|Thrush on Tongue (Copyright: adam88x / 123RF Stock Photo)|
I have mentioned several times since early October that I’ve been worse than usual and going through a bad period. The source of that worsening is a flare-up (again) of yeast overgrowth, after I needed strong antibiotics for bronchitis/early pneumonia two months ago. I was waiting to write about it until I could tell you what worked to get rid of it. I’m not 100% yet but have improved enough to tell you more about what has worked for us (my son also struggles with yeast overgrowth after several years on antibiotics for Lyme).
Yeast or candida is naturally occurring in our bodies and is not damaging normally. Problems occur when the yeast takes over. This often happens after a course of antibiotics because they kill off the good bacteria (aka probiotics) in our gastrointestinal systems that normally keep yeast/candida in check. Because yeast overgrowth often occurs when you take antibiotics, people being treated for Lyme disease and other tick infections are at especially high risk. Our LLMD (Lyme specialist) was the first one to prescribe antifungals for yeast overgrowth for both of us. In addition, the immune dysfunction of ME/CFS makes us more susceptible to bacterial infections than most, so many of us get recurring infections, like bronchitis, sinus infections, and ear infections, that require the use of antibiotics.
- Take strong probiotics. Probiotic strength is shown by the number of billions of active cultures in each capsule. When yeast overgrowth flares up, we shoot for at least 100 billion units a day. They must be taken away from any antibiotics or even herbals with antibacterial properties (like olive leaf, oregano, or monolaurin) and work best on an empty stomach. We take them before breakfast and before bedtime. Saccharomyces boulardii is a specific type of probiotic that works against yeast, so you should take that as well as general probiotics, with a variety of strains in them. See my post on probiotics for details of the ones we take, plus tips on how to purchase and store them so they remain effective.
- Eliminate sugar, yeast, alcohol, and grains from your diet. Depending on how severe the yeast overgrowth is, you may need to severely restrict your diet. Yeast feeds on sugar and, to a lesser degree, on grains (especially refined grains). We already eat a Paleo diet (no refined sugar, very limited natural sugars like honey, no grains, no dairy), but I got even stricter to try to get the yeast overgrowth under control. Yes, it is difficult at times, but it is better than feeling so horrible. First thing to eliminate is sugar in almost all forms – a small amount of honey or coconut sugar is OK, and we still eat small amounts of fruit and use Stevia for sweetening. You also want to avoid alcohol and yeast (so no bread). If that alone doesn’t work, then also eliminate flour and other grains. I got so desperate, I even eliminated fruit from my diet entirely for a while.
- Take antifungal supplements and herbals. There are many natural substances that have antifungal properties. There are many combination products available that include multiple ingredients, but read the labels carefully to be sure you can tolerate all ingredients (for instance, Uva Ursi is a diuretic and not good for those with ME/CFS; some can not tolerate berberine because it lowers blood sugar, etc.) Natural antifungals include:
- Aged Garlic Capsules (we like Kyolic, which also included ginger)
- Use probiotic toothpaste. This is a new one for us, but it is definitely helping. Thanks to a blog reader for suggesting it! Our dietician said she uses it, too. The brand we are using it Designs for Health Periobiotic. I am still brushing with my regular toothpaste, then rinsing, then brushing again (tongue and gums especially) with the probiotic toothpaste (you spit it out but don’t rinse after).
- Rinse with antifungals. We have used a few drops of tea tree oil in a small cup of water as a mouthwash (spit it out!), and our dietician recently recommended rinsing with Nystatin mouth rinse (requires a prescription) and Argentyn 23 silver solution. There are others as well. Most you use as a mouthwash--swish and spit--but she said the Argentyn 23 is swish and swallow. I just bought some but haven’t tried it yet. Do NOT use regular mouthwash that contains alcohol.
- Take prescription antifungals. For both my son and I, ALL of the above still didn’t get our yeast overgrowth under control. In that case, you need to see your doctor and ask for prescription antifungals. The three most often prescribed are Diflucan (fluconazole), Nystatin, and less commonly, Ketoconazole. For stubborn cases (like ours!), it can be more effective to alternate between two or more of them. I am currently alternating days with Diflucan and Ketoconazole. My son has been alternating with all 3 for a year now.
If achiness or cognitive dysfunction are prominent symptoms for you and/or you’ve noticed some soreness or visible thrush in your mouth or itchiness in your vaginal area, you should see your doctor and look into the possibility of yeast overgrowth as an underlying cause. It amazes me every time I go through this just how horrible it makes me feel and how it worsens all of my ME/CFS symptoms. With yeast overgrowth under control, I feel really good and have mental clarity--I even have energy!--and it’s the same for my son. Treating yeast overgrowth makes a huge difference in overall well-being for people with ME/CFS and Lyme disease (and other bacterial tick infections).
UPDATE 5/18/17: About two and a half years have passed since I first wrote this post. Interestingly, what I describe above about my own experiences at that time was a turning point for me. I have stayed on prescription antifungals ever since. Once I got that bad flare-up of yeast overgrowth under control, I gradually backed off the dose, but I found that I still needed to take antifungals. When I tried going off of them completely, the achiness, exhaustion, and brain fog quickly returned. My doctor wasn't thrilled, but she could see the thrush in my mouth and often prescribes long-term antifungals for her HIV/AIDS patients. I am currently taking just Diflucan (fluconazole), and I alternate between 100 mg (1 pill) and 200 mg a day. Sometimes, I can go two days in between the higher doses, but when I try to cut back to just 100 mg a day every day, my symptoms return. My son is still alternating all three types of prescription antifungals, in a 4-day rotation, even though he stopped taking antibiotics for Lyme almost four years ago (he is on an all-herbal protocol now).
In addition, I have stuck to a strict diet, with no sugar, no grains, and no yeast, and my son and I both still take over 100 billion units of probiotics every day, including Saccharomyces boulardii. The reason he still needs all three antifungals (and at a higher dose than me) is that he does not stick to the diet as strictly (he's 22 and in college!).
I want to emphasize that this regimen keeps both of us feeling quite good: no aches, no thrush in the mouth, no exhaustion (unless we overdo), and excellent mental clarity. When we cheat on the diet, skip probiotics, or reduce the antifungals, our symptoms flare up. In fact, last weekend, I made a cake for my father-in-law's 92nd birthday. I ditched the Paleo stuff and used REAL sugar and white flour, for a change. The cake was delicious, and I allowed myself a treat and had a piece (OK, a piece and a half - it was really good!). By that evening, I was achy and had a mild sore throat. I doubled up the antifungals, took extra probiotics, and got back on the Paleo diet, and within 24 hours, I was feeling better again. It's still amazing to me what a difference it makes in my overall illness to have the yeast overgrowth under control, and it's the same for my son.
Things haven't changed much since that last update three years ago! We both still take prescription antifungals daily (though we both dropoped the ketoconazole, which is a much harsher medication and should only be taken for short periods), plus all the herbals listed above and the Paleo diet (even stricter now because my son is now gluten-intolerant, too). My son recently had extensive testing done (he's developed additional GI problems), which still show severe yeast overgrowth, so he is barely staying ahead of the symptoms with these treatments and diet. His new medical team switched him from the bunches of probiotics we were taking to just Mega SporeBiotic twice a day(it's a little cheaper purchased through clinic we go to). One of the specialists explained to me that it's not just numbers with probiotics and that this one is best for him for now (and I recently switched, too). We are both keeping up the saccharomyces boulardii, since it is specific to yeast (2 capsules, twice a day). They are running additional tests on my son to get to the bottom of his GI problems, many of which contribute to yeast overgrowth.
What has worked for you to help control it? Please share your tips and advice in the comments!