Effectively diagnosing and treating Candida

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

Nutritional deficiencies such as low zinc or low selenium may also decrease resistance to yeast overgrowth. A good multivitamin supplement should take care of these deficiencies. The one that I recommend for all of my patients for overall nutritional support is the Energy Revitalization System Vitamin Powder (also by Integrative Therapeutics), which replaces 35 tablets of supplements with one good tasting drink each day.

The best thing patients can do to combat yeast overgrowth is to try to avoid it in the first place. When they get an infection, immediately begin treating it naturally. Hopefully, you will be able to prevent it from turning into a bacterial infection that might require an antibiotic. In my experience the most effective immune stimulant for fighting infections is a Thymulin mimic called ProBoost (from Klabin Marketing -- 800-933-9440). This is an incredibly popular product with my patients, who use it sublingually at the first sign of any infection. If patients find, however, that they must take an antibiotic, all is not lost. They can still lessen the severity of yeast overgrowth by avoiding sweets and by taking nystatin plus either taking acidophilus pearls (not within three to six hours of an antibiotic) or by eating one cup of yogurt with live and active acidophilus cultures daily. Don't use the yogurt (or milk) if they have sinusitis or pneumonia, because the milk protein causes mucus to thicken and makes it hard for the body to fight these infections.

What If the Yeast Comes Back?

It is normal for yeast symptoms to resolve after treatment. After six weeks on the Sporanox or Diflucan, most people feel a lot better. However, symptoms may recur soon after they stop taking the antifungal. If this happens, I would continue the Sporanox or Diflucan for another six weeks or for as long as is needed to keep the symptoms at bay. More frequently, people feel better after treatment and stay feeling fairly well for a period of six to twenty-four months. At that time, it is common to see a recurrence of symptoms, especially if they are eating too much sugar or are taking antibiotics.

The best marker that I have found for recurrent yeast overgrowth is a return of bowel symptoms, with gas, bloating, and/or diarrhea or constipation. If these symptoms persist for more than two weeks, especially if there is also even a mild worsening of the CFIDS/FMS symptoms, it is very reasonable to retreat them empirically with six weeks of nystatin and perhaps Sporanox or Diflucan. In addition, I would also resume treatment if there is a recurrence of vaginal yeast or sinus infections. If a second round of treatment resolves the symptoms, you may opt to repeat this regimen as often as is needed, usually every six to twenty-four months. By using some of the natural remedies listed earlier in this chapter, however, you may be able to avoid repeated use of antifungals and the possible risk of patients becoming resistant to them.

Some people find that they need to stay on the antifungals for extended periods of time--years, in some cases--or the symptoms recur. If this is necessary, I add the natural remedies. I do, however, also use prescription medications when needed. The main risk of long-term use of the antifungals Sporanox and Diflucan is liver inflammation. As mentioned earlier, if these medications are used for extended periods, liver function should be monitored. Consider checking the ALT and AST liver tests (also called the SGOT and SGPT test) every three to six months and anytime that a severe flulike feeling or worsening of symptoms occurs. In addition, it is very important to take 200 milligrams of lipoic acid a day as long as they are on the medication. Although I am not aware of any studies on using lipoic acid with antifungals, I have seen no worrisome liver tests in patients using this natural substance while taking these antifungals. As an alternative, instead of taking the antifungals every day, many people find they can get long-term suppression of the yeast by taking 200 milligrams of Sporanox or Diflucan twice a day, one day each week (for example, each Sunday).