Effectively diagnosing and treating Candida

Townsend Letter for Doctors and Patients, Oct, 2005 by Jacob Teitelbaum

Further Yeast Treatment Recommendations

As noted above, if symptoms of yeast overgrowth are caused by an allergic or sensitivity reaction to the yeast body parts, symptoms may flare up when mass quantities of the yeast are suddenly killed off. This is called a yeast die-off reaction. If patients get this reaction, start their treatment with acidophilus pearls and a sugar-free diet for a few weeks, followed by Phytostan and/or Citricidal before beginning nystatin. Give the nystatin in tablet or powder form. The powdered forms need to be refrigerated and Kronos Pharmacy (800-723-7455) has excellent prices on one million unit nystatin capsules. I generally recommend beginning with 500,000 international units a day for one to three days, and increasing the dosage by 500,000 international units every one to three days (slower if yeast die-off is a problem) until the patient is taking 1,000,000 international units two to four times a day. Give this dosage for five to eight months. (If they develop nausea, reduce the dosage.) One month after beginning the nystatin, I add 200 milligrams of Diflucan or Sporanox every morning for six weeks. If symptoms flare, give just 100 milligrams each morning for the first three to fourteen days. If symptoms recur after the patient stops the Diflucan or Sporanox, I recommend continuing the medication for an additional six weeks (or longer if needed) at 200 milligrams a day.

Sporanox should be taken with food. If it is taken alone, its absorption is greatly reduced. When the patient is taking Diflucan or Sporanox, they should not use cholesterol-lowering medications in the pravastatin (Mevacor) family, which also includes Baycol, Lescol, Lipitor, Pravachol, and Zocor (all of these can also flare fibromyalgia pain even when not combined with Diflucan/Sporanox). Also, antacid medications such as cimetidine (Tagamet), nizatidine (Axid), ranitidine (Zantac), and famotidine (Pepcid) prevent the proper absorption of Sporanox. At the high price of Sporanox per dose, you will want the patient to absorb every last bit of the medication. If they need to be on an antacid medication, you should use Diflucan instead of Sporanox. Unfortunately, the antifungal terbinafine (Lamisil) does not seem to work very well for Candida yeast overgrowth.

Many books on yeast overgrowth, including Dr. Crook's, advise readers to avoid all yeast in the diet. This advice is based on the theory that an allergic reaction to yeast is the cause of the problem. In my experience, trying to avoid all yeast in foods often results in a nutritionally inadequate diet and little benefit. Although a subset of patients does appear to have true allergies to the yeast in their food, they account for a small percent of my patients with suspected yeast overgrowth. These people may benefit from the stricter diet recommended in Dr. Crook's book. Interestingly, once adrenal insufficiency and yeast overgrowth are treated, most people find that their allergies and sensitivities to yeast and other food products seem to improve or disappear.