Polly: Supplements to kill or inhibit the growth of yeast are an important part of many treatment plans. However, you may have to try several different antifungals before you find one that is suitable for you. Different antifungals kill different strains of yeast. Some doctors will test you to find out which antifungal will kill the type of yeast in your body, and other doctors will just try several different antifungals and see which one helps. It is often hard to tell if an adverse reaction is due to the medication itself or due to the toxins released when the yeast die. You must be careful not to indiscriminately use antifungals. Your main problem may be bacteria, not yeast.
How To Lessen The Die-off Reaction
Polly: When yeast die, they release alcohol and other toxins. This can make you quite ill. Here are a few things you can try that might help minimize your reactions.
1) It is very important that you are not constipated before killing the yeast or bacteria. Perhaps, try some magnesium or Smooth Move tea if you are constipated. You don’t want the released toxins to recirculate. This would make you sicker.
(If you are severely constipated, suspect a Clostridium infection. See article entitled “Constipation-predominant IBS” by the Probiotic Therapy Research Centre http://www.probiotictherapy.com/physicia…ses_2.html )
2) Charcoal, by soaking up the toxins may be a significant aid to reducing die-off symptoms.
3) Yet, why suffer the brunt of all the toxin release if you don’t have to? Get rid of the bulk of the yeast with mechanical means before killing the remainder?try either the Attogram method or colonics. Dr. Rogers suggests that Milk of Magnesia can get things moving too.
4) Before starting antifungals, start with a low carbohydrate diet that stops feeding the yeast. The diet in itself may cause some die-off. After your body adjusts to the diet, start the antifungals slowly. Going slowly will allow your body more time to handle the toxins.
5) According to Dr. Shaw, vitamin B6, glutathione, N-Acetyl-Cysteine, and lipoic acid may help protect you from some of the toxins that are released. (If you are mercury poisoned, please read the chapter in book 6 on this condition before trying the N-acetyl cysteine, lipoic acid, or glutathione.)
6) Some antifungals like Nystatin will cause the yeast to burst and empty their contents into you. This type of an antifungal may be more difficult for your body to handle than an antifungal that causes the yeast to shrivel-up instead of burst. If you are having a hard time with one type of antifungal, try a different one. You may have an easier time handling the die-off.
7) Sometimes an adverse reaction to a prescription antifungal is due to the dyes and other fillers in the product. For those who suspect this problem, the doctor can order IV solutions of these antifungals, and have the patient take the appropriate amount orally.
Antifungals And Clostridium
Polly: Clostridia is a harmful bacterial resident of the intestines. It is resistant to most antibiotics and so it can take over the intestinal environment after treatment with antibiotics. Apparently it can be a problem after antifungal therapy too.
Most of us are well aware that taking antibiotics can set us up for a fungal infection. So we are careful to take an antifungal and/or probiotics when taking antibiotics. However, how many of us have considered that taking an antifungal could lead to an overgrowth of the wrong bacteria? I’m presently listening to some lecture tapes from the DAN! 2000 Conference on autism, and on one of these tapes, an unidentified doctor mentions that one must treat Clostridia bacteria overgrowth at the same time that antifungals are given. It sounds to me like the yeast can keep the growth of Clostridia down, and when you eliminate the yeast with an antifungal, then the Clostridia has a field day.
When asked how to treat Clostridia, this doctor replied that you use either Flagyl (metronidazole), which is a strong antibiotic, or a yeast called Saccharomyces boulardii, which is considered a probiotic. I’ve read that Clostridium can also be killed by the antibiotics vancomycin, rifampicin, teicoplanin or bacitracin. (Watch out for strains of Clostridia that are resistant to these antibiotics.) Bifidus secretes an enzyme that kills Clostridia and thus increasing the presence of Bifidus bacteria would be desirable.  Biocidin is an herbal product that will kill Clostridium too. http://www.biobotanicalresearch.com Phone number 800-775-4140.
MM: Yes, this was my experience after the antifungals too. I never took the prescribed Flagyl, but took mega doses of probiotics. Sounds like I should do a follow-up urine test to see whether I’ve taken care of the Clostridium.
Mary in Pennsylvania: Polly, I can personally testify to that occurring. While being treated for small bowel bacteria overgrowth with Flagyl/Tinidazole, I constantly took probiotics and Nystatin. I still had a candida overgrowth and addressed it after all the antibiotics were discontinued but months later I felt more fatigue then I had felt all my life. After a dysbiosis panel was done, it was determined that indeed all the small bowel bacteria overgrowth and fungal were gone but now I had a whopping overgrowth of Clostridia. (My panel showed a reading of 100 when less than 0.7 is the reference.) I took vancomycin with Harry’s Custom Probiotics and completely eradicated the Clostridia (confirmed by urine dysbiosis panel). Only ONE of the fungus compounds went high again, even though I had taken an antifungal with the antibiotic therapy. Now I’m just using Amphotericin B (liquid suspension) with Harry’s Custom Probiotics. So hopefully I’ll get everything in check after this, but it’s a long steady process that you have to monitor closely and change your strategy as needed.
Avandish: Hi Polly, There have been studies of Clostridium difficile in the elderly in which bifidobacteria taken at doses of about 20 billion or more kept this bacteria in check. It even was effective in patients that no other treatment had helped. I have also read that L. acidophilus has some of the same potential against this particular strain. It is hard to tell up from down these days.
Mary G: Polly, Dr. Cranton suggests that it is not advisable to take antibiotics and antifungals simultaneously because doing so could promote the growth of resistant fungal organisms against which no therapy would be effective. He suggests that if antibiotic therapy is necessary, it is advisable to subsequently resume the anti-yeast program for a month or more, but only after antibiotics are discontinued. I wonder if this also applies to herbals which are both antibiotic and antifungal (like grapefruit seed extract and garlic)? Doc Darren suggests that this might also be a problem.
Sally: Dr. Rogers recommends discontinuing antifungals if it is necessary to take an antibiotic. She believes the combination can foster the growth of Candida tropicalis. Probiotics should be continued throughout.
MM: Also, don’t ignore the fact that the script antifungal drugs have ANTIBIOTIC properties. This is cited in my Merck Manual; they also say that because of cost, few choose to use antifungals for their antibiotic properties. Maybe the yeasts are NOT keeping the Clostridium at bay, but instead, the antifungals kill off enough GOOD flora to allow the Clostridium to take over.
Polly: Good point. It certainly seems to be a constant battleground for supremacy in the intestines. Perhaps we really need to be looking into probiotics more. By the way, N-acetyl-cysteine (NAC), helps protect one from the Clostridium toxins.  However, if you are mercury poisoned, or if you are hypothyroid, you must be particularly careful with how much NAC that you use. If you are hyperthyroid, you should be watchful too.
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©2002 by Polly Hattemer, also known as Pauline Hattemer