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Thrush on Tongue (Copyright: adam88x / 123RF Stock Photo) |
(Updated 8/22/23)
Overview:
If you have ME/CFS (myalgic encephalomyelitis / chronic fatigue syndrome), long-COVID, or Lyme disease, and 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 to look into the possibility of yeast overgrowth (candida) as an underlying cause. Yeast overgrowth is very common in ME/CFS due to our specific kind of immune dysfunction and in Lyme due to antibiotic use.
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 pretty 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).
In fall 2014, my ME/CFS had been worse than usual for months. The source of that
worsening was a flare-up (again) of yeast overgrowth aka candida, after I needed strong
antibiotics for bronchitis/early pneumonia two months earlier. When I first wrote this blog post, I wasn't 100% back to my normal baseline yet but was 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).
Another bad yeast flare-up in summer 2023 led to further discoveries.
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 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 and the right types. Probiotic strength is shown by the
number of billions of active cultures in each capsule. We take probiotics every day, but when yeast
overgrowth flares up, we increase the dose. Renew Life is a good brand that contains 12 different probiotic strains, including those that are important if you are taking (or have taken) antibiotics. When I take antibiotics or have a yeast flare-up, I switch to this stronger variety of Renew Life, with 50 billion units. With this latest yeast flare-up, our functional medicine specialist recommended TruBifido, in addition to the others I usually take. Saccharomyces boulardii
is a specific type of probiotic that works against yeast, so you should
take that (we take 2 twice a day) as well as general probiotics, with a variety of strains in
them, daily. We take saccharomyces boulardii and regular probiotics every day, all the time. I add the Renew Life (50) and TruBifido when the yeast flares up. Probiotics
must be taken away from (by at least 90 minutes to two hours) 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.
- 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, at least temporarily. 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 get
even stricter to get yeast overgrowth under control when it gets bad. With this latest flare-up, in 2023, I've been strict no sugar at all, no refined grains (only a few occasional whole grains, like oats or a bit of brown rice), not even a sip of alcohol, and very little fruit. Yes, it is
difficult at times, but it is better than feeling so horrible. First thing
to eliminate is sugar in almost all forms. Check labels because sugar is added to all kinds of foods. Usually, a small amount of honey or
coconut sugar is OK, and we still eat small amounts of fruit, but with this worsening, I've eliminated all sweeteners except xylitol and stevia (we like Truvia brand which contains stevia and erythritol). Most sugar alcohols (they end in -ol on ingredient lists and are present in many products labeled "sugar-free") also feed yeast ad should be avoided, but erythritol and xylitol have actually been shown to fight yeast. Normally, with the other treatments on this list, I can tolerate fruit, but when it's as bad as it has been recently, then I only eat blueberries (which are actually anti-yeast) and an occasional piece of watermelon (very low sugar). Avocados have almost no sugar, so they're OK, too. Search online for "anti-candida diet" to find lots of information and resources. Check out my delicious recipe for a Paleo Chocolate Smoothie, with great health benefits and options for a yeast-friendly smoothie. And for a treat, try my recipe for Sugar-Free Chocolate Bark.
- Take antifungal supplements and herbals. There are many natural substances that have antifungal properties that can be taken separately or together. Some combination products 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:
- Caprylic Acid
- Paramicrocidin (grapefruit seed extract)
- Aged Garlic Capsules (we like Kyolic, which also includes ginger)
- Olive Leaf Extract, Oregano (we use ADP brand emulsified oil of oregano as it is easier on the stomach), Monolaurin--these all have natural antibacterial, antiviral, and antifungal properties, so they help ME/CFS in other ways, too.
- MCT Oil - Medium-Chain Triglycerides, a component of coconut--contains caprylic acid.
- Coconut oil or other unsweeetened forms of coconut (note that coconut contains monolaurin, caprylic acid, and MCT oil)
NOTE: Careful not to take too much caprylic acid, MCT oil, and coconut oil together - they all come from the same source (coconut oil) and too much can cause diarrhea.
- Use anti-candida 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. This brand contains probiotics, xylitol, grapefruit seed extract, and silver (note that some recommend swallowing silver solution, but that can have serious health risks). 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). 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. Ketoconazole should only be used short-term; I just took it for a month when my yeast flared up badly and wasn't responding to other treatments. Normally, I take Diflucan (fluconazole) every day to keep the yeast in check; my son alternates Diflucan and Nystatin. My doctor said chronic yeast overgrowth is also very common in HIV/AIDS and other immune disorders, and so she feels comfortable keeping me on prescription antifungals long-term, as she does for those other patients.
I want to emphasize that this regimen usually 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 splurged on a half cookie Saturday evening with friends and a chocolate croissant Sunday morning (I was craving a treat!), and things got worse again. I doubled up the antifungals, took extra probiotics, and got back to my strict diet, and within 48 hours, I was feeling better again. Hopefully, as I continue to improve, I will be able to relax the diet a little bit (at least add more fruit back in), and not see such a big effect.
What has worked for you to help control it? Please share your tips and advice in the comments!
14 comments:
Yikes - sorry about the weird font changes - couldn't fix that! Sometimes Blogger has a mind of its own.
Don't worry about the font. Great, concise advice, thank you.
Jason
Great post!
Thank you Jason.
I was on one of the very first LDN yahoo groups when LDN first came out, and when quite a few users started having problems with candida we somewhat determined by patient experience that there is a subset of people who will experience increased candida infection from LDN use. I had to stop using it myself for that very reason and was not real happy about that. You do realize that the azole type of antifungals are very hard on the liver right? I had to decide whether LDN or good liver function was a priority for me. I do find like you that using ketoconazole for a while does make me feel much better.
That's so interesting, Marion - I have never heard of a connection between yeast overgrowth and LDN. That doesn't change anything for me - LDN benefits me so much that I wouldn't give it up. My yeast overgrowth is now under control with powerful probiotics, restricted diet, and Diflucan daily. My doctors feel comfortable with that & it keeps me feeling good. All of my doctors make sure to keep a close eye on liver function because of all the meds & supplements I take. My son does still take ketoconazole but only every 4 days - he's on a rotation of the different antifungals. Thankfully, liver function is still very good for both of us! We take supplements to help with that, too.
Thank you so much for the info! I really appreciate it.
Thank you for a great post. I have yeast overgrowth proven by test from mouth. i just wonder where I can get the ADP – emulsified oil of oregano? Can't find anything using google. Thank you!
I included a link at the end of the post - we buy ours through Amazon. Here is the link again: https://amzn.to/2q2OlEq
Sue
Great! Thank you :-)
Great information that is clear to understand. Thank you! Have you shared what herbal protocols your son is on? I did not see that blog but would be very interested in the information.
The herbals/supplements he takes (and me, too) for yeast overgrowth are listed in this blog post. Did you mean his herbal protocol for the tick infections? That's the Byron White protocol, currently taking A-Bart to get at both Lyme and bartonella.
Let me know if you had other questions or I misunderstood what you are asking -
Sue
Can we trust Amazon to store it correctly?
I'm guessing your question refers specifically to probiotics? I only order them from Amazon (or other mail order) when the weather is cool. Before it gets to about 70 degrees, I stock up my fridge and buy locally from a store that keeps them refrigerated.
Do you use mouthwash if so which one?
Re: mouthwash -
No, I don't use any mouthwash regularly. When my yeast flares up badly, I sometimes rinse (swish and spit) with a few drops of tea tree oil (a natural antifungal) in a cup of water (don't swallow it), as described in this post. You have to be careful with commercial mouthwashes - many contain alcohol which would make yeast worse.
All the other treatments listed here work effectively. I haven't seen any specifically anti-candida mouthwashes.
Sue
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