Too many yeast in the intestines (yeast overgrowth) is a common problem that occurs in those with chronic Lyme disease either during treatment or prior to beginning treatment. Antibiotics used to treat Lyme can lead to too many yeast. Immune suppression prior to starting antibiotics can also cause yeast overgrowth. Yeast overgrowth can result in an ongoing systemic allergic reaction to the yeast that can suppress the immune system. Yeast overgrowth also leads to inflammatory cytokine excess that cause many of the Lyme disease symptoms and pain. Food allergies and sensitivities can be the result of yeast overgrowth too. In this video and written article I lay out a number of natural and prescription medicine options to treat yeast.
How to Diagnose Yeast Overgrowth of the Intestines in Lyme Disease Treatment
For information about diagnosing too many yeast read A Silent Problem. Do You Have Yeast?
The Azoles Plus Nystatin
The most common and effective prescription medicines used to treat yeast are from the azole family of antimicrobials. These include fluconazole (Diflucan), ketoconazole, and itraconazole (Sporanox). The other common prescription anti-yeast medication is nystatin, but is much weaker than the azoles. I usually use diflucan 200mg 1 pill daily for 30 days combined with nystatin 500,000 IU 2 pills 2 times a day. You could also replace the nystatin with an herbal combination mixture 2 pills 2 times a day. (Common herbs found individually or mixed together include: pau d’arco, caprilic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.) Also take a high quality probiotic. I recommend a Prescript-Assist Pro by Researched Nutritionals which is shown to promote intestinal health and healthy immune function. Read more about this probiotic and why I prefer it over acidophilus-based probiotics in Superior Probiotic for Immune and Intestine Health.
So a treatment using an azole includes
- a probiotic plus
- fluconazole, ketoconazole, or itraconazole plus
- nystatin or an herbal combination mixture.
Marty Ross MD Discusses Treating Yeast in Lyme disease.
For more information read the whole article found below the video.
Alternatives to The Azoles
If you prefer to not use the azoles or should not take them then use an herbal combination mixture or a compounded prescription medicine called amphoterecin B.
- Take an herbal combination mixture 2 pills 2 times a day. (Common herbs found individually or mixed together include: pau d’arco, caprilic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.) Also take the Prescript-Assist Pro soil-based probiotic I mention above. This herbal approach will work, but may take 3 months. For bad yeast infections you may even need to stop your prescription antibiotics while trying this approach.
- Amphotericin B is only manufactured in an IV formulation. But for intestinal yeast infections it must be mixed up by a compounding pharmacist to be used orally. In an oral form it is not absorbed at all into the blood stream and has no systemic toxicities. I am pointing this out because in an IV from it is terribly toxic to the organs of the body. But in an oral form it is completely safe. Take Amphoterecin B as a 200mg pill 3 times a day for 2 months. You will need a prescription for this medication sent to a compounding pharmacy. For a really severe yeast infection you may even need to stop your prescription antibiotics too. Also take the Prescript-Assist Pro soil-based probiotic I recommend above.
Unfortunately yeast are becoming resistant to fluconazole. When this happens there are four other options. With each of these options be sure to include the probiotic mentioned above.
- One is to try the amphoterecin B for 2 months. Our local compounding pharmacy charges $250/month for this.
- Another is to use itraconazole 100mg 2 pills 1 time a day for 30 days combined with either the nystatin or an herbal combintation mixture discussed above. Without insurance coverage this costs around $500/month.
- A newer option I am using in my practice is terbinafine 250mg (Lamisil). This medicine is approved for the treatment of fungus infections. It is in an entirely different family than the azoles. In a generic form it costs around $50 for a one month treatment.
- An experimental option is lufenuron. This is a veterinary medicine that blocks the production of chitin found in the coverings of yeast. Chitin is a hard fibrous substance found in insects and yeast. It is not found in humans. The medicine is sold in 9gm packets. Take 3gm for 3 days in a row. I find that 4 rounds of treatment are needed. Repeat doses are taken every 11 days after the first dose for 3 more days. Be aware this is an experimental treatment. Human studies have note been done, but it does appear safe in animal studies including those done in primates. See Lufenuron. An Experimental Yeast Treatment for more information about this medicine and where to purchase it.
Often in yeast resistance I will also advise my patients to stop other herbal and prescription antibiotics. Because of costs I usually use terbinafine first, then amphoterecin B, and finally itraconazole. I save lufenuron as a last resort.
While treating yeast it is important to limit simple sugars and juices. Simple sugars are those items which have a lot of sugar added like coke, candy, cookies, cake, and ice cream. Limit simple sugars to starve yeast. For those with a great deal of resistance I recommend a Paleo diet.
by Marty Ross MD