer Die-Off Reaction, and Interstitial Cystitis

Quercetin has strong anti-inflammatory effects. First it limits the expression of NF-kB which is a signalling chemical inside cells that causes genetically derived messengers for inflammatory chemicals production. As a kinase enzyme inhibitor, quercetin also decreases the production of inflammatory cytokines inside of cells. It is also a strong antioxidant that deceases oxidizing agents that trigger inflammation. Finally, it blocks cyclooxygenase enzymes used to produce inflammatory prostaglandins.


Quercetin is a bioflavanoid that comes from a variety of foods like red onions, grapes, apples, berries, cherries, broccoli, citrus fruits, green tea and capers.


  • For support in pain, Herxheimer die-off reactions, and interstitial cystitis, Quercetin 250mg, 2 pills 3 times a day.
  • For allergy support, Quercetin 250mg 2 pills 2 times a day.


Quercetin is very safe to take. In theory it may alter the effectiveness of quinolone antibiotics like Levaquin, Cipro, and Avelox. However, clinically, I did not find this to be the case in my Seattle practice.


The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.


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  2. Butler T. (2017). The jarisch-herxheimer reaction after antibiotic treatment of spirochetal infections: a review of recent cases and our understanding of pathogenesis. Am. J. Trop. Med. Hyg. 96:46–52. 10.4269/ajtmh.16-0434
  3. D’Andrea G. Quercetin: a flavonol with multifaceted therapeutic applications? Fitoterapia. 2015;106:256–71.
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  8. Strle K , Drouin EE, Shen S, El Khoury J, McHugh G, Ruzic-Sabljic E, Strle F, Steere AC. Borrelia burgdorferi stimulates macrophages to secrete higher levels of cytokines and chemokines than Borrelia afzelii or Borrelia garinii. The Journal of Infectious Diseases. 2009;200(12):1936–1943,
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